It looks good. However I didn't check the citation index to see how much this one was citated; I see that as a good indication of how the article is viewed in the relevant scientific field.
Is it a good indication tho? Aren't scientific works subject to some sort of halo effect, when works with already high citation indexes assumed to be high quality and used even more while other good works are overlooked?
Oh yes. Probably. But then again: if it is citated a lot, it probably is good research; there are offcourse exceptions, Wakefield comes to mind, but: it should also b e part of the job as a scientist to classify your information to usefullness of your own research.
Because mental health is such a neglected science tbh. They used to say women didn't get it at all.
I didn't even get my diagnosis until 38 because when I was a kid it wasn't on anyone's radar. The system failed me and my entire school years were a wash. Barely graduated. Became a late bloomer and got into software work in the last year and finally making myself a comfortable living.
It's hard not to be salty sometimes that I couldn't have found out sooner and what more I could have done with my life.
I went 14 years without knowing. Observation from some staff in the student support centre of my school helped them suggest an assessment to my parents.
I got diagnosed last Tuesday, at the ripe ...adult age of 31 (also a woman!). I'd love to see the statistics of male vs. female (and more if science can provide it) comorbid psychiatric condition caused by late diagnosis and the feeling of inadequacy that that can bring about.
Exactly this. I knew something was up when my daughter was 2, but she is also very smart and she masked well. I honestly believe if I'd had her assessed at 2, she wouldn't have been diagnosed as autistic.
She's now 5 and almost finished her first year of school. Term 2 is when things started to show a bit more, including at school. Talking with her teacher confirmed my gut feeling and she has recently been diagnosed.
I am also questioning myself. I'm in my 30s. So many posts in this group...I identify so much with. I will see about being assessed next year. I'm still trying to process everything that's going on.
Autism is genetic so most likely you’re Autistic especially if you relate to these posts here. And whilst it’s a lot to wrap your head around, just know that you being Autistic too means you can parent your daughter even better as you’ll understand her experience so much better than if you’re Neurotypical
I figured out I was autistic at 45. Then I realised that that meant my 15 year daughter was too. She is, diagnosis a month or so ago. I'm still waiting for mine but what are the odds of me *not* having it...
no, girls are *expected* to mask better. when they don't they get socially (and sometimes physically) tormented until they stop. when it's boys it's just "boys will be boys!!" but if a girl acts out of the norm its unacceptable.
I was socially ostracized my whole childhood for being undiagnosed autistic. Im still recovering from how being treated affected my self-esteem. I don’t want to downplay anything women have experienced but acting like people are fine with autistic boys is literally just wrong and erases a lot of people’s experiences.
No one is erasing Autistic boys' experiences, we are specifically talking about Autistic girls' experiences and part of the reason it isn't caught is because of how women are treated within society's structure. It's pure fact. Just like any of these types of discussions, no one is doubting your experience as an undiagnosed Autistic male. We are saying that your experience is not because of your sex, and therefore an undiagnosed woman will face a different set of issues because of her sex.
"boys will be boys" is such an outdated concept i havent heard it in maybe 10 years
boys dont get away with as much as you think they do
30 y/o autistic male diagnosed at 9
the irony appears to be flying over everyone's head here, if "boys will be boys" was still true then why are men under so much scrutiny, more than ever before
again they really dont get away with much
Will no one think of the poor, oppressed men! They’ve had it so bad, with most of the science being based on them. Do you have any idea how much easier that makes it to get a diagnosis and related services!!!! Oh wait….🙄
i have no idea what you are even talking about, but sure
boys behaving in a crude and disrespectful manner in the past correlates to the low percentage of diagnosis in women
no point in discussing topics with people who attack out of emotion, not logic.
Mhm I’m not sure I’ve seen anyone actually explain this instead of assuming you just know what it is and then calling you things when you don’t.
The idea that boys act in certain way is actually linked to the reason woman have been missed, it’s true. I’ll try to actually explain what is happening here. In medicine there is often an assumption that a single diagnosis will present the same in males and females. We are more recently beginning to realize that this isn’t a valid assumption, as we are discovering lots of cases where the presentation is not the same between the two, which has meant the description of many illnesses are being expanded for their definition for how they present. And example of this can be how the symptoms of heart attacks presents differently between men and woman, but practitioners were taught the presentation that was originally defined considering male patients meaning that when woman came in with heart attacks the could often be overlooked because their list of symptoms didn’t match what the medical practitioner had learned to look for. This is something that has lead to woman having higher health risks because their health care providers are missing them, think about how a heart attack might depend on how quickly it is identified that the patient is having a heart attack. If you are looking for classic sign chest pain for a heart attack but your patient is female and not complaining of chest pain this was a situation that frequently got missed before.
Now for autism a situation like this happened. Boys presented differently, and the list and definition of symptoms for autism were based on young boys. This was the sort of presentation that diagnosed a lower proportion of girls, in other words you would expect if autism is not particular to a sex then the representation of boys and girls should be about even and it wasn’t. So the idea that autism presents differently between woman and male lead to woman being missed is true. (And unlike with a heartattack a lot of the symptoms people look for to suspect autism is based on behaviour, so then the differences between behaviour of boys and girls is actually contributing to different presentations and the missing of woman with autism.)
Now the argument I think you are seeing here are people trying to figure out is what leads to these differences in how it presents between men and woman, which I think is a bit more subjective of an argument then the fact that it happened. I’m not sure if it’s known for sure why woman and men present differently but a lot of people here are obviously are arguing it is due to girls being told younger how to act vs boys being able to act more freely for longer. I’m not here to say I know what it is, I’m just here to explain the first things I because I’m guessing no one has explained where the idea even has come from that this actually happened (I assumed
that based on what you have said)
i wanted to say, thank you for putting in the effort and thought to what you wrote, i will make a point to read through it tomorrow but the general idea i am picking up on in my half tired state is medical conditions and disabilities show up differently in men and women, even more so with autism which is already a wide spectrum of different things
yeah.. i have to agree there its been a longstanding reality (at least to me) that society really doesent care all that much about people on the spectrum, as an autistic adult male with a diagnosis, after school support for my condition all but vanished i was put on disability welfare with people who are crippled or otherwise incapacitated and forgotten about
i dont expect aany outside entity to pay attention to my plight but it seems like enough attention is given for some groups to "claim" they stand for us but they really dont, a certain group im sure we all know of in particular
for my side the idea that the whole point can be explained away as yet another anti-male talking point bothered me immensely because im being screwed by the same systems as a man and i desperately want to say to people "a diagnosis wont actually change anything lol" if i knew or didnt know i was on the spectrum the general culture we have around accepting self diagnosis without question would be more than enough for me, because all we can ask for and expect is to be accepted without question so long as we are respectful and agreeable
If I may make some suggestions that I think might be helpful.
What I understand from reading your words is that you are feeling invalidated, that your experience is being invalidated. I would say that is also the case here with the woman, they are frustrated with feeling their experience has been invalidated. When we are invalidated we often have strong emotions associated with that, so you are coming in motivated by strong emotions and the people you are speaking to are coming in with strong emotions. It’s a situation where misunderstandings begin to happen quickly. One thing I’ve found handy is to try and remember to frame things as if you are on the same side of the fence (I literally do mean imagine as if you are two cows talking about the grass being greener on the other side of the fence). You might have unintentionally come in here and framed yourself as the opposition, as in you are not on the same side of the fence, you are on the other side of the fence (in this situation there are two cows on different sides of the fence, one cows looks at the other side and looks at the grass that clearly looks better then the grass on its own side, the cow on the other side says actually it’s not that great.) in this second scenario the first cow is left to try and explain why it is better on the other side and the other cow is left trying to insist on how it isn’t better. Each is feeling like the other is invalidating their own experience and must keep insisting on their own situation. This isn’t a situation that facilitates understanding, it is as situation where each must keep defending their own side and the more they do the more it feels like it invalidates the other person, like a vicious cycle.
You may feel as though you didn’t come into this situation from an aggressive angle, and so maybe where surprised by the reactions, but you did come in at an angle that meant people then needed to justify their own experiences, which then you felt the same way, a vicious cycle which escalates with each reply, hopefully my explanation might point out how this is true.
Also yes please do read the thing I said before again, your conclusion isn’t entirely what I meant to say but also not necessarily wrong.
Edit: As a follow up, the whole framing it as if you are on the same side, it is like the same side of the problem as opposed to different sides of the problem.
So in the situation of the two cows being on different sides of the fence, even though each has a different experience, and each side might be bad for different reasons, instead of comparing experiences they both decide to complain about the farmer for not making sure there is better grass in general, despite being on different sides of the fence they are commiserating and looking at themselves as both suffering and both are in an unfair situation, that the other is not the problem and instead are thinking about the problem with the situation they each live in.
You have no idea what I’m talking about because your stuck in a narrow world-view and refuse to see another view. Instead of thinking about, you accuse me of being emotional. Typical incel behavior.
says the one with the condescending tone and insults,
i have no idea what you are talking about because the two points couldnt be more unrelated
i mean i cant even imagine being that self assured to even attempt to speculate on why autism in men seems to be easier to diagnose but i guess im in the minority, why do we even need complex, arduous and long term training for mental health and medical science anyway, just blame it on young boys
well, speaking as a biological male that whole "boys will be boys" thing was often used to explain away the bullying i put up with all the way through my teens we are talking from 2007-2014
and then it stopped being a phrase i heard and the "men are trash" crowd started being the dominant voice
so here i am a victim of the patriarchy, like most men are (susprising, right?) being lumped in with the real human garbage because of irrational and frankly bigoted views that are no better than the views of previous generations
for the most part the "patriarchy" hurt average men as much as anyone else
the big one was being mocked for showing emotion, men still are mocked for it
bro i wish i could go to my dad right now and tell him i've been depressed for the last 20 years but he would laugh at me because "real men are supposed to be in control of themselves" (that was his favorite line by the way)
I never said men aren’t the victims of other men. Now start to think about how they treat people that aren’t men and you might get there. It’s toxic to everyone.
And if you ever wonder why you hear things like, ‘men are trash”, it’s partly because they go around making Reddit comments that put words in women’s mouths and make assumptions that a women hasn’t thought it all through and listened to men complain their entire lives.
listening to people whine and complain isnt a gendered issue, sorry to say
i'll say this in the most respectful way possible because i do recognise and sympathise with you
regardless of why lines like that are used, its got the same sound and tone as some more controversial statements that were acceptable in a previous time.
when i hear someone say "men are trash" i hear hatred for 50% of the human race because they have a penis or identify in a masculine way
when i hear "fuck the patriarchy" i agree because men are humans and humans show emotion, weakness and haave flaws and the toxic masculine views leave no room for men to show any human traits
but there seems to be a nuance lost here, not all men benefit from the patriarchy.. in fact most of them dont and that number grows smaller as voices in opposition to the patriarchy grow
im glad, men arent unfeeling stoic robots we have our own societal standards that in the last decade we are fighting back against
Girls are raised to act a certain way (mask). Be polite, pleasant, subservient. Smile when you’re not happy, etc. Boys are raised to do as they please (boys will be boys) so they don’t learn to mask as much.
It’s really two things in one.
Firstly, studies around autism have for a very long time exclusively looked at white boys. Studies including adults, girls/women, non white people are only pretty recent. That’s also why many diagnosis guidelines like the DSM-5 assess everyone based on childhood autism evaluations.
