Autistic Girls and Women: Signs We Might Be Missing

While over 99% of the British public have heard of autism, few understand the non-neurotypical condition

Despite an estimated 700,000 people across the UK falling on the spectrum, many feel that Autism Spectrum Disorders (ASD), also known as Autism Spectrum Conditions (ASC) are still widely misunderstood by the general public. According to The National Autistic Society, while over 99% of people in the UK have heard of autism, only 16% of autistic people and their families feel that the general public understand how autism can affect their behaviour.

Many common misconceptions about autism still widely circulate. From people thinking children will ‘grow out’ of autism to assuming all autistic people are geniuses, perhaps one of the most common misconceptions is that autism just affects boys and men.

Are there more autistic men and boys than women and girls?

There are more diagnosed cases of autistic men than women currently in England. Studies greatly vary in their estimates of the exact numbers, ranging widely from 2:1 male to female, all the way through to 16:1. Leading charity, The National Autistic Society report their figures at 3:1 amongst adult service users, with 5:1 boys to girls in schools. While just under 2% of men and boys have an ASD diagnosis, just 0.2% of women and girls in England have received the same diagnosis. But does this mean that there are more autistic males than females?

According to the Journal of Autism and Developmental Disorders, ‘many females who, if skilfulls assessed, would meet full diagnostic criteria for ASC, never recieve a diagnosis and the help that, potentially, comes with it’. Women are more frequently diagnosed later in life compared to their male counterparts, whilst many girls go undiagnosed or recieve a different diagnosis entirely.

Why aren’t women and girls diagnosed as often?

Research suggests that teachers under-report autistic traits in female students. Unless showing signs of more severe autistic traits, cognitive or behavioural problems, many telltale signs are dismissed as neurotypical behavior.

Research reported in the Journal of Autism and Developmental Disorders suggests there may be a female-specific autism type that has different signs and ways of presenting than it does in males, resulting in current diagnostic methods missing the signs. The original definition from Hans Asperger in 1944 focused on boys, as he believed girls were not affected by the confition.

One 2015 study suggested that autism is under-diagnosed in girls, skewing the ratio of male to female autism statistics as the diagnostic criteria is largely based on the behavioural characteristics of boys and men.

Another popular theory explores the idea that girls and women are better at camouflaging, or masking, their difficulties. Dr Louis Kraus, a psychiatrist specialising in autism, suggests that the signs and symptoms of autism can often be less obvious in girls. Many girls and women can blend in, learning to mimic the behaviour around them, whereas boys may lean towards more isolated behavior which can be easier to spot. Male traits may stand out more amongst their peers, whilst female traits can be dismissed a ‘quirks’. The very behaviour that helps girls to blend in can delay diagnosis and support.

Why is diagnosis important?

It isn’t for everyone. Labelling people and conditions aren’t always best for everyone, however some people find it can be a relief to put a name to what they have been experiencing or feeling. Others find it can be almost freeing, as it can provide an explanation and release any guilt or self-blame they may have felt for their difficulties understanding or interpreting social situations and interactions. For children and teens in particular, a diagnosis can be the first step to securing additional help or guidance that might be needed. A diagnosis can also be the first step towards self-acceptance and understanding for many individuals.

Signs to look out for in girls VS boys

• Girls may have a range of ‘autistic traits’ that present in a more subtle way than their male counterparts. Some better known traits, such as repetitive or ritualistic behaviour are more likely in males than females.

• Autistic boys may appear to spend more time alone or seem isolated whilst other children appear to be playing together. Autistic girls may stay close to their peers, but may not feel socially connected or can come across as overlooked in social situations. This can come across as them ‘flitting in and out’ of different activities or social groups. They may appear more social however they may struggle with socially acceptable responses and behaviour. Girls may be more likely to learn conversational phrases they can reuse, imitate social behaviour of their friends or from TV shows, or create their own ‘social script’ to help them through regular interactions.

• Autistic girls are often quiet and well-behaved compared to their male counterparts. Many are sticklers for the rules, following them closely and striving for perfection (which can come across as being overly-critical of themselves, or showing frustration or upset when making small or large mistakes). According to child psychologist Kevin Pelphrey, director at the Autism and Neurodevelopmental Disorders Institute, autistic girls may be more likely to understand social expectations, even if they can’t fully meet them.

• High levels of anxiety can often arise as girls try to adapt and understand social situations and cues others may take for granted.

• Having fewer or just one intense friendship, or no close friendships at all can both be typical for autistic girls.

• A common characteristic amongst both genders can involve compulsive behaviour, particularly around collecting certain objects or having a specific special interest. While boys may develop a more niche special interest, girls may focus on a more socially acceptable or more common interest shared by their friends (such as focusing on a specific band or show), but with higher levels of intensity. Research suggests autistic girls may lean towards special interests with a more social or nurturing nature (focusing on animals, specific shows or celebrities) while boys can be more likely to focus on technical hobbies or facts. Both may have an interest in collecting, organising and cataloguing items around a specific interest or hobby.

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For more information on autism, diagnosis processes, support and more, visit The National Autistic Society, NHS Choices, or Counselling Directory, or discover more about the adult diagnosis process.