Thursday, May 3, 2018

Are autistic women superior camouflagers? or autism's a bitch.

Autism's a bitch. It's made life miserable for me starting before the age of 3, when my brain gave out and I stopped speaking, threw tantrums, and smeared feces on the wall. My parents took me to a neurologist in 1958 when practically no one, including doctors, had ever heard of autism. The neurologist did not know what to make of my behavior and it was felt my problems were likely psychological rather than due to an organic impairment and I was whisked off to a psychoanalyst's couch for more than ten years. I was in special ed for eight years of my life. As an adult I was fired from a variety of jobs and had other problems.

I guess the above paragraph is old news for any regular reader of this blog for the last several years. However, I've come across a new popular question in autism research on whether or not some autistic individuals can hide or mask their disability or as the researchers put it camouflage the disabling aspects of their autism so no one would know they are handicapped.

The question of camouflaging has recently come up in autism discussions, articles, and even in academic journals because some believe the reason there's a 2:1 ratio of autistic males to females in more severe cases yet a ratio of 6:1 in the higher-functioning cases is because many autistic females fly under the radar because they are so adept at masking or camouflaging their symptoms.  They won't come to the attention of school teachers, parents, pediatricians, etc. Or the pressures to fit in with non-handicapped peers and to mask their symptoms caused them to have other problems such as depression or anorexia when they really had autism all along. Or because clinicians are prejudiced against diagnosing autism in girls, they're diagnosed with something else.

Though research in the area is still new, some scientists and clinicians have published papers suggesting some autistic persons camouflage their problems and that women on the spectrum have a better ability to do this than their male counterparts. Allison Ratto, one of these researchers, appeared on C-Span with Autistic Self-Advocacy Network president and staunch neurodiversith proponent Julia Bascom.

This theory has been embraced by some eminent persons in the autism world including Simon Baron-Cohen and Autism Speaks Chief Science Officer Thomas Frazier.  They state that it's likely the true male/female ratio of autism is 2:1 rather than the generally accepted 4:1.

Some female neurodiversity proponents, such as some character who calls herself "autism with skip" on twitter, have even gone as far as saying there's complete parity between autistic males and females.

There's no evidence for this statement and for it to have validity its proponents would have to explain away the female protective effect found in so many studies.  I've written about this  in a previous blog post

However, the protective effect does not explain away a 6:1 or greater male to female ratio.  It could still be 2:1 because certain high-functioning females weren't diagnosed.  

I've also written a piece in which I point out methodologic flaws in the interpretation of the data suggesting the camouflage hypothesis as a factor, but I'm hoping to get it published as a magazine article at some point, so, for this reason, I'm not including it in this blog post.  However, if I can't get it published anyplace I may write a blog post about it at some future time.

I've also corresponded with Allison Ratto about some of these points and she was nice enough to answer my email and address them.

As I've written before, the autistics who promote neurodiversity seem to be disproportionately female.  Therefore, they seem to have an interest in not only ensuring that all of these supposedly undiagnosed females get their dx, but also seem to want to create an entirely different diagnostic definition for women as opposed to men.  Julia Bascom has written about this.

Some of these female neurodiversity proponents have stated that some women did not get diagnosed until adulthood when their son or daughter was diagnosed and only then they received a diagnosis.  If they were able to have children, they're higher functioning than I am as well as most autistic persons, male or female.


If I could have disguised my autism, I certainly would have done it. It would have been nice to have friends, lovers, and a job without being fired. It would have been nice if I could have been so well-behaved as a child I could have attended a regular school. I wish I could have controlled my loud voice and funny movements, even if I had done my twiddling (self-stim) only in my bedroom at home and never demonstrated any of my movements publicly. I've known several autistic people over the past few years, including pretty high-functioning ones and there's no way most of these people would not have been spotted as someone with some sort of problem in a pretty short period of time.

I believe it is sexist and chauvinistic to claim that women have a superior ability to disguise their autism to men.  To date, there is no evidence to suggest this.  The studies on camouflaging are still new and I'm sure more will come out.  They should see what the data says in multiple studies before stating this hypothesis as fact or likely. 

Men on the autism spectrum have just as much reason to attempt camouflage as women.   They have the same disabilities and attitudes from society that would handicap them due to their problems being overt.  To say women have more reason to camouflage has no basis other than prejudice.  

