High Functioning Autism in Women: Defying Expectations

Discover the journey of women with high functioning autism, their unique challenges, and triumphant tales.

judah schiller
Judah Schiller
May 4, 2024
Published On
May 4, 2024

Understanding High-Functioning Autism in Women

The exploration of high-functioning autism in women brings attention to gender disparities in autism diagnosis and the camouflaging behaviors often exhibited by females with Autism Spectrum Disorder (ASD).

Gender Disparities in Autism Diagnosis

Women are less frequently diagnosed with autism than men, and high-functioning autism is particularly underdiagnosed in women. This disparity in diagnosis can lead to women not receiving the support they need, making it vital to address and understand these gender differences [1].

Recent research indicates that females with ASD have higher Autism Spectrum Quotient (AQ) scores than males with ASD. Despite this difference not being statistically significant after Bonferroni correction, it does hint at a distinctive way ASD presents itself among females.

Camouflaging Behavior in Females with ASD

One of the reasons for the gender disparities in autism diagnosis is the tendency for females with ASD to engage in camouflaging more than males with ASD. Camouflaging refers to the process of masking or compensating for autistic traits during social interactions. This behavior can make it more difficult to identify ASD in females, potentially contributing to the difference in prevalence between males and females [2].

Contrary to some assumptions, camouflaging is not associated with social phobia. Rather, it is negatively correlated with emotional expressivity in females with ASD but not in males with ASD. This suggests that the camouflaging behavior might be linked to the way females with ASD manage and express their emotions [2].

In conclusion, understanding the unique ways high-functioning autism presents itself in women is crucial in addressing the gender disparities in autism diagnosis. By recognizing the camouflaging behavior often exhibited by females with ASD, healthcare providers can better support women on the autism spectrum.

Behavioral Differences in High-Functioning Autism

Behavioral patterns in individuals with high-functioning autism differ significantly by gender. The nuances are particularly evident in females, manifesting in unique ways such as emotional expressivity and social masking or camouflaging.

Emotional Expressivity in Autistic Females

Emotional expressivity refers to an individual's ability to communicate their emotions, often through facial expressions, body language, and tone of voice. For women with high-functioning autism, emotional expressivity can be a challenge. Research shows that camouflaging in females with autism spectrum disorder (ASD) is negatively correlated with emotional expressivity, particularly positive expressivity [2].

This implies that the more a woman with ASD engages in camouflaging behavior, the less likely she is to express her emotions openly. The reasons behind this can be complex, and can include a desire to fit in socially, the fear of being misunderstood, or simply not knowing how to express emotions in a way that others can understand.

Social Masking and Camouflaging

Camouflaging, also known as masking, is a common behavior among women with high-functioning autism. It entails modifying one's behavior, mannerisms, and reactions to blend in or appear more 'normal' in social situations. Women with ASD often learn to camouflage their behaviors and mask their innate tendencies, such as changing facial expressions and body language to fit in with others around them [3].

Studies indicate that females with ASD engage in camouflaging more than males with ASD, potentially contributing to the difference in prevalence between males and females. Furthermore, females with ASD exhibit significantly more camouflaging than males with ASD.

While camouflaging can help women with ASD navigate social situations more easily, it can also be emotionally draining and can lead to feelings of isolation or misunderstanding. It's important to note that while camouflaging can be a coping mechanism, it does not change the underlying experience of ASD.

Understanding these behavioral differences is crucial to improving diagnosis and support for women with high-functioning autism. It highlights the need for increased awareness and understanding of how ASD manifests in different genders, and underscores the importance of tailoring support and interventions to meet individual needs.

Challenges Faced by Women with High-Functioning Autism

Despite the term "high-functioning," women with high-functioning autism face numerous challenges in their everyday lives. These difficulties often encompass sensory sensitivities and overload as well as struggles with social interactions.

Sensory Sensitivities and Overload

One of the common challenges faced by women with high-functioning autism is sensory processing disorder. This condition can cause noise, crowds, bright lights, strong tastes, smells, and being touched to be unbearably intense [4]. These sensory sensitivities may lead to sensory overload, where the individual becomes overwhelmed by the amount and intensity of sensory input. This can cause extreme discomfort, anxiety, and can even result in a meltdown.

The ability to manage sensory overload is crucial for women with high-functioning autism. Strategies can include avoidance or reduction of sensory input, use of sensory aids such as earplugs or sunglasses, and employing calming techniques such as deep breathing or grounding exercises.

Social Interaction Difficulties

Social interactions pose a significant challenge for women with high-functioning autism. Recognizing social cues and body language can be a major obstacle in making friends, finding and keeping a job, and dating. Interpreting non-verbal cues, understanding sarcastic or passive-aggressive communication, and managing sensory sensitivities can be difficult and exhausting [3].

In social settings, women with high-functioning autism may appear shy or submissive. This behavior can be misinterpreted as introversion rather than as a sign of autism, leading to further miscommunication and misunderstanding.

Despite these challenges, it's important to remember that each individual's experience with autism is unique. With the right support and understanding, women with high-functioning autism can develop strategies to navigate these challenges and thrive in their personal and professional lives.

Mental Health Implications in Women with Autism

Understanding the mental health implications of high-functioning autism in women is crucial as these individuals often face unique challenges and co-morbid conditions that may impact their overall well-being.

