News and Knowledge

In November, two female celebrities in the United Kingdom announced that they had been diagnosed with autism as adults. Their announcements and the flurry of related news that followed them has put the topic of how autism is diagnosed and how it expresses differently in females in the spotlight.

Television presenter Melanie Sykes was diagnosed at the age of 51. In an interview in Hello! Magazine she said that she has “always felt different to other people and how they think and operate, but now I know it’s because I’m autistic. It makes me feel validated as I understand why.” Model and autism awareness campaigner Christine McGuiness was diagnosed in her 30s after her three children were diagnosed. In an article in the Manchester Evening News she said that the diagnosis was “such a huge relief. Just to know there was a reason why I felt this way and why I struggled with certain things.”

A study published in September in the Journal of Child Psychology and Psychiatry noted that the number of people diagnosed with autism in the United Kingdom jumped by 787 percent between 1998 and 2018, likely due to increased recognition. The increase was greater for females than males. Researchers compared the rates of autism recorded in doctors’ records in England, covering over 9 million patients. The study’s lead author, Ginny Russell, Ph.D., from the University of Exeter, said that the definition of what “constitutes autism has changed over time, and females and adults were not often thought of as having autism 20 years ago.”

A 2016 Scottish study reported on prevalence rates across genders and age, providing evidence that females are diagnosed later than males:

• Very young children: 5.5 boys to every one girl
• Adolescents: 2.3 boys for every one girl
• Children and adolescents together: 2.3 boys for every one girl
• Adults: 1.8 males for every one female

Misdiagnosis and Masking

Girls are often diagnosed with other conditions, particularly social anxiety, ADHD, depression, and others, noted Australian researchers Tony Attwood , Ph.D., and Michelle Garnett, Ph.D., in an article on their website. A 2021 Italian study, published in Brain Sciences, also found that girls are often diagnosed with other mental health conditions, such as obsessive-compulsive personality, eating disorders, and social anxiety.

Late diagnoses of females may also occur because girls camouflage their differences in order not to be seen as different, explained Dr. Attwood , Ph.D., in a North Coast Courier article. Similarly, Hannah Belcher, Ph.D., an autism researcher at King’s College London who was diagnosed with autism at 23, said in a Guardian article that females may have some cognitive advantages in terms of memory and mental flexibility that enable them to do better in social situations, masking their autism. In a 2021 research study she and three other researchers conducted, the research team found that when non-autistic people rated first impressions, they rated autistic people less favorably than non-autistic people and autistic males less favorably than autistic females. French neuroscientist Fabien Cazalis and writer Adeline Lacroix pointed out in a 2017 article on The Conversation website that girls may have fewer troubles making friends than autistic boys, and their interests, while similarly consuming, are considered more “ordinary” — horses, for example — than autistic boys’.

Speaking Out About Their Experiences

A recent book and movie describe the experiences of women diagnosed as adults. Dr. Sarah Bargiela, a clinical psychologist in Australia who was diagnosed as an adult, teamed up with illustrator Sophie Standing to create Camouflage. The graphic novel published in 2019 uses real life case studies to highlight the experiences of autistic women. The women’s stories illustrate how isolation affected them and how they are moving beyond those negative experiences.

A new Irish film, Mildly Different, looks at the life of Christina, a young woman who receives a diagnosis of autism in adulthood. Director Anna Czarska, who was diagnosed with autism as an adult, said in an article on the “Her” website that she wanted to give “autistic individuals, as well as their families, authentic representation.” She hopes that her short film will give autistic women “a voice, it could give autistic individuals a way to say ‘that’s it, that’s what it’s like for me.’”

As Belcher noted in The Guardian article, autistic women are becoming more visible, giving “others courage to do the same. This is really positive for raising awareness of different autism presentations.”

Sherri Alms is the freelance editor of The OARacle, a role she took on in 2007. She has been a freelance writer and editor for more than 20 years.