Simon Baron-Cohen's irresponsibility is par for the course, going back to his autistic people have vision as keen as birds of prey statement which he later had to retract.  However, for the chief science officer of an organization like autism speaks to state this is likely is appalling.  I suppose this is also par for the course for autism speaks given their track record.  

Female neurodiversity proponents new crusade to do this gives new meaning to the term autism's a bitch. 

12 comments:

Yuval said...

I have personally known two female neurodiversity advocates. Both can pass for normal in public, and both were never in special education.

Perhaps looking at special education experiences is the secret to determining the validity of a potential late diagnosis.

cubeangel said...

Jonathan

I think it's time to question the whole field of psychology and psychiatry itself. If you look all of the different disorders listen in the DSM none of them have any objective and scientific way to test for any of the disorders. Cancer we can test for by doing what is called biopsies. Is there any blood test or anything like that that would show the presence or absence of autism, bipolar disorder, borderline personality disorder, etc? Or depression? We're always told it is due to a chemical imbalance but what is a balanced brain supposed to look like? What chemicals are out of balance exactly? And, what is the actual test that determines if there is an imbalance in the brain? The problem is that psychology and psychiatry is not a hard science.

jonathan said...

@Cubed. Here I do agree with you. That is a good point, at this stage, there are no good biochemical markers for most disorders in the DSM. In some cases autism can be caused by identifiable causes like certain mutations, or by metabolic problems, or cerebral folate deficiency that you can actually see (Roger Kulp might comment if he reads).

Hopefully, at some point, we can test for chemical marker and this will eliminate the need for questionable subjective diagnoses.

Anonymous said...

"suggesting some autistic persons camouflage their problems and that women on the spectrum have a better ability to do this than their male counterparts."

Oh, that one's easy: on avergae, girls (including any autistic ones) get *taught* social skills more than boys (including any autistic ones) get taught social skills in the first place.

Anonymous said...

"If they were able to have children, they're higher functioning than I am as well as most autistic persons, male or female."

The ability to have children doesn't only come from social skills.

Women and girls have got pregnant from being raped and/or having their marriages arranged too, not only from using social skills to attract guys to have sex with.

jonathan said...

Well, I doubt most of these autistic women became pregnant as a result of rape. Arranged marriages in western cultures went out centuries ago. I see no evidence that girls are taught more social skills than boys and that has nothing to do with an alleged superior ability or more motivation to camouflage difficulties.

Anonymous said...

If you can fake it, you're not autistic. Its as simple as that. Autism isn't a shirt you can put on and take off.

will said...

I had a medium functioning autistic girlfriend some years ago. She could not get a job on her own or take care of her completely without assistance. though pretty that does not always mean high IQ's. That BS about girls with autism camoufloging or whatever is just stupid ASAN if you are reading this. Rhett syndrome and CDD is similar to autism usually in females and a hell with no chance of recovery.

Anonymous said...

I see evidence that the stuff girls get taught *informally* includes paying more attention to people around them. If you didn't see it, then maybe you're not paying enough attention to social stuff.

As for "in the West," autistics exist in cultures in the non-Western world and in non-western subcultures inside the Western world too, including the cultures and subcultures with arranged marriages.

As for rape, aren't autistics at higher risk (controlling for other factors) of being raped or otherwise violently attacked than non-autistics are? Some of social cues that non-autistics use to figure out who's more likely to attack them are cues that autistic people don't understand.

Anyway, just saying ""If they were able to have children, they're higher functioning" as if it's a 100% guarantee, instead of saying "they're probably higher functioning," is too rigid, stereotypical, and narrow-minded to be accurate. I thought you didn't like the rigidity, stereotyping, and narrow-mindedness that can come with autism?

Anonymous said...

"I had a medium functioning autistic girlfriend some years ago. She could not get a job on her own or take care of her completely without assistance. "

That's another way the ability to get pregnant doesn't prove high functioning. She couldn't do all that stuff and she still probably could get pregnant (especially if you had sex with your girlfriend without a condom).

Anonymous said...

Don;t forget the way some boys are taught to act *more* autistically than girls are ("don't care what other people think!!!" "caring what other people think is for girls and sissies!!!" "just study study study STEM and people will respect you in the future!!!" [some families push it on both sons and daughters, some push it on sons more, far fewer push it on daughters more]").

Anonymous said...

That is, how to pay more attention to people around them is one of the things girls are usually taught to do more than boys are usually taught to do.