The Bad and Good News About Autism in Girls

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PSYCHIATRIC VIEWS ON THE DAILY NEWS

During my long career in psychiatry, I remember the time when girls were underdiagnosed as having attention deficit disorders (ADD) compared with boys. The difference was that they were more hypoactive instead of hyperactive, daydreaming instead of restless, and thereby less noticeable. That is probably why the disorder was generally called attention-deficit/hyperactivity disorder (ADHD).

Now, a similar development is occurring with autism, as reported in the New York Times on April 10, 2023: “More Girls Are Being Diagnosed with Autism.”¹ Autism has long been associated with boys. About a decade ago, when the current DSM-5 came out, the rate was almost 5:1 toward boys. As early signs of the condition are now more on our radar, that gap is narrowing.

Once again, girls have less obvious physical manifestations of the disorder. They seem to camouflage their social challenges better. It may reflect a faster brain development that is involved in social relationships. Later in childhood though, girls with autism seem to start to stand out and are more likely to develop anxiety and depression. Sexual abuse becomes more common.

Now, many women in adulthood are finally being diagnosed with mild autism that was missed in childhood. Rates of Black and Hispanic individuals being belatedly diagnosed with autism have gone up too. All of this indicates we should not ignore gender and cultural influence on symptom expression.

The bad news is that the prevalence of girls with autism is higher than previously thought. The good news though, is that the delayed recognition is helping personal understanding of this neurodiversity. When still necessary, treatment can also be provided. Actually, the “bad” may not be so bad if the strengths of mild autism are recognized and valued.

We know that such neurodiversity can be a boon in the tech industry. Perhaps more girls with autism will now be hired, too.

Dr Moffic is an award-winning psychiatrist who has specialized in the cultural and ethical aspects of psychiatry. A prolific writer and speaker, he received the one-time designation of Hero of Public Psychiatry from the Assembly of the American Psychiatric Association in 2002. He is an advocate for mental health issues related to climate instability, burnout, Islamophobia, and anti-Semitism for a better world. He serves on the Editorial Board of Psychiatric Times™.

Reference

1. Ghorayshi A. More girls are being diagnosed with autism. New York Times. April 10, 2023. Accessed April 20, 2023. https://www.nytimes.com/2023/04/10/science/autism-rate-girls.html