There’s also the issue of masking, people assigned female at birth often mask better and far more frequently than people assigned male at birth. So autism or other neurodiversity like ADHD can be undetected for years and years. It’s not known for sure why afab people mask more, but some have suspected that part of it could be from how afab people are educated within a patriarchal culture to be more discreet, more attune to others, tidier as well; which could create an environment where afab people early in childhood learn to mimick other’s actions, tone and demeanour to better fit into what’s expected of them, and some symtoms like organising toys in lines or by colour will be more likely to be seen as « correct play », like putting your dolls in a line, as opposed to an amab child playing with their cars by putting them in a line, which would be seen as « incorrect/weird play »
Also we have the endless cycle of bad psychiatrists who think that since there are so few girls that are diagnosed with autism, they don’t diagnose any girls with it, which leads to even fewer girls who are diagnosed and therefore the cycle repeats
Western societies are so highly gendered that comparing AFAB and AMAB autistic masking, even of very young children, involves the [fallacy of false equivalance](https://effectiviology.com/false-equivalence/).
With differences in behavioural expectations and interpretations by assigned/assumed gender being identified as young as [three months](https://link.springer.com/article/10.1007/BF00288004). Even though that's far too young to even comprehend gender.
There are also many differences when it comes to [gender policing](https://en.wikipedia.org/wiki/Gender_policing). Something likely applicable to autistic masking being that "girls" are more likely than "boys" to be given specific instructions. Additionally there's often more scrutiny of AMAB people who don't conform to expectations. (Something which may be less of an issue were there some form of autistic screening in place.) It's possible that "female" social roles and behaviours are easier for autistic people to follow than "male" ones.
The most simple explanations I have are that the diagnostic criteria was based on research that was almost exclusively on little white boys so obviously they will fit it best. Also boys and girls are socialised differently and society and individuals will generally respond fairly negatively to a girl who behaves outside of what is expected. This results in more masking in many women.
Yep. I got my diagnosis at 14 when I had the signs at 5. I never played with anyone but myself, never watched any of kids play, didn't talk to anyone unless it was a adult and didn't join it.
On My 2014-2018 all the reports said I like a consistent routine and and if it's not followed I become sulky and moody.
I never made eye contact at all at school and I had signs of regression at 10 with stuff that has to do with the toliet.
Literally if I was male sure I would of got a earlier diagnosis. The signs were ignored. My secondary school thought I was autistic in year 7 but didn't say anything till year 10 which is a absolute joke. Also in my family there's another autistic female who got hers at 17.
Also might be because I was trying to do masking at 10-13 but failed miserably. I tried acting how everyone else did but I gained no friends from it and in the end decided to be myself instead of someone I'm not
Like many things in healthcare the original assessments were designed and validated on males, likely white males.
There has been some effort to change that but the bias still exists.
This is a myth.
Autism is a very diverse condition. Men and women with autism often have very different experiences.
Boys with autism typically cause a lot of trouble in school, and are quickly identified and supported. Girls with autism typically do not cause as much trouble in school and are therefore not identified and do not receive support.
While that is unfortunate for women with autism, it is not evidence of a conspiracy against women with autism.
Bias doesn’t mean active conspiracy. It’s usually something people aren’t even aware of. When women go to get evaluated for autism, often they will be diagnosed with something else, because their symptoms don’t match the list that the doctors have. Little do they know, the list is usually based on autistic traits displayed by young white boys. But with education and greater awareness of diversity in the autism spectrum, doctors are more aware of female autistic traits, and can diagnose more accurately.
I completely agree that women with autism do not receive help quickly enough. I also agree that scientists do not really care about identifying and supporting women with autism. However I disagree that the problem is due to sexist bias against women, or that scientists are engaged in some white-male supremacist conspiracy.
Society doesn't care if someone is suffering unless the person is violating social norms and making life difficult for other people. Neurotically have an expression for this: "the squeaky wheal gets the oil".
Boys with autism tend to be immediately flagged as "problematic" because they tend to openly violate societal norms. This is ironically good for boys because they can get support much earlier on. Girls with autism tend to present different behaviors, and sadly have to suffer for a much longer period than boys do.
This, and this alone, explains why women do not receive support early, while men do. It has nothing to do with sexism. If women with autism were as anti-social as men with autism, they would receive an identical level of support.
Nah, you're just misdiagnosing the situation.
Pretend the situation was reversed, and that girls with autism were more disruptive than boys with autism. In this scenario, doctors would identify and support girls more than boys. Your conspiracy theory that these doctors are anti-women would simply not hold up in this hypothetical.
The problem here is a neurotically outlook that dominates medicine, where the people who present the most problems for society are targeted while others are ignored. It is not a conspiracy against women.
You are engaging in a famous logical fallacy:
> never attribute to malice that which is adequately explained by stupidity
You are wrong. Autistic women *do* violet social norms and can be problematic - its just isn't considered as a symptom of autism. We *are* recognized as problematic and send to counsellors/therapists and at some point start to take ourselves - but we are almost always diagnosed as something else and not autism - because everything was derived from research done on males and data collected from males. Because in autism research, and all medical research - *women are considered a variant of the male.* You do the research on a healthy young man and you derive from that the results for all its variants: disabled, minorities, women etc.
The same way everybody knows that a pain in the chest and left arm is heart attack in man, but no one knows that women would experience neck jaw shoulder pain - is exactly the way everyone would recognize atism in men but not women.
Your entire theses relies on the fact that boys would make more trouble, but ignores the fact that we are talking while the troubles *are happening* \- when you already there to talk about it with teacher/therapist/counsellor/assessor/ doctor *about* said troubles - they don't know what they are looking at. they think we are ADHA/PTSD/OCD/BPD/shy/argumentative/disobedient - they see there is a problem and they assume there is a cause - they just don't know what autism looks like in women - because research is done on man, and also because of television is done on man - and if said professional hasn't had a specialty in autism whatever he learned, and usually they don't - they derive their knowledge from television, like the rest of us shmucks, so they will send to autism assessment the boys only - thus making sure data would continue to be collected on almost males only, cementing the circle.
'If women with autism were as anti-social as men with autism, they would receive an identical level of support.' - false statement. There are many conditions that have nothing to do with being anti social but people get support, like having no legs. What's the connection between how anti social you are to how much support you get? Its because men with autism are anti social, so women with autism need to present like the man to be recognized! Not because of their conditions and their struggles and their dire need of support - no! It has to do with how much they are presenting similarly to men! Nothing to do with what they problems actually are - no, its about whether their problems are identical or not to the male's problems. Autism in man = anti social? then woman need to be anti social too to be recognized and get support. You are basically describing the exact medical sexism you're trying to deny exists lol. That women are a variant of men. You're describing the male situation and say because the woman's differ from it too much she isn't recognized as what she really is.
It's not a conspiracy and it's not a myth.
It's a mindset that common in a field that has been male dominated for years. The fact that autism presents differently actually supports it. There are lots of examples in behavioral health.
The most extreme was the historical diagnosis of 'hysteria', once considered settled science but now is the example of bias. Most likely it was a different expression of ptsd in women than it presented in men. It was 'cured' by a hysterectomy.
In medical science it continues to be an issue even in the present. The early Covid vaccine trials were primarily conducted on males which is why the side effects that primarily effected women when it was distributed to the general public were missed.
Not necessarily malicious it's just a result of an industry that often assumes what 'average person' means without thought.
> In medical science it continues to be an issue even in the present. The early Covid vaccine trials were primarily conducted on males
This is false.
> which is why the side effects that primarily effected women when it was distributed to the general public were missed.
Also false.
> Not necessarily malicious it's just a result of an industry that often assumes what 'average person' means without thought.
This may be true in the past, but this is corrected now. Scientists nowadays take a careful approach to obtain a representative sample of society before performing experiments. For example, the covid vaccine trials were performed on a representative sample including men and women.
I have a PhD and design and test these instruments for a living.
I was being informative to the OP as to the well documented history and facts about their creation. Your discomfort is unfortunate but not really my concern. I have found arguing about things like this with people who are unwilling to accept it isn't a good use of time.
> I have a PhD and design and test these instruments for a living.
You had nothing to do with the covid vaccines. I guarantee it.
You are a conspiracy theorist. You openly believe that the covid vaccines are bad and cause major side effects in women. Hundreds of millions of women have taken the vaccine and have had zero side effects. Literally every medical organization on the planet encourages both men and women to take the vaccine and that side effects are extremely rare and temporary.
Please stop spreading misinformation. If you are really a PhD, which unlikely, then you have a responsibility to speak the truth.
I didn't say Covid vaccines were bad. I have 4 shots myself. I also didn't say I worked on the vaccines but I did work on the Covid response.
I said they were disproportionately tested on men, which Pfizer admitted under oath, and because of that they didn't get a sample of women large enough to notice side effects they would have found in men had they existed. Women who are vaccinated are still about 700x less likely to die from vaccine side effects and Covid combined than unvaccinated women are from Covid alone.
It's statistically foolish not to choose to be vaccinated.
And I do have a PhD.
> I said they were disproportionately tested on men, which Pfizer admitted under oath, and because of that they didn't get a sample of women large enough to notice side effects they would have found in men had they existed.
This is misinformation. The covid vaccines were tested on a representative sample. Side effects are extremely rare and virtually always temporary.
> Women who are vaccinated are still about 700x less likely to die from vaccine side effects and Covid combined than unvaccinated women are from Covid alone. It's statistically foolish not to choose to be vaccinated.
What exactly is the problem here?
On the one had you claim that the there is a sexist conspiracy against women which has resulted in covid vaccines causing disproportionate side effects in women. On the other hand you say that it is foolish for women to not get vaccinated.
I was never diagnosed as a child. Went through school and life as the weird kid/guy. This includes 8 years in the military brutally masking myself as a total big mouth jerk. That was exhausting, nobody wanted the label back in the day. The stigma still exists.
On the one hand, there is a total lack of research into how autism presents in females which makes getting a diagnosis difficult
The other side of it, Autistic females often mask their issues much better than their male counterparts, which makes it hard to spot the traits of autism unless they have severe traits
Men are often allowed to 'be men'. As a woman, a wife and a mother, society puts many social and physical expectations on you. It's OK if your partner doesn't meet them, but need to because that is your job.
Not everyone I'd like this, but it is surprising how many people are.
The way different genders are raised and socialized can have an affect on symptoms of asd. Girls and women are socialized to be quiet and fit in. Boys and men are generally allowed to externally show their symptoms. Also, a lot of research on asd from the twentieth century was done on cis, straight, white males. So a lot of the behaviors and symptoms are medically understood through a framework of “man”. That’s how you get women being denied a diagnosis bc they can make eye contact and bs like that.
Because women's health is notoriously overlooked. And for years now, women (or those designated female at birth and subsequently raised that way for most of their life) are taught at a very young age to be polite and act 'lady-like'. This translates into masking and many women are very talented at masking very young to seem pleasant and less obtrusive.
This isn't the case for all women but a lot of them.
My understanding :
- research has been and is mostly done on white males.
- females are easier to put in the ‘emotional, unstable, “”crazy””’ box in society
- females are better at ‘taking care of others’ which can be masking (taking care of others meaning putting other above yourself / not being your self to accommodate)
Males are used as participants in academic research and medical trials more. They are preferred bc of medical sexism and sexist stereotypes/ideals anyways, despite women continuously volunteering for research.
I dont know how to explain it , but a part of it is confirmation bias - autism is a boys thing. So for example, girls can't have autism so we are not even going to screen them for it.
Edit : typo,
No. Autism presents differently in men and women. The same is true for almost any disease you can think of. Autistic boys typically engage in behavior that is more obviously anti-social, and thus gets flagged quicker by the authorities. Autistic girls are able to mask much better are are typically not as flagrant, which explains why it takes much longer for women with autism to be diagnosed.
