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Why females often get diagnosed later in life

Alien0n3arth

I watched today a video (in german) by Tom Harrendorf,  a youtuber, who himself is a diagnosed (formally) autistic and he works in the area of autism 15 years and is also a leader of a local support group. 

He brings various studies in his videos. Today I watched a video from him, where he put together (according to the study) - reasons, why women so often get diagnosed later in life. It turns out, that it's not masking, at least not to high degree - the reason why it happens. 

Girls and women are naturally more social than men. It applies to both, allistic women and men, and autistic women and men. So if the diagnostic setting involves one diagnostician and one autistic woman, the diagnostician alone may not be able to catch the difficulties, the woman has. So then she might be false diagnosed as not autistic,  because she is able to have a conversation with the diagnotician. So as Tom Harrendorf says, in order to be able to pick up on an autistic high functioning female, her social difficulties,  tgere should be more, than one person in the setting and then it would be visible, how much that autistic woman struggles to stay on track.

He also mentioned the bias, although the symptoms between males and females are similar, there are still more men diagnosed. Not sure if autism truly affects men more often than women, or girls and women just go undetected for years. Or entire lifes. An autistic girl is more likely to be labeled shy, lazy etc. I was labeled shy, obsessive and stubborn. Tge author also says, that "masking" in autism is actually very doubtful and hard to perform. Why? It's because of the nature of autism- difficulties reading social, non verbal cues, facial expressions,  difficulties understanding anything ambiguous etc. So I relate to it - I'm mostly unaware or very little aware of my body, my stimming, that's why I can't just stop it, so it happens,  that someone changes their seat when they see my weird movements with my hands. Also when it comes to my behaviour and interests, I may try to modify it only when someone tells me directly,  what I should change and that they find it weird or wrong (whatever about me). Otherwise I just don't know it. I always wanted to be like others, but had no idea how to do it. I still can't practically do it, but this man's videos help me understand how autistic minds differ from allistic minds. I don't have a formal diagnosis,  I can only say I relate a lot to the autistic experience. 

Here is the link to the video:

https://youtu.be/mkJ0vl0YjT4?si=R7nmCUeZmIp2Lz1P

I'm curious of any thoughts and experiences in this topic.

At tge end of the video Tom asks if ladies on tge spectrum or with suspected autism fear or feared being not taken seriously and not recognised because of masking. He also mentioned,  that women are more likely to get other diagnoses. Also my case- depression and tourette in the past. Tourette turned out to be false.

  • its not just females getting late diagnosed, but i did read autism is harder to detect in female due to being naturally more sociall and talkative, many of them wear bright colours 

  • in reply to Expecto_Patronum

    Yes, the "try harder" was also my experience 

  • in reply to Alien0n3arth

    I think I did basically talk in full sentences when I started talking but my speech sounds were weak so I was difficult to understand. I don't think this helped as it was put down as a physical issue with speech as opposed to something like autism.

    My interests may have been more "socially acceptable" but the degree to which I liked them and obsessed over them was not typical.

    I think my mum had a hard time accepting my differences too. She was quite embarrassed by them I think. I've no idea whether school ever raised the possibility or whether they didn't see possible explanations either. My general experience was that school just thought I was naughty and needed to try harder.

  • in reply to Expecto_Patronum

    I was also late to start speaking, but when i started, I spoke with full sentences and kinda like I was more mature than my actual age. Before there was no cooing. My intrests were quite stereotypical- trams, I used to draw tram lines with stops, whole city plans, infrastructure, but before I even could write, I drew faces. One next time another, whole notebooks filled with them like passport photos. I didn't play with kids, I was scared of the chaos and noise they made and couldn't do role-playing. I was missed because my mom couldn't accept having a daughter with special needs. In the late 90's my teachers suggested autism, it made her mad. When I asked her if I had autism,  because I overheard the teachers, she was also mad. Later I was diagnosed depression. She had no issues with depression and tourette and me being put on awful meds. Till today, as I mentioned my therapist suspecting autism in me- she is mad. So there are various reasons,  why someone was no diagnosed.  There is also a possibility,  that even though there were suspicion, I might have turned out not autistic because of the knowledge and awareness being outdated back then.

  • in reply to Alien0n3arth

    I've always been a funny in-between. I'm certainly not like other women. As a child I definitely found boys easier than girls (although it was difficult to get along with either). I don't think I'd still say that was the case. I  probably find a particular category of adult women easier to get on with now - people that are more on the nurturing side of personality. 

  • in reply to Bunny

    Thank you for sharing the link, the "extreme male brain theory" got my attention. I was told multiple times by female peers, including my step sister, that im like a boy. There was also a colleague at work who told me the same thing. I was kind of a bit amazed, but on other hand I feel it my whole life, that im profoundly different. I also hear that the brain of autistic female works somehow like a brain of non-autistic male. Which makes somehow sense to me.

    I work in a male team, I'm.the only female there and I hear from my colleagues that im absolutely different than other women and they like working with me. Do maybe it also contributes to the 'late diagnosis' - autistic males find less environments where they can somehow fit in, than us females. I don't fit in with the female peer group,  but I can much better fit in with a male peer group. In my workplace the male colleagues make small talk and gossip more or less same as females, but the big difference for me is that they don't ask me "what's wrong with me" why I don't do small talk. They say I'm very quiet and bring peace and I'm organised and my hyperfocus on the task let me do it quickly. 

    Tom Harrendorf brought up once a study, that claimed the autistic phenotype is actually more prevalent in females than males, but because of the social roles and expectations, the autistic symptoms are more problematic and recognisable in males.

  • This sounds very similar to what Gina Rippon says in her book The Lost Girls of Autism. I'm not sure that having two people in the room would be a good idea, I think it could lead to more masking and attempts to appear "normal", it could also feel very intimidating, if one asks a question and the other interupts, I for one wouldn't know who I should be talking too and it could easily feel a bit "good cop, bad cop".

  • As a child I would say there was a fairly large bias on the fact that I was a) a girl and b) fairly intelligent. I really struggled socially throughout all my school years and all I was ever told was "you just need to try harder". 

    I think growing up in the 90s there were still misconceptions regarding language etc. Although as a young child I was late to talk and then hard to understand when I did start talking. When I got to about 6, I was chatty and could manage 2 way conversation. I think at that time they generally expected autistic kids not to be able to do that and missed the signs such as taking things literally and being too direct.

    The same with rigidity. Although I've never liked change admittedly so that was a sign. But things like rigid interests. I liked horses and Harry Potter which probably weren't seen as unusual.