Revisiting Expectations of Autism in Females
The expectations of how autism in females presents need to be revisited, reframed, and aligned with reality. Crucial moves in that direction can help address the pressing issue of missed identification in this large group of adults and young adults with autism. This problem is at once urgent and multi-faceted: females are not only more likely to have been disregarded in the past (and still even today) in screenings and diagnoses, but they are also more likely to have received prior inaccurate diagnoses in attempts to account for their symptoms, like anxiety and depression.
The Impact of Misdiagnosis
Some women have faced years of therapy or pharmaceutical intervention to address a mental disorder that doesn’t exist, perhaps even being referred to inpatient treatment in institutional settings to determine only later that autism in females is what is at the root of their difficulties. When finally identified, those who were misdiagnosed in the past can at last reclaim their lives through self-awareness and can begin to make use of greatly needed appropriate supports and accommodations. And, for the first time, they can accurately assess their needs regarding education, employment, leisure, and social relationships.
The Biological Aspect of Autism in Females
Another separate but often ignored reason, why the underdiagnosis of autism in females is of special concern, is because of the basic biological and physiological makeup of females. Menstruation, possible pregnancies, and inevitable pre-menopause and menopause each lead to wide hormonal fluctuations that hold formidable sway over the female experience in the course of a lifetime. The well-known phenomena of premenstrual syndrome and the far more impactful premenstrual dysphoric disorder, as well as postpartum and postnatal depression, all-cause emotional dysregulation, which can be severe.
Hormonal Influences on Autism in Females
Fluctuations in hormone levels impact brain chemistry and, due to inherent differences in autistic brains, are likely to affect autistic females differently. Despite these realities, researchers Jan Schlager and Jacqueline Berko have recently asserted, “The topic of hormonal influences on autism in females has received scant attention from health care workers.” And unbelievably, Rachael Mosley and colleagues even determined as recently as 2022, “Nothing is known about how autistic women handle the menopausal transition.” Nothing?!? That is simply unacceptable.
The Need for More Research
Research I reviewed reveals a growing reality whereby some females can manage, mask, or cope with their autistic characteristics and symptoms until reaching menopause, whereupon the onslaught of hormonal changes leaves them no longer able to do so, finally leading to a diagnosis. The influence of hormonal variation on autism in females needs more attention.
The Future of Autism Awareness
As societal awareness grows regarding the many, varied presentations autism can take, progress in these areas needs to be swifter to help a growing population of adult autistic people better understand themselves for improved mental, emotional, and physical health. The understanding and acceptance of autism in females is a crucial part of this progress.