For a long time, people thought that autism was an exclusively male condition. Although studies have varied, experts believe the ratio of autistic males to autistic females is 3:1.
This doesn’t necessarily mean that autism is less common in girls. In fact, it is much more likely that fewer girls are being diagnosed because their autistic traits are different and are more difficult to spot.
Late diagnosis for girls can cause problems later on, including mental health issues and even eating disorders. This resource covers some signs and traits of autism in girls that parents and teachers should look for.
Table of contents
- Does autism present differently in girls?
- Are women diagnosed with autism less than men?
- Signs of autism in girls
Does autism present differently in girls?
Autism can present differently in girls compared to boys. This difference is partly why many girls go undiagnosed or are diagnosed later in life. Girls often show less obvious signs than boys, making it harder to spot. Here are some ways autism may present differently in girls:
Social masking
Girls with autism often work hard to fit in by imitating social behaviours they observe in others.
Interests
While boys may have highly specific interests, girls’ interests are usually more aligned with their peers.
Emotional responses
Girls might be more prone to internalising their emotions. This can lead to anxiety or depression, which can be mistaken for other conditions.
Stronger social connections
Some girls may develop better social skills and appear to have strong friendships, but these relationships can still be challenging or overwhelming for them.
Are women diagnosed with autism less than men?
Research shows that women are often diagnosed with autism less frequently than men. Compared to men, women showed both a significantly greater delay in referral to mental health services and a significantly higher age at diagnosis of ASD.
The difference in diagnosis rates can be due to a number of reasons. This could range from diagnostic biases to awareness. Additionally, many women may mask or compensate for their symptoms, leading to underdiagnoses.
Learn more about why so many autistic women are misdiagnosed.
Signs of autism in girls
Autism can present differently in girls, making it harder to recognise. While some signs are similar to those in boys, girls may display them in more subtle or socially adapted ways. These traits can include:
Social interaction
Autistic children often find social situations difficult or even distressing. This appears to be less of an issue in girls, but that doesn’t mean they aren’t affected.
Because they are raised to place greater importance on friendships than boys, autistic girls are more driven to try to fit in. They can go to enormous lengths to mask their difference, adopting elaborate strategies such as practising pre-prepared greetings or faking eye contact.
They often enjoy watching programmes with predictable social interaction over and over again, learning these ‘scripts’ to use within social situations. Many will do this so effectively that their internal discomfort can be difficult to detect.
Special interests
One of the better-known traits on the autistic spectrum is the single-minded pursuit of a specific interest, often to the exclusion of much else.
Where autistic males are often fascinated by stereotypically boyish interests such as trains or gaming, girls are equally likely to focus their attention on more feminine pursuits.
Whether it’s Disney films, fantasy stories, or drama, their level of interest is no less intense than boys. Still, the fact that these are seen as ‘normal’ for girls sometimes means that the unusual depth of their fascination can be overlooked.
Social touch
One area where you might spot the signs of ASD in girls more easily than boys is their reaction to touch. Younger girls are often touchy-feely with their friends. An aversion to hugging or stroking hair can make them stand out from their neurotypical peers.
Similarly, an unusually strong aversion to certain textures can indicate that a child of either gender might be on the autistic spectrum.
Trusting
Autistic girls will often be very trusting and tend to take people at face value. This can put them at risk of manipulation by their peers or adults, who might take advantage of this vulnerability.
Amy Gravino, a certified autism specialist and consultant diagnosed at age 11 says, "In my experience, I’m a lot more trusting than my neurotypical peers, and this leads me not always to see when someone has duplicitous intentions. I believe what people say upfront because I’m very upfront. That leads to many women on the spectrum being taken advantage of."
Teaching autistic girls how to keep themselves safe, especially as they become old enough to have sex or be encouraged to try dangerous or illegal activities, is vital.
Eating disorders
The relationship between children and food is always complicated, but for autistic children, eating can have a much deeper significance.
Issues about texture, colour and routine combine to make mealtimes a particular flashpoint. For some autistic girls, controlling food can be the beginning of a pattern that leads to anorexia.
Studies of females with anorexia show that they have elevated autistic traits. Diagnosis of both disorders is often made quite later when anorexia takes a different shape than neurotypical children. An early diagnosis of ASD means you can access expert support for your child’s food issues and have a greater chance of helping them avoid developing an eating disorder.
Misdiagnosis
Because of the difficulties in detecting autism in girls, their symptoms may be misdiagnosed. Depression, anxiety, and personality disorders are more common diagnoses. Time is often wasted treating the wrong condition. Schools and medical professionals must be educated to raise awareness of gender-specific autistic traits.
You can also learn more in our full resource on the different symptoms of autism.