Support & Education for Adults on the Autism Spectrum: How the Symptoms of ASD [level 1] Differ in Women Compared to Men

RE: "How are the symptoms of autism spectrum disorder different in women as compared to men?"

The symptoms of ASD in ladies are not hugely different from those in guys. However, females on the autism spectrum are more likely to camouflage their symptoms.

Common forms of camouflaging include preparing jokes or phrases ahead of time to use in conversation, mimicking the social behavior of others, imitating expressions and gestures, and forcing themselves to make eye contact during conversations.

While both men and women with ASD can camouflage their symptoms, it appears to be more common with the ladies. This could explain why they’re less likely to be diagnosed. Studies suggests that, compared to guys, ladies with ASD have less of a tendency to become hyper-focused on a subject or activity, but have more emotional problems (e.g., depression, anxiety).

Generally speaking, females who have ASD are different, not in the core traits of the disorder, but in how they react to the disorder. They tend to mask their social and communication problems in specific ways that are different from the guys on the spectrum. As a result, ladies are often under-diagnosed, or diagnosed with a different disorder. In either case, many of them struggle to cope with their symptoms without the benefit of needed resources and support.

Studies show that ladies with ASD are different from female NTs in how their brains analyze social information. Amazingly, the brain of a woman with ASD is more like the brain of an NT male than that of an autistic male.

Early in life, females with ASD show a greater desire to connect with others. Their interests are more similar to those of NTs. They are more likely to engage in pretend play (characteristic of girls, in general). Also, they are less drawn to repetitive behaviors. Even though they may not be as socially active as NT girls, they often have intense friendships with girls who provide compassion and guidance in social situations.

Girls, and later grown women, often develop coping strategies that cover-up the trouble they have “fitting-in.” They often use imitation or imagination, identifying with other female role-models in an effort to learn how to “act” socially. They figure out the best way to remain undetected by studying social situations and practicing appropriate ways of behaving.

Being well behaved and compliant at school furthers the development and refinement of social skills for these young girls. As a result, they stand out less than boys with ASD. Girls on the spectrum tend to overcome or hide their deficits. As they develop and mature, such deficits appear less pronounced and cause less difficulty for them, in general.

Unlike many autistic guys, ladies with ASD tend to prefer one-on-one social interactions and single friendships (often close and intimate). Although they may have difficulty in group situations, they can be very good at relating directly to one person. They tend to be less solitary than guys with ASD, and are more likely to seek out relationships with the opposite sex, moving towards long-term romantic relationships.

Women on the autism spectrum are more sensitive to emotions in others than guys with ASD. Ironically, the desire in autistic ladies to connect is frequently painful as they encounter ASD-related social and communication problems.

Loneliness is a common complaint amongst these women. More than 65% of adults with ASD report suicidal thoughts - of this percentage, 77% are females. Clearly, ladies on the spectrum think, feel and act differently than their male counterparts. But it’s different - not necessarily better.

Women are often under-represented in individuals who have a diagnosis of ASD when higher IQ is factored in. This means that of those with a higher intelligence level, women are less likely to be given a diagnosis of ASD. This may be because women with higher intelligence can use their intelligence to develop coping strategies and to learn ways to navigate their life experiences despite their ASD symptoms.

Even within the range of average intelligence, autistic women are often able to display more socially acceptable and functional skills in their social interactions as compared to autistic men. This may be due to how these women can learn to imitate those around them - even when social skills don’t come naturally.

One theory of the differences between autistic men and women (related to restrictive and repetitive behaviors) is that women often have “fewer” of these types of behaviors – and they have “different” types of these behaviors. The restrictive or repetitive behaviors of women may not be noticed as much – and may appear more “socially appropriate.” Autistic women also have limited interests, but these interests appear to be socially acceptable, and therefore are less noticed as a symptom of ASD.

In summary, men and women on the autism spectrum differ in the following areas:

as IQ increases, women are less likely to be diagnosed with ASD, which may have to do with their ability to develop coping strategies to manage their life experiences despite having the disorder
at a young age, women on the spectrum seem to have more motor deficits, but fewer communication deficits
men are diagnosed at a 4:1 ratio when compared to women
autistic women often display fewer - and different - types of restrictive or repetitive behaviors as compared to men, and these behaviors are less noticeable to others

Emotional, Social, Physical, Behavioral, and Cognitive Traits that Women with ASD May Exhibit:

1.   Abused or taken advantage of as a little girl, but didn’t think to tell anyone
2.   Allergies and food sensitivities
3.   An emotional incident can determine the mood for the day
4.   Analyze existence and the meaning of life
5.   Appearance of hearing problems, but hearing has been checked and is fine
6.   As a little girl, it was hard to know when it was her turn to talk
7.   Aversion to answering questions about themselves
8.   Becomes overwhelmed with too much verbal direction
9.   Calmed by external stimulation (e.g., soothing sound, brushing, rotating object, constant pressure)
10.   Can’t relax or rest without many thoughts

