Autism in Girls

by Eleanor Barber

Many people associate boys with autism, and there are around three times as many boys diagnosed with the disorder than girls. Some studies have theorised that this is because girls are protected from autism due to the fact that girls diagnosed with autism tend to be more severely affected than boys diagnosed with autism. However others believe that autism is under diagnosed in girls, due to the way it presents itself, particularly in girls with average intelligence.

Both girls and boys with autism often have restricted interests, however the restricted interests of girls are seen as more socially acceptable. Whereas boys with autism may obsessively play with trains or cars [moving parts tend to be more standard interest in autistic boys], girls with autism may obsessively collect shells or feathers [these are seen to be more arbitrary than trains so don’t bring up warning signs in teachers or parents]. Because of gender differences girls are more likely to be chatty, and less disruptive than boys, however this is true for both autistic girls and neurotypical girls, so these are hard to see the differences.

Some girls with autism seem to have good social skills. However for many this is exhausting as its like “having to do maths all day”. For many girls the social world of other girls is completely bewildering, as girls tend to have much more tighter social groups than boys. Some girls deal with this by making the same social interactions, as if they are in a play, once they believe that they have perfected a specific skill. Some researchers theorise that girls are better than boys are hiding their symptoms, especially in structured environments, like doctor or psychologist visits.

Due to boys being diagnosed 3 times the rate of girls, boys are routinely used in studies about autism, rather than having a mix of girls and boys. This means that diagnostic tests are done towards boys rather than girls, which causes more advanced tests to be focused on boys rather than the girls. We are currently trying to characterise girls with autism by studying girls who were diagnosed according to boy centric criteria. This causes more and more girls to be pushed out of diagnostic in their early years, as many girls with mild autism are diagnosed 2 years later than their male autistic peers. However due to recent questioning of the difference of girls and boys in autism, researchers are more actively trying to get girls in their studies.

Girls with autism often develop other mental health disorders due to their autism being so narrowly understood. This leads to girls being misdiagnosed many times during their life. Many girls with autism develop disorders like depression [34%] or anxiety [36%]. Studies have suggested that girls with autism are more likely to develop anorexia, however these studies were too small to know for sure. This can lead to a downward spiral that can eventually result in suicide or attempted suicide. Many girls feel pressure to be perfect; this is particularly present in girls with autism, which can lead to them becoming experts in music or science but can also lead to them becoming obsessed with losing weight. Girls with autism are often diagnosed with mental illness before being diagnosed with autism due to mental illness being seen as more of a girls problem.

Some studies suggest that girls are protected from autism due to the X chromosome. They also suggest why girls are more severely affected by autism as there have to be more modifications in the X chromosome so the autism affects girls more severely. Girls mainly present autism like symptoms when they are in high risk families, whereas boys present the symptoms in low risk families as well.