Male Autism, Female Autism, Or Neither? Not just boys: Rethinking Autism and gender stereotypes

By Onyiu Wong

When many people picture autism, they often imagine the same stereotype: a socially awkward boy with an intense fascination for trains, math, or computers. While this portrayal may reflect the experiences of some autistic individuals, it represents only a marginal part of an extraordinarily diverse spectrum. 

Jennie often says ‘if you’ve met one person with Autism, you’ve met one person with Autism!’ Autism Spectrum Condition (ASC) can present very differently from one individual to another, and one of the most overlooked sources of this variation is gender. 

Historically, autism research has been dominated by studies of boys and men, creating a largely male-centred understanding of the condition (Haney, 2016; Krahn & Fenton, 2012). As a result, both public perceptions and diagnostic criteria have been skewed by male presentations of autism, and this longstanding bias may help explain why men are currently three times more likely than women to receive an autism diagnosis (Brickhill et al., 2023). 

Although part of this difference may reflect genuine variation in prevalence, researchers increasingly argue that it also mirrors the ways in which autism presents differently across sexes - and how existing diagnostic approaches may be better suited to recognising male presentations. 

Importantly, this does not mean there is a distinct “male autism” and “female autism”. Rather, autism is a highly diverse condition, and the ways in which autistic traits are expressed can be influenced by biological and social factors. Understanding these differences is therefore essential - not only for challenging outdated stereotypes, but also for ensuring that autistic individuals of all genders are recognised, diagnosed, and supported appropriately.

One of the clearest ways in which ASC can present differently in men and women is through social communication. Although social communication differences are considered a core characteristic of autism, research suggests that they are not always expressed in the same way across sexes. For example, Goddard et al. (2014) found that autistic girls used more complex language during conversation than age- and IQ-matched autistic boys. Similarly, a large meta-analysis by Wood-Downie et al. (2020), which combined findings from 16 studies involving 2,730 participants, found that autistic females generally demonstrated stronger social communication and interaction skills than autistic males. 

However, better social communication does not mean autistic girls experience fewer social challenges. Rather, their differences may be less immediately obvious to parents, teachers, or clinicians because they often communicate in ways that more closely resemble those of their neurotypical peers. As a result, the social difficulties experienced by autistic girls can be overlooked or misunderstood. 

Recognising these differences has important implications for both research and clinical practice. As Sedgewick et al. (2016) argue, understanding how social communication varies between autistic men and women is essential for formulating more sensitive diagnostic assessments and ensuring that support can be tailored to each individual’s needs.

Another important way in which ASC can present differently between men and women resides in a phenomenon known as masking, which refers to the conscious or unconscious strategies that autistic individuals use to camouflage or compensate for autistic traits during social interactions (Corbett et al., 2020). Rather than reflecting an absence of social difficulties, masking often involves considerable effort to appear socially “typical” by observing, copying, and adapting to the behaviour of others. 

Research suggests that masking is particularly common among autistic women (Dean et al., 2017; Corbett et al., 2020). One possible explanation is that girls often experience stronger societal expectations around social relationships, communication, and emotional expression from an early age. As a result, autistic girls may receive more opportunities - and feel greater pressure - to develop strategies that help them fit in socially (Gould, 2017). Over time, these strategies can become highly sophisticated, making autistic traits less immediately visible to others. 

Masking can take many different forms. For example, Corbett et al. (2020) found that autistic females tend to display greater vocal expressiveness than autistic males. This included differences in the tempo, pitch, tone, volume, and rhythm of speech, suggesting that the ability to modify vocal expression may play an essential role in successful masking. 

Masking can also influence how autistic girls navigate social situations more broadly. Gould (2017) observed that, at first glance, autistic girls often appeared indistinguishable from their neurotypical peers. They spent time conversing with others, traversed confidently between friendship groups, and actively participated in social interactions, meaning that untrained observers were less likely to recognise their underlying social difficulties. However, upon closer inspection, while these girls were able to initiate and join social interactions, they often struggled to sustain mutual engagement during activities requiring social synchronisation or to adjust their behaviour in response to changing group dynamics (Gould, 2017). 