11.   Chronic fatigue
12.   Come across at times as narcissistic
13.   Confused by tone of voice, proximity of body, body stance, the rules of accurate eye contact, posture in conversation, etc.
14.   Constipation
15.   Conversations are often exhausting
16.   Daydream a lot
17.   Deep thinkers
18.   Desires comfort items (e.g., blankets, teddy, rock, string)
19.   Diagnosed with a mental illness
20.   Didn’t participate in class

21.   Difficulty:
•   filtering out background noise when talking to others
•   making and keeping friends
•   transitioning from one activity to another
•   understanding directional terms (e.g., north, south)
•   understanding group interactions
•   with fine motor activities (e.g., coloring, printing, using scissors, gluing)
•   with loud or sudden sounds

22.   Dislike being in a crowded mall, crowded gym, and/or crowded theater
23.   Don’t simplify
24.   Don’t take things for granted
25.   Dreams are anxiety-ridden and vivid
26.   Easily fooled and conned
27.   Eating disorders
28.   Emotions can pass very suddenly or are drawn out for a long period of time

29.   Escape:
•   by playing the same music over and over
•   into other rooms at parties
•   regularly through fixations and obsessions
•   routinely through imagination, fantasy
•   through a relationship (imagined or real)
•   through counting, categorizing, organizing, etc.
•   through mental processing
•   through the rhythm of words

30.   Everything has a purpose
31.   Everything is complex
32.   Excellent rote memory
33.   Exceptionally high skills in some areas and very low in others
34.   Experience multiple physical symptoms
35.   Experience trouble with lying
36.   Extreme anxiety for no apparent reason
37.   Feel as if missing a thought-filter
38.   Feel extreme relief when they don’t have to go anywhere or talk to anyone

39.   Feelings:
•   of being misplaced and/or from another planet
•   of confusion and being overwhelmed
•   of dread about upcoming events and appointments
•   of isolation
•   of polar extremes (e.g., sad/happy)

40.   Feels the need to fix or rearrange things
41.   Find it difficult to understand manipulation and disloyalty
42.   Find it difficult to understand vindictive behavior and retaliation
43.   Find norms of conversation confusing
44.   Find unwritten and unspoken rules difficult to grasp, remember, and apply
45.   Food obsessions
46.   Frustration is expressed in unusual ways
47.   Generalized Anxiety
48.   Had imaginary friends as a little girl
49.   Have a continuous dialogue in mind that tells them what to say and how to act when in a social situation

50.   Have had bouts of depression
51.   Highly intelligent
52.   Hold a lot of thoughts, ideas, and feelings inside
53.   Honest
54.   Imitate friends or peers in style, dress, attitude, etc.
55.   Imitate people on television or in movies
56.   Immune challenges
57.   Intolerance to certain food textures, colors or the way they are presented on the plate (e.g., one food can’t touch another)
58.   Irregular sleep patterns
59.   Irritable bowel

60.   Knowing they have to leave the house causes anxiety
61.   Lack in coordination
62.   Little impulse control with speaking
63.   Make friends with older or younger females
64.   Many and varied collections
65.   Mastered imitation
66.   May have a very high vocabulary
67.   May need to be left alone to release tension and frustration
68.   Misdiagnosed
69.   Monopolize conversations

70.   Naïve
71.   Numbers are calming (e.g., numbers associated with patterns, calculations, lists, etc.)
72.   Obsess about the potentiality of a relationship with someone
73.   Obsessively collect and organize objects
74.   OCD
75.   Often drop small objects
76.   Often get lost in their own thoughts and “checks out”
77.   Often sound eager and over-zealous or apathetic and disinterested
78.   Often harbor guilt for “hibernating” and not doing “what everyone else is doing”
79.   Over-interest in certain subjects

80.   Perfectionism in certain areas
81.   Philosophize
82.   Poor muscle tone, double-jointed
83.   Practice/rehearse in mind what they will say to another before entering the room
84.   Prepares themselves mentally for outings and appointments, often days before a scheduled event
85.   Prolific writers drawn to poetry
86.   Question place in the world
87.   Question the actions and behaviors of themselves and others
88.   Reveals intimate details to strangers
89.   Search for right and wrong

90.   See things at multiple levels, including their own thinking processes
91.   Sense of humor sometimes seems quirky, odd, or inappropriate
92.   Sense of pending danger or doom
93.   Sensory Issues
94.   Serious and matter-of-fact in nature
95.   Share in order to reach out
96.   Survive overwhelming emotions and senses by escaping in thought or action
97.   Tendency to overshare
98.   Tends to either tune out or break down when being criticized
99.   Tics

100.   Trained themselves in social interactions through readings and studying of others
101.   Transitioning from one activity to another is difficult
102.   Uncomfortable in public bathrooms
103.   Unusually high or low pain tolerance
104.   Visualize and practice how they will act around others
105.   Walks without swinging arms freely
106.   Wonder who they are and what is expected of them
107.   Worry about what is eaten