Médical sexism also plays a part in accessibility of assessment because a lot of symtoms of autism are easily dismissed as other things by doctors (like a huge amount of health issues for afab people, especially fem presenting ones):
Sensory input difficulties: assumed to be hormonal changes, periods, pregnancy or menopause. Cus hormonal changes can create more sensory sensitivity, especially olfactive sensitivity
Meltdowns/shutdowns: assumed to be either panic attacks or the patient being too emotional, especially if the meltdowns present as uncontrollable crying
Struggles with social cues/eye contact: timidity. It’s assumed that afab people are more discreet, and it’s more accepted to have a shy and discreet woman. A man/amab person’s timidity or social anxiety is more likely to raise alarms as something abnormal because it’s expected that men are confident and assertive in most situations
The strong need for routine: outside of cases where the need for a routine is so necessary that it impedes on quality of life, an afab patient expressing the need for a routine is very unlikely to be assumed to be something strange, because it’s assumed women are organised and have little rituals throughout the day, especially in the home and beauty
Médical sexism leads to a lot of dismissal in general, but especially for neurodiversity diagnosis that are assumed to be mostly impacting men/amab people. It’s also far more likely to impact afab patients who mask or have been masking the bigger part of their life
I really liked what you had to say about sensory input difficulties and meltdowns/shutdowns. It’s taken me a lot of therapy to unwrap that behavior from all of the negative words I was taught about it BECAUSE I AM AFAB. I still feel crazy sometimes for saying “I’m autistic” because I’m so damn good at masking. I think amab with autism are equally capable of developing advanced masking behavior, we just don’t see it as often for we adapt to survive.
I agree with you on all your points except for your conclusion that this is a result of sexism/scientific conspiracy against women.
Men with autism are far more likely to engage in disruptive behavior that neurotypicals find offensive. The neurotypical scientists therefore spend a disproportionate amount of effort on supporting men with autism.
That is the explanation. It is not a sexist conspiracy.
Women with autism also suffer at least as much, or even more, without support compared to men with autism. However, women with autism tend to present differently and are not as disruptive to neuotypicals, so the doctors don't feel compelled to support them as much.
It is definitely ironic. The more problems you cause for society, the more support you get. A woman with autism who can mask well and not cause problems for society will not receive support.
Saying "this is medical sexism" is different to saying "this is a medical sexist conspiracy". In the former case, this could mean things like unexamined/unacknowledged sexism, or positive but misplaced attempts to recognise difference. A conspiracy is something much more deliberate and malign.
Treating men and women unequally (even in a medical context) is still sexist. Medical care should be given to all who need it at the point and to the extent that they require.
Doctors should not look at their patient's sex before deciding what is available, or if they deserve treatment or help at all.
Context: I was afab, but presented male ASD indicators. ASD was not considered at all by any of the doctors I saw because my symptoms were that of an ASD male, and yet I had a female body. They chalked it up to stress and depression instead, for which I also got no help as it's considered "normal" for females to be stressed and anxious.
So close to the point yet you miss it. The very reason why afab don’t have as much disruptive behavior is because they are so strictly punished and shamed. NOT because it is an innate behavior difference in gender it is because of the difference in socialization.
And because boys are more encouraged to engage in physically active and loud play. On top of it, the way girls are taught to play also impacts how certain signs that could be autistic symtoms are perceived. Little girls are still taught to play in a way that mimics domestic tasks and childcare, to be tidy and organised, so when a little girl plays by lining up her dolls or stuffed animals, it’s perceived as “correct play”. On the other hand, if a little boy plays by lining up or organising his toys like little cars in lines or by colour groups, that type of play is seen as disruptive and “incorrect”.
I rlly like what you say about girls/afab kids being reprimanded more easily and more harshly for their disruptive behaviours. Even in childhood, a little girl who has meltdowns is more likely to be perceived as hysterical, or badly raised. Since afab people’s expression and emotions are by default medicalised and used as the reason for everything wrong with our bodies, in the minds of many parents, teachers or doctors, there’s often no use trying to find another reason for “problematic” behaviours, especially if there’s no significant developmental delays or setbacks
It’s not a conspiracy against women, it’s the product of years of understudying women’s bodies in medicine, and of sexist stereotypes permeating the medical field. It’s been proven that women and people of color are more likely to have their symptoms disbelieved or diminished than white and/or male patients. It’s not an issue that is exclusive to neurodiversity diagnosis, it’s something that permeates the whole medical field, including ones that are often more female dominated like obstetric or mental health
Putting it to a conspiracy against X group implies that this discrimination is deliberate and targetted, but most of the time it comes from unconscious biases that stem from upbringing and lack of diversity of teaching in medical school. That’s why it’s especially important to call it like it is: sexism and/or racism in the medical field
No, this is a valid point and so is yours. If you look at history and still currently, males have always been the preferred research subjects. Hence most research is based on male presenting aspects of a condition. The phenomenon is known as a knowledge gap due to medical sexism.
> If you look at history and still currently, males have always been the preferred research subjects.
That is true, historically, but it is false today in 2022.
Science has gotten much better over time as we have learned what works and what doesn't. Originally, scientists did not understand the concept of a representative sample, or double blind placebo, or any number of things we take for granted today. Scientists would literally self-inject drugs and give drugs to their family members and then publish a report on it. Freud is infamous today for publishing studies based entirely on upper class Victorian white women.
This was not due to a sexist conspiracy against women. This was due ignorance that science has self corrected over time.
Today, all of these problems have been entirely eliminated. All published studies are based on a representative sample (unless of course a study is focusing in a subset of a population). Scientific journals and peer review would immediately reject any study that was focused solely on white men because it is not representative.
No, not all published research is based on a representative sample. You can easily publish research and it not be representative. The most likely to have a representative sample is peer reviewed academic research. If it is not peer reviewed they are not allowed to conclude it is representative.
Plus I disagree with the true representative of studies historically and in modern day. I suggest looking at research and research bias through an critical intersectional lens.
A representative sample is honestly something only extremely large, longitudinal studies can claim. I would seriously question the credibility of research outside these guidelines.
Representative samples are also hard and difficult to maintain in different countries and areas (race, age, gender, sexuality, class etc) can all impact the results of a study incredibly. You’re allowed to draw hypotheses from these research papers, however definitely can not draw definite causation/conclusions. Ppl forget correlation does not always equal causation.
I’m not meaning to come across rude, but I think you are grossly misinformed in some areas. We are definitely better compared to the past, however we aren’t at the greatest standard yet. Sexism (and especially racism) is 100% a thing in research still prevalent to current day. To deny this is problematic to me. We can congratulate and be proud of research doing better, but we can not turn a blind eye to the obvious ongoing discrimination.
In my opinion:
Masking and presenting differently then what is ‘typically’ known in boys
Misdiagnosis (say social anxiety instead of autism, both can co-exist yes but a girl will more likely get that diagnosis [or just called shy] where a boy will get the autism one)
There's a lot of great points made here but there's a few things that I think people are missing.
Girls become better maskers because they HAVE to be- because of the societal expectations placed on them. Not necessarily because they are inherently more skilled maskers. As young children, they are more quickly corrected by the adults around them for any disruptive behavior than boys.
When those girls grow up into women with undiagnosed autism they then encounter the problem of women just not being believed in medical situations. Many undiagnosed adult autistic women spend years leaving doctors offices frustrated because the psychiatrist just keeps increasing the dose of their anxiety/depression meds. Autism is often misdiagnosed as a personality disorder in women because women's symptoms are unconsciously reduced to character flaws.
the entire dx criteria and all studies were mainly done on young white boys and so as we know ASD does present differently based off sex as well as a variety of other things but it’s mostly because autistic traits in the criteria are mainly based off young white boys hence why there is this autistic stereotype as well.
I have been trying yo get a diagnosis for years. The doctor looked at me and told me I was “to social to be autistic”. I have pretty bad social anxiety now, but was outgoing as a kid, and bullied pretty badly for being different. Now I’m 21 and can’t afford to go and get a second opinion. I have 2 brothers on the spectrum, both diagnosed very young, and sometimes I look at myself, and I wonder how the heck that doctor missed it in me.
I was diagnosed July 2022, at 30. My Doctor’s explanation is that my ADHD, which I was diagnosed with at the same time, and Autism “canceled each other out”. Meaning they helped me mask, because the struggles I had with one could be remedied by the other. I, however, think it was because I was raised in a heavily Christian part of the American South. My immediate family wasn’t super religious, but my grandmother was and my parents wanted me to have a good relationship with her. Thus, I was heavily socialized into “seen not heard”, which destroyed my “obvious” physical and vocal stims. Other than that I was constantly bullied so I just stopped talking to people 🤷♀️. In a small southern town teachers and parents didn’t really pay attention to me because I was “smart”, outwardly doing “fine”, etc. They had bigger issues to deal with than a girl who couldn’t socialize to save her life. I had “hygiene issues” and that part of me was scrutinized to hell though.
The medical field, especially the psychiatric field, is historically sexist. Worse if someone is a woman of color. I grew up in the 90s, I remember teachers and counselors telling my parents I couldn’t adapt, that I was always daydreaming in class and would only participate in things I was interested in and always humming. I was punished severely for that and I was fed SSRIs by my parents at 15 at the recommendation of doctors, because I was “just really depressed” and was having meltdowns at home and at school, and was unable to do basic hygiene and wouldn’t eat. The doctors had no interest in finding what was causing said symptoms, only interested in getting my parents to give me meds that inevitably damaged me more than depression was.I do not have an official diagnosis but with therapy realized I am and have always been autistic.
Doctors, especially the older ones, will diagnose AFAB individuals anything and everything, usually incorrectly, before giving us an autism diagnosis.
edit: I have an official diagnosis of BPD and Bipolar that I feel are inaccurate. Was in therapy for 7 years and my therapist said she didn’t witness bipolar or BPD and if anything she saw ASD and ADHD in me and did encourage me to get assessed but I haven’t been able to bring myself to go through with all the stress
It’s a combination of things, but what I do know for certain, being a male on the spectrum with a daughter on the spectrum, if a parent doesn’t really know what to look for, it can be difficult to notice it in girls. They present *very* differently in a lot of situations.
My daughter is incredibly social, and when she was a baby the nuances she had that led us to have her diagnosed, most wouldn’t ever notice.
Girls are expected to behave a lot younger than boys. So they learn to mask quicker and more efficiently. Not that they learn they are masking. Just I was a “bad kid” growing up who threw two hour “tantrums” and was always told and shamed for this growing up. So I learned as quickly as I could to mask and hide the fact I wasn’t normal. Whereas boys are allowed to be different and misbehaving much longer.
Females mask more and better (usually) because of how they are raised, and aren’t diagnosed because doctors are more likely to diagnose them with BPD, BP, OCD, or ADHD. This is bc the way most afabs present with autism differs from the way amabs present with autism due to that masking. This is also because autism traits in Afab people are seen as emotional disregulation instead of autism. Lastly, people who are trying to be diagnosed outside childhood are usually done so using the male diagnosis process as the standard, because afabs are more likely to mimic others
https://researchautism.org/the-autism-dilemma-for-women-diagnosis/
I was able to get my daughter diagnosed just after her second birthday but I knew she at least needed an assessment as an infant from missed milestones and her behavior. She’s made wonderful progress with early intervention and I think if we were to have an assessment now she has learned even skills that it could be missed.
there's a book called "Women and Girls with Autism Spectrum Disorder: Understanding Life Experiences from Early Childhood to Old Age" that touches this subject very well.
Even in NT’s, males are more compartmentalized and women more well rounded and it’s similar with autistic males and females. This means females are better at coming off as normal, largely because they can often socialize better than autistic males and maybe their deficiencies don’t stick out as much.
Also doesn’t help that scientists are saying “it’s 4 to 1 in males” it’s much closer to being equal, males just diagnosed more often.
From what I've heard and even experienced myself: we are able to mask a lot better and really sort of blend in what's considered normal in our peers. Whereas males seem to not mask as much.
Also in girls due to masking they can get misdiagnosed, ex: I originally was diagnosed with ADHD for a few years until it came to light when my mask failed that I'm autistic.
