The differences in the presentation of autism based on gender

According to the Australian Bureau of Statistics, far more males than females are diagnosed as autistic in Australia, recording that 3.5 Australian males are diagnosed on the spectrum to every one female. When you look at the history of autism, males have been recognised as having autism at higher rates than females. Female prevalence rates are increasing, however the National Guideline for the Assessment and Diagnosis of Autism Spectrum Disorders suggests that the reported gender ratio prevalence rates may not reflect the true gender ratio of autism. The guidelines report that boys are more likely to be identified as being on the spectrum than girls, even when their symptoms are at the same level.

Gender differences

There are no separate diagnostic criteria for different genders. It is important to remember that gender differences are as vast as autism differences. While some of the characteristics may present in one person of one gender, they may not in others.

Boys on the spectrum

It is important to remember that gender presentation differences are as vast as autism differences. While some of the characteristics below are commonly observed in males, they too are often observed in females.

They can include difficulty with:

• Social or emotional communication. For example, they’re less likely to smile or show you things.
• Reading and using non-verbal communication, such as nodding and shaking the head, or using hand gestures.
• Developing and maintaining relationships appropriate to their age.
• Developing close friendships.
• Using eye contact when speaking or being spoken to.
• Changes occurring in routines.
• Stereotyped or repetitive speech, movements or use of objects, such as flapping hands or toe walking.
• Strongly reacting to sensory input such as sound, pain or textures.
• Restricted or fixated interests, such as only playing with certain toys or discussing certain topics.

Girls on the spectrum

It is important to remember that gender presentation differences are as vast as autism differences. While some of the characteristics below are commonly observed in females, they too are often observed in males.

They can include:

• Lack of desire for social interaction.
• A lack of desire to interact with others.
• Being perceived as a ‘loner’ or ‘shy.’
• A tendency to imitate others (copy, mimic or mask) in social interactions, which may be exhausting.
• A tendency to ‘camouflage’ difficulties by masking or developing compensatory strategies.
  Having just one, or a few, close friendships.
• Behaving in an intense or possessive way within friendships.
• A tendency to be ‘mothered’ within their primary school peer group; or perhaps being bullied in secondary school.
• Advanced language skills for their age.
• A good range and frequency of non-verbal communication.
• Demonstrating a good imagination and can easily escape into fiction and pretend or fantasy play, but play is prone to being one-sided, scripted and overly controlled.

According to the National Diagnostic Guidelines, girls on the spectrum are likely to display:

“Less frequent and severe repetitive behaviours and stereotypes and use greater range and frequency of non-verbal (gestural) communication (than males)…particularly amongst individuals without Intellectual disability.”

Restricted interests may be less focused on objects or things and more focused on movement, people or animals. For example, girls are more likely to be interested in soap operas, celebrities, pop music, fashion, horses, pets, and literature. And repetitive behaviours might include constant hair ‘twirling’.

It is important to remember that many males will also demonstrate these characteristics.

Women on the spectrum

Camouflaging and Masking

Camouflaging and masking is gaining more recognition among the autism and autistic community.

Camouflaging or masking can be defined as the difference between how people seem in social contexts and what’s happening to them on the inside. It can include the presentation of behaviours such as:

• Mimicking the behaviour of others in order to blend in.
• Force themselves to make eye contact with people during conversations.
• Imitate gestures or expressions they see others using.
• Have a steady stream of pre-prepared responses, jokes or phrases to use when conversing with others.

Simon Baron-Cohen and his colleagues found that autistic women camouflage to a greater extent than autistic males.

For more information about seeking a diagnosis visit our pages Getting a diagnosis for children (under 18) or Getting a diagnosis for adults (over 18).