Why autistic women don’t fit the DSM-5 criteria
Autism is a spectrum, so regardless of what you know, you’ll rarely see someone who exhibits exactly what you know. Perhaps you are unaware, but the main diagnostic criteria that is present in the DSM-5 pertains to the MALE characteristics. Much like most of medicine, a woman’s experience has been reduced to the idea that we are simply “little men”. See this article for more on that!
In females, autism presents differently.
*enter shocked face here*
A female’s gender role (i.e. how we are forced into social situations from a young age… aka gender stereotyping) leads to this ability to apply our attention to detail and observation skills to very good use. What do female autistics do from childhood? We copy. We mimic social cues and social interactions which makes us go ‘unseen’. We can read you and copy you, so our behaviour often does not reflect what you *think* you know about autism.
Now, I am sure someone wants to say, “but that’s just mirroring; every child does it”. Indeed. That is true for non-autistics. We, however, are aware that we do not fit in, even though we look like you; we know we’re copying you. It’s a cognitive thing. It’s NOT automatic. It’s thought-out, planned copying. And the interesting thing about female autism is that our level of copying you is actually often better than how you do it.
Growing up, females on the spectrum learn to fit in. We realize it’s a survival mechanism, so we survive. We hide our autistic traits, we “pretend” to be normal, for YOUR benefit. It is extremely taxing on our well-being, and many women on the spectrum (including me) experience anxiety and depression at times, trying to produce this “perfect social expression” so that you will accept us. We do it do be accepted, even though it hurts us.
Other than the mimicking, females on the spectrum struggle because our special interests are most commonly things that are strangely considered “normal” for our gender. Where a boy may fixate on trains (which is often stereotyped as inherently male), the appearance of such an interest is included as an example in the DSM. However, a girl with a passion for teddy bears, flowers, or sewing — this is considered ‘acceptable’…. even if her whole room is covered with those things, or if she seems obsessed with those things, it’s still okay. Somehow, being female means “it’s normal”. And, furthermore, when a female autistic child fixates on 1 person, making that person their special interest, no-one bats an eyelid — everyone just says, “aww she has a best friend”. If she is shy, that’s also acceptable. If she is overly energetic, that is “fun”; babylike, that is “cute”; a bookworm, that is “studious”… we constantly overlook the female experience with gendered thoughts!
Do I look autistic? Probably not. But then again, you are looking for male characteristics.
And one more thing — when ANY autistic person is completely involved in something they love, be that a hobby or a job, they will (like any human) excel. We, when doing what we are skilled at, qualified for, and enjoy; we will shine. We may seem unusually extrovert, fun, loud, engaging and/ or inspired. We may seem “without trouble”, and really — is that not a true reflection of any human in such a similar situation?
I excel in teaching and leading groups; reaching, inspiring, mentoring and supporting others. I shine where I am designing new products, being innovative, developing something, solving a problem, applying research, or simply “doing good”.
If you want to help autistics shine, let us demonstrate our talent and ability, and stop saying to us “you don’t look autistic”; better be humble and note your destructive bias. Better be kind and see our ‘humanness’ first.