Autism Spectrum Disorder (ASD) contains a wide range of conditions and behavioural patterns; there is no single disorder with specific symptoms. Because of its complexity, the diagnosis of ASD is much more difficult than other mental illnesses and conditions. One of the most compound difficulties regarding diagnosing ASD is gender.
When it comes to ASD diagnoses, almost 80% of the patients are men. Does this imply that this disorder has a higher prevalence in men, you ask? Well, not at all actually. According to research, ASD is most likely equally distributed across gender identities. Where is this diagnosis imbalance primarily focussing on men and boys stemming from, you ask? There are several explanations.
Firstly, one of them is compensation and discretion. Women are better at camouflaging their ASD because not only do girls/women tend to be better at ‘social mimicry’ than boys/men but also certain behaviours will not be understood as symptomatic and will rather be explained through gendered assumptions on femininities. For example, when women are more silent or watch and imitate behaviour patterns, people around them are less likely to consider these instances symptomatic than if men do the same.
Secondly, similarly to ADHD, there is a huge data gap and a lack of research on the matter. There simply isn’t enough research about women and genderqueer individuals living with ASD, which means that some potential symptoms and behaviour patterns have not even been diagnosed/uncovered, and therefore cannot even be picked up by clinicians. However, there is more, even if women manage to name their behaviours as potentially falling within the spectrum, (biased) clinicians often misdiagnose them, where 42% of women are incorrectly told they have mental, personality, or eating disorders. Borderline Personality Disorder, Depression and Bipolar Disorder are the most common misdiagnoses.
Thirdly, there is a lot of stigma surrounding men and boys on the spectrum. When people think of men and boys with ASD, they often think of stereotypical behaviour and have a one-dimensional image of what it means to be on the spectrum – yes hello Dr. Sheldon Cooper from Big Bang Theory. These outdated and stereotypical understandings of autism may have harmful consequences on the wellbeing and mental health of individuals with ASD, especially for young individuals.
Lastly, some studies demonstrated that gender identity tends to show more variation and fluidity among people on the spectrum compared to the general population. Therefore, research and conceptualisations also have to move beyond a binary understanding of gender differences among people living with ASD in order to be able to support patients adequately.
Therefore, addressing these issues demand a shift where one’s gender identity is taken into account in understanding the issue faced by an individual, such that researchers and clinicians should work not only on diagnosing women and girls as well as normalising it but also on destigmatising and de-stereotyping men and boys that live with ASD. More work should also be put into understanding non-binary and genderqueer individuals living with ASD.