How Is Autism Different In Girls?

May 13, 2023

According to the Centers for Disease Control and Prevention, significantly more boys have been diagnosed with autism than girls. In fact, it appears about four boys have a diagnosis for every girl. In the past, researchers theorized autism was more prevalent in boys because of genetic differences. But recent research has indicated there may not be a significant gender gap in autism at all, but rather it appears this way as girls tend to present their neurodivergent behaviors differently, and so they tend not to be noticed. There's even a term for them: 'lost girls,' named for the way they're overlooked. Girls are often raised with different social expectations than boys, which could be a contributing factor in the different symptom presentations.

Learn more about precisely how and why autism appears differently in girls now.

Diagnostic Data Derived Around Boys

Autism is a difference in neurological development that causes sensory processing issues, repetitive behaviors, and trouble learning social skills and verbal communication, the extent to which varies based on the individual, hence why it is typically considered a spectrum condition. But according to clinical neuropsychologist Susan Epstein, the classic model of symptom presentation is based entirely on boys. In fact, most of the research regarding autism has been based on male patients. In fact, researchers now believe these models of autistic behavior may have actually hindered progress in understanding autism and how the brains of individuals with autism function. Boys tend to be loud and have obvious hyperfixations, while the presentation in girls may be more subtle. The main takeaway is this: Autism can present in hundreds of unique ways, and limiting diagnosis to one very narrow set of characteristics is detrimental.

Keep reading to learn about how overlapping diagnoses may come into play in girls with autism next.

Overlapping Diagnoses

With girls, autism often comes with overlapping diagnoses or misdiagnoses. The behavioral symptoms may be attributed to a different mental health condition like poor self-esteem, anxiety, and depression. One of the biggest mistakes a parent or doctor can make is assuming social unhappiness is an intrinsic part of girlhood. Many doctors see girls who experience anxiety and distress in social situations, but they can often believe being unhappy around peers is just part of the 'growing-up-girl package.' It's not. While social dysfunction can be the result of depression or low self-esteem, doctors need to dig deeper instead of putting the patient into a stereotypical box. Many girls are also misdiagnosed with attention deficit hyperactivity disorder, or they have ADHD along with autism and it masks the autistic traits. It's especially common for ADHD to be diagnosed in girls whose symptom presentation includes hyperactivity with a more subtle social impairment.

Uncover the information about the quieter symptom presentation in girls with autism next.

Quieter Symptom Presentation

Girls with autism often have a quieter symptom presentation than boys with the condition. Of course, symptom presentation differs from individual to individual, and there are girls who meet the stereotypical 'loud' diagnostic criteria for autism. But a good portion of girls make active attempts to hide their symptoms, or they're brushed off by health professionals who see the symptoms as normal behavior. For example, a girl might become hyper-fixated on horses, unicorns, or fairies, but since interest in these things is often expected for girls, it's overlooked. Girls might struggle in social situations, but rather than make their distress clear, they become more passive and withdrawn. It's likely some of this can be blamed on society. Girls are often encouraged to be quieter, to tolerate situations that cause discomfort, and to hide their distress instead of expressing it.

Understand how stereotypes may play a role in how autism is different in girls now.

Stereotypes Can Interfere

Stereotypes have hampered research into autism and the way it presents as a neurodivergence. The most common stereotype of a child with autism is a nonverbal or barely-verbal boy who doesn't play with friends, has sensory meltdowns, and obsesses over trains of bugs. And it's true some children with autism do look like this. But what researchers are now finding is that this image represents only a tiny sliver of the actual population dealing with autism. By focusing on rigid stereotypes, the medical field has failed to explore the other ways autism symptoms can present. This issue doesn't just affect girls; it also affects boys whose symptoms aren't stereotypical. For autism to be better understood and more accurately diagnosed, medical professionals need to do away with stereotypes and learn about alternative symptom presentations.

Continue for more information about how autism is different in girls than it is in boys now.

Exhibit Less Repetitive Behavior

One of the hallmarks of autism is the use of repetitive behaviors and 'stimming.' These repetitive behaviors are often a form of self-soothing. The most commonly recognized ones are things like rocking, humming, or clapping. Many doctors won't consider an autism diagnosis for an individual who doesn't seem to present with classic repetition behaviors. But a 2005 study conducted by Stanford University indicated girls with autism typically engage in less restricted and repetitive behaviors than boys. There was also a difference in the children's brain structures. With that said, girls with autism may still 'stim,' but it might not be in ways people recognize. They may click pens repeatedly, sharpen pencils down to nothing, or shake their legs.

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