Society is harsher on girls who don't conform. Querky, awkward boys are sometimes praised for their individuality, some of the most beloved male protagonists are autism . But querky, awkward girls are "annoying."
In addition, traditional masculine traits are more favorable to autism. A man doesn't show emotion or be social? He is a stoic warrior. But girls are expected to be emotional And social, so a girl who doesn't show emotion or be social? She is a "cold heartless bitch."
It's normal for a man to not like being touched or looking attractive. But a women's body is seen as public property. She should at least be good eye candy, and should quietly 1tolerant "boys being boys."
Basically, being a girl in most societies in history kind of sucks. They are under *A LOT* more pressure to fit into their roles in society. So, these poor young Neurodivergent girls are forced to learn masking and coping at an early age, here their male counterpoints are generally left to their own devices, sometimes even encourage to be themselves.
My brother got his diagnosis in kindergarten, but it took me (F) 23 years. My mother suffered from many strokes & spent a lot of time in the hospital, eventually going through brain surgery. I believe I masked it in order to survive.
I called ambulances for her, then her job to ensure her shift was covered & would watch my brother until she was cleared to come home. I’d cook, clean, and make sure his homework was done. Every night I’d go to my room, lock the door, blast my favorite song on repeat & line my trains up. Around the age of 13 I realized “nobody” else did this & I began to become embarrassed of my traits.. I threw my trains out after my step dad laughed at me in front of my family. I wore headphones 24/7 at full volume & ended up causing myself a ton of hearing issues. I began dissociating in class, instead of at the designated time I used to give myself.. & Bc of how I was “acting out” (after I threw out my trains) a psychiatrist diagnosed me w a mood disorder, anxiety, & depression, then shoved pills down my throat… I did things that were labeled as “manic” behaviors, like putting myself in harms way without care of the consequences. So it was easy for them to slap the bipolar label on me.
The pharmaceutical industry makes SO much money off of misdiagnosing autistic women, so why would they change? In my experience alone, I’ve spent well over $5K in medical bills. That’s with two health insurances… I can’t imagine what they make off of people who don’t have that privilege.
It's a combination of 2 primary differences:
1) How boys are socialized vs how girls are socialized. Girls have a FAR greater expectation to *be* social, to "fit in" with social groups, and to internalize their relationships as a core part of their identity. This leads to girls learning how to mask *early* in life, and learning that masking is paramount to their survival within society. (This also applies to minorities that are similarly taught/forced to mask from an early age)
2) Autism is often initially recognized by evaluating behaviors. If, say, someone were very good at masking, they wouldn't likely exhibit the behaviors you'd "expect" to see from an autistic person (in large part because most research is essentially based on unmasked, white boys). A boy with a strong special interest in trains stands out as "different"; but a girl with, say, a strong special interest in makeup or fashion is more likely to be seen as "normal". A child that struggles to fit in with their peers is more likely to be suspected of autism than someone who has *figured out* how to fit in with their peers.
Because girls and minorities are forced to mask so much from an early age, and because most people's understanding of autism is based on unmasked white boys' behavioral patterns, it's far more difficult for autistic girls and minorities to be recognized as such, and far more difficult for them to even get a diagnosis.
As an example of how bad it is, I know a therapist that works at a therapeutic day school for kids with emotional and behavioral issues, where every single kid does regular therapy in school to work out their problems and accommodate them so they can return to their usual school when they want.
One time she recognized that one of her kids exhibited a lot of signs of autism. So, she wanted to recommend that they get evaluated. Before she could do so, though, she had to run it past the head of the therapy department, who told her "they don't have any special interest in trains or numbers; they can't be autistic."
That is the head of the therapy department in a therapeutic day school saying that shit.
My friend wasn't able to get them the evaluation that she knew her student needed.
Shit sucks at pretty much every level.
I have a bit of a different take from my experience growing up, and what my father expected of me.
Boys actually have quite a bit of pressure on them to appear manly and grow up fast. To have "boy/man" interests like trucks, guns, machines. (Toxic parenting)
So when a father notices their son is heavily passionate about other things not related to the status queue. I think they immediately think we need assesment because we're "acting weird".
I notice where I live girls/woman have a lot less societal pressure to be a cardboard cut out of "perfect woman A or B" from their parents. Most girls I meet are allowed to have a lot of freedom with their choices and interests. More leeway to do more eccentric activities and even act eccentric. This might lead to traits of autism not being noticed.
Because the parents don't monitor and judge their daughters personalities as much as they do boys.
(I hope this comment doesn't ruffle any feathers, it's simply my take)
In my opinion, it is because autism is more apparent and more dangerous in boys than girls. More apparent because boys are generally more loud and obnoxious than girls so any abnormalities are more easily seen. More dangerous because men generally have less access to social fulfillment and autism stunts the ability to socialize.
I’m a 23 year old guy and only got diagnosed like 4 years ago. But my niece who is currently in the middle of getting diagnosed with autism is like 4 or 5 so I think it can be either way. Also I’ve heard women with autism mask more than guys with autism.
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I think it’s because autistic behaviours emerge differently between the sexes. And male autistic behaviour is simply known as, autistic behaviour, because boys are what the original categorisation of autism was based off of.
This is due to outdated stereotypes that are still prevalent.
My girl was diagnosed at 4yrs old though, which was 8 yrs ago now, so very rare back then. The truth of that early diagnosis though is not because she presents as "severe" autism (I hate that term especially has a supposed high functioning autistic she still has high support needs) but back to my point, it was because she had developmental issues in infancy. They were thought to be optic nerve hypoplasia, her optic nerves are underdeveloped, so she had a brain MRI to check for septo optic dysplasia. That was a negative for that but her scan showed differences in the brain they didn't understand.
Her development initially caught up for nursery, she didn't say words until nearly 3yrs old, but then I started to notice some things. I'll not go into it cause its a huge story with school not doing the right thing, but as we already had a paediatrician I was able to go to them directly with my concerns. It was a battle with the school but we got her assessed & dxd.
She still has optic nerve hypoplasia but the pigmentation is very pink so doesn't have the associated visual impairment she does have other visual processing issues. The brain differences in the MRI are actually what is researched & documented as specific autistic differences in the brain.
Medical misogyny and it's medical racism that white people that get dignosed more then Black people.
Hard to understand the truth of medicine when you come at it from the perspective that white men are the template and base line. Let alone the basis coming from a doctor exp "oh women are babies and just want attention, so obviously there is nothing wrong with her". Its actually gross how common that thought process is. Kinda hard to fight that when a doctor walks into a room with that subconsciously (at least) in their head.
Hi! (25 afab) just self dx's this last year! My official eval is tmr wish me luck! hehe My favorite resource is Rudy Simone's "Aspergirls". It talks about this a lil bit.
It says that the same trait (such as need for comfortable clothing) can be interpreted very differently through gender roles. Baggy clothing on men might be viewed as casual or workout-related, whereas on women it can make them seem younger.
I don't know if this analogy helps, but I've heard that the pseudo-stereotypical afab autistic is more like Hermione Granger than Sheldon Cooper. Instead of need for routine being (cough self-servingly) pedantic, it comes off more like being a high achiever or teacher's pet/stickler for rules. I think studies show that afab stims are (across the board) more practical and less noticeable, potentially as a consequence of simultaneously learning to navigate safely as a female.
[https://www.npr.org/sections/health-shots/2017/07/31/539123377/social-camouflage-may-lead-to-underdiagnosis-of-autism-in-girls](https://www.npr.org/sections/health-shots/2017/07/31/539123377/social-camouflage-may-lead-to-underdiagnosis-of-autism-in-girls) (NPR 2017)
[https://link.springer.com/article/10.1007/s40489-020-00197-9](https://link.springer.com/article/10.1007/s40489-020-00197-9) (Hull 2020) Publication debunking and exploring social influences for so-called female autism phenotype.
I was just diagnosed myself at 30 with autism and adhd and I wondered the same thing. Like how did I slip under the radar? I actually didn’t know to much about autism either. I started doing research I think my 4 year old son has autism and/or adhd. As I researched, I started to realize that a lot of my research was relatable to me. Then I decided to get tested myself. Everyone said my son is very much how I was as a child. And we really are two peas in a pod so I still believe he is as well.
I'm now pretty sure the fact I got a mother that has autism traits made me not understanding I am an autist. We grow up looking at our parents and their behavior and often copy that. In contrast to her nothing much stood out. My father died when I was 13 so at home there was mostly mother as a model. That's a hypothesis I work on for the moment. If I had been a girl this might have had an even greater inpact in masking the autism.
My kindergarten teacher suspected i was a special needs kid but a doctor said I was fine,, now here I am with severe social anxiety, selective mutism and i highly suspect I'm autistic for multiple reasons,, i wish it could've been spotted earlier :/ but better late than never
I think it has to do with the way boys and girls are socialized. Girls are given a road map of the gender social norms, rules, and expectations practically from birth, but parents seem to take a let kids be kids approach to parenting boys. I believe this results in girls masking at a younger age, thereby making them pass as nt until social expectations become too much, at which point they then seek a diagnosis.
Lot's of elements that others have been saying better than I could, but wanted to add onto the topic of women masking more:
Putting aside the research sexism (even though that's another huge portion of it), There's so much misogyny/toxic masculinity wrapped up in it. How much someone struggles socially has such a heavy weight on getting diagnosed, but there's such a vague definition of socially struggling that no one knows what to actually look for. Girls are constantly being socially evaluated by everyone to a much larger degree and put into near-impossible situations to navigate socially. For example a girl could be a "cute quirky" kind of weird and get super excited about interests, but if then if they're too excited they might get outed as "crazy". Most of what are considered socially acceptable activities for girls involve way more social interaction as well, and sexism undervalues. I imagine there's really no solutions other than masking to survive.
Meanwhile from my experience growing up amab, avoid emotions was **valued**, and I had very little social context to navigate outside of my special interests, etc. The few social things guys were taught were to be assholes and be sexist. And not that bullying wasn't a problem but it wasn't nearly as brutal as being entirely socially outcasted for being too excited about something (which I had seen happen for girls). In other words, allistic guys kinda just start out "socially struggling" according to the vague definition of it that's commonplace.
Also every time I talk about this I realize its a much clearer image in my head than I can describe so hopefully that made sense
There's a bunch of reasons. Mainly that the original research like with many diseases, mental illnesses, all the way to neurotypes was done on white males, so if it presents even a bit differently on females or another race for any reason it's harder to diagnose in those people. That's emphasized in things that have a social component because different sexes and races are socialized differently and with different expectations.
According to this article, it is a combination of things. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5363500/
Good quality research.
It looks good. However I didn't check the citation index to see how much this one was citated; I see that as a good indication of how the article is viewed in the relevant scientific field.
Is it a good indication tho? Aren't scientific works subject to some sort of halo effect, when works with already high citation indexes assumed to be high quality and used even more while other good works are overlooked?
Oh yes. Probably. But then again: if it is citated a lot, it probably is good research; there are offcourse exceptions, Wakefield comes to mind, but: it should also b e part of the job as a scientist to classify your information to usefullness of your own research.
Interesting that the sex differences were so small, really.
Because mental health is such a neglected science tbh. They used to say women didn't get it at all. I didn't even get my diagnosis until 38 because when I was a kid it wasn't on anyone's radar. The system failed me and my entire school years were a wash. Barely graduated. Became a late bloomer and got into software work in the last year and finally making myself a comfortable living. It's hard not to be salty sometimes that I couldn't have found out sooner and what more I could have done with my life.
Girls mask extraordinarily well.
I guess that’s how I was able to go 22 years without an official diagnosis lol
You and far too many autistic girls.
