top of page

Don’t Forget the Girls: How Biases Towards Male Development Have Impacted Female Autism Diagnoses.

It’s no secret that women are underrepresented in medical studies and clinical trials. This underrepresentation then leads to misunderstanding how certain illnesses or treatments affect certain populations. What, then, does that mean for male and female autism diagnoses?

As autism awareness and understanding is growing among the scientific community, so are the deficits in diagnostic standards. While the Autism spectrum disorder (ASD) was once thought to occur in males at a 4:1 ratio, recent analysis shows that the actual ratio may be closer to 3:1. “Taken together, the etiological literature suggests that it is unlikely that ASD is equally common among males and females. However, there is growing evidence that current diagnostic procedures may fail to capture the female manifestation of ASD and thus exaggerate the sex imbalance in prevalence rates” (Halladay et al. 2015; Kirkovski et al. 2013; Loomes et al. 2017). Females have been found to be diagnosed with ASD at significantly later ages and to experience greater delays in between receiving an initial evaluation and a clinical ASD diagnosis” (Begeer et al. 2013; Shattuck et al. 2009; Siklos and Kerns 2007).

Previously, females diagnosed with ASD were often more significantly impaired and of lower IQ than their male counterparts. This led medical professionals to believe that while females were less likely to be affected by ASD, those who were would typically display more severe symptoms and impairments. Now, however, researchers have begun to understand gender differences in ASD differently. For example, it is now understood that females often “mask” their autistic traits by mimicking neurotypical social behaviors, have a wider vocabulary (and therefore less noticeable speech delays), and may better respond to non-verbal cues and eye contact. They are also less likely to engage in repetitive behaviors.

Current male-biased diagnostic criteria may leave females affected by ASD without a diagnosis or with a misdiagnosis, barring them from resources to which they would have access were this gender bias to be corrected. It is incumbent upon the medical community to continue to include girls and women in clinical studies, in order to avoid misunderstandings like those that have plagued females living with ASD.

-- Elena Kalvar

Source: Journal of Autism and Developmental Disorders

bottom of page