Autism in women and girls

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If something has different symptoms, it is generally regarded as a different illness / condition
Expert and developmental psychologist Uta Frith made some observations about the symptoms of autism often being very different in women and girls to how it often presents in men and boys.
So would it unreasonable for it not to be something totally different? Still a form of neurodivergence but not what is actually autism
You obviously get girls/women with the “classic” symptoms (eg Temple Grandin), and presumably there are boys who aren’t being diagnosed with whatever the neurodivergence actually is, because their symptoms are the same as those more common in women and girls - which aren’t being looked for in a lad

This. The only way it would present differently is if you compared a higher functioning girl with a lower functioning boy, and also didnt know many autistic people

That’s basically it
A high functioning autistic girl is so mindblowingly different to a low functioning autistic boy that it just seems a different thing all together
Still struggles, still neurodivergence, but different
Different like say anorexia and bulimia (and obviously for that there are people who have both, but that’s different to them being a continuum)

Yes but the whole point is that extreme sensory seeking and sensory aversion (as an example) is not typical therefore it is divergent from the ‘norm’.

Why are you so keen to argue that it should be called something else for girls/ women? So many were/are missed due to the traditional male diagnostic criteria (and stereotypes).

Autism is a spectrum. I'm female and I'm autistic.

It is extremely common in many physical and mental
health conditions to have very different symptom profiles among different individuals.

I think it could also be problematic if we defined male and female versions of autism and then ended up
with boys receiving the female diagnosis and vice versa.

A high functioning autistic boy will be massively different to a severely autistic boy too. Why do you think they wouldn’t be?

I think what you are getting at is perhaps why do boys with autism often fixate on violence, act out physically, speak in a monotone manner (although personally I find girls do this when they aren't masking - dd doesn't intone at home much) and have fewer socialising skills than girls. If you really break it down these are all to do with masking and gender stereotypes - boys are allowed to act out, shout, be violent and not intone. If a girl does it she is called names like highly strung or too sensitive. Add to that the brain differences where boys have more links to triggers in the amygdala for fear and react with violence, less social pathways than girls... Autism is the same base but the brains of the sexes process it in different ways, then you can add or decrease severity, social cues and experiences... Everyone is different and autism is not the same for all but I think that is a rough generalisation of the sexes you are trying to make?

It’s not that there should be male and female versions
Its just that it often seems like the same umbrella term is used for something that manifests in different ways - and often the manifestation in females is different to males. The brain scan article up thread demonstrates differences between SOME of the girls diagnosed with ASD and SOME of the boys - and read it as sex differences, but I read it as two different types of brain. The girls with more stereotypical symptoms had similar brain scans to the boys with the more stereotypical symptoms
if the manifestation is different, I just think is it disingenuous to have it under the same umbrella term, because it’s a different thing.
(I like nice clear categories )
It would also be useful in terms of differentiating need.

The medical world is full of diagnoses where two people can present very differently but still have the same disorder. Lupus, for example, or schizophrenia. We simply don't categorise every single different presentation as a separate disorder, because we recognise that individual differences will effect how a disorder presents in different people.

Is there a particular reason you are struggling to see that girls with autism are just as autistic as boys with autism?

Schizophrenia is symptom bingo and lupus turns up on a blood test (plus there’s a distinctive rash)

I don’t disbelieve that girls and boys can be equally autistic, my point is that are all of them with the diagnosis actually autistic or is it something else?

My social media has been full of smug righteousness from presumably the self diagnosed (The daily tism) and it’s doing my head in.
Also having to deal with the incongruence of a 2 year old who walks pigeon toed, cannot or will not play/enggae with her peers, doesn’t smile , lashes out at the other children at nursery - so much biting - hates loud noises, is frankly peculiar, and a young woman who I’ve known since she was three days old and didn’t have any of this has now been diagnosed as autistic. WTAF

Parents treat their children differently. A paediatrician said to me that, faced with a son with poor social skills, parents will often send him to rugby club, whereas with a daughter they will send her to Stagecoach.

So girls are already being given more social skills support, so itbis no surprise that they can appear more socially able, more able to mask.

