However, it is currently unclear whether autistic presentation differs between cisgender women and gender-diverse people. This was in accordance with the ethical standards of the national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. All extracted components were considered to be consistent with girls' and women's autistic trait presentation (Table 3). I avidly observe other females socializing, 8. ( even with degrees and experience with childhood autism, as you state, they are looking for criteria to fit male children). We used a version of the GQ-ASC,16 modified for use with adult women. if I was a male child, failing to recognize there is a distinct difference The AQ is scored on a 4-point agree/disagree scale (definitely agree, slightly agree, slightly disagree, and definitely disagree). Change ), You are commenting using your Facebook account. The whole “birds of a feather” thing is pretty on point, isn’t it? A receiver operating characteristic analysis indicated an excellent level of discrimination. Some time passed, and although I didn’t feel the need to get diagnosed as such, I did wonder. But this list, compiled from several sources on women with autism, could easily be speaking about me specifically: Misdiagnosis is only a small part of the problem. We do not know if any of the 350 autistic women who completed the survey have an intellectual disability, and we do not know if having an intellectual disability will change the results of the study. Anyway, I don’t know if I should go see a psychiatrist for real, I just told the online test. This aligns well with the report that over 90% of autistic women have attempted to camouflage their autism.9 The nature of social interactions are inherently more complex in adult years than in childhood, with demands that may otherwise fall on parents or carers and the buffer that presents no longer being an option for many. 1). Wow, those all sound like me. This  site  is  not  intended to replace  the  medical  advice  of  a  trained  medical professional. I adopt a different persona in different situations, 10. would he come to this conclusion and possibly be wrong? Masking is not coping, it’s hiding and it’s terribly anxiety inducing. The findings of our study can help doctors and mental health professionals work out which women should be assessed for autism. We found significant differences in all components, and the total score (Table 5). We interpreted the extracted components as follows: (1) Imagination and play: Describes interest in fantasy, fiction, and reflection on the quality and content of imaginative play in childhood; (2) Camouflaging: Describes effortful attempts to reduce the visibility of autistic traits; (3) Sensory sensitivities: Describes sensory processing hyper- and hyposensitivities across various modalities; (4) Socializing: Describes barriers to social understanding and participation; (5) Interests: Describes age-advanced and nonstereotypically feminine interests; and the subsequently excluded component (6) Compliant behavior: Describes behavior that is compliant with authority and peers. It is worth noting that autistic traits, as displayed by girls and women, are not always effectively measured by the AQ due to inherent sensitivity issues.19 We made the methodological decision to use the AQ, as at present it is one of the most reliable screening tools for measuring the presence of autistic traits. I avidly observe other females socializing, 15. We presented participants with a plain language statement explaining the nature of the study and asked them to give their informed consent to participate. Non-urgent advice: See a GP if: you think you may be autistic ; It has been reported that many autistic girls do not show a strong preference for female-typical toys,31,32 and that autistic women frequently identified as “tomboys” in childhood.33 Item number 32 (I am talented in music) appears to be qualitatively different from the other items in this component, with internal consistency improving for the component overall if this item is removed. quite happy to give me one of his favorite diagnoses instead. No diagnosis appointment after having gone over the basic interviews and his verbally stating that I seemed to have autism but wanted to try to sort out if any symptoms were from other causes (trauma etc) that was why we set up the testing… testing could not happen because he is so ill and has officially retired now. I love that I have the opportunity to tweak and edit and make things perfect so that the world can understand and see me clearly; without the physical awkwardness, the shy tics or the occasional inability to meet another human gaze. This began long before my PTSD symptoms ever started. Kolmogorov–Smirnov tests indicated that all GQ-ASC items were non-normally distributed (p < 0.001), which was expected, as we included only autistic cases. It includes four subscales: Play (between 5 and 12 years old), Friendships and Social Situations, Abilities and Interests, and Sensory Profile. This is especially true if I’m anxious and so when I’m talking to someone I don’t know well or there is a group of people, sometimes thought seems impossible and I have a much harder time forming coherent sentences and recalling information. for diagnosis, because the doctor didn’t know what to look for in a female with If the address matches an existing account you will receive an email with instructions to reset your password. Table 6. The skills needed to sort out autism in adults after years of learning to cope and to ‘play the game’ of socially intricate rules is not something most doctors in the USA have much experience with. Diagnosis does mean the world. 