Autism in females

Autism Spectrum Disorders (ASD) are currently more commonly diagnosed in males, with a ratio of about 1 female for every 4 males diagnosed.^[1] Currently, one in every 189 females is diagnosed with Autism Spectrum Disorder (ASD).^[2] There is some evidence that females may also receive diagnoses somewhat later than males, however thus far results have been contradictory.^[3] Researchers have also debated whether a diagnostic gender bias has played a role in females being under diagnosed with Autism Spectrum Disorder.^[4] Researchers have speculated a gender bias in the parental reporting due to the expectations and socialization of gender roles in our society^[5] As of yet, there have been no studies specifically addressing the occurrence of autism in intersex individuals, and this is an area that requires further research. Several theories exist to explain the male-female sex based discrepancy, such as a genetic protective effect,^[6][7][8] the Extreme Male Brain Theory,^[9][10] and phenotypic differences in the female presentation.^{[8][11][12][13]}

Summary

Differences in presentation of autistic traits are widely supported within the autistic community, and gaining support in the professional field. Hans Asperger was one of the first people to study autism, yet all of this students were male. Since biological differences exist between males and females, it follows that the presentation of autism would differ as well. Recent studies suggest this to be true, with evidence of increased incidence of social anxiety,^[12] anorexia nervosa,^[14][15] and self-harm.^[16] Autistic females, and clinicians who work closely with them, have compiled many resources highlighting the traits that are often associated with autism as it presents in females.^[17][18] Some of the main differences noticed in females compared to their male counterparts include increased social mimicry abilities, more expressive gestures, special interests perceived as "more practical", and more prevalent interest in animals.^[17] Several other characteristics of autism that have been noted specifically in females include: uneven learning profiles, difficulty in completing higher education, struggles with organization, difficulties communicating feelings or asking for help, anxiety, depression, gender dysphoria, high levels of empathy, sensitivity to suffering, and individuals are often highly intuitive. For a more complete list of characteristics please refer to some of the lists available online, such as those by Tania Marshall or Rudy Simone.

With these differences in presentation combined with differential coping ability, often enabling females to blend in with peers through mimicry in spite of lack of understanding, ASD frequently goes unrecognized in females. This can lead to a lack of support and understanding from family, friends, teachers, and themselves which can damage self-esteem and impede the development of useful coping strategies. There are more females seeking diagnosis after the diagnosis of a close family member or friend where they learn more about the condition and how it has effected them throughout their lives. Many report feelings of relief, forgiveness and understanding within themselves upon receiving a diagnosis, as it helps to explain everything they struggled with since childhood.^[19][20]

While there are many suggested practices produced by the clinical research community, it is highly advocated within the autistic community to learn more about autism through interactions with actual autistic individuals. You can learn a lot from people sharing their stories on how autism has affected their lives, from every day situations, to therapy and medication. There are many books, websites, videos and blogs all dedicated to autistics advocating for themselves and sharing their stories, as well as support forums such as Wrong Planet.^{[21][22][23][24][25]}

Misdiagnosis

Many individuals report receiving one or more misdiagnoses throughout their lives, before their autism was identified. Some of the most common misdiagnoses include Borderline personality disorder, and Obsessive–compulsive disorder. Other common co-morbid conditions which are often identified before ASD are ADHD, Social anxiety disorder, Major depressive disorder, Bipolar disorder, Eating disorder, Sensory processing disorder, and Tourette syndrome.^[26]

Sexuality

Sexuality is often discussed within the autistic community, with many observations that identities other than cis-hetero seem to be more common than is observed in the neurotypical population. There have not been many formal studies on this to date, however members of the community speculate that autistic individuals generally have different ideals, perceptions, and desires than neurotypicals, or simply do not comprehend or agree with society's expectation, making them more apt to diverge from the norm.

Sexual orientation

In an ongoing study conducted at the University of Massachusetts Boston found autistic participants to more often identify as something other than heterosexual compared to an allistic (non-autistic) control group (92% and 72% respectively).^[27] The study also found autistic individuals to be more likely to identify as asexual (37% ASD vs 22% NT).

Gender identity

In the same study, preliminary results demonstrate that assigned female at birth individuals on the autistic spectrum are much more likely to have trans, fluid, or non-binary gender identities than allistic counterparts, with 50% of autistic participants reporting a gender other than cisgender versus only 22% of the control group.^[27]

Another study looking at the co-occurrence of ASD in patients with Gender Identity Disorder found 7.8% of patients to be on the autism spectrum.^[28] This is much higher than the estimated 1% of people with ASD in the general population, suggesting a link between autism and gender variance.