Girls' obsessive interests often revolve around pop stars, animals, soaps - these are seen as appropriate. Boys often fixate on something more mechanical - my nephew was obsessed with vacuum cleaners - and if they are into pop stars, soaps etc it is seen as unusual and part of their autism (my nephew is obsessed with Lady Gaga).

So it has a lot to do with cultural expectations.

I think girl presentation is less an issue than not really using aspergers or levels. Because different severity and aspergers which was the same but no language delay could point to different causes.
whereas obviously when researching you can study girls boys or boys and separate the data.

i think its likely girl asd is the same cause but different presentation because we are now seeing many women with asd having asd kids.
someone i know gas what i think maybe a high level asd/aspergers boy but doesnt seem asd themself. However their brother has asd kids. Another friend has a slightly more severe asd kid and an adhd kid and their brother is likely asd.
i dont think the women present asd or girl asd. In fact the mum of asd kids do seem quite stubborn but if anything very sociable and popular but also more adhd than asd.

I think there is a link with pcos and having asd/adhd kids. So high testosterone and insulin resistance. Which would make sense re increase asd rates in kids as increased high blood sugar and probably gestational diabetes.
But what is interesting there is obviously testosterone has a different affect on adults.
i guess then we may see a decrease in asd rates as more people go on weight loss meds (which may also help the insulin resistance as were t2 diabetes meds).

i think t1 diabetics may also be more likely to have autistic kids? But obviously its really only 100 years of so that diabetics have survived.

I think you're trying to say, without exactly saying, that there's only one "real" autism presentation and all the rest are faking it.

I don't agree at all.

But you'd never have nice clear categories. I know they use the levels in America. I've seen people online say they're sometimes a level 2 and sometimes a 3

Virtually every medical with a several symptoms will have people with totally different needs. I belong to a Facebook group which is a mix of parents and adults. Some of those adults like me, had an incidental finding and have a few obvious symptoms but those symptoms aren't always a cause of a serious health condition. Virtually everyone with that diagnosis will have autism along with some neurological symptoms such as epilepsy. Some have quite severe developmental delays but we all have the same diagnosis

I was hoping we'd moved away from belittling females with autism, dismissing them and diagnosing them with mental health conditions they don't have. I don't think I know a single male with autism who was told he had depression and anxiety. I know many females who were.

In lots of ways 'autism' isn't a very useful term because it tells you almost nothing about a particular person's support needs (and we personally find it hard to try and untangle all of DD's different ND diagnoses as well, so in that sense it's useful for us to know she is ND but we can't point at which bit is which specific ND). But the same goes for lots of other different conditions, and what it serves as is a useful shorthand for the types of issues someone might be facing, helps people understand and communicate that themselves,and also that it's not just bad parenting or a mental health condition.

From a what happens when you get a diagnosis perspective it shouldn't really matter either because any support is based on need. Except for-

There's a whiff of the 'default male' about this; that the way ASD is more likely to be experienced by men is the 'proper' OG ASD, and the women's is like the lesser spotted version. I don't think that's what you intended btw but medical misogyny is so deeply embedded in the system I absolutely think they would be treated as a hierarchy - 'proper' ASD trumping the 'something else'.

Fwiw DD has a very 'classically male' presentation, so in your scenario what do you do about that?

Let me give you a small example. Taking things literally. A lot of assessors will ask about metaphors, sarcasm, figures or speech, jokes etc. Now , some children/people will never get them but a lot can learn to identify/recognise them even if they don’t fully get them.

Now DD could get jokes , by the time she was in school get some sarcasm, understand figures of speech /metaphors and that “i don’t want to see anything on the floor “ doesn’t simply mean putting everything on the sofa. She still sat there on the carpet, while being hurt , without saying a word because carpet time was “quiet time”. She was the good, quiet, easy but “shy” kid. Luckily secondary actually SEE her and are supportive in us seeking a diagnosis.

What on earth are you basing the 'radically different presentations' for men and women on?

Autism doesn't present radically different in a gender split, to anyone who knows a flying fuck about it. It's just that we accepted certain standards for girls and not for boys, or vice versa.

Eg: boy is obsessive about trains = autistic
Girl is obsessive about popstars = just being a girl
Man gets overwhelmed and angry = he's autistic
Women gets overwhelmed and angry = that's either 'just' because she's a woman and expected to be emotional, or because she's mental (eg incorrect diagnosis of BP)

Autism does present differently in different individuals (spiky profiles) but do some research before starting such ignorant goady threads. There's crap like this on here pretty much daily right now. It isn't the responsibility of all the autistic people to correct and educate you.

