I started talking between one and two. Growing up, I always had plenty of friends to play with: my army of cousins, and the kids on my block, who spent every okay-weather day racing bikes and playing manhunt. I was a polite little girl, always considerate of others. I got swept up in the Disney Renaissance, but the movies’ climaxes were always complicated for me. When Gaston fell to his death and Scar got devoured by hyenas, I felt a pang of sympathy for those loathsome villains.
They were frightened, and I couldn’t turn off my empathy for frightened creatures, even if they were the bad guys.
If my parents had taken me to a doctor and said, “We think our daughter’s autistic,” they would’ve been laughed out of the office.
So my parents weren’t concerned that I gobbled up Reese’s cups but spat out anything with peanuts. She’s a picky eater, they thought, never mind that my issue was texture, not taste.
If I cried hysterically after a long afternoon at the shopping mall, well, don’t all kids have tantrums? And my Harry Potter obsession was super common (hello, fellow 90’s kids). Maybe I just had a nerdy side?
Autism was seen as a nonspeaking boy rocking back and forth– and that’s pretty much it. Or maybe it was a socially awkward genius obsessed with train time tables. Of course, those are valid autistic descriptions under a broad spectrum, but either way, these over-simplified stereotypes in mainstream and professional understanding were squarely male.
But here’s the thing: I was an autistic child. I am an autistic adult. And I’m not alone; there are many girls and women and non-binary people like me, whose autistic traits go unrecognized because of their gender. Because as it turns out, autistic girls often present differently than autistic boys, and even mental health professionals are not always aware of the signs.
Medical Research Has a Girl Problem
The current approach to medical research is still woefully incomplete. “Scientifically verified studies” often means “studies that only (or mostly) tested the half of the population with Y chromosomes, and assumed those results apply to everyone.”
Autism is one such under-researched condition. What we know about symptoms of autism may really just be symptoms of autism in boys. Girls will often show different symptoms.
As a result, a belief emerged that autism is a boy condition. 1 in 59 children have ASD, and boys are four times as likely to be diagnosed. What can we do to help these boys? the neurotypical world asks. Why does it affect them so much more?
Well, autism doesn’t favor boys. The girls simply go ignored, or are misdiagnosed. It’s impossible to know how many lost autistic girls there are. What we thought was a large gender gap might be a lot narrower, or even nonexistent.
Girls have special interests just like boys, but these interests tend to be more socially acceptable for girls, like fashion and horses. Most people wouldn’t bat an eye at a girl who always wants to play with her Barbies. I was crazy about Harry Potter, but at the height of 90’s Pottermania, what eight-year-old wasn’t?
There are also some differences in socialization. I was sometimes shy, but had no problem making friends in elementary school. Something shifted in middle school. Suddenly, I couldn’t navigate the complex, gossip-ridden world of tween drama; I still wanted to play pretend.
If you compare a snapshot of me at age 8 with me at age 12, they look like two completely different kids. No wonder my parents never considered autism–at the time, no one even knew that girls’ social difficulties can come later in adolescence. My issues were chalked up to puberty hitting me with the force of a freight train.
In reality, I was showing a characteristic that’s fairly common for autistic girls. But because we’re still stuck seeing the male model as the everyone model, we don’t recognize this as a symptom of autism.
Girls tend to be better at masking. Girls are often hyper aware of social interactions, either because of biological differences or the way they were raised (personally, I think it’s more of the latter). They become mimics, masking so often that when they do come out as autistic, they get a lot of, “But you don’t act autistic!”
This might not seem like a bad thing–isn’t it good to be so “high-functioning?”–but masking comes at a cost. Masking causes stress, and many autistic women report feeling constantly exhausted. It could also cause suicidal tendencies, as some studies show that camouflaging is a factor in the high suicide rate among autistics.
There are consequences for overlooking girls. The girls themselves are no less autistic just because they aren’t diagnosed. I always knew that I was different, but didn’t know why. If someone told me, “Jude, you’re autistic, and that’s okay,” it would’ve saved me years of painful questions.
There are also wider societal implications. If autism isn’t a “boy” condition, then our entire view of autism is limited and inaccurate. If the gender gap doesn’t really exist (or is narrower), then the “alarmingly high” autism rates are actually much higher. Instead of viewing autism as a recent epidemic, maybe these high numbers indicate that autism is a normal, inherent part of humanity.
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- Review: The Promise and Disappointment of Everything’s Gonna Be Okay - September 21, 2020