Asperger and Autism Spectrum: Women and Girls
Written by By Kim Wutkiewicz for AANE (The Asperger/Autism Network)
Women with Asperger profiles are less likely to be diagnosed and more likely to be misdiagnosed for a number of reasons. Additionally, many professionals have been trained to recognize typical Asperger/autism spectrum expression more easily in males than in females. While many professionals and advocates are working hard to change this reality, there is still a long way to go in terms of universal understanding and recognition of the unique gifts and challenges of Asperger women. While the core characteristics of an Asperger profile does not differ between genders, girls and women might demonstrate different outward reactions to the profile. While every girl and women with an Asperger profile is unique, many share certain experiences.
As a young girl, she may know that she is different, noticing that her interests veer away from those of her peers. She may prefer having only one or two friends, or to play in solitude, having an appreciation of and focus on specific interests.
She might demonstrate an aversion to what is popular, what is feminine, or what is fashionable. Sensitive to textures, she might prefer to wear comfortable, practical clothing. She might appear naive or immature, as she is out of sync with the trends or the social norms.
She might work very hard to “camouflage” her social confusion and/or anxiety through strategic imitation, by escaping into nature or fantasy, or by staying on the periphery of social activity.
She might show different sides of her personality in different settings. “A girl with Asperger’s syndrome may suffer social confusion in silence and isolation in the classroom or playground but she may be a different character at home, the ‘mask’ is removed.” (Tony Attwood). At home, she might be more prone to releasing her bottled up emotions through meltdowns.
She might be exhausted from the work of deciphering social rules or of imitating those around her to hide her differences.
She might be anxious in settings where she is asked to perform in social situations. This could lead to mutism, escapism, or a focus on routines and rituals.
Frequently, women with Asperger profiles, like neurodiverse men, have intense special interests; however, these special interests can follow different sets of themes. Historically, women have been less likely than men to be interested in transportation, computers, or astronomy, and more likely to be passionate about literature, the arts, animals, environmental activism, and other topics with relational themes. That said, when it comes to special interests, anything goes for both genders. There are no limits to the variety and depth of interests or expertise for both females and males with Asperger profiles. As always, these interests are ever-evolving with the times.
While many people have fought long and hard to ensure universally accepted gender equality, boys and girls are still often socialized differently in our modern culture. In many places, women are still often expected to place more value on relationships than on hard-skills. Consequently, Asperger females may feel stigmatized in ways that are different than males. One study by Simon Baron-Cohen and Sally Wheelwright found that “women are more likely to enjoy close, empathetic supportive friendships, to like and be interested in people; to enjoy interaction with others for its own sake; and to consider friendships important”1. The gap between societal expectations and personal interests can be greater in females with Asperger profiles than in males with Asperger profiles because societal expectations for a strong social identity traditionally can be higher for females. Females may also have more difficulty in forming friendships because female relationships are frequently based on nuanced emotional and social exchanges, whereas male friendships have historically been more activity-based.2 Like males, females on the Asperger/autism spectrum are likely to have experienced a history of bullying. However, how bullying manifests can tend to take on different characteristics based on gender. No matter how subtle or overt, exclusion and bullying can be profoundly traumatizing and affect the self-confidence and sense of security of the target individuals.
Other Related Mental Health Concerns
Women with Asperger profiles can experience co-occurring mood disorders and often internalize feelings of frustration and failure. Starting in adolescence, they have high rates of depression and anxiety — 34 and 36 percent, respectively. A few studies have also found an compelling overlap between autism and eating disorders such as anorexia, although the studies are too small to estimate how many women have both.
Females with ASD’s often develop “coping mechanisms” that can cover up the intrinsic difficulties they experience. They may mimic their peers, watch from the sidelines, use their intellect to figure out the best ways to remain undetected, and they will study, practice, and learn appropriate approaches to social situations. Sounds easy enough, but in fact these strategies take a lot of work and can more often than not lead to exhaustion, withdrawal, anxiety, selective mutism, and depression. – Dr. Shana Nichols
While co-occurrence can factor into the picture, some women are misdiagnosed with personality disorders: Borderline Personality Disorder, Avoidant Personality Disorder, Schizoid Personality Disorder, for example. It is important to recognize that these diagnoses can sometimes obscure the strengths and struggles of women who have Asperger profiles.
Females with Asperger profiles may be at risk for victimization because of the social naiveté associated with ASD. One study of children with developmental disabilities found rates of sexual abuse 1.7 times higher than those in the general population.4 Females with Asperger profiles should work with family, friends, therapists, and coaches to develop clear sets of rules on safety. To explore this topic in greater detail, we recommend Liane Holliday Willey’s book, Safety Skills.