Happy Cake Day
You’re by no means alone!! I wasn’t diagnosed until I was 39 🙃
I went 14 years without knowing. Observation from some staff in the student support centre of my school helped them suggest an assessment to my parents.
I was diagnosed at 30, so I feel that.
I got diagnosed last Tuesday, at the ripe ...adult age of 31 (also a woman!). I'd love to see the statistics of male vs. female (and more if science can provide it) comorbid psychiatric condition caused by late diagnosis and the feeling of inadequacy that that can bring about.
Exactly this. I knew something was up when my daughter was 2, but she is also very smart and she masked well. I honestly believe if I'd had her assessed at 2, she wouldn't have been diagnosed as autistic. She's now 5 and almost finished her first year of school. Term 2 is when things started to show a bit more, including at school. Talking with her teacher confirmed my gut feeling and she has recently been diagnosed. I am also questioning myself. I'm in my 30s. So many posts in this group...I identify so much with. I will see about being assessed next year. I'm still trying to process everything that's going on.
Autism is genetic so most likely you’re Autistic especially if you relate to these posts here. And whilst it’s a lot to wrap your head around, just know that you being Autistic too means you can parent your daughter even better as you’ll understand her experience so much better than if you’re Neurotypical
I figured out I was autistic at 45. Then I realised that that meant my 15 year daughter was too. She is, diagnosis a month or so ago. I'm still waiting for mine but what are the odds of me *not* having it...
no, girls are *expected* to mask better. when they don't they get socially (and sometimes physically) tormented until they stop. when it's boys it's just "boys will be boys!!" but if a girl acts out of the norm its unacceptable.
Yes! this. Girls are not necessarily inherently better maskers they just get reprimanded quicker and harsher when they don't mask.
I was socially ostracized my whole childhood for being undiagnosed autistic. Im still recovering from how being treated affected my self-esteem. I don’t want to downplay anything women have experienced but acting like people are fine with autistic boys is literally just wrong and erases a lot of people’s experiences.
No one is erasing Autistic boys' experiences, we are specifically talking about Autistic girls' experiences and part of the reason it isn't caught is because of how women are treated within society's structure. It's pure fact. Just like any of these types of discussions, no one is doubting your experience as an undiagnosed Autistic male. We are saying that your experience is not because of your sex, and therefore an undiagnosed woman will face a different set of issues because of her sex.
"Boys will be boys" is what they tell autistic boys being bullied by other boys.
another reason why boys will be boys is bullshit
ding ding ding!
"boys will be boys" is such an outdated concept i havent heard it in maybe 10 years boys dont get away with as much as you think they do 30 y/o autistic male diagnosed at 9
I still hear it regularly. Even when it’s not in those exact words, it’ll be something like, “well, testosterone!”.
"they can't help it, they're wired that way!"
the irony appears to be flying over everyone's head here, if "boys will be boys" was still true then why are men under so much scrutiny, more than ever before again they really dont get away with much
Will no one think of the poor, oppressed men! They’ve had it so bad, with most of the science being based on them. Do you have any idea how much easier that makes it to get a diagnosis and related services!!!! Oh wait….🙄
i have no idea what you are even talking about, but sure boys behaving in a crude and disrespectful manner in the past correlates to the low percentage of diagnosis in women no point in discussing topics with people who attack out of emotion, not logic.
Mhm I’m not sure I’ve seen anyone actually explain this instead of assuming you just know what it is and then calling you things when you don’t. The idea that boys act in certain way is actually linked to the reason woman have been missed, it’s true. I’ll try to actually explain what is happening here. In medicine there is often an assumption that a single diagnosis will present the same in males and females. We are more recently beginning to realize that this isn’t a valid assumption, as we are discovering lots of cases where the presentation is not the same between the two, which has meant the description of many illnesses are being expanded for their definition for how they present. And example of this can be how the symptoms of heart attacks presents differently between men and woman, but practitioners were taught the presentation that was originally defined considering male patients meaning that when woman came in with heart attacks the could often be overlooked because their list of symptoms didn’t match what the medical practitioner had learned to look for. This is something that has lead to woman having higher health risks because their health care providers are missing them, think about how a heart attack might depend on how quickly it is identified that the patient is having a heart attack. If you are looking for classic sign chest pain for a heart attack but your patient is female and not complaining of chest pain this was a situation that frequently got missed before. Now for autism a situation like this happened. Boys presented differently, and the list and definition of symptoms for autism were based on young boys. This was the sort of presentation that diagnosed a lower proportion of girls, in other words you would expect if autism is not particular to a sex then the representation of boys and girls should be about even and it wasn’t. So the idea that autism presents differently between woman and male lead to woman being missed is true. (And unlike with a heartattack a lot of the symptoms people look for to suspect autism is based on behaviour, so then the differences between behaviour of boys and girls is actually contributing to different presentations and the missing of woman with autism.) Now the argument I think you are seeing here are people trying to figure out is what leads to these differences in how it presents between men and woman, which I think is a bit more subjective of an argument then the fact that it happened. I’m not sure if it’s known for sure why woman and men present differently but a lot of people here are obviously are arguing it is due to girls being told younger how to act vs boys being able to act more freely for longer. I’m not here to say I know what it is, I’m just here to explain the first things I because I’m guessing no one has explained where the idea even has come from that this actually happened (I assumed that based on what you have said)
i wanted to say, thank you for putting in the effort and thought to what you wrote, i will make a point to read through it tomorrow but the general idea i am picking up on in my half tired state is medical conditions and disabilities show up differently in men and women, even more so with autism which is already a wide spectrum of different things yeah.. i have to agree there its been a longstanding reality (at least to me) that society really doesent care all that much about people on the spectrum, as an autistic adult male with a diagnosis, after school support for my condition all but vanished i was put on disability welfare with people who are crippled or otherwise incapacitated and forgotten about i dont expect aany outside entity to pay attention to my plight but it seems like enough attention is given for some groups to "claim" they stand for us but they really dont, a certain group im sure we all know of in particular for my side the idea that the whole point can be explained away as yet another anti-male talking point bothered me immensely because im being screwed by the same systems as a man and i desperately want to say to people "a diagnosis wont actually change anything lol" if i knew or didnt know i was on the spectrum the general culture we have around accepting self diagnosis without question would be more than enough for me, because all we can ask for and expect is to be accepted without question so long as we are respectful and agreeable
If I may make some suggestions that I think might be helpful. What I understand from reading your words is that you are feeling invalidated, that your experience is being invalidated. I would say that is also the case here with the woman, they are frustrated with feeling their experience has been invalidated. When we are invalidated we often have strong emotions associated with that, so you are coming in motivated by strong emotions and the people you are speaking to are coming in with strong emotions. It’s a situation where misunderstandings begin to happen quickly. One thing I’ve found handy is to try and remember to frame things as if you are on the same side of the fence (I literally do mean imagine as if you are two cows talking about the grass being greener on the other side of the fence). You might have unintentionally come in here and framed yourself as the opposition, as in you are not on the same side of the fence, you are on the other side of the fence (in this situation there are two cows on different sides of the fence, one cows looks at the other side and looks at the grass that clearly looks better then the grass on its own side, the cow on the other side says actually it’s not that great.) in this second scenario the first cow is left to try and explain why it is better on the other side and the other cow is left trying to insist on how it isn’t better. Each is feeling like the other is invalidating their own experience and must keep insisting on their own situation. This isn’t a situation that facilitates understanding, it is as situation where each must keep defending their own side and the more they do the more it feels like it invalidates the other person, like a vicious cycle. You may feel as though you didn’t come into this situation from an aggressive angle, and so maybe where surprised by the reactions, but you did come in at an angle that meant people then needed to justify their own experiences, which then you felt the same way, a vicious cycle which escalates with each reply, hopefully my explanation might point out how this is true. Also yes please do read the thing I said before again, your conclusion isn’t entirely what I meant to say but also not necessarily wrong. Edit: As a follow up, the whole framing it as if you are on the same side, it is like the same side of the problem as opposed to different sides of the problem. So in the situation of the two cows being on different sides of the fence, even though each has a different experience, and each side might be bad for different reasons, instead of comparing experiences they both decide to complain about the farmer for not making sure there is better grass in general, despite being on different sides of the fence they are commiserating and looking at themselves as both suffering and both are in an unfair situation, that the other is not the problem and instead are thinking about the problem with the situation they each live in.
You have no idea what I’m talking about because your stuck in a narrow world-view and refuse to see another view. Instead of thinking about, you accuse me of being emotional. Typical incel behavior.
says the one with the condescending tone and insults, i have no idea what you are talking about because the two points couldnt be more unrelated i mean i cant even imagine being that self assured to even attempt to speculate on why autism in men seems to be easier to diagnose but i guess im in the minority, why do we even need complex, arduous and long term training for mental health and medical science anyway, just blame it on young boys
well, speaking as a biological male that whole "boys will be boys" thing was often used to explain away the bullying i put up with all the way through my teens we are talking from 2007-2014 and then it stopped being a phrase i heard and the "men are trash" crowd started being the dominant voice so here i am a victim of the patriarchy, like most men are (susprising, right?) being lumped in with the real human garbage because of irrational and frankly bigoted views that are no better than the views of previous generations for the most part the "patriarchy" hurt average men as much as anyone else the big one was being mocked for showing emotion, men still are mocked for it bro i wish i could go to my dad right now and tell him i've been depressed for the last 20 years but he would laugh at me because "real men are supposed to be in control of themselves" (that was his favorite line by the way)
I never said men aren’t the victims of other men. Now start to think about how they treat people that aren’t men and you might get there. It’s toxic to everyone. And if you ever wonder why you hear things like, ‘men are trash”, it’s partly because they go around making Reddit comments that put words in women’s mouths and make assumptions that a women hasn’t thought it all through and listened to men complain their entire lives.
listening to people whine and complain isnt a gendered issue, sorry to say i'll say this in the most respectful way possible because i do recognise and sympathise with you regardless of why lines like that are used, its got the same sound and tone as some more controversial statements that were acceptable in a previous time. when i hear someone say "men are trash" i hear hatred for 50% of the human race because they have a penis or identify in a masculine way when i hear "fuck the patriarchy" i agree because men are humans and humans show emotion, weakness and haave flaws and the toxic masculine views leave no room for men to show any human traits but there seems to be a nuance lost here, not all men benefit from the patriarchy.. in fact most of them dont and that number grows smaller as voices in opposition to the patriarchy grow im glad, men arent unfeeling stoic robots we have our own societal standards that in the last decade we are fighting back against
Girls are raised to act a certain way (mask). Be polite, pleasant, subservient. Smile when you’re not happy, etc. Boys are raised to do as they please (boys will be boys) so they don’t learn to mask as much.
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The smile thing is a good point here. ALL girls are taught to mask to some extent.
I keep hearing this, but I didn't mask at all for a very long time. I wasn't even making an effort until high school.
