Do More Boys Have Autism Than Girls?

Do More Boys Have Autism Than Girls?

Takeaway: More boys than girls are diagnosed with autism, but does that mean autism primarily affects boys? Recent research shows that while there are indeed gender differences with autism, there’s another factor at play. Often, fewer girls are diagnosed because they’re better at covering up their autistic traits and blending in. But thankfully, as autism testing improves, we’re able to spot and help more of these overlooked children.

Autism is a complex phenomenon because it describes a spectrum of traits and behaviours.

Children with autism have brains that develop differently from what we’d typically expect. And these developmental differences mean they experience life in unique ways. But there isn’t just one type of autism. Sure, children with autism usually have similar traits — repetitive behaviours, problems with language, difficulty socialising, etc. But these traits affect each child’s life differently. And this is why we think of autism as describing a spectrum of possible traits and behaviours. It’s a much more complex phenomenon than just a single oversimplified personality type. Learn more about autism spectrum disorder (ASD).

Autism’s nuances don’t end there, because the autism spectrum varies between boys and girls, too. But why?

Studies show that there are about four boys with autism for every girl that’s diagnosed. But why is this? Is it that more boys have autism? Or is it that we’re overlooking many of the girls? And if that’s the case, is it because boys and girls show different sorts of autistic traits? This would make sense because boys and girls, in general, tend to develop differently. (For example, research shows that while young boys establish very stable friendships, young girls display far more advanced social skills.) But does this difference carry over into autism, too?

Let’s start with genetics. Boys may indeed be more likely to develop autism than girls. And scientists have many theories about why this could be.

Researchers have been exploring gender differences in autism for a while now. And they have a few theories as to why boys may indeed be more likely to develop autism than girls. For example, one theory suggests that certain genes tend to trigger autism, and boys might have more of these types of genes. And another theory suggests that higher testosterone levels in the foetus might also set the stage for autism, explaining why boys are more affected.

But there’s more. Autism seems to express itself differently in boys and girls.

Brain scans reveal that men and women with autism show different types of activity in their frontal lobes. So, gender seems to influence how autism expresses itself, too. For example, boys show more visible behaviours like being aggressive and hyperactive — which are easy to spot in a classroom. Meanwhile, girls internalise their reactions — feeling depressed and anxious — which often goes unnoticed.

This difference lies at the heart of the issue because we’re often more tuned into how boys experience autism than how girls do.

A lot of the time, we simply notice autism in boys more than we do in girls. For example, let’s take the ‘repetitive behaviour’ trait in autism, which causes children to develop specific, restricted play habits. With boys, this could mean they develop an obsession with trains and start memorising train timetables and model numbers. And this obsession might be a stark contrast to how their classmates play. But girls with autism often become obsessed with things other girls are obsessed with, too — like pop stars and celebrities. So, it’s less likely to stand out as being unusual.

Also, we tend to expect more from girls, socially. And this might indirectly pressure girls with autism to try and blend in better.

Traditionally, society has given boys and girls different gender roles (although we’re now slowly changing this). For example, girls are often expected to be more sociable than boys. And so girls with autism might see socialising as something they should be doing. This, in turn, means they’ll try to make friends even if they don’t quite feel up to it. We often don’t hold boys up to the same standard, though. So, boys with autism are less likely to force themselves to socialise, which makes it easier to recognise that they need help. As a result, they get diagnosed more often. (Note: Boys have a different set of pressures to girls — for example, they’re expected to be good at sports. And this can be traumatic for boys who have autism combined with dyspraxia.)

This tendency for girls to blend in is so common that there’s a term for it. We call it ‘camouflaging.’

Girls come up with ingenious ways to mask their autistic traits. For example, if they find conversations awkward, they might ‘prepare’ for them in advance. This could involve standing in front of a mirror and practising the facial expressions they’ve seen their classmates make. That way, in the next conversation, they’ll know how to put on a ‘surprised’ face even if they don’t necessarily feel the emotion. And mini-tricks like this form a sort of social camouflage. But all this takes effort, which makes their lives so much more stressful. Think of it as an actor performing a role for a play, except that the play is now their entire life!

The final piece of the puzzle is that autism testing tends to be biased toward boys.

From the earliest days of their research in the 1940s, scientists assumed that autism primarily affected boys. So, most of the tests they developed had questions skewed to diagnose boys rather than girls. Testing strategies have evolved over the years, but we still see a bias. For girls to be diagnosed, they usually need to have more severe autistic traits, complex behaviour issues, and intellectual disability. Girls with higher IQs and less pronounced autistic traits are often overlooked and end up ‘hiding in plain sight.’

We’ll surely learn more about these gender differences in autism over the coming years. But it’s a matter of asking the right questions.

The answers we get depend on the quality of the questions we ask. For example, asking, ‘Why are more men than women affected by autism?’ is different from, ‘Why do men show autistic traits more easily than women?’ And as scientists start to ask more pointed questions, we see great leaps forward in autism research. This is heartening because it means that we can give our girls and boys the targeted help they need and deserve.

Are you concerned that your child might have autism? If so, consider contacting a specialist.

The Ed Psych Practice offers face-to-face and online assessments, consultation, advice, and problem-solving strategies for parents, nurseries, schools, and colleges in London. We have psychologists, paediatricians, and therapists who can help assess your child and offer guidance and support.

Want to see how else you can help your child? You might enjoy some of our other posts.

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