By: Michael Rock

It is often said that men with autism are four times as common as women with autism. As more research comes out, this statistic seems to better reflect the rate of diagnosis than the actual prevalence, particularly in cases of people with autism that do not have intellectual disabilities.

The discrepancy in diagnoses, some argue, is the result of how autism tends to manifest differently in women than in men. In fact, there is a case that autism can better be detected in women and girls not by comparing how similar they are to men with the condition, but how different they are from other women without it. 

Another reason why the diagnosis rate is more common among men and boys than women and girls is differences in how both groups are socialized. Women with autism often better pass as neurotypical than their male counterparts, and shyness, introspection, and calmness, traits that many people with autism display are generally seen as more “normal” in girls and women than boys and men.

The “Extreme Male Brain Theory”, which suggests that all people with autism are more like men in terms of their abilities to cognitively empathize with others and systemize information, was recently backed up by a comprehensive study at the University of Cambridge.

In contrast, the “Gender Incoherence Theory” suggests that men with autism are more like neurotypical women, while women with autism are more like neurotypical men. An additional study that showed strong connections between the cerebellum, which controls movement, language, and emotion, and the cerebral cortex, which regulates memory and sensory perception, in women with autism and weak such connections in men with autism, provides evidence to this theory.

The ways that boys and girls with autism tell stories may also offer insights into the ways they experience it. According to the Children’s Hospital of Philadelphia, both utilize more nouns in their stories than those without autism. However, girls with autism incorporate more words describing mental processes, such as “think” and “know.” The unique style of storytelling girls with autism essentially overlaps with those of both autistic boys and neurotypical girls.

One of the more unique phenomena of people with autism, however, is the higher prevalence of gender dysphoria. In other words, people with autism are more likely than the general population to be transgender. One 2014 study suggests that more than 5% of people with autism are transgender, with another study suggesting that as many as 7.8% of transgender people are on the spectrum. While these studies suggest that gender dysphoria, like autism, has a heavy genetic component, an alternative explanation is that people with autism are generally less constrained by socio-cultural expectations and thus have an easier time coming out as transgender than those without autism.

As we become more aware of the similarities and differences among men, women, and non-binary people with autism and those without, there will likely be a greater ability to intervene early in helping those with autism who are less likely to be diagnosed as such, so that they can get the help they need to make life easier for them.

Michael Rock is a New York City-based reporter and self-advocate with autism. A graduate of Brandeis University, his work has appeared in Kings County Politics, Chelsea Now, Our Town, Queens County Politics, and WhoWhatWhy.