Young Women and Autism
Written by Dr. Richard O. Williams
The blog below is my second on the topic of autistic girls and women. To read the first blog on this topic, click here. My keen interest in this subject stems from raising my daughter, who was very lucky to be diagnosed at an early age. Since her diagnosis, female autism has become a dominant focus of my interest in autism.
In primary school, autistic girls learn how to act socially normal. Their peers teach them what is right, what is weird, and what is cool. They become masters at camouflage and social mimicry. (See the former blog) Secondary school is a different matter. Girls in high school become hard and mean to each other. They form cliques and small groups of friends who act and think alike. They are the first to focus on anything and everyone who behaves a little weird or wears different clothes. They now reject their former friends because they are socially freaky, unusual, and strange. The autistic girl quickly learns that the underlying difference she felt earlier had become a significant source of distress. It takes the form of being rejected and bullied for being different. Severe anxiety, low self-esteem, and a burning desire for inclusion take a psychological toll that will last a lifetime. Don’t forget, the sensory hypersensitivities in autism include emotions that can cause exaggerated responses to rejection and exclusion.
Autistic girls and women internalize and suppress their stress and emotions rather than acting out as boys do. This often results in a diagnosis of depression, bulimia, or anorexia. If a mother asks a pediatrician or psychologist if the problem could be autism, the answer likely no. A friend of mine asked a doctor if her daughter might have autism. He replied, “it isn’t autism” because she makes eye contact, has social friendships, and now has just an eating disorder. The doctor seems to be looking for the traits of boys.
The autistic women who move into adulthood carry the scars of secondary school. Their insecurity and low esteem linger, and they search for inclusion. The autistic adult woman can adapt to the new demands of work and social activities but is still aware that she is different. Not knowing the nuances of social interaction leads to tension in the workplace and moving from one job to another. Not understanding social mixing with men is another story. Passive and compliant women are vulnerable in their relationships with men. The underlying terror of being rejected easily slips into being manipulated. The fear of saying no when she knows full well, she should, often leads to sexual manipulation and abusive relationships.
By far, one of the greatest human tragedies in our understanding of autism has been the failure to accurately and timely diagnose autism in girls and women. The inability to recognize autism early in girls and the late diagnosis of autism in women has taken an enormous human toll. The lack of intervention in the early years and the damage of lost marriages and families, jobs, and wrong diagnoses in adulthood is an avoidable tragedy.