According to new research, autism is not as common among women as it is among men because it better hides the usual signs of the disease.
Some people with autism use strategies to mask traits associated with the condition during social interactions, a phenomenon known as social camouflage. Scientists participating in the study say that educating doctors about camouflage could help reduce the number of missed autism diagnoses.
Scientists studied the results of an online survey designed to measure gender differences in camouflage in autistic and non-autistic adults. They found that women with autism exhibited more camouflage behaviors than men, which corroborated earlier observations from self-reported studies. No difference in camouflage between the sexes has been reported in non-autistic groups.
"The effect was not as great as expected," said Dr. Will Mandy of University College London, one of the authors of the study, published in the journal Autism and presented at the British Science Festival .
"What I find interesting is how camouflage is ubiquitous. When we begin to understand why, it is alarming; for beginners, it is an obligation rather than a choice. It is very often a matter of self-preservation, to avoid intimidation or attacks. "
Common camouflage behaviors include learning to make eye contact or suppressing the drive to move physically that some people with autism would find comforting, calling for paralysis, such as a swaying body or a flapping of hands.
Data from non-binary and other sexes were also studied and no difference in behavior was found, although the sample size of these groups was small.
"In its most complex form, [social camouflaging] involves the adoption of a character. In women in particular, this could involve watching other women or girls who seem to be popular and copying their gestures or their clothes, "continued Mandy.
"Those who are vigilant about autism will not be surprised by these results," said Hannah Hayward, a researcher on autism among women at King's College London. "We find that for many girls, their autistic traits are neither resumed nor recognized in the same way that boys have been to school. This is because we try to adapt their diagnosis to the same model as men, but often they do not fit this criterion because their presentation is slightly different.
"I talked to a lot of people [autistic] Women who say they have consulted their GP, but because they have used these social camouflage strategies, such as eye contact and communication, have missed a diagnosis of autism.
"[Social camouflaging] is not a common diagnostic criterion at the moment, but if it did, I think more women would be diagnosed. As a society, we must do better to understand this and change our perspective on what is autism. "
Laura Hull, of University College London and also author of the study, hopes that her work will lead to positive change. "If we could become aware of social camouflage in the NHS or Nice guidelines, and let it be known how common it is for men and women, it would be so important."