Autism in Boys and Girls: Understanding Differences

Girl

Key Takeaways

• Autism presents differently in males and females, impacting diagnosis rates and timing.

• Girls and women are more likely to mask symptoms, leading to underdiagnosis or misdiagnosis.

• Social expectations and gender stereotypes influence the recognition of autism traits.

I've done hundreds of assessments and I've noticed differences between boys and girls, men and boys. Often girls are older when they come to see me.

Parents sometimes feel guilty they haven't had their daughter assessed before. The truth is, often girls go unnoticed because they're quiet, they appear to be playing with others, but may be more likely to be watching, they're often great readers and have an amazing vocabulary - especially about their special interests. If kids are doing great in school and not disrupting the class then they're OK? Or are they? Many women and girls tell me they just don't want to be seen and try to stay invisible because they feel uncomfortable being looked at, even when crossing the road for example. 

Because girls mask from a very early age it can be hard to know if they're struggling. 

The other reason I see for later diagnosis of children is unconditional parent love. As our kids grow we grow and adapt to their needs and maybe don't notice that there's a gap opening up between our child and other kids. We love them just as they are and are happy to help when they get suck. It doesn't seem to be a problem that needs fixing. It's never a mistake to love and accept your child just as they are. So be at peace and put that burden down if it's one you've been carrying. 

Parents, kids and later diagnosed adults alike have a lot to process follwoing a diagnosis. It takes time and that's OK. It's a journey rather than a destination. 

Aspect	Boys/Men	Girls/Women
Prevalence	Diagnosed 3-4 times more often than females	Underdiagnosed; prevalence may be closer to 2:1
Age of Diagnosis	Typically diagnosed earlier in childhood	Diagnosed later, often into adolescence or adulthood
Behavioural Traits	Externalising behaviours like aggression, hyperactivity, and repetitive actions	Internalising behaviours such as anxiety, depression, and emotional withdrawal
Social Skills	More noticeable social communication difficulties	Better at masking difficulties through mimicry; appear more socially adept
Restricted Interests	Often focused on niche topics (e.g., trains, technology)	Interests align with peers (e.g., animals, celebrities), making them less noticeable
Camouflaging	Less likely to camouflage symptoms	Frequently mask traits to fit societal norms, leading to delayed diagnosis
Crisis Moments	Outward expressions of distress (e.g., meltdowns)	Inward responses (e.g., shutdowns), often mistaken for mental health issues
Diagnostic Bias	Diagnostic criteria tailored to male presentation	Symptoms often overlooked due to differing presentation and societal expectation

#AutismAwareness #GenderDifferences #ASD #Neurodiversity #AutismDiagnosis