5 Subtle Signs of Autism Spectrum Disorder in Women
Women with autism often display very different symptoms than men with autism, which may lead to an incorrect diagnosis or failure to be referred for diagnosis.
Not only do many women with autism spectrum disorder (ASD) act in a more socially neurotypical way—usually as a result of having put a considerable amount of effort into learning how to act socially—but the focus of their attention is different to that of men with ASD.
Here are five signs of autism in women:
1. Intense focus on a person/band/celebrity
One of the criteria used for determining ASD—for instance, in Simon Baron-Cohen’s Asperger’s Test1—is an intense focus on “things,” which may be related to collecting and hobbies such as train spotting.
Women with ASD also display very intense interests but, whilst they may be focused on objects, their focus is just as likely to be on people. Girls growing up with ASD may become obsessed with a celebrity or band to the extent that they need to know every single fact about them. Many of my clients who are in relationships become so focused on their partner that they can lose sight of their own needs.
Because a focus on celebrities and people is seen as more “normal” than a focus on collecting model cars or napkin rings, it contributes to the fact that girls and women may fail to be diagnosed with ASD.
2. Anxiety and depression
Like many women, I was diagnosed with anxiety and depression. Having ASD and trying to fit into a neurotypical world is hard, and women can become depressed and anxious as a result of constantly struggling to cope with things that many people find easier. Without a diagnosis of ASD, it’s easy to judge oneself harshly and it’s easy for other people to misunderstand you, both of which can lead to feelings of low self-esteem, anxiety, and depression.
3. Disliking uncomfortable clothes
Many children with autism have sensory issues relating to clothing including sensitivity to fabrics, textures, tags, and comfort. Adult women with ASD may continue to be sensitive when it comes to wearing uncomfortable clothes and may choose comfort and function over style.
Whilst I’m not as sensitive as I was when I was a child—when I couldn’t touch wool or wet nylon and would have a tantrum if there was a tag on my clothes—I still have to cut the top of my socks and always choose comfort over style.
4. Lack of eye contact
Since receiving my own diagnosis and working with other women with ASD, I’ve become more aware of the difficulty women with autism may have in making eye contact. As with other aspects of social interaction, many women have learned to make eye contact and force themselves to do so, but it’s not something that comes naturally and can be quite tiring.
5. Less severe symptoms than men with ASD
Girls with ASD may display less severe symptoms than boys.2 This could be the result of several factors, including a stronger desire to learn socially acceptable ways of acting and repression of certain ASD behaviours. Girls with ASD may also simply be seen as more “quiet”—a quality that is regarded in itself as more socially acceptable.
For me, having ASD means being regularly confused. I’m confused about other people’s motives, partly because I don’t pick up on what’s about to come and I don’t understand what’s behind their actions. I tend to be very naïve and take other people at face value. I’m confused when others think I’ve been rude, selfish, or inappropriate when I’ve been trying to act my best.
I have very poor facial recognition which results in regular confusion as people who are completely unknown to me strike up conversations. These days, I try and surround myself with supportive, honest people—but as a younger woman, the social confusion, particularly, meant I was quite open to manipulation and could become very hurt by others’ actions, as I failed to understand what was behind them.
Because of the difference in women’s ASD symptoms and because women may learn to mask their symptoms beneath a veneer of copied neurotypical behaviours, women with ASD are sometimes referred to as being “camouflaged”3 which contributes to the fact that so many women go through life without a diagnosis. Hopefully, as the understanding of women’s presentation of ASD increases, diagnostic criteria will become more encompassing and more women and girls will receive the correct diagnosis.