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What You Need To Know About Autism In Girls and Women, by Christy Wilkens

In December 2020, at the age of 43, I learned I was autistic.

Really, I learned nothing new. I was simply given a new lens to understand the things I had always known to be true about myself. But without that lens, I had struggled to understand those truths, and even fought against and loathed them.

I am easily overwhelmed by sensory input. It’s hard for me to engage in conversations with multiple participants. I forget names and faces. I consciously mimic the body language, tone, and facial expressions of people around me. I immerse myself so deeply in my “special interests” that I lose track of the real world. And when I run out of capacity, my brain and body just shut down.

These traits made homeschooling six children an unusualy large challenge. Eventually, it wasn’t feasible anymore, and I spent no small amount of time feeling like a failure and beating myself up. But these same traits are very common to many autistic people. In fact, they are some of the hallmarks that led me to wonder about a diagnosis in the first place.

Along my path of autism education and diagnosis, I learned that -- as an autistic female with low support needs who is also intellectually gifted -- my “flavor” of autism is the most likely to be missed. On average, autistic females are diagnosed later than males, and we are often misdiagnosed with other conditions first. Here’s why.

Existing diagnostic criteria for Autism Spectrum Disorders are based on research using boys and men.

The seminal studies used to define autism and establish diagnostic criteria have relied on data from study participants who were overwhelmingly male. It should be no surprise, then, that boys are diagnosed at much higher rates than girls.

Recent research using brain-activity measures has shown that the brains of autistic girls are markedly different from neurotypical girls, but different also from autistic boys. New and better studies are needed to investigate what’s known as the “female autism phenotype”, and should lead to more accurate diagnoses for females of all ages.

Girls and women are more socially adept at camouflaging and masking their autistic traits.

Girls who are diagnosed at young ages tend to be the ones who have the most profound (and most “male”) autistic traits: extreme repetitive behavior, restricted interests, and lack of social reciprocity. Many autistic girls, though, hide in plain sight because they study and adopt the behaviors of the people around them, practices known as camouflaging and masking. These practices come at a steep mental cost, though, and eventually the strategies may fall apart, especially during the socially delicate middle grades or at major life transitions.

Girls and women often have “special interests” that are more socially acceptable.

Autistic boys might memorize train schedules or line up cars by the dozens. Autistic girls, though, might be obsessed with more typical interests like fashion, horses, or art. The difference lies in degree. They are interested in these things with a ferocity, passion, and depth that is atypical.

Where autism co-occurs with other diagnoses, their effects compound and obscure each other.

Autism and giftedness can both lead to extreme social awkwardness. It’s why, especially given the complicating factors already mentioned, gifted autistic females are under-diagnosed. But autism can also be either compounded or hidden by other neurodivergence or mental health issues, like anxiety, ADHD, or mood disorders. Diagnosing autistic females becomes even trickier in the context of related neuropsychological issues.

Accepting my autism as a blessing

Why write an article like this for a website about raising Catholic kids with disabilities?