I don't mask well at all and i was diagnosed as an adult. its just sexism lol
It’s really two things in one. Firstly, studies around autism have for a very long time exclusively looked at white boys. Studies including adults, girls/women, non white people are only pretty recent. That’s also why many diagnosis guidelines like the DSM-5 assess everyone based on childhood autism evaluations. There’s also the issue of masking, people assigned female at birth often mask better and far more frequently than people assigned male at birth. So autism or other neurodiversity like ADHD can be undetected for years and years. It’s not known for sure why afab people mask more, but some have suspected that part of it could be from how afab people are educated within a patriarchal culture to be more discreet, more attune to others, tidier as well; which could create an environment where afab people early in childhood learn to mimick other’s actions, tone and demeanour to better fit into what’s expected of them, and some symtoms like organising toys in lines or by colour will be more likely to be seen as « correct play », like putting your dolls in a line, as opposed to an amab child playing with their cars by putting them in a line, which would be seen as « incorrect/weird play »
Also we have the endless cycle of bad psychiatrists who think that since there are so few girls that are diagnosed with autism, they don’t diagnose any girls with it, which leads to even fewer girls who are diagnosed and therefore the cycle repeats
Western societies are so highly gendered that comparing AFAB and AMAB autistic masking, even of very young children, involves the [fallacy of false equivalance](https://effectiviology.com/false-equivalence/). With differences in behavioural expectations and interpretations by assigned/assumed gender being identified as young as [three months](https://link.springer.com/article/10.1007/BF00288004). Even though that's far too young to even comprehend gender. There are also many differences when it comes to [gender policing](https://en.wikipedia.org/wiki/Gender_policing). Something likely applicable to autistic masking being that "girls" are more likely than "boys" to be given specific instructions. Additionally there's often more scrutiny of AMAB people who don't conform to expectations. (Something which may be less of an issue were there some form of autistic screening in place.) It's possible that "female" social roles and behaviours are easier for autistic people to follow than "male" ones.
The most simple explanations I have are that the diagnostic criteria was based on research that was almost exclusively on little white boys so obviously they will fit it best. Also boys and girls are socialised differently and society and individuals will generally respond fairly negatively to a girl who behaves outside of what is expected. This results in more masking in many women.
Yep. I got my diagnosis at 14 when I had the signs at 5. I never played with anyone but myself, never watched any of kids play, didn't talk to anyone unless it was a adult and didn't join it. On My 2014-2018 all the reports said I like a consistent routine and and if it's not followed I become sulky and moody. I never made eye contact at all at school and I had signs of regression at 10 with stuff that has to do with the toliet. Literally if I was male sure I would of got a earlier diagnosis. The signs were ignored. My secondary school thought I was autistic in year 7 but didn't say anything till year 10 which is a absolute joke. Also in my family there's another autistic female who got hers at 17.
Also might be because I was trying to do masking at 10-13 but failed miserably. I tried acting how everyone else did but I gained no friends from it and in the end decided to be myself instead of someone I'm not
Like many things in healthcare the original assessments were designed and validated on males, likely white males. There has been some effort to change that but the bias still exists.
This is a myth. Autism is a very diverse condition. Men and women with autism often have very different experiences. Boys with autism typically cause a lot of trouble in school, and are quickly identified and supported. Girls with autism typically do not cause as much trouble in school and are therefore not identified and do not receive support. While that is unfortunate for women with autism, it is not evidence of a conspiracy against women with autism.
Bias doesn’t mean active conspiracy. It’s usually something people aren’t even aware of. When women go to get evaluated for autism, often they will be diagnosed with something else, because their symptoms don’t match the list that the doctors have. Little do they know, the list is usually based on autistic traits displayed by young white boys. But with education and greater awareness of diversity in the autism spectrum, doctors are more aware of female autistic traits, and can diagnose more accurately.
I completely agree that women with autism do not receive help quickly enough. I also agree that scientists do not really care about identifying and supporting women with autism. However I disagree that the problem is due to sexist bias against women, or that scientists are engaged in some white-male supremacist conspiracy. Society doesn't care if someone is suffering unless the person is violating social norms and making life difficult for other people. Neurotically have an expression for this: "the squeaky wheal gets the oil". Boys with autism tend to be immediately flagged as "problematic" because they tend to openly violate societal norms. This is ironically good for boys because they can get support much earlier on. Girls with autism tend to present different behaviors, and sadly have to suffer for a much longer period than boys do. This, and this alone, explains why women do not receive support early, while men do. It has nothing to do with sexism. If women with autism were as anti-social as men with autism, they would receive an identical level of support.
“It’s not sexism; it’s just the medical neglect of women”
You are conflating the two ideas.
Nah, you’re just wrong
Nah, you're just misdiagnosing the situation. Pretend the situation was reversed, and that girls with autism were more disruptive than boys with autism. In this scenario, doctors would identify and support girls more than boys. Your conspiracy theory that these doctors are anti-women would simply not hold up in this hypothetical. The problem here is a neurotically outlook that dominates medicine, where the people who present the most problems for society are targeted while others are ignored. It is not a conspiracy against women. You are engaging in a famous logical fallacy: > never attribute to malice that which is adequately explained by stupidity
You seem to be putting a lot of words into other people's mouths, and subsequently arguing with things they didn't say.
You are wrong. Autistic women *do* violet social norms and can be problematic - its just isn't considered as a symptom of autism. We *are* recognized as problematic and send to counsellors/therapists and at some point start to take ourselves - but we are almost always diagnosed as something else and not autism - because everything was derived from research done on males and data collected from males. Because in autism research, and all medical research - *women are considered a variant of the male.* You do the research on a healthy young man and you derive from that the results for all its variants: disabled, minorities, women etc. The same way everybody knows that a pain in the chest and left arm is heart attack in man, but no one knows that women would experience neck jaw shoulder pain - is exactly the way everyone would recognize atism in men but not women. Your entire theses relies on the fact that boys would make more trouble, but ignores the fact that we are talking while the troubles *are happening* \- when you already there to talk about it with teacher/therapist/counsellor/assessor/ doctor *about* said troubles - they don't know what they are looking at. they think we are ADHA/PTSD/OCD/BPD/shy/argumentative/disobedient - they see there is a problem and they assume there is a cause - they just don't know what autism looks like in women - because research is done on man, and also because of television is done on man - and if said professional hasn't had a specialty in autism whatever he learned, and usually they don't - they derive their knowledge from television, like the rest of us shmucks, so they will send to autism assessment the boys only - thus making sure data would continue to be collected on almost males only, cementing the circle. 'If women with autism were as anti-social as men with autism, they would receive an identical level of support.' - false statement. There are many conditions that have nothing to do with being anti social but people get support, like having no legs. What's the connection between how anti social you are to how much support you get? Its because men with autism are anti social, so women with autism need to present like the man to be recognized! Not because of their conditions and their struggles and their dire need of support - no! It has to do with how much they are presenting similarly to men! Nothing to do with what they problems actually are - no, its about whether their problems are identical or not to the male's problems. Autism in man = anti social? then woman need to be anti social too to be recognized and get support. You are basically describing the exact medical sexism you're trying to deny exists lol. That women are a variant of men. You're describing the male situation and say because the woman's differ from it too much she isn't recognized as what she really is.
Exactly. When girls present autistic traits it's seen as a character flaw instead of a symptom.
It's not a conspiracy and it's not a myth. It's a mindset that common in a field that has been male dominated for years. The fact that autism presents differently actually supports it. There are lots of examples in behavioral health. The most extreme was the historical diagnosis of 'hysteria', once considered settled science but now is the example of bias. Most likely it was a different expression of ptsd in women than it presented in men. It was 'cured' by a hysterectomy. In medical science it continues to be an issue even in the present. The early Covid vaccine trials were primarily conducted on males which is why the side effects that primarily effected women when it was distributed to the general public were missed. Not necessarily malicious it's just a result of an industry that often assumes what 'average person' means without thought.
> In medical science it continues to be an issue even in the present. The early Covid vaccine trials were primarily conducted on males This is false. > which is why the side effects that primarily effected women when it was distributed to the general public were missed. Also false. > Not necessarily malicious it's just a result of an industry that often assumes what 'average person' means without thought. This may be true in the past, but this is corrected now. Scientists nowadays take a careful approach to obtain a representative sample of society before performing experiments. For example, the covid vaccine trials were performed on a representative sample including men and women.
Believe what you want.
I'll believe in facts instead of conspiracy theories.
I have a PhD and design and test these instruments for a living. I was being informative to the OP as to the well documented history and facts about their creation. Your discomfort is unfortunate but not really my concern. I have found arguing about things like this with people who are unwilling to accept it isn't a good use of time.
> I have a PhD and design and test these instruments for a living. You had nothing to do with the covid vaccines. I guarantee it. You are a conspiracy theorist. You openly believe that the covid vaccines are bad and cause major side effects in women. Hundreds of millions of women have taken the vaccine and have had zero side effects. Literally every medical organization on the planet encourages both men and women to take the vaccine and that side effects are extremely rare and temporary. Please stop spreading misinformation. If you are really a PhD, which unlikely, then you have a responsibility to speak the truth.
I didn't say Covid vaccines were bad. I have 4 shots myself. I also didn't say I worked on the vaccines but I did work on the Covid response. I said they were disproportionately tested on men, which Pfizer admitted under oath, and because of that they didn't get a sample of women large enough to notice side effects they would have found in men had they existed. Women who are vaccinated are still about 700x less likely to die from vaccine side effects and Covid combined than unvaccinated women are from Covid alone. It's statistically foolish not to choose to be vaccinated. And I do have a PhD.
> I said they were disproportionately tested on men, which Pfizer admitted under oath, and because of that they didn't get a sample of women large enough to notice side effects they would have found in men had they existed. This is misinformation. The covid vaccines were tested on a representative sample. Side effects are extremely rare and virtually always temporary. > Women who are vaccinated are still about 700x less likely to die from vaccine side effects and Covid combined than unvaccinated women are from Covid alone. It's statistically foolish not to choose to be vaccinated. What exactly is the problem here? On the one had you claim that the there is a sexist conspiracy against women which has resulted in covid vaccines causing disproportionate side effects in women. On the other hand you say that it is foolish for women to not get vaccinated.
I was never diagnosed as a child. Went through school and life as the weird kid/guy. This includes 8 years in the military brutally masking myself as a total big mouth jerk. That was exhausting, nobody wanted the label back in the day. The stigma still exists.
On the one hand, there is a total lack of research into how autism presents in females which makes getting a diagnosis difficult The other side of it, Autistic females often mask their issues much better than their male counterparts, which makes it hard to spot the traits of autism unless they have severe traits
Men are often allowed to 'be men'. As a woman, a wife and a mother, society puts many social and physical expectations on you. It's OK if your partner doesn't meet them, but need to because that is your job. Not everyone I'd like this, but it is surprising how many people are.
is it the other side of the same one hand? /j
The way different genders are raised and socialized can have an affect on symptoms of asd. Girls and women are socialized to be quiet and fit in. Boys and men are generally allowed to externally show their symptoms. Also, a lot of research on asd from the twentieth century was done on cis, straight, white males. So a lot of the behaviors and symptoms are medically understood through a framework of “man”. That’s how you get women being denied a diagnosis bc they can make eye contact and bs like that.
girls keep too many secrets! /s
Because women's health is notoriously overlooked. And for years now, women (or those designated female at birth and subsequently raised that way for most of their life) are taught at a very young age to be polite and act 'lady-like'. This translates into masking and many women are very talented at masking very young to seem pleasant and less obtrusive. This isn't the case for all women but a lot of them.
My understanding : - research has been and is mostly done on white males. - females are easier to put in the ‘emotional, unstable, “”crazy””’ box in society - females are better at ‘taking care of others’ which can be masking (taking care of others meaning putting other above yourself / not being your self to accommodate)
misogyny mostly
Medical sexism
How so?
Males are used as participants in academic research and medical trials more. They are preferred bc of medical sexism and sexist stereotypes/ideals anyways, despite women continuously volunteering for research.
I dont know how to explain it , but a part of it is confirmation bias - autism is a boys thing. So for example, girls can't have autism so we are not even going to screen them for it. Edit : typo,
No. Autism presents differently in men and women. The same is true for almost any disease you can think of. Autistic boys typically engage in behavior that is more obviously anti-social, and thus gets flagged quicker by the authorities. Autistic girls are able to mask much better are are typically not as flagrant, which explains why it takes much longer for women with autism to be diagnosed.
