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03-Mar-2020 11:00

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There are no guidebooks for these girls or their families about how to deal with puberty and menstruation, how to navigate the dizzying array of rules in female friendships, how to talk about romance and sexuality or even just stay safe from sexual predators.Advocates and scientists in other disciplines have run up against and resolved many of these same problems, but in autism, the fact that boys and girls are different is sometimes treated as if it’s a startling new discovery.In the past two to three years, there has been an uptick in the attention paid to the issues that affect women with autism.More money is now available for scientists to study whether and how autism differs in boys and girls.As they enter their teens, girls struggle to keep up with the elaborate rules of social relationships.Cribbing style notes on what to say and how to say it, many try to blend in, but at great cost to their inner selves.What we do know is grim: On average, girls who have mild symptoms of autism are diagnosed two years later than boys. From the start, girls’ restricted interests seem more socially acceptable — dolls or books, perhaps, rather than train schedules — and may go unnoticed.But the fact that diagnostic tests are based on observations of boys with autism almost certainly contributes to errors and delays.

Scientists and service providers rarely acknowledge the additional challenges being female may bring, whether physical, psychological or societal.

Maya does have some of the conditions she’s been diagnosed with over the years — she’s been depressed since the age of 11, has crippling social anxiety, and in her teens, wrestled with anorexia.

But these were just expressions of the autism that was there for anyone to see had they looked closer.

Unpublished results from Pelphrey’s lab confirm what common sense suggests: Women with autism are fundamentally different from men with autism.

Autism’s core deficits may be the same for both, but when the symptoms intersect with gender, the lived experience of a woman with autism can be dramatically different from that of a man with the same condition.“Clinically, my general impression is that young girls with autism are different [from boys], but it has been very hard to show that in any kind of a scientific way,” says Catherine Lord, director of the Center for Autism and the Developing Brain at Weill Cornell Medical College in New York City.

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