Principles of Gender-Specific Medicine, Third Edition, Chapter 15 - Behind the Mask: The Experience of Assessment, Diagnosis, and Living with Autism for Girls and Young Women

The conceptualization of autism has largely been based on the male population and the condition is widely understood to affect males more than females. However, this work has been critiqued from a gender perspective and charged with androcentric practices, leading to an unawareness of the needs of females on the spectrum.
In this chapter, we discuss the development of classification and assessment criteria and provide an overview of theories and hypotheses related to gender differences in Autism Spectrum Condition (ASC). We also present data from in-depth interviews with adolescent females with a diagnosis of autism, illustrating some of the social challenges that these young women face on a daily basis, particularly during adolescence when specific complex challenges arise. Girls reported using various masking and imitation strategies, which while effective at one level, also have serious psychological costs. Finally, we offer suggestions for clinical practice and further research.