The majority of female clients coming to me for assessment or counseling tell me they went many years with the wrong diagnosis, or there was a correct diagnosis but autism was missed. In other words, these girls and women flew under what I call "the autism radar." Why? Autism has largely been defined using criteria that relate more to boys and men. This needs to change.
Women and Girls "Present" Differently
Autism diagnosis is currently defined by behavior - what people do. Behaviors that "look" more "classically autistic" will get attention. So the student who has trouble sitting still in class, the child who is disrupting the birthday party, the employee who says unexpected or possibly "inappropriate" things to customers, or the friend who says "rude" things to others will get attention. They will be "picked up" on the autism radar. Girls and women tend to have fewer of these outward, obvious, or disruptive behaviors. Girls and women tend to have more internalized (inward) symptoms or feelings that are not obvious to others - and they don't get picked up on the autism radar. This delays diagnosis and understanding.
Masking and Assimilating
To find out if girls and women are autistic, it is important to ask about their internal experience, not just ask about their behavior. So I ask a lot of questions about whether they mask or assimilate in social settings, with their family and friends, or at school or work. Many say they do. Many watch and study others to find out how to handle a given situation. Many practice what to say or do. Others try to hide their autistic behaviors, such as stimming. This helps them to "blend in" to social settings, but this can be absolutely exhausting. Some autistic clients tell me they need to spend time recovering after big social events - or even going to the grocery store. Being seen as neurotypical comes with a cost.
"But You Don't Look Autistic"
Many of my female clients tell me that whey they first brought up autism to their family or friends, they were told, "but you don't look autistic!" They were told, "you make eye contact, so you can't be autistic" or "you are empathetic and you have friends - no way do you have autism!" Newsflash - autistic people can and do make eye contact, are empathetic, and have friends. Autistic people also can be super funny, creative, caring, smart, driven, and successful. The old saying, "When you have met one person with autism, you have met ONE person with autism" is perhaps even more true when it comes to girls and women. We can't base autism only on how people act.
What About LGBTQIA+ folx?
Autistic people are more likely than non-autistic people to be non-binary, gender fluid, or trans. For example, maybe they were assigned male at birth, but feel more female or gender fluid. Autistic people are also more likely to identify with various aspects of the LGBTQIA+ community. These multiple facets of identity make each person unique - and can make traditional, male-centered assessment inaccurate.
You Deserve a Respectful Assessment
It is important to take in to consideration all aspects of your life, experience, and identity in order to provide the most accurate diagnostic assessment. It is my goal as your psychologist to create a respectful and collaborative space so that you or your loved one receives the most accurate evaluation. I welcome your questions! Click below to learn more.
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