Sexual Satisfaction

A study conducted by Byers and Nichols (2014), explored the level of sexual satisfaction of high functioning autistic individuals. The researchers tested the sexual and relationship satisfaction of neurotypical individuals versus high functioning autistic individuals. The results suggest that men with ASD are generally less satisfied with their relationship or marriage compared to neurotypical men and women and women with ASD.^[29]

Public figures

• Temple Grandin is a well known autistic woman who has written many books and given many presentations on autism.
• Daryl Hannah is a popular actress with autism who struggles with anxiety and has done interviews on how it has affected her life.
• Rosie King is an autistic person from a family with several autistic siblings. They have hosted a short documentary called "My Autism and Me" as well as presented on autism at a TED conference.
• Valerie Paradiz is an autistic woman who has been a strong advocate in designing curricula for people with autism.
• Donna Williams is an Australian writer, artist, singer-songwriter, screenwriter and sculptor.

Documentaries

• Girls with Autism ITV follows three girls at Limpsfield Grange, a specialized school in the UK.
• Changing the Face of Autism is a low budget documentary interviewing women with autism on their experiences.
• My Autism and Me is a short documentary produced by BBC on ASD.

Television

• Sonya Cross in The Bridge. Though not explicitly stated in the show, Sonya is portrayed as autistic. The producers brought on Alex Plank as an advisor in developing the character.
• Rebecca Blithely of Strange Empire. Described as "strange" and having a brain too large for her head. The creator has stated Rebecca is on the autistic spectrum.^[30]
• Temperance Brennan in Bones displays many traits of an ASD, though it is never formally disclosed.
• Maura Isles in Rizzoli and Isles also displays many traits though ASD is not stated.
• Heather Kuzmich of America's Next Top Model discussed her Asperger's and ADHD on the show.
• Julia in Sesame Street^[31]
• Fiona Helbron in Elementary (TV series), an extremely smart, but socially awkward highly functional autistic individual, who describes herself as "NA, neuro-atypical" on the autistic spectrum. Works as software engineer.

Movies

• Temple Grandin in Temple Grandin
• Mandy in Fly Away
• Linda in Snow Cake
• Isabelle in Mozart and the Whale
• Lisbeth Salander in The Girl with the Dragon Tattoo (2011) is canonically speculated to be on the spectrum.
• Poppy in Dustbin Baby

Books

Fiction

• M is for Autism is a novel written by the students at Limpsfield Grange about a girl with autism.^[32]
• Millennium series - The main character Lisbeth Salander is speculated to have an ASD.
• Freak by Marcella Pixley
• Chelsea and Casey in the book "The Same Difference" by Deborah Lynn Jacobs.^[33]
• In "Mockingbird" by Kathryn Erskine, Caitlin, an eleven-year-old girl diagnosed with Asperger's deals with the loss off her older brother.^[34]
• Clover Donovan travels through time with her autism service dog in "Viral Nation" and "Rebel Nation" written by Shaunta Grimes.^[35]

Non-fiction

• Aspergirls by Rudy Simone
• AspienGirl by Tania Marshall
• AspienWoman by Tania Marshall
• AspienPowers by Tania Marshall
• Girls Growing Up on the Autism Spectrum by Shana Nichols, Gina Moravcik, Samara Tettenbaum
• Asperger's and Girls by Tony Attwood et al.
• Lucy's Story: Autism and Other Adventures by Lucy Blackman and Tony Attwood
• A Real Person: Life on the Outside by Gunilla Gerland
• Thinking in Pictures by Temple Grandin
• Women From Another Planet? Our Lives in the Universe of Autism by Jean Kearns
• Songs of the Gorilla Nation: My Journey Through Autism by Dawn Prince-Hughes
• Pretending to be Normal: Living with Asperger Syndrome by Liane Holliday Willey
• Nobody Nowhere: the Extraordinary Autobiography of an Autistic by Donna Williams
• Somebody Somewhere: Breaking Free From the World of Autism by Donna Williams
• Life and Love: Positive Strategies for Autistic Adults by Zosia Zaks
• Parenting Girls on the Autism Spectrum: Overcoming the Challenges and Celebrating the Gifts by Eileen Riley Hall
• Safety Skills for Asperger Women: How to Save a Perfectly Good Female Life by Liane Holliday Willey

Music

• Susan Boyle
• Ladyhawke
• Courtney Love

References