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By Spătaru Miruna
Introduction
Autism is a neurodevelopmental disorder that impacts around 1 in 36 children (Maenner MJ, Warren Z, Williams AR, et al., 2020) as well as adults. In order for autistic people to receive proper help and the tools necessary to navigate a world that is not catered to their needs, they have to be medically diagnosed by a specialist.
Unfortunately, the process of diagnosing autistic people has its own gender-based biases that disadvantage girls and women. Studies show that girls are diagnosed much later in life than boys and in a smaller number.
Defining autism
According to the American Psychological Association, autism is defined as a disorder that impacts neurological development, which affects social interactions and communication of all means. Moreover, autistic children or adults may have narrow, but very intense interests, repetitive behaviours, that help autostimulation, an impaired ability in what regards communication or lack of it and a preference for routine. Such manifestations can be observed in children as young as three years old (American Psychological Association).
Gender differences in autism symptoms
Autism is a spectrum, meaning that its manifestations and symptoms are very diverse. Moreover, it has been shown that gender plays a role in how an autistic person behaves. For
example, hormones, such as testosterone, have an influence on autism.
Girls are also better at masking it than boys, as they internalise distress (such as panic attacks, eating disorders, mood swings), leading to less external manifestations than those of boys , which are easier to notice. Such symptoms of autism seen in women are less likely to be noticed by clinicians, both because they are more subtle, but also due to the male-dominated knowledge regarding autism (Haney, J. L., 2015, 396–407).
Problems with the testing system
Neurologists and psychiatrists use a series of standardised tests that determine whether a person has autism or not and to what extent is autism affecting their emotional, linguistic , cognitive or social abilities. Unfortunately, it has been proven by various studies that the tests are mainly made to fit symptoms shown mostly in boys. Also, most studies regarding autism have been conducted on male subjects , meaning that the current understanding of autism is made through a male-centred perspective (Young, H., Oreve, M.-J., & Speranza, M., 2018). Thus, the medical instruments are rarely or not at all gender-inclusive, and many girls are not diagnosed with autism because they do not fit the ”boy” symptoms. This practice fails to consider the variety of autism manifestations and leads to misdiagnosis or neglection of female autistic patients .
Parents make a difference as well, because the diagnosis process takes into account the child’s behaviour , through the parent's subjective perspective . We have to note here that our current culture views more aggressive behaviours in boys as normal, but in girls these manifestations are deemed as negative. Also, they expect girls to excel in communication and social play more than they expect boys to (Young, H., Oreve, M.-J., & Speranza, M., 2018). A study has been conducted by Gillberg, C., who shows that female patients are more likely to be misdiagnosed and not to receive proper treatment than male patients (Gillberg, C., 2008).
Why is it a feminist issue?
I believe that the misdiagnosing of autistic female patients resides from the male-centred research and testing system. It is a clear sign of medical discrimination based on gender, that negatively affects girls and women. Autism is a disorder that can impact one's daily life, social skills, professional career and overall satisfaction of life. Not receiving proper care and help due to the lack of research on a big percentage of the population is absolutely unacceptable, as it puts people's lives at risk and shows that there was and still is little to no interest in women’s health .
Sources
American Psychology Association, 2023, APA Dictionary of Psychology.
GILLBERG, C. (2008). Autism and related behaviours. Journal of Intellectual Disability
Research, 37(4),
Haney, J. L. (2015). Autism, females, and the DSM-5: Gender bias in autism diagnosis. Social
Work in Mental Health, 14(4), 396–407.
Maenner MJ, Warren Z, Williams AR, et al., Prevalence and Characteristics of Autism Spectrum
Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring
Network, 11 Sites, United States, 2020. MMWR Surveill Summ 2023;72(No. SS-2):1–14.
Young, H., Oreve, M.-J., & Speranza, M. (2018). Clinical characteristics and problems
diagnosing autism spectrum disorder in girls. Archives de Pédiatrie
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