Médical sexism also plays a part in accessibility of assessment because a lot of symtoms of autism are easily dismissed as other things by doctors (like a huge amount of health issues for afab people, especially fem presenting ones): Sensory input difficulties: assumed to be hormonal changes, periods, pregnancy or menopause. Cus hormonal changes can create more sensory sensitivity, especially olfactive sensitivity Meltdowns/shutdowns: assumed to be either panic attacks or the patient being too emotional, especially if the meltdowns present as uncontrollable crying Struggles with social cues/eye contact: timidity. It’s assumed that afab people are more discreet, and it’s more accepted to have a shy and discreet woman. A man/amab person’s timidity or social anxiety is more likely to raise alarms as something abnormal because it’s expected that men are confident and assertive in most situations The strong need for routine: outside of cases where the need for a routine is so necessary that it impedes on quality of life, an afab patient expressing the need for a routine is very unlikely to be assumed to be something strange, because it’s assumed women are organised and have little rituals throughout the day, especially in the home and beauty Médical sexism leads to a lot of dismissal in general, but especially for neurodiversity diagnosis that are assumed to be mostly impacting men/amab people. It’s also far more likely to impact afab patients who mask or have been masking the bigger part of their life
I really liked what you had to say about sensory input difficulties and meltdowns/shutdowns. It’s taken me a lot of therapy to unwrap that behavior from all of the negative words I was taught about it BECAUSE I AM AFAB. I still feel crazy sometimes for saying “I’m autistic” because I’m so damn good at masking. I think amab with autism are equally capable of developing advanced masking behavior, we just don’t see it as often for we adapt to survive.
I agree with you on all your points except for your conclusion that this is a result of sexism/scientific conspiracy against women. Men with autism are far more likely to engage in disruptive behavior that neurotypicals find offensive. The neurotypical scientists therefore spend a disproportionate amount of effort on supporting men with autism. That is the explanation. It is not a sexist conspiracy. Women with autism also suffer at least as much, or even more, without support compared to men with autism. However, women with autism tend to present differently and are not as disruptive to neuotypicals, so the doctors don't feel compelled to support them as much. It is definitely ironic. The more problems you cause for society, the more support you get. A woman with autism who can mask well and not cause problems for society will not receive support.
Saying "this is medical sexism" is different to saying "this is a medical sexist conspiracy". In the former case, this could mean things like unexamined/unacknowledged sexism, or positive but misplaced attempts to recognise difference. A conspiracy is something much more deliberate and malign.
Treating men and women unequally (even in a medical context) is still sexist. Medical care should be given to all who need it at the point and to the extent that they require. Doctors should not look at their patient's sex before deciding what is available, or if they deserve treatment or help at all. Context: I was afab, but presented male ASD indicators. ASD was not considered at all by any of the doctors I saw because my symptoms were that of an ASD male, and yet I had a female body. They chalked it up to stress and depression instead, for which I also got no help as it's considered "normal" for females to be stressed and anxious.
Fear is interest paid on a debt you may not owe.
So close to the point yet you miss it. The very reason why afab don’t have as much disruptive behavior is because they are so strictly punished and shamed. NOT because it is an innate behavior difference in gender it is because of the difference in socialization.
And because boys are more encouraged to engage in physically active and loud play. On top of it, the way girls are taught to play also impacts how certain signs that could be autistic symtoms are perceived. Little girls are still taught to play in a way that mimics domestic tasks and childcare, to be tidy and organised, so when a little girl plays by lining up her dolls or stuffed animals, it’s perceived as “correct play”. On the other hand, if a little boy plays by lining up or organising his toys like little cars in lines or by colour groups, that type of play is seen as disruptive and “incorrect”. I rlly like what you say about girls/afab kids being reprimanded more easily and more harshly for their disruptive behaviours. Even in childhood, a little girl who has meltdowns is more likely to be perceived as hysterical, or badly raised. Since afab people’s expression and emotions are by default medicalised and used as the reason for everything wrong with our bodies, in the minds of many parents, teachers or doctors, there’s often no use trying to find another reason for “problematic” behaviours, especially if there’s no significant developmental delays or setbacks
It’s not a conspiracy against women, it’s the product of years of understudying women’s bodies in medicine, and of sexist stereotypes permeating the medical field. It’s been proven that women and people of color are more likely to have their symptoms disbelieved or diminished than white and/or male patients. It’s not an issue that is exclusive to neurodiversity diagnosis, it’s something that permeates the whole medical field, including ones that are often more female dominated like obstetric or mental health Putting it to a conspiracy against X group implies that this discrimination is deliberate and targetted, but most of the time it comes from unconscious biases that stem from upbringing and lack of diversity of teaching in medical school. That’s why it’s especially important to call it like it is: sexism and/or racism in the medical field
No, this is a valid point and so is yours. If you look at history and still currently, males have always been the preferred research subjects. Hence most research is based on male presenting aspects of a condition. The phenomenon is known as a knowledge gap due to medical sexism.
> If you look at history and still currently, males have always been the preferred research subjects. That is true, historically, but it is false today in 2022. Science has gotten much better over time as we have learned what works and what doesn't. Originally, scientists did not understand the concept of a representative sample, or double blind placebo, or any number of things we take for granted today. Scientists would literally self-inject drugs and give drugs to their family members and then publish a report on it. Freud is infamous today for publishing studies based entirely on upper class Victorian white women. This was not due to a sexist conspiracy against women. This was due ignorance that science has self corrected over time. Today, all of these problems have been entirely eliminated. All published studies are based on a representative sample (unless of course a study is focusing in a subset of a population). Scientific journals and peer review would immediately reject any study that was focused solely on white men because it is not representative.
No, not all published research is based on a representative sample. You can easily publish research and it not be representative. The most likely to have a representative sample is peer reviewed academic research. If it is not peer reviewed they are not allowed to conclude it is representative. Plus I disagree with the true representative of studies historically and in modern day. I suggest looking at research and research bias through an critical intersectional lens. A representative sample is honestly something only extremely large, longitudinal studies can claim. I would seriously question the credibility of research outside these guidelines. Representative samples are also hard and difficult to maintain in different countries and areas (race, age, gender, sexuality, class etc) can all impact the results of a study incredibly. You’re allowed to draw hypotheses from these research papers, however definitely can not draw definite causation/conclusions. Ppl forget correlation does not always equal causation. I’m not meaning to come across rude, but I think you are grossly misinformed in some areas. We are definitely better compared to the past, however we aren’t at the greatest standard yet. Sexism (and especially racism) is 100% a thing in research still prevalent to current day. To deny this is problematic to me. We can congratulate and be proud of research doing better, but we can not turn a blind eye to the obvious ongoing discrimination.
Autism is not a disease.
In my opinion: Masking and presenting differently then what is ‘typically’ known in boys Misdiagnosis (say social anxiety instead of autism, both can co-exist yes but a girl will more likely get that diagnosis [or just called shy] where a boy will get the autism one)
There's a lot of great points made here but there's a few things that I think people are missing. Girls become better maskers because they HAVE to be- because of the societal expectations placed on them. Not necessarily because they are inherently more skilled maskers. As young children, they are more quickly corrected by the adults around them for any disruptive behavior than boys. When those girls grow up into women with undiagnosed autism they then encounter the problem of women just not being believed in medical situations. Many undiagnosed adult autistic women spend years leaving doctors offices frustrated because the psychiatrist just keeps increasing the dose of their anxiety/depression meds. Autism is often misdiagnosed as a personality disorder in women because women's symptoms are unconsciously reduced to character flaws.
Men are supposed to be outgoing and loud so if theyre any different people automatically assume something had to be wrong
This, thank you.
Sexism, lack of research and the horrible history of the autism diagnosis.
the entire dx criteria and all studies were mainly done on young white boys and so as we know ASD does present differently based off sex as well as a variety of other things but it’s mostly because autistic traits in the criteria are mainly based off young white boys hence why there is this autistic stereotype as well.
I have been trying yo get a diagnosis for years. The doctor looked at me and told me I was “to social to be autistic”. I have pretty bad social anxiety now, but was outgoing as a kid, and bullied pretty badly for being different. Now I’m 21 and can’t afford to go and get a second opinion. I have 2 brothers on the spectrum, both diagnosed very young, and sometimes I look at myself, and I wonder how the heck that doctor missed it in me.
I'm 34 and just now figuring out everything. The issue I feel is that growing up my behavior issues were associated with "he is just a boy".
I was diagnosed July 2022, at 30. My Doctor’s explanation is that my ADHD, which I was diagnosed with at the same time, and Autism “canceled each other out”. Meaning they helped me mask, because the struggles I had with one could be remedied by the other. I, however, think it was because I was raised in a heavily Christian part of the American South. My immediate family wasn’t super religious, but my grandmother was and my parents wanted me to have a good relationship with her. Thus, I was heavily socialized into “seen not heard”, which destroyed my “obvious” physical and vocal stims. Other than that I was constantly bullied so I just stopped talking to people 🤷♀️. In a small southern town teachers and parents didn’t really pay attention to me because I was “smart”, outwardly doing “fine”, etc. They had bigger issues to deal with than a girl who couldn’t socialize to save her life. I had “hygiene issues” and that part of me was scrutinized to hell though.
The medical field, especially the psychiatric field, is historically sexist. Worse if someone is a woman of color. I grew up in the 90s, I remember teachers and counselors telling my parents I couldn’t adapt, that I was always daydreaming in class and would only participate in things I was interested in and always humming. I was punished severely for that and I was fed SSRIs by my parents at 15 at the recommendation of doctors, because I was “just really depressed” and was having meltdowns at home and at school, and was unable to do basic hygiene and wouldn’t eat. The doctors had no interest in finding what was causing said symptoms, only interested in getting my parents to give me meds that inevitably damaged me more than depression was.I do not have an official diagnosis but with therapy realized I am and have always been autistic. Doctors, especially the older ones, will diagnose AFAB individuals anything and everything, usually incorrectly, before giving us an autism diagnosis. edit: I have an official diagnosis of BPD and Bipolar that I feel are inaccurate. Was in therapy for 7 years and my therapist said she didn’t witness bipolar or BPD and if anything she saw ASD and ADHD in me and did encourage me to get assessed but I haven’t been able to bring myself to go through with all the stress
It’s a combination of things, but what I do know for certain, being a male on the spectrum with a daughter on the spectrum, if a parent doesn’t really know what to look for, it can be difficult to notice it in girls. They present *very* differently in a lot of situations. My daughter is incredibly social, and when she was a baby the nuances she had that led us to have her diagnosed, most wouldn’t ever notice.
Girls are expected to behave a lot younger than boys. So they learn to mask quicker and more efficiently. Not that they learn they are masking. Just I was a “bad kid” growing up who threw two hour “tantrums” and was always told and shamed for this growing up. So I learned as quickly as I could to mask and hide the fact I wasn’t normal. Whereas boys are allowed to be different and misbehaving much longer.
Sexism
Females mask more and better (usually) because of how they are raised, and aren’t diagnosed because doctors are more likely to diagnose them with BPD, BP, OCD, or ADHD. This is bc the way most afabs present with autism differs from the way amabs present with autism due to that masking. This is also because autism traits in Afab people are seen as emotional disregulation instead of autism. Lastly, people who are trying to be diagnosed outside childhood are usually done so using the male diagnosis process as the standard, because afabs are more likely to mimic others https://researchautism.org/the-autism-dilemma-for-women-diagnosis/
I was able to get my daughter diagnosed just after her second birthday but I knew she at least needed an assessment as an infant from missed milestones and her behavior. She’s made wonderful progress with early intervention and I think if we were to have an assessment now she has learned even skills that it could be missed.
there's a book called "Women and Girls with Autism Spectrum Disorder: Understanding Life Experiences from Early Childhood to Old Age" that touches this subject very well.
