Autism in girls: 5 reasons why it’s different

Autism in girls

I often get asked why I was diagnosed with autism so late in life, and why it wasn’t caught when I was a child. There are two main reasons. The first one is that I grew up in France, a country that is decades behind in autism understanding and acceptance. Even now, in France, in 2018, families have to fight the system in order to get a diagnosis and receive therapies for their children, even those who are severely autistic. The second reason is that I’m a girl. Indeed, autism in girls is harder to spot. Generally, women are better at hiding their symptoms which makes autism in girls less obvious to the untrained eye, and even to some trained observers too.

As a result, girls are diagnosed with autism with a lot less frequency than with boys. Even when properly diagnosed, autism in girls is less prevalent. To be exact, 1 in 37 boys and 1 in 151 girls is diagnosed with an autism spectrum disorder. Women also tend to be diagnosed later in life than men. This was the case for me, being diagnosed at 26 years old. If you’re here because you’re wondering whether or not you’re autistic, you can read my post about signs and symptoms of high-functioning autism in adults. Today, though, I really want to focus on the differences between autism in girls and boys.

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Autism camouflage

Some people, like me, become good at hiding their struggles and effective at mimicking normative social behavior. It’s sometimes referred to as ASD camouflage. We all make small adjustments to fit in better with our peers and to conform to social norms, but autism camouflage is a whole other level of adjusting. For me, it means a constant and elaborate effort. It allows me to live a somewhat normal life but it comes with a cost. I’m often physically exhausted, on edge, and anxious. I think that’s why it hurts when people tell me that I don’t look autistic. Even though that’s often what I’m going for it feels dismissive because they have no idea how much work goes into looking “normal” and fitting in.

Below are ways in which autism in different in girls and boys. Keep in mind that every single person on the autism spectrum is unique.

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What are 5 differences between autism in boys and girls

1 –  A lot of the tools used to diagnose autism come from studying boys. This is the case with what experts called “repetitive and restricted behaviors” like lining things up, fascination with spinning wheels or singular parts of objects, or obsessions with, for example, trains. Research now shows that girls have milder repetitive behaviors, or sometimes simply different ones.

2 – Boys tend to be more aggressive while girls are more withdrawn and passive. They may appear overly shy. This definitely applies to me, and it’s harder to know what’s going on pathologically when the person presents, simply, fewer outwardly observable behaviors.

3 – Girls with autism tend to have strong interests in things that are considered more mainstream like sport and music. My obsession was soccer. Boys may have strong interests that are a bit more out of the box.

4 – Girls are more likely to learn how to hide their symptoms. They’re better at copying social behavior to fit in. I’ve become pretty good at it. This is the autism camouflage I was referring to.

5 – Autistic girls are more likely than boys to functionally deal with anxiety and depressions. Another often invisible struggle though.

In a nutshell…

According to the most recent DSM-5, in order to receive an autism spectrum disorder diagnosis it’s now required that someone have some repetitive behaviors and obsessions. The less obvious nature of girls’ obsessions plus our ability to hide our symptoms better than boys are what I personally think the main reasons are why girls are diagnosed with autism less frequently than boys. There’s also a higher chance to stay undiagnosed when girls have an average or higher IQ. Unless girls are severely autistic and also have an intellectual disability then it’s likely they won’t be diagnosed until their teenage or adult years. My hope is that in the future there will be different autism scales used to diagnose autism in girls and boys, or some other metric to account for these inherent differences.

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  • Reply
    2018-07-22 at 5:57 PM

    This post hit home in so many ways… thank you so much and may God bless you for sharing this information… I’m working hard on getting my daughter formally diagnosed while their doctors say that even when she is showing the traits she is “too young”… kisses to Charlie and Jude

  • Reply
    2018-07-22 at 10:11 PM

    My grand daughter is diagnosed as classic autism. She is loving and sweet but very opinated when she know what she wants. Thanks for this post.

  • Reply
    Ron Kerns
    2018-07-23 at 3:09 PM

    I’ve can relate too, and have all the so-called “female traits”…that are supposed to be ‘different’ from males.

    I camouflaged so well, that it I didn’t get diagnosed until I was 46. It was only after I recognized some traits from a character on a TV show, did I ever even begin to suspect it. At first, I was like “Me? Autistic? Nah. Can’t be”….I continued watching the show, did more googling…and, it became more apparent that perhaps I was.

    Once I completed the evaluation/assessment…the psychologist was in near disbelief…”How did you make it this far, and for so long?”….”severe level of impairment” is repeated over and over.
    At best, i thought I would ‘barely’ get a diagnosis.
    Now, I know…it all wasn’t ‘just in my head’.

  • Reply
    María Gracia
    2019-03-15 at 4:35 AM

    Amazing post as usual Eileen, can wait for your book. I currently live in the Middle East and in here is like autism is only a “boy” condition, I was lucky her pediatrician was heavily eastern trained and shared my concerns. She is not fully diagnosed yet, they say we have to wait until she is five (FIVE) years old, she’ll be four in April… I still got her into ABA and OT and we are working hard, really hard, your instagram and blog are an amazing source of help for me, blessings

  • Reply
    2019-04-08 at 4:46 PM

    Our daughter scored 5/7, not enough to diagnose her. They said because she was able to have friends and maintain eye contact better than some. Still to this day she wont always maintain that eye contact.

  • Reply
    Lindsay Hickey
    2019-04-09 at 8:39 PM

    I have it and it still struggle to even prove to the courts. It something that they do not want to deal with I think as it mental illness. I also have the anxity and depression as well.

  • Reply
    2021-08-30 at 8:00 PM

    Wow I was raised as a tomboy so I still not on the line of make or female I have traits of both

  • Reply
    2021-10-04 at 9:02 PM

    Sadly, the rate of actual diagnosis in females is ridiculously low. “1 in 37 boys and 1 in 151 girls is diagnosed with an autism spectrum disorder.” and this was written in 2018. That shocks me, given the number of autistic females that I know and if you count how many are mistakenly diagnosed with BPD, anxiety, ADHD, etc. the numbers I expect are much closer to even with males.

    Psychs who are able and willing to identify autism in females, and particularly female adults are sadly lacking. I know of so many horror stories where women who have struggled all their lives finally get an opportunity for a formal diagnosis only to be dismissed, gaslighted, and verbally abused for considering they might be autistic. It’s truly disgusting.

    Since females present differently, there is MUCH work to be done to train psychs to recognize and acknowledge autism in females. Right now it takes enormous bravery to put yourself out there with the very high risk of someone figuratively laughing at you and your struggles. This has GOT to change.

    I’d say (my best guess only) that females MIGHT POSSIBLY be autistic at a SLIGHTLY lower rate than males, but no where near the figures that are considered “correct”. If all those women were counted, who have been forced to self-diagnose, due to ignorant doctors, the female autistic population would be far closer to that of the male autistic population.

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