Skewed Gender Ratios in Autism Diagnoses: The Bias in Autism Diagnoses
Autism Spectrum Disorders (ASD) are a group of extremely complex developmental disabilities that entails challenges in social interaction, speech, nonverbal communication, and persistent behaviors. While symptoms of Autism Spectrum Disorder are usually similar in boys and girls, current diagnostic methods for ASD often overlook girls, resulting in misdiagnoses or late diagnoses. As a result, many autistic women are not diagnosed correctly until they are adults. 1 in 68 children are on the spectrum of Autism, but the true number is likely higher as a result of the disparities between girls and boys when it comes to Autism diagnoses.
The criteria for diagnosing Autism Spectrum Disorder are based on (almost entirely), data obtained from studies. Historically, studies of Autism Spectrum Disorder have included three to six times more boys than girls- a huge disparity. As a result, Autism is often overlooked or misdiagnosed in girls and women as the symptoms of ASD in boys and girls differ. Previously, it was thought that ASD was four times more common in boys than in girls. However, experts now believe that to be false as a result of the lack of ASD diagnoses in girls. Many experts are now pushing for new methods in diagnosing ASD for younger children in order for all children to receive the support they need in order to achieve the best quality of life.
Many social and personal factors help females mask or compensate for the symptoms of Autism Spectrum Disorder. Jennifer O’Toole, author and founder of the AsperKids website, was found to be on the spectrum after her husband and kids were diagnosed. The reason for her late diagnosis was because she masked her symptoms well and copied the behaviors of other people in order to fit in. When talking about the ability girls have to mask ASD symptoms, University of Cambridge developmental psychopathologist, Simon Baron-Cohen, said, “If you were just judging on the basis of external behavior, you might not really notice that there's anything different about this person. It relies much more on getting under the surface and listening to the experiences they're having rather than how they present themselves to the world.”
Additionally, many biological factors make it so that girls are less likely to develop ASD. Females with ASD are generally misdiagnosed with ADHD (Attention Deficit/Hyperactivity Disorder), OCD (Obsessive Compulsive Disorder), and according to some researchers, Anorexia. The “extreme male brain theory” is a theory that autism is caused by fetal exposure to higher than normal levels of male hormones, such as testosterone. Hence, the high amount of male hormones shapes a mind that is more focused on “systemizing”, understanding and categorizing objects and ideas rather than “empathizing”. Recent research has backed this theory. If this hypothesis is correct, then it means that there will be more males than females on the spectrum.
When Frances Pelphry, a 16-year-old girl was diagnosed with Autism Spectrum Disorder, she was five years old. Her father, Kevin Pelphry, is a leading autism researcher at Yale University’s Child Study Center but even he did not recognize the symptoms of autism in his daughter. Her parents suspected that there was something unusual about her development, but the last thing they expected was autism. On the contrary, her brother Lowell was diagnosed with ASD when he was 17 months old. With Lowell, it was quick, according to their parents. However, with Frances, they were sent from doctor to doctor where they were told to watch and wait. They were also informed that the reasoning behind her behavior was because she “was a girl”. The blatant disregard for prevalent symptoms of autism in Frances and many other girls highlights the difference between ASD diagnoses in boys and girls.
There are many disparities in the diagnosis of Autism Spectrum Disorder and it is important to understand and spread awareness about this issue. Accurate diagnoses are important because the earlier one gets diagnosed with ASD, the more support they can receive in order for them to reach their full potential in society. An organization that specifically helps autistic women and non-binary people is the Autistic Women & Nonbinary Network (AWN), which helps provide community, support, and resources for Autistic women, girls, transfeminine and transmasculine nonbinary and genderqueer people, trans people of all genders, Two-Spirit people, and all others of marginalized genders. As a society, we should petition for more research to be done in ASD in girls, as well as adopting new methods of diagnosing ASD so it is unbiased and does not favor one gender.
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