This is an interesting one. We would say it is not. You still get the same profile of difficulties with social skills, along with unusual or repetitive behaviours. What is different is how these difficulties and behaviours manifest. But, as clinicians working with autism, we should be used to this – because we are used to the spectrum.
Language difficulties, for example, ‘look’ different in a person with severe autism than in a person with high-functioning autism (what was previously labelled as Asperger Syndrome). The first may be non-verbal and the second may speak in a formal and stereotyped way.
The ‘female’ presentation of autism is no different. It just represents variance. And, having seen many males in clinical practice who present with this ‘female’ profile, we would argue that it is not sex specific. It is just another manifestation of autism, at the higher end of the spectrum.
The issue is more about healthcare and education professionals lack of awareness of the many faces of autism, rather than a lack of knowledge about the ‘female’ presentation per se. This is a huge problem because it means that people with less well-known profiles of autism are less likely to get a diagnosis, and the help and support they need.
These are some of the characteristics of what is described as the ‘female’ presentation of autism:
- Socially motivated but they just get it wrong
- Interests tend to be related to social behaviours, such as music, animals and understanding oneself
- More likely to internalise (in the form of anxiety or depression) their problems than externalise them through behaviour – meaning that people underestimate the extent of their difficulties
- Tend to mask, camouflage or hide their autism in attempt to fit in
People in this group often do not ‘look’ like they have autism. Their presentation is far removed from the textbook description of what autism is (i.e. a non-verbal person sitting in a corner of a room and rocking back and forth), but the impact on them is just as significant.
Our clients tell us that it is “exhausting” and “energy zapping” trying not to look autistic all day. The leads of emotional outbursts or meltdowns. We also see people in this group who are hugely vulnerable to exploitation or abuse because of the difficulties they have understanding social relationships.
And they struggle to maintain education or jobs because they feel lost and without a clear identity.
For these reasons, it is of great importance that an assessment is completed by a specialist team. Research tells us that people with the above profile are at risk of getting missed or not receiving a diagnosis until later in life, and we all know how powerful and helpful a timely diagnosis is…