Females with Asperger profiles may perceive their sexuality in varied ways. Due to the numerous taboos around discussion of sexuality among women, females with Asperger profiles rarely have forums for explicit conversation about this topic. Sensory sensitivities can be particularly challenging for females with Asperger profiles. Women with Autism Spectrum diagnoses are frequently put on medications with side effects that lead to reduced sexual arousal. This may lead to more Asperger women perceiving themselves as asexual.
Despite their challenges, many women with Asperger profiles are very successful at parenting. One woman with an Autism Spectrum difference stated that she has more vivid memories of her childhood than her peers and consequently is better able to relate with her child. That said, women with Asperger profiles might struggle with the many executive functioning tasks required of a parent. In addition, women with Asperger profiles may become especially challenged when their children become adolescents, whose social interactions become the primary foci of their lives. Parents on the autism spectrum may feel that they struggle in relating to other children’s parents and at setting up social interactions for their children. They may also feel that parenting with a disability is extremely stigmatized. Parents with Asperger profiles may need support from family, friends, and professionals for help with these challenges.
First Person Account: Personal account of a woman with an Asperger Profile.
If you want to learn more, there are now a number of beautifully written, informative books by and about women with AS or Autism that address a range of topics:
Hendrickx, S. (2015). Women and Girls with Autism Spectrum Disorder: Understanding Life Experiences from Early Childhood to Old Age. London: Jessica Kingsley.
Cohen, T. (2015). Six-Word Lessons on Female Asperger Syndrome: 100 Lessons to Understand and Support Girls and Women with Asperger’s (The Six-Word Lessons Series). Washington: Pacelli Publishing.
Grandin, T. (2013). The Autistic Brain: Helping Different Kinds of Minds Succeed. New York: Houghton Mifflin.
Simone, R. (2012). 22 Things a Woman with Asperger’s Syndrome Wants Her Partner to Know. London: Jessica Kingsley.
Willey, L.H. (2012). Safety Skills for Asperger Women: How to Save a Perfectly Good Female Life. London: Jessica Kingsley.
Simone, R. (2010). Aspergirls: Empowering Females With Asperger Syndrome. London: Jessica Kingsley.
Attwood, T., Grandin, T., et al. (2006). Asperger’s and Girls: World-Renowned Experts Join Those with Asperger’s Syndrome to Resolve Issues That Girls and Women Face Every Day! Texas: Future Horizons.
Birch, J. (2003, February). Congratulations! It’s Asperger syndrome. London: Jessica Kingsley.
Blackman, L. (1999). Lucy’s story: Autism and other adventures. Mt. Ommaney, Australia: Book in Hand.
Grandin, T. (1995). Thinking in pictures: And other reports from my life. New York: Bantam Doubleday Dell Publishers Groups, Inc.
Grandin, T. (1996, August). Emergence: Labeled autistic. New York: Warner Books, Inc
Miller, J. K. (Ed.). (2003). Women from another planet? Our lives in the universe of autism. Bloomington, IN: AuthorHouse.
Peers, J. (2003). Asparagus Dreams. London: Jessica Kingsley
Prince-Hughes, D. (2004). Songs of the gorilla nation: My journey through autism. New York: Harmony Books.
Willey, L. H. (1999). Pretending to be normal: Living with Asperger Syndrome. London: Jessica Kingsley.
Williams, D. (1992). Nobody, Nowhere: The Extraordinary Autobiography of an Autistic. New York: Avon Books
Williams, D. (1994). Somebody, somewhere: Breaking free from the world of autism. New York: Times Books.
Williams, S. (2005). Reflections of self. Kentwood, MI: The Gray Center for Social Learning and Understanding.
Baron-Cohen, S. & Wheelwright, S. (2003) The Friendship Questionnaire: An Investigation of Adults with Asperger Syndrome or High-Functioning Autism, and Normal Sex Differences. Journal of Autism and Developmental Differences, 33:5, p.509-517.
Zaks, Z. (2006) Life and Love: Positive Strategies for Autistic Adults. Kansas: Autism Asperger Publishing Co.
Wagner, S. (2006) Educating the Female Student with Asperger’s. In Asperger’s and Girls (pp. 15-32). Texas: Future Horizons.
Henault, I. (2005) Sexuality and Asperger Syndrome: The need for socio-sexual education. In K.P Stoddart (Ed) Children, Youth, and Adults with Asperger Syndrome (pp. 110-121). Philadelphia: Jessica Kingsley Publishers.