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. She might be anxious in settings where she is asked to perform in social situations. Little's MCAR test determined these values to be missing completely at random (χ2(839) = 850.58, p = 0.38), and they were replaced using an expectation maximization technique. We identified four items in this component, each relating to the active process of developing and displaying strategies that minimize the impact of social challenges.8 Each item reported high component loading values, and high communalities, with this component recording the highest degree of internal consistency (ω = 0.67). I also had to start taking methylated vitamins and treat a condition that was also causing me some hormonal issues. I am attracted to females with strong personalities who tell me what to do, 18. thoughts and feelings because neither the evaluation nor its conclusion were anything After testing fairly high on the online test I took, the psychiatrist told me I’m not on the  spectrum at all, but have similar traits that are more likely caused by attachment disorder. 33 Item number 32 (I am talented in music) appears to be qualitatively different from the other items in this component, with internal consistency improving for the component overall if this item is removed. This study aimed to explore the structure of the GQ-ASC to establish its most salient features as they apply to adult cisgender and trans autistic women. completely unfamiliar with autism in women couldn’t see it in me, but he was It was only recently when someone on one of my fibromyalgia support groups posted about being diagnosed with ASD in her 50s, and how it is so common that women with ASD end up with fibromyalgia and other disorders. Sensory processing hyper- and hyposensitivities are considerably more common in autistic individuals than in nonautistic individuals,27 and reported to be more prominent in autistic girls than boys.28 The autistic experience of the sensory world is complex, as it is often described as a source of pain and distress, and also as a source of pleasure and safety.29 This paradoxical relationship is reflected in the retained items that describe both sensory overload and the soothing quality sensory input can have. These questions appear to explain adult autistic social challenges well, although they may not accurately reflect the experiences of autistic women with higher support needs, or a co-occurring intellectual disability, as they describe a high degree of insight and active responding to social missteps. I wish you the best with your upcoming appointment. Sexual orientation, gender identity, and romantic relationships in adolescents and adults with autism spectrum disorder, Ingudomnukul E, Baron-Cohen S, Wheelwright S, Knickmeyer R, Elevated rates of testosterone-related disorders in women with autism spectrum conditions, Toward brief “red flags” for autism screening: The short autism spectrum quotient and the short quantitative checklist in 1,000 cases and 3,000 controls. These include, although are not limited to, gendered assumptions about how autism presents and who it impacts1; an increased likelihood that female autistic traits will be attributed to other causes3,4; standardized assessment measures that may not be sensitive enough to capture autistic girls and women who experience and express their autism in unique and nuanced ways5–7; and active attempts by autistic girls and women to camouflage, or mask challenges related to their autistic traits to blend into social situations.8,9. I feel like I’ve found the pieces to adequately explain why other people have also insisted that I am “quite unique” to downright “bizarre.”. Despite how well I seem to hide, I do have my cognitive issues and deficits, things that I’ve been dealing with my whole life, as well as things that have become a problem since the surge in my chronic illness the last 10-15 years. “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). The items all recorded high component loading values, and communalities, with no notable changes to internal consistency with the exclusion of any individual item. The sample contained 350 autistic women (M age = 36.21, standard deviation [SD] = 10.10) and 322 nonautistic women (M age = 34.83, SD = 9.93), screened using the Autism Quotient. Variables with a KMO below 0.50 were removed from subsequent PCA iterations (n = 1, KMO = 0.45; Kaiser, 1974). I took the online test too. I think it is imperative to talk to the Dr you are thinking about seeing to ask pertinent questions before setting up a diagnostic appointment. Quantifying and exploring camouflaging in men and women with autism, Cassidy S, Bradley L, Shaw R, Baron-Cohen S, Risk markers for suicidality in autistic adults, Identifying the lost generation of adults with autism spectrum conditions, Kapp SK, Gillespie-Lynch K, Sherman LE, Hutman T, Deficit, difference, or both? Factor analysis scree plots for data and for modeled parallel analysis based on 1000 permutations. I think I have done it right this time. Furthermore, we made this methodological decision to include both cisgender and trans women in an attempt to retain a more inclusive and representative cohort. How autism spectrum disorders presents in women would not be examined for many decades to come, leaving many girls and women who mask well (typically better than men do) to fend for themselves. I will be thinking of you and hoping you can find another person who is qualified and accessible. Official diagnosis is access to help if needed. I just have a mountain of medical debt right now and am dealing with more urgent medical needs at the moment. provided supervision and guidance for all components of analysis, interpretation of findings, and reporting of results. During that time I have worked with many many children on the spectrum, all showing varying traits and extremes. This may be attributable to differential trait presentation between men and women, or gendered understandings of autism inherent in the development of each scale, or both.
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