These findings have important implications for diagnosis and support. Because autistic girls may appear socially competent on the surface, their underlying difficulties can easily be overlooked by parents, teachers, primary care professionals, and even clinicians who are unfamiliar with how autism can present in females (Dean et al., 2017; Lai et al., 2017). 

Consequently, many girls may not receive an autism diagnosis until much later in life - or may never receive one at all - reducing their opportunities to access timely support and intervention (Gould, 2017). 

"Improving awareness of masking, and recognising the many ways it can present, is therefore essential for ensuring that autistic individuals of all genders receive accurate diagnoses and appropriate support" (Dean et al., 2017; Lai et al., 2017).

A third area in which ASC can present differently between men and women is in the nature of restricted interests. One of the most well-known characteristics of autism is having highly focused interests, but these are often misunderstood as simply having an unusual hobby. In reality, what distinguishes a restricted interest is not necessarily what someone is interested in, but how they engage with it. 

Compared with typical hobbies, restricted interests are characterised by an exceptional level of intensity, depth, and commitment (Cascio et al., 2014). Autistic individuals often devote substantial amounts of time and energy to their interests, developing an encyclopaedic knowledge that goes far beyond that of most people with a similar hobby (Cascio et al., 2014). These interests can also become so absorbing that they interfere with aspects of everyday life, distinguishing them from the interests commonly seen among neurotypical individuals (Cascio et al., 2014). 

Fundamentally, research suggests that the content of these interests can differ between autistic males and females. Where autistic boys are more likely to develop intense interests centred on objects, systems, or mechanical topics, autistic girls are more likely to develop equally intense interests focused on people or animals (Sedgewick et al., 2016). Consequently, their interests often resemble those of other girls their age, such as celebrities, popular music, or drawing. The crucial difference is not the topic itself, but the extraordinary intensity and level of engagement with which the interest is pursued. 

Similar patterns have also been observed in academic interests. Edwards et al. (2023) found that autistic females were more likely to report interests in subjects such as psychology, whereas autistic males more commonly reported interests related to technology, science, and mechanical topics such as transportation. The same study also found that restricted interests tended to be less pronounced overall among autistic females than autistic males (Edwards et al., 2023). 

These differences have important implications for autism assessment. Because many autistic girls develop interests that appear socially typical for their age and gender, their restricted interests may not stand out to parents, teachers, or clinicians in the same way that more stereotypically “autistic” interests often do. Edwards et al. (2023) therefore argue that professionals should be aware of these more nuanced presentations, particularly as conventional assessment tools may not adequately capture the kinds of interests more commonly reported by autistic females (Clarke et al., 2021). Greater awareness of these differences could help reduce the likelihood that autistic girls are overlooked during the diagnostic process.

In the end, ASC is an incredibly diverse condition, and no two autistic individuals will experience it in exactly the same way. Rather than representing two distinct forms of autism, this article illustrates and discusses just some of the ways in which autistic traits can be expressed differently depending on social influences. 

Some of these differences may reflect genuine variation in how autism presents across sexes. Others may arise because our understanding of autism - and the diagnostic tools used to identify it - has historically been shaped by research that focused predominantly on boys and men. At the same time, gender-related social expectations may encourage autistic girls and women to develop coping strategies, such as masking, or to express autistic traits in ways that appear more socially typical. Together, these factors can make autism more difficult to recognise in many females. 

Ultimately, recognising these differences is not about creating separate diagnostic labels for men and women, but instead, broadening our understanding of what autism can look like. By transcending outdated stereotypes and acknowledging the full diversity of autistic presentations, clinicians, educators and the wider public can help ensure that autistic individuals of all genders receive timely diagnoses, appropriate support, and opportunities to thrive.

At Chiltern ADHD Clinic CIC, we understand that neurodivergence never exists in a vacuum. Gender, culture, ethnicity, sexuality, upbringing and life experiences can all shape how traits are expressed, understood and potentially masked. Our therapeutic work therefore looks beyond stereotypes and standardised scores to understand the whole person. We approach everyone with curiosity, considering their unique context rather than expecting them to fit a narrow or outdated picture of neurodivergence. A lot of us (Jennie included) received a diagnosis later in life, which could be - in part - due to some of these same stereotypes!

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