Autism Is Likely Under-Diagnosed in Women Due to Gender Bias

Autism has long been a disorder more commonly seen in men. But new research suggests that perhaps doctors are simply missing the signs of autism in women

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Autism has long been a disorder more commonly seen in men. You’ll often see a ratio thrown around: there are four times as many men with autism than women. And researchers have been looking for an explanation—like a difference in genetic make-up—for this disparity. But new research suggests that perhaps the explanation is simpler than that. Maybe doctors are simply missing the signs of autism in women.

This new research suggests that the widespread assumption that autism is a male-dominated disorder might skew researchers away from seeing it in women, who might have different symptoms.

The researchers write, in their paper:

Since autism was first recognized, males with autism have disproportionately skewed research. Females with autism have thus been relatively overlooked, and have generally been assumed to have the same underlying neurobiology as males with autism.

To see whether there might be differences in the ways men and women experience and express autism, scientists looked at MRIs of 120 subjects. Their data suggest that there might indeed be differences in the brains of men and women with autism. The sample size is small, and it’s likely too early to really know whether the particular differences these researchers found can be chalked up to sex. But the idea that the gender ratio of autism might be in part due to misdiagnosis interested outside researchers.

“I would be surprised if this study did not become extremely influential in the field, as it raises a series of important new questions about the nature of gender differences in Autistic Spectrum Disorder,” Sebastain Gaigg told The Conversation.

The idea that women might be under-diagnosed isn’t new, though. In 2008, ABC ran a special report on women with autism and talked about the under-diagnosis problem. “Almost all the research is on boys,” Brenda Myles told ABC. “Well, first of all there are more boys than girls with autism spectrum disorders, but second of all, girls are underdiagnosed.”

Girls are under-diagnosed with autism for a whole host of reasons. Anna North, at BuzzFeed, runs down a few of them:

Jennifer McIlwee Myers, who has Asperger’s and is the author of “How to Teach Life Skills to Kids with Autism or Asperger’s,” concurs. She says boys on the spectrum are more likely to respond to their difficulties with anger and aggression, while girls are more likely to “deal with issues quietly,” cultivating extreme “niceness” and imitating other girls’ behavior. Boys who have the vision problems that sometimes go with autism spectrum disorders may hit other boys, she explains, while girls might instead cling to other girls. And a boy who attacks other kids is going to get intervention a lot faster than a girl who cries quietly every day. Myers says there are “a lot of invisible girls” who are autistic but never get help, because nobody notices.

These tendencies to want to please can hurt women later in life, North argues, especially if they mask an autism diagnosis. But whether it’s because of their brain structure or the different coping mechanisms that culture teaches different genders, women with autism are being overlooked.

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