Autism, a neurodevelopmental condition, has long been associated with males, but a recent study challenges this notion. The research, conducted by the Karolinska Institutet in Sweden, reveals a surprising finding: autistic girls are significantly less likely to be diagnosed compared to their male counterparts. This disparity persists even as girls and women reach adulthood, where diagnosis rates become nearly equal.
The study, published in the BMJ, analyzed the diagnosis rates of autism among individuals born in Sweden between 1985 and 2020. Out of the 2.7 million people tracked, 2.8% were diagnosed with autism between the ages of two and 37. Interestingly, by the age of 20, the diagnosis rates for men and women were almost identical, contradicting the previous assumption that autism is more prevalent in males.
Dr. Caroline Fyfe, the lead author, explains, "Our findings suggest that the gender difference in autism prevalence is much lower than previously thought, due to women and girls being underdiagnosed or diagnosed late."
The research further highlights a concerning trend: boys were diagnosed on average nearly three years earlier than girls, with a median age of 15.9 for girls and 13.1 for boys. This leads to a three to four times higher likelihood of boys being diagnosed with autism under the age of 10. However, by the age of 20, girls "catch up" due to a rapid increase in autism diagnoses during adolescence.
Anne Cary, a patient and patient advocate, argues that "systemic biases in diagnosis, rather than a true gap in incidence," are responsible for the discrepancy in diagnosis rates. She suggests that the methods and tools used to diagnose autism may be biased and in need of refinement, as they might not adequately account for the unique presentation of autism in girls and women.
The study also found that while gender disparities in diagnosis rates remained consistent for children under 10 over the last three decades, they decreased rapidly for all other age groups. This indicates that the male-to-female ratio for autism spectrum disorder is lower than previously assumed, and in Sweden, it may no longer be distinguishable by adulthood.
Autism charities emphasize the need to tackle gender stereotypes and improve diagnostic practices. Dr. Judith Brown, from the National Autistic Society, states, "Gender should never be a barrier to receiving an autism diagnosis and access to the right support."
Jolanta Lasota, CEO of Ambitious about Autism, highlights the unique experiences of autistic girls, who have often been overlooked. She emphasizes the importance of understanding the different presentations of autism in girls and women, and adapting support services accordingly.
Dr. Conor Davidson, a former autism champion, notes that autism in girls is more likely to go undetected during childhood, with signs emerging during adolescence or early adulthood. He also highlights the long waiting lists for autism assessments, both for children and adults, and the need for timely access to care for autistic women.
This study serves as a call to action for the autism community, urging a reevaluation of diagnostic practices and a more nuanced understanding of autism in girls and women. As the field continues to evolve, it is crucial to address these disparities and ensure that all individuals, regardless of gender, receive the support and diagnosis they deserve.
