Autism and Gender: Are there differences?
September 21, 2008 by Kristina Chew, PhD
Filed under Health
A recent post asking if autism is different in girls led to an interesting discussion; Sullivan also noted that the IACC Strategic Plan specifically mentioned “research on females with ASD to better characterize clinical, biological and protective features.” Back in August of 2007, the Telergraph, Charlotte Moore (author of George and Sam and the mother of three sons, two of whom are autistic) interviews four autistic women—one of whom (Lauren) was only diagnosed at the age of 23—-and asks whether the rate of autism in women is lower than that in men is due to women being better able to pretend to be “normal.” The women whom Moore interviews are very much aware of being different and of struggling to “conform to normal social expectations of female behaviour”; they’ve been bullied and been misdiagnosed with psychiatric illnesses or learning difficulties:
social stereotyping can lead to autistic behaviour going unnoticed. A woman who depends heavily on a dominant husband and has little life outside the home may well escape scrutiny. In school, while autistic boys are typically loud, disruptive and destructive, girls can be quiet, passive and compliant, but mentally absent; and students who give no trouble are less likely to be flagged up by a busy teacher.
Moore also cites a theory connecting autism to anorexia in some women:
Christopher Gillberg of the National Centre for Autism Studies at the University of Strathclyde explains, ‘A girl may be withdrawn and uncommunicative without attracting attention, but when she develops a calorie fixation it becomes a serious problem. Counting calories may be a manifestation of autism. Some women could be going undiagnosed.’
One psychiatry professor has even described anorexia as possibly being the “female Asperger’s. (Conversely, it could be argued that anorexics, while being obsessive-compulsive and having a “distorted pattern of processing information,” are too aware of social, of society’s norms and hyper-imagine what other people might be thinking about their bodies and appearance.)
Moore makes this comment about changing trends in the diagnosis of autism:
When the first of my two autistic sons was diagnosed in 1994, someone told me that autism was more prevalent among Jews (my sons’ father is partly Jewish). This notion probably arose because many mid-century psychiatrists and psychoanalysts were Jewish, so interest in and awareness of unusual mental states was higher among Jewish families, who were therefore more likely to seek consultations for their children. Similarly, Asperger believed autism to be more prevalent amongst the professional classes, failing to see that it was simply more likely that such a parent would seek his advice. We now know that autism is not related to ethnicity, income or social class. Are we about to find that it is not as strongly linked to gender as has been supposed, that there are more autistic women out there than we imagine?
I’m going to hazard a less-than-hesitant “yes.”
I’d second your yes. I’m already seeing a big difference in the makeup of the self-contained classes that two of my children attend…when we started my girls were the first autistic girls that a lot of their teachers had ever met, and now I’d say that my one daughter’s class is pretty evenly split between males and females. It is nice to finally be seeing some research into autism in girls, because in my experience at least, it does manifest a bit differently (although that could just be my kids).
I’m not sure that I’d buy a link between autism and anorexia in girls without a lot more research- I grew up (after it became well-known in the 70s) having to be seen by many doctors as I was 5′11″, and didn’t hit 85 pounds until grade 10 (I wasn’t anorexic- I just didn’t gain weight even though I ate like a horse. Now, I definitely do gain weight!) So I spend a lot of time talking to doctors about eating disorders, and it does seem to me that anorexic girls are hyper-aware of societal “rules”, and behaviours, and able to outwardly follow them. I can see some similar characteristics in that a lot of the anorexic women I have known definitely have OCD as well as obsessive characteristics , but their entire social outlook seems to be quite different than anything I’ve ever read about autism. It will be interesting to see what research comes out.
And we’re back on the anorexia bandwagon in my house again- one of my daughters is 5′7″ and still weighs 67 pounds, and the other is 5′2 and 64 pounds. The first eats like crazy (fortunately we’ve managed to overcome most of her food issues), and the second is just a bit behind in growth because of chemotherapy (and the fact that she definitely has food preferences). Fortunately I’ve got it better than my mother did with me because at least I can show my girls’ daughters pictures of me when I was their age, which actually goes a long way in helping to refute the anorexic fears.
I’m thrilled to see research going on about autism in women now- it’s going to be interesting to see what happens.
This connection is interesting. I have both a daughter with autism (however she is the opposite of anorexic) she likes food too much and overeating is more her issue.
But I also have a sister with anorexia and I have always thought that she had other underlining issues such as being “cognitively inflexible” she definitely has a “distorted pattern of processing info.” and severe OCD was something that she has always had. And she has been diagnosed with mental issues…So this is very interesting, at least to me.
Youngest is, like FF’s daughter, far too fond of food to be anorexic. But she has some OCD behaviours that are simply directed at other aspects of her life than restricting food intake. Her autistic behaviours were very much according to the textbook but still somewhat difficult to diagnose because the assessors were tempted to think that her use of social toys (dolls, figures) was a sign of social behaviours whereas she was playing in self-contained, closely scripted ways typical of autism.
Youngest is also the only girl in her ASD class and has been, now, for two years. Integration’s good for her in that she gets to interact with other girls besides her older sister.
Jean Kearns Miller’s anthology, Women From Another Planet?, is an excellent background-read on the subject.
I don’t buy the autism-anorexia connection except for the OCD link. Anorexia seems like another manifestation entirely of OCD, control, social pressures and awareness, etc., that don’t mesh with our experience of autism or anything else I’ve read about it. Many girls who are anorexic are perfectionists who are excellent students and socially active but who need that control because of other aspects of their lives. Do we think that these anorexic actresses, for example, are that way because of autism? No…it’s societal pressure, self image, and control.