#autism article

Excerpt:

Whereas autistic men like myself are often identified early on, women report that their symptoms are dismissed, sometimes for many years, due to stereotypes about their gender and race.

“Social awkwardness? Of course not; apparently I’m just rude—like all the stereotypes of ‘sassy’ black women rolling their heads and necks in a circle while firing off some retort,” Onaiwu says. “Lack of eye contact? Apparently I’m a ‘shy girl’ or ‘playing hard to get’ or ‘shifty.’ Or maybe I’m just being respectful and docile because I’m African and direct eye contact might be a faux pas. Sensory overload, or maybe a meltdown? Nope, more like aggression or being a drama queen. Anything but what it really is—an Autistic person being Autistic who happens to be black and happens to be a woman.”

According to Sharon daVanport, who identifies as autistic and serves as president of Autism Women’s Network, these types of gendered expectations can be very difficult to navigate. For instance, “an eight-year old boy might have an intense interest in collecting maps,” leading his parents to worry that his desire to remain inside all the time is a signal that something might be wrong. “In contrast, a young girl who spends hours upon hours researching her intense interest will be considered quiet, polite, lady-like, and all the other gender-based labels which society assigns to girls before they’re even born,” she said.

[...]

Excerpt:

Imagine you are visiting a very different culture – if you are from Europe or the United States, then perhaps somewhere like Japan. On arrival at your host’s house, you hesitate on the threshold – should you remove your shoes? Is shaking hands appropriate? Should you have brought a gift? Is your host offended already, but being polite by not showing it?

In this situation, where the unspoken social rules are mysterious to you, it would be natural to watch others carefully and copy what they do. Over time, by observing and copying, you might succeed in blending in – but it will be exhausting, even after some things become almost habitual. And, of course, there is always the risk that your tactics backfire – for instance, you might inappropriately copy behaviour that’s deemed acceptable only from one gender, or in one specific context.

Excerpt:

A process involved in neurodevelopmental disorders that we are only just beginning to understand is “compensation” – the way that a deficit can be partially or wholly masked by automatic mental processes and/or deliberate behavioural strategies. For instance, a person with dyslexia may achieve typical levels of reading ability after an earlier diagnosis, not because the disorder has gone away (subtle tests might show continuing problems in phonological processing, for example) but through the use of behavioural strategies, such as reverse-engineering a tricky word from the meaning of words around it. In a new review in Neuroscience and Biobehavioral Reviews Lucy Anne Livingston and Francesca Happé, at the Institute of Psychiatry in London, take us through what compensation might mean for autism.

[...]

Excerpt:

Highly intelligent people with autism tend to evaluate behavior based upon outcomes, not intentions.

[...]

Two friends take a coffee break at a chemical plant. Mary asks Grace to pass the sugar, and Grace hands her a dispenser clearly labeled ‘Sugar.’ Unbeknownst to either woman, however, the dispenser contains not sugar, but a poisonous chemical that looks like it. Mary drinks her toxin-sweetened coffee and dies a few hours later. 

Is Grace to blame?

Most people would say, “No,” because Grace didn’t know that the dispenser contained poison. But after reading 20 similar vignettes in which the actions of protagonists led to either a negative or neutral outcome, a group of 24 highly intelligent adults with autism consistently assigned a higher degree of moral blame to individuals with innocent intentions, compared with controls.

[...]

“It’s been very difficult to demonstrate [mind blindness] on behavioral tests, especially with adults who are very clever,” says Uta Frith, emeritus professor of cognitive development at University College London and one of the architects of the theory of mind. Highly intelligent people with autism learn to use logic to help them correctly answer questions, she says. “This is part of their wonderful ability to adapt, to get around things.”

[...]

Excerpt:

Jasmine Ghibli was diagnosed with autism at two years old in America. The diagnosis was taken away from her when she moved to Scotland after her GP decided she was the "wrong sex" to be autistic.

Now at 18, Jasmine has her diagnosis but not without enduring years of frustration at a system that she thinks appeared to forget the female face of autism.

Nicole Bonner, Jasmine's mother, said their GP told them that, "autism isn't for girls - she's just a bad kid."

After moving to Scotland from America, the children's hospital informed Nicole that Jasmine wasn't autistic, and that her original diagnosis was unrecognised.

Speaking to BBC Scotland's The Nine, Jasmine, from Helensburgh, said the confusion around her diagnosis caused her mental health to deteriorate.

She says the lack of support and bullying at school led her to attempt to kill herself three times - the first time was when she was just seven.

[...]

"I can't express how important it is to empower autistic women and girls," she says. "One of the main reasons I want to raise awareness is that it's so easy to feel lonely and ostracised as an autistic person, but particularly as an autistic woman.

Excerpt:

Between 8 and 10 percent of children and adolescents seen at gender clinics around the world meet the diagnostic criteria for autism, according to studies carried out over the past five years, while roughly 20 percent have autism traits such as impaired social and communication skills or intense focus and attention to detail. Some seek treatment for their gender dysphoria already knowing or suspecting they have autism, but the majority of people in these studies had never sought nor received an autism diagnosis. What’s more, roughly the same numbers of birth males and females appear to be affected — which is surprising, given that in the general population, autism skews male.

At this early stage of research into the overlap between autism and gender dysphoria, much remains unknown — for example, whether gender identity develops differently in people with autism. This lack of information challenges both clinicians and families who want to do what’s best for transgender children.

[...]

Only recently have researchers begun systematically exploring the overlap between gender dysphoria and autism; the first study to assess the convergence of the two conditions was published just six years ago. It included 231 children and adolescents who had been referred to the Gender Identity Clinic of the Vrije University Medical Center in Amsterdam between April 2004 and October 2007. The researchers found the incidence of autism among the children was 7.8 percent, 10 times higher than the rate in the general population. Among the adolescents in the sample, the incidence was even higher, at 9.4 percent.

[...]

Still, she cautions that sometimes, what looks like autism may actually be untreated gender dysphoria. “So much of the experience of being trans can look like the spectrum experience,” she says. People who don’t want to socialize in their birth genders may seem to have poor social skills, for example; they may also feel so uncomfortable with their bodies that they neglect their appearance. “That can sometimes be greatly alleviated if you give that person appropriate gender support,” she says.

Others agree with these insights. A 2015 study by researchers from Boston Children’s Hospital reported that 23.1 percent of young people presenting with gender dysphoria at a gender clinic there had possible, likely or very likely Asperger syndrome, as measured by the Asperger Syndrome Diagnostic Scale, even though few had an existing diagnosis. Based on these findings, the researchers recommend routine autism screening at gender clinics.

Excerpt:

In its 2012 survey of more than 8,000 autistic people and family members in the UK, the NAS found that women and girls were more likely to be misdiagnosed than men and boys (41% of females had been diagnosed with another condition on assessment, compared to 30% of males). And once they were diagnosed, women and girls were less likely to access extra support. In cases of Asperger syndrome, only 8% of girls were diagnosed before they had reached the age of six, compared to 25% of boys; and only 20% of girls were diagnosed by the age of 11, compared to 50% of boys. Many women remain undiagnosed until their 20s or 30s.

[...]