Anxiety and Depression in Autistic Females

A significant concern in the realm of high-functioning autism in women is the prevalence of anxiety and depression. Females with high-functioning autism spectrum disorder (ASD) often engage in camouflaging, a behavior that involves masking ASD symptoms with the motivation to assimilate. This camouflaging can lead to mental exhaustion and heightened anxiety. Additionally, the desire for social inclusion, coupled with challenges in achieving it and other stressors like sensory issues, difficulties at work or school, or disruptions in routines, may contribute to high anxiety and depression in these women.

Co-Morbid Conditions and Challenges

Beyond anxiety and depression, women with autism have a higher prevalence of specific co-morbid conditions compared to neurotypical women. These conditions include eating disorders, with a notable prevalence of anorexia. The increased rate of eating disorders in autistic women may be linked to factors such as social isolation, a need for control, and heightened anxiety levels [5].

Also noteworthy is the potential for these women to be diagnosed with Borderline Personality Disorder (BPD). This is due to the presence of symptoms that are important and distinct in females with high-functioning ASD, including less need for friends, preference for solitary activities, lack of initiation to interact socially in a group, less attention to personal appearance, and clear interests from early teenage life. This diagnosis can lead to feelings of hopelessness and self-blame.

These co-morbid conditions and challenges emphasize the need for comprehensive mental health support for women with high-functioning autism. Understanding these implications can help healthcare professionals, families, and the women themselves better address and manage these conditions, improving the overall quality of life for these women.

Diagnosis and Identification of High-Functioning Autism

The identification and diagnosis of high-functioning autism (HFA) in women is a complex process. This is due in part to the unique presentation and challenges associated with HFA in women, which can often lead to misdiagnosis or late diagnosis.

Late Diagnosis in Females with HFA

Females with high-functioning autism spectrum disorder (ASD) are often undiagnosed since they do not meet the diagnostic criterion, leading to false negative results from standardized instruments. They have a distinct presentation, challenges, and impairments, which require understanding for early identification and effective treatment.

In fact, females with high-functioning ASD are diagnosed even later in life compared to males and initially present with behavioral, affective, and anxiety symptoms. They may have multiple previous diagnoses and do not show progress or improvement with evidence-based interventions. These females lack a distinct profile of ASD, leading to unique challenges in dealing with the condition.

Late diagnosis of ASD in females has serious implications for understanding and interventions for impairments related to these disorders. Current diagnostic measures often have false negative results for females, and there is a need for gender-specific validated instruments for screening. These individuals often seek help when they experience affective and anxiety symptoms [6].

Unique Presentation and Challenges

Women are less frequently diagnosed with autism than men, and high-functioning autism is especially underdiagnosed in women. This can lead to women not receiving the support they need.

Females with high-functioning ASD often engage in camouflaging, which involves masking ASD symptoms with the motivation to assimilate. This leads to mental exhaustion and heightened anxiety. Compensation, another behavior, involves enhancing tendencies to compensate for deficits. These behaviors make it difficult for these individuals to meet the diagnostic criterion.

These unique presentations and challenges associated with high-functioning autism in women highlight the need for greater awareness, understanding, and support. With improved diagnostic tools and interventions, women with HFA can receive the help they need to thrive.

Resources and Support for Autistic Women

Navigating the world with high functioning autism can present a unique set of challenges, particularly for women. However, numerous resources are available which aim to provide support, educational outreach, and foster understanding for the female autistic experience.

Advocacy Organizations and Networks

Several organizations focus on advocating for and supporting women on the autism spectrum. The Autistic Women & Nonbinary Network (AWN) works to provide resources, advocate for better healthcare and services, and create a supportive community for autistic women and nonbinary individuals. Similarly, the Asperger/Autism Network (AANE) offers a variety of resources including support groups, educational programs, and information on navigating life with autism.

In addition to these organizations, numerous books provide valuable insights into the experiences of autistic women. For example, "Camouflage: The Hidden Lives of Autistic Women" by Sarah Bargiela explores the unique challenges and experiences of women with autism, providing a deeper understanding of this often-overlooked population.

Notable Female Autism Advocates

There are several notable advocates who have used their experiences with autism to promote understanding and acceptance. Dr. Temple Grandin, a renowned author and speaker, has shared her experiences living with high-functioning autism, providing valuable insights into the condition and advocating for the rights of those on the spectrum.

Another remarkable advocate is Greta Thunberg, the young climate activist. Greta has spoken openly about her experiences with autism, using her platform to challenge stereotypes and raise awareness about the condition.

Advocate About Contributions
Dr. Temple Grandin Renowned author and speaker Advocacy for the rights of those on the spectrum
Greta Thunberg Young climate activist Uses her platform to challenge stereotypes and raise awareness about autism

These resources and individuals provide invaluable support and advocacy for women with high-functioning autism, helping to promote understanding, acceptance, and equality. Whether you're an autistic woman seeking resources, or an ally looking to learn more, these resources offer a wealth of information and support.


[1]: https://www.canada.ca/en/public-health/services/diseases/autism-spectrum-disorder-asd/support-autism-spectrum-disorder-asd.html

[2]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6753236/

[3]: https://www.thrivingwellnesscenter.com/blog/autisminwomen

[4]: https://www.verywellhealth.com/why-high-functioning-autism-is-so-challenging-259951

[5]: https://www.vanderbilt.edu/autismandinnovation/for-autistic-women/

[6]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7919612/