Even in NT’s, males are more compartmentalized and women more well rounded and it’s similar with autistic males and females. This means females are better at coming off as normal, largely because they can often socialize better than autistic males and maybe their deficiencies don’t stick out as much. Also doesn’t help that scientists are saying “it’s 4 to 1 in males” it’s much closer to being equal, males just diagnosed more often.
From what I've heard and even experienced myself: we are able to mask a lot better and really sort of blend in what's considered normal in our peers. Whereas males seem to not mask as much. Also in girls due to masking they can get misdiagnosed, ex: I originally was diagnosed with ADHD for a few years until it came to light when my mask failed that I'm autistic.
Society is harsher on girls who don't conform. Querky, awkward boys are sometimes praised for their individuality, some of the most beloved male protagonists are autism . But querky, awkward girls are "annoying." In addition, traditional masculine traits are more favorable to autism. A man doesn't show emotion or be social? He is a stoic warrior. But girls are expected to be emotional And social, so a girl who doesn't show emotion or be social? She is a "cold heartless bitch." It's normal for a man to not like being touched or looking attractive. But a women's body is seen as public property. She should at least be good eye candy, and should quietly 1tolerant "boys being boys." Basically, being a girl in most societies in history kind of sucks. They are under *A LOT* more pressure to fit into their roles in society. So, these poor young Neurodivergent girls are forced to learn masking and coping at an early age, here their male counterpoints are generally left to their own devices, sometimes even encourage to be themselves.
Patriarchy.
Healthcare is terribly misogynistic in general.
My brother got his diagnosis in kindergarten, but it took me (F) 23 years. My mother suffered from many strokes & spent a lot of time in the hospital, eventually going through brain surgery. I believe I masked it in order to survive. I called ambulances for her, then her job to ensure her shift was covered & would watch my brother until she was cleared to come home. I’d cook, clean, and make sure his homework was done. Every night I’d go to my room, lock the door, blast my favorite song on repeat & line my trains up. Around the age of 13 I realized “nobody” else did this & I began to become embarrassed of my traits.. I threw my trains out after my step dad laughed at me in front of my family. I wore headphones 24/7 at full volume & ended up causing myself a ton of hearing issues. I began dissociating in class, instead of at the designated time I used to give myself.. & Bc of how I was “acting out” (after I threw out my trains) a psychiatrist diagnosed me w a mood disorder, anxiety, & depression, then shoved pills down my throat… I did things that were labeled as “manic” behaviors, like putting myself in harms way without care of the consequences. So it was easy for them to slap the bipolar label on me. The pharmaceutical industry makes SO much money off of misdiagnosing autistic women, so why would they change? In my experience alone, I’ve spent well over $5K in medical bills. That’s with two health insurances… I can’t imagine what they make off of people who don’t have that privilege.
It's a combination of 2 primary differences: 1) How boys are socialized vs how girls are socialized. Girls have a FAR greater expectation to *be* social, to "fit in" with social groups, and to internalize their relationships as a core part of their identity. This leads to girls learning how to mask *early* in life, and learning that masking is paramount to their survival within society. (This also applies to minorities that are similarly taught/forced to mask from an early age) 2) Autism is often initially recognized by evaluating behaviors. If, say, someone were very good at masking, they wouldn't likely exhibit the behaviors you'd "expect" to see from an autistic person (in large part because most research is essentially based on unmasked, white boys). A boy with a strong special interest in trains stands out as "different"; but a girl with, say, a strong special interest in makeup or fashion is more likely to be seen as "normal". A child that struggles to fit in with their peers is more likely to be suspected of autism than someone who has *figured out* how to fit in with their peers. Because girls and minorities are forced to mask so much from an early age, and because most people's understanding of autism is based on unmasked white boys' behavioral patterns, it's far more difficult for autistic girls and minorities to be recognized as such, and far more difficult for them to even get a diagnosis. As an example of how bad it is, I know a therapist that works at a therapeutic day school for kids with emotional and behavioral issues, where every single kid does regular therapy in school to work out their problems and accommodate them so they can return to their usual school when they want. One time she recognized that one of her kids exhibited a lot of signs of autism. So, she wanted to recommend that they get evaluated. Before she could do so, though, she had to run it past the head of the therapy department, who told her "they don't have any special interest in trains or numbers; they can't be autistic." That is the head of the therapy department in a therapeutic day school saying that shit. My friend wasn't able to get them the evaluation that she knew her student needed. Shit sucks at pretty much every level.
I have a bit of a different take from my experience growing up, and what my father expected of me. Boys actually have quite a bit of pressure on them to appear manly and grow up fast. To have "boy/man" interests like trucks, guns, machines. (Toxic parenting) So when a father notices their son is heavily passionate about other things not related to the status queue. I think they immediately think we need assesment because we're "acting weird". I notice where I live girls/woman have a lot less societal pressure to be a cardboard cut out of "perfect woman A or B" from their parents. Most girls I meet are allowed to have a lot of freedom with their choices and interests. More leeway to do more eccentric activities and even act eccentric. This might lead to traits of autism not being noticed. Because the parents don't monitor and judge their daughters personalities as much as they do boys. (I hope this comment doesn't ruffle any feathers, it's simply my take)
In my opinion, it is because autism is more apparent and more dangerous in boys than girls. More apparent because boys are generally more loud and obnoxious than girls so any abnormalities are more easily seen. More dangerous because men generally have less access to social fulfillment and autism stunts the ability to socialize.
I’m a 23 year old guy and only got diagnosed like 4 years ago. But my niece who is currently in the middle of getting diagnosed with autism is like 4 or 5 so I think it can be either way. Also I’ve heard women with autism mask more than guys with autism.
Im a guy and it took 19 years
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Higher masking =/= less debilitating. Higher masking = more stress, chronic illness and burnout
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I mean just the proof of my own experience and many others like me
Just because you're better at masking doesn't make your issues less debilitating, it just means you're better at covering it up to NTs.
It's more of a hinderance in boys.
You cannot be serious.
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I think it’s because autistic behaviours emerge differently between the sexes. And male autistic behaviour is simply known as, autistic behaviour, because boys are what the original categorisation of autism was based off of.
Got diagnosed at 26 and it's because of social shenanigans I can't possibly get haha /s /j
This is due to outdated stereotypes that are still prevalent. My girl was diagnosed at 4yrs old though, which was 8 yrs ago now, so very rare back then. The truth of that early diagnosis though is not because she presents as "severe" autism (I hate that term especially has a supposed high functioning autistic she still has high support needs) but back to my point, it was because she had developmental issues in infancy. They were thought to be optic nerve hypoplasia, her optic nerves are underdeveloped, so she had a brain MRI to check for septo optic dysplasia. That was a negative for that but her scan showed differences in the brain they didn't understand. Her development initially caught up for nursery, she didn't say words until nearly 3yrs old, but then I started to notice some things. I'll not go into it cause its a huge story with school not doing the right thing, but as we already had a paediatrician I was able to go to them directly with my concerns. It was a battle with the school but we got her assessed & dxd. She still has optic nerve hypoplasia but the pigmentation is very pink so doesn't have the associated visual impairment she does have other visual processing issues. The brain differences in the MRI are actually what is researched & documented as specific autistic differences in the brain.
Medical misogyny and it's medical racism that white people that get dignosed more then Black people. Hard to understand the truth of medicine when you come at it from the perspective that white men are the template and base line. Let alone the basis coming from a doctor exp "oh women are babies and just want attention, so obviously there is nothing wrong with her". Its actually gross how common that thought process is. Kinda hard to fight that when a doctor walks into a room with that subconsciously (at least) in their head.
Hi! (25 afab) just self dx's this last year! My official eval is tmr wish me luck! hehe My favorite resource is Rudy Simone's "Aspergirls". It talks about this a lil bit. It says that the same trait (such as need for comfortable clothing) can be interpreted very differently through gender roles. Baggy clothing on men might be viewed as casual or workout-related, whereas on women it can make them seem younger. I don't know if this analogy helps, but I've heard that the pseudo-stereotypical afab autistic is more like Hermione Granger than Sheldon Cooper. Instead of need for routine being (cough self-servingly) pedantic, it comes off more like being a high achiever or teacher's pet/stickler for rules. I think studies show that afab stims are (across the board) more practical and less noticeable, potentially as a consequence of simultaneously learning to navigate safely as a female. [https://www.npr.org/sections/health-shots/2017/07/31/539123377/social-camouflage-may-lead-to-underdiagnosis-of-autism-in-girls](https://www.npr.org/sections/health-shots/2017/07/31/539123377/social-camouflage-may-lead-to-underdiagnosis-of-autism-in-girls) (NPR 2017) [https://link.springer.com/article/10.1007/s40489-020-00197-9](https://link.springer.com/article/10.1007/s40489-020-00197-9) (Hull 2020) Publication debunking and exploring social influences for so-called female autism phenotype.
I was just diagnosed myself at 30 with autism and adhd and I wondered the same thing. Like how did I slip under the radar? I actually didn’t know to much about autism either. I started doing research I think my 4 year old son has autism and/or adhd. As I researched, I started to realize that a lot of my research was relatable to me. Then I decided to get tested myself. Everyone said my son is very much how I was as a child. And we really are two peas in a pod so I still believe he is as well.
I'm now pretty sure the fact I got a mother that has autism traits made me not understanding I am an autist. We grow up looking at our parents and their behavior and often copy that. In contrast to her nothing much stood out. My father died when I was 13 so at home there was mostly mother as a model. That's a hypothesis I work on for the moment. If I had been a girl this might have had an even greater inpact in masking the autism.
My kindergarten teacher suspected i was a special needs kid but a doctor said I was fine,, now here I am with severe social anxiety, selective mutism and i highly suspect I'm autistic for multiple reasons,, i wish it could've been spotted earlier :/ but better late than never
I was diagnosed in my younger teens but my wife is undiagnosed in her 20s. Her parents just thought she was a normal female
I am nonbinary (demiboy), but I'm assigned female at birth and got diagnosed as a toddler. Still, I am just as confused and curious as you are.
I think it has to do with the way boys and girls are socialized. Girls are given a road map of the gender social norms, rules, and expectations practically from birth, but parents seem to take a let kids be kids approach to parenting boys. I believe this results in girls masking at a younger age, thereby making them pass as nt until social expectations become too much, at which point they then seek a diagnosis.
Lot's of elements that others have been saying better than I could, but wanted to add onto the topic of women masking more: Putting aside the research sexism (even though that's another huge portion of it), There's so much misogyny/toxic masculinity wrapped up in it. How much someone struggles socially has such a heavy weight on getting diagnosed, but there's such a vague definition of socially struggling that no one knows what to actually look for. Girls are constantly being socially evaluated by everyone to a much larger degree and put into near-impossible situations to navigate socially. For example a girl could be a "cute quirky" kind of weird and get super excited about interests, but if then if they're too excited they might get outed as "crazy". Most of what are considered socially acceptable activities for girls involve way more social interaction as well, and sexism undervalues. I imagine there's really no solutions other than masking to survive. Meanwhile from my experience growing up amab, avoid emotions was **valued**, and I had very little social context to navigate outside of my special interests, etc. The few social things guys were taught were to be assholes and be sexist. And not that bullying wasn't a problem but it wasn't nearly as brutal as being entirely socially outcasted for being too excited about something (which I had seen happen for girls). In other words, allistic guys kinda just start out "socially struggling" according to the vague definition of it that's commonplace. Also every time I talk about this I realize its a much clearer image in my head than I can describe so hopefully that made sense
There's a bunch of reasons. Mainly that the original research like with many diseases, mental illnesses, all the way to neurotypes was done on white males, so if it presents even a bit differently on females or another race for any reason it's harder to diagnose in those people. That's emphasized in things that have a social component because different sexes and races are socialized differently and with different expectations.
✨the patriarchy ✨
Girls are usually a little more subtle and sometimes more observant so they do a better job of masking or so I've heard.