“Classically male” presentation by my logic is a different form of neurodivergence to “classically female”. Maybe I should have avoided sex and said internalised and externalised .
it has been the point I’ve been trying to make - ive been saying that when they present in different ways , are they the same thing. Consensus is, yes, people are actually fairly happy with a term so broad as to be nigh on meaningless

There is a general acceptance of different levels of autism that relate to how much support the individual needs.

Again, 5 mins of research would have told you that exists, and could have avoided this pointless thread.

But you are looking at the superficial presentation, not the underlying drivers.

Autism runs like a seam through my dad's family but is completely absent in my mum's.

The males and females in my dad's family may present differently, but there are common themes.

This! Why is MN allowing these ableist threads by the same goady posters.

There’s lots of conditions which can present differently in different people but are still the same condition. As well as conditions already mentioned on this thread, such as CP and epilepsy, DS can present very differently in different people. For example, some are sensory seekers, some sensory avoidant; some are verbal, some aren’t; some are capable of independent living and working as adults, some adults aren’t; some are toilet trained, some aren’t; some have associated heart problems, some don’t; some are in mainstream schools, some in SS, some with EOTAS/EOTIS/C; some use a wheelchair, some don’t; some have enteral feeding, some don’t… There are other conditions too that could be used as examples.

Even before encompassing all presentations under ASD, there was still a wide variation in autism presentations. It didn’t tell you, for example, if the person was verbal or not, if they were sensory seekers, sensory avoidant or a mixture, whether they displayed SIB or not, whether they needed an SN buggy or wheelchair, whether they needed a specialist bed or not, whether they were toilet trained, whether they ate orally, whether they would go on to live independently or need 24/7 3:1 support in a secure placement or something in between…

It’s not a goady thread and no one’s forcing anyone to engage. a better question might have been neurodivergence in girls. Consensus is I am being unreasonable. Consider me told

I don’t disbelieve girls are autistic, I don’t disbelieve that it’s a spectrum and I understand spiky profiles , and the American system of levels has some merit, even if it is is probably mostly to do with health insurance

(I do think failing to differentiate between severe and mild is an oversight - everyone may struggle but some struggles are bigger than others and most people know what is meant when someone describes it as severe/profound even if it isn’t official terminology)

Further digging in attempts to educate myself has however led me to Naomi Fischer and the nature article by Uta Frith and I still think they are onto something .

Both of whom have equally had criticism.

It isn’t as simple as saying those with what is being termed by some as profound autism have severe autism and no-one else has extensive difficulties as a result of severe autism.

DS3 is autistic. He would still have been diagnosed with autism before the move to encompass all under ASD. He would not have been diagnosed with Asperger Syndrome. However, he does not have a co-morbid LD so would not meet the criteria being floated around for profound autism. Yet he is severely autistic and profoundly disabled with complex according to wording on professional paperwork. So much so it is inappropriate for provision to be delivered in school and he has a comprehensive EOTIS package with 2:1 at all times. He also has a social care package. Again with 2:1 care. He needs support with activities of daily living. Everyone involved in his care agrees he will need 24/7 care for life and will never be independent.

1. No idea what your question is, still.
2. I don't think you understand what a spectrum is. It isn't linear.
3. Levels are used in the US, and though not usually used in the NHS, they are understood enough that individuals or their parents often use them as shorthand.
4. The reason they're not formally used in the UK is because the people who actually need to know about someones autism, ie those who might need to support them, would get information about their individual profile. Not because people are too stupid or stubborn to accept that a non verbal 14 year old who wears nappies will have different support needs to a 6 year old who is verbal and continent.
5. Uta Frith's basic idea isn't radical - people have recognised that autism can co exist with intellectual disability for years, but doesn't automatically, and the two are different. However the way she has promoted this idea more recently is harmful. You haven't uncovered a nugget of genius there.
6. Saying that a thread isn't goady, when you refer to 'smug self diagnosis' from internet memes is either a) you're lying b) you have the emotional intelligence and empathy of pebble or c) you're trolling. I'll leave you to decide which.