September 4, 2018

Why female autism is questioned

Last updated on February 25, 2021

You don’t have real autism.

You are coping just fine—why bother getting a label?

Everyone thinks they are on the spectrum now.


Autism in women

Autistic women are a subculture within a subculture; only 1% of the population has autism spectrum disorder, and females are a percentage of that percentage. And while the same diagnostic criteria as men apply to women, we can present differently from autistic men.

But it’s not just that it can present differently in women, but those gender differences also lead to differences in perception of autism based on gender. From a very young age, we are pressured more than boys to socially adjust. And the research shows that autistic people are capable of those social skills, but we lack the motivation to accomplish them due to differences in dopamine.

Women are expected to overcome social challenges more so than men, and so seemingly autistic women don’t tend to present as autistically in the social domain. As a result, tremendous pressure is put on them to perform socially; it is not the case that social challenges are less prevalent in autistic women.


The cost of socializing

Many of us are forced to mask and camouflage our behaviour such that we cannot be identified as autistic. But the cost to us is significant with:

  • 70% of autistic females having suicidal proclivities
  • 50% of autistic females attempting suicide, and;
  • 10% of autistic females succeeding in committing suicide.

These are terrifying statistics, not to mention a tragic consequence indeed.

An illustration of a person being rained on by dark, ominous clouds.

For more information on autism and suicidality, have a look at:

Autism & suicidality

Challenges with coping

I have identified women on the spectrum who score higher in psychometric testing than men. They have meltdowns, they may self-harm, they may engage in head-banging to alleviate stress, or use alcohol and other drugs in order to cope—all of which tends to be done in private.


Residing in limbo

For neurotypicals that know us, it is frightening and confusing when we come out and share who we are.

We seem so normal to them. The media often portrays autistic males, and has shown few representations of autistic females (Saga Norén from The Bridge is a notable exception). People don’t tend to see how much we struggle and how many autistic challenges we face, as we often don’t meet people’s expectations of autism. We are generally not like the gifted male savant on TV, nor the perpetually struggling autistic who can’t live on their own. But we face the same autistic challenges, even if we hide them well. People do not realize that we don’t identify with our classmates, workmates, and neurotypical peers.

They have no idea what our private thoughts are. Our behaviours are often just seen as quirks (or evidence that we don’t try hard enough), and we are careful to choose special interests that are socially acceptable and revered. And so who we are is not understood. We become invisible. Not wholly unseen, but camouflaged to the extent that many people would deny our autism.


Fear and confusion

So often it is the case that what people do not understand frightens them, and/or stay away from. Too difficult and nuanced to understand. It seemingly doesn’t present as autistic, so autistic women must not really be autistic.

Some people feel tremendous guilt based on how they treated us only when we get our diagnosis—I can never really understand this. What makes it okay for a person to mistreat us when we are thought of as neurotypical, but not when we are autistic?


Autistic challenges

What is important to understand both for those of us on and off the spectrum, is that we autistics have issues, habits, and traits that bind us together as a group.

Some of the more obvious are sensory issues, challenges at work, relationship issues, social issues, depression, and anxiety. Many of us suffer from guilt about being autistic, most of us have received innumerable misdiagnoses prior to the correct diagnosis.

Other traits are a preference for comfortable clothing, little make-up, an easy to maintain hairstyle, a preference for fewer friends, and more time alone. It is easy to mistake us for introverts.


Late diagnosis

Many of us do not get diagnosed in our childhood, but instead in our 40s and 50s. And while it may make those around us uncomfortable, we have to review every part of our life, and reframe it in this new context. The later we are diagnosed, the more damage to our psyche and relationships.

For the first time, we understand who we are. However, it can be confusing to those around us who have known/perceived us as depressed, anxious, or neurotypical.

An illustration of a black hole with an accretion disc.

For more information on this topic, have a look at:

An autism diagnosis later in life

Support us

I would ask that you support us. Don’t tell us that we seem normal, or that we are not on the spectrum, or make us feel guilty for being autistic.

As human beings, we have a basic need to understand ourselves. For many of us, it is to return home, and know it for the first time.

The Embrace ASD symbol.

References

This article
was written by:
dr-natalie-engelbrecht

I’m a dually licensed registered psychotherapist and naturopathic doctor, and a Canadian leader in trauma, PTSD, and integrative medicine strictly informed by scientific research.

And not only do I happen to be autistic, but my autism plays a significant role in who I am as a doctor and how I interact with and care for my patients and clients.

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