Welcome to day 23 in the A to Z Challenge on autism. Today, I discuss autism as it maniffests itself differently depending on the autistic person’s gender. I particularly focus on women and girls with autism. IN tomorrow’s post, I will discuss autism as extreme male behavior.
It used to be thought that autism, and Asperger’s Syndrome in particular, is far more common in males than in females. Four to even eight times as many boys were thought to have Asperger’s than girls. In recent years however, there has been more attention paid to the ways in which autism spectrum disorders manifest themselves differently in girls and women.
There is little scientific research focused specificaly on females with autism. However, anecdotal evidence suggests that females with autism display the following characteristics, which differ from males with autism:
- Better social imitation skills.
- A desire to interact directly with people.
- Shyness or passivity as opposed to being active but odd.
- Better imagination.
- Better language development.
- (Special) interests focused on animals or people rather than objects.
Stereotypes about what is considered typical male or female behavior commonly hinder the diagnosis of females with autism. For example, characteristics such as shyness and oversensitivity are often seen as typical female characteristics rather than signs of an autism spectrum disorder. Another example is a girl who plays with dolls and is hence thought to display appropriate pretend play. On closer observation though, it is found that she plays with the dolls stereotypically.
Girls and women with autism usually also develop inventive strategies to hide their autistic tendencies. This often leads them to burn out or get depressed, which is then seen as the reason for their inability to cope rather than a consequence. There is finally also a bias towards diagnosing certain disorders in certain genders. As a result, many women with autism or ADHD end up with a diagnosis of for example borderline personality disorder because of their hypersensitivity.
Fortunately, authors like Rudy Simone (author of AsperGirls) internationally and Henny Struik in the Netherlands have raised increasing awareness of the fact that women too can be autistic and that their behavioral characteristics often differ from those in men with autism. I was honored to have been quoted (only a few lines) in Henny Struik’s book and I love AsperGirls. I hope that books like these will reach health professionals and researchers so that diagnostic tests for autism are adapted to meet the specific challenges of diagnosing females.
There’s a lot of pooha against girls wearing pink lately. Apparently, dressing girls in pink is limiting their future success. Blimey. As the author of Parenting Highs and Lows says, pink is a color. No feminist in their right mind would say that having black skin limits people’s future success, even though in our still pretty racist society, it does. And I know you can change what clothes you wear and not what color your skin is, but so what?
In my opinion, firstly, this is holding girls and women accoutnable for the stereotypes created by society. When I was still active in feminist circles, I learned that making the minority feel responsible for defeating society’s steretotypes, is discrimination. Besides, if girls should not wear pink because it limits their future success, this is only perpetuating the idea that girls wearing pink should not be successful. This is ultimately counterproductive.
I haven’t even touched on what it is that girls are being unsuccessful in when they’ve been wearing pink. It is said to be limiting their careers. As if the only successful women are those who have a career outside the home. This is the mostly male, White, able-bodied society’s norm of success, and women’s rights include the right not to conform to this norm. The so-called feminists who are encouraging people to stop dressing girls in pink because it limits their ability to conform to the societal notion of success, are merely perpetuating the stereotypes they’re meaning to defeat.
Now I for one am not a big fan of pink. I never quite liked the color. I also do not agree with the idea that girls should wear pink, or that real girls or boys wear any color or even sort of clothes in particular. That’s stereotypical. People of any gender should be allowed to wear whatever they want, and if that is perceived to limit their ability to do whatever they want in life, that’s discrimination. Blaming the person being discriminated against, is allowing the discrimination to continue.
Yesterday, I bought Parenting Girls on the Autism Spectrum by Eileen Riley-Hall. I’ve only read bits and pieces of it yet, but what struck a chord with me are the problems faced by both passive and aggressive autistic girls due to gender stereotypes and stereotypes about what autism should be.
First, most girls on the autism spectrum are passive. This can easily lead to them being ignored in a classroom or even at home. I notice this on my ward, too, because I’m fairly withdrawn. Because of this, my needs are not always met, as there are many patients who act out to get what they need. In the book, Riley-Hall talks about a girl in her daughter’s nursery who was so shy that she could easily be isolated if not for her attentive teacher. Passive autistic girls, according to Riley-Hall, need as much one-on-one attention as possible. This seems coutnerintuitive, because they aren’t causing any trouble or being a danger to themselves or others. Then again, they too need to learn to relate to others. It is sad in this respect that isolation is no longer a ground for care in the Netherlands. Apparently, you need to be aggressive to be seen. Please note that, in DSM-IV, passive autism is seen as more severe than the active-but-odd type.
Yet aggressive autistic girls are also often mistreated. According to Riley-Hall, gender stereotypes dictate that less aggression should be expected and tolerated from girls than from boys. Consequently, if an autistic girl acts out, she’s punished more harshly than a boy. Riley-Hall does not say this, but it is my expereince that aggression in women and girls is also interpreted differently than in males. For example, many more women are diagnosed with borderline personality disorder rather than for example ADHD. Fortunately, researchers and clinicians are becoming more and more aware of gender differences in the symptoms of psychiatric and neurodevelopmental disorders.