Strong Female Character

In recent years, it has become widely understood that women and girls with autism are undiagnosed or misdiagnosed at a disproportionate rate compared to their male counterparts. Gael Orsmond, a Boston University professor who specializes in research on the social relationships of young people with autism, asserts that autism is diagnosed “three to four times more often in boys than girls,” despite the criteria for the condition being the same across genders (“Why Do So Many Autistic Girls Go Undiagnosed?” BU Today). Many factors have contributed to this gender imbalance. Historically, the medical field has considered autism to be a predominantly male condition, operating under the assumption that women are simply less likely to have autism. However, this understanding was based largely upon early studies that relied on data exclusively from male subjects, creating a large gender bias in psychologists’ foundational image of autism.

More recently proposed hypotheses about the cause of underdiagnosis for women include the idea that women are more likely to engage in effective masking behaviors, either naturally or because of social conditioning. Sharada Krishnan, a student of Orsmond, says, “It could be partly a societal expectation of women. We expect that women have more pressure to fit in” (“Why Do So Many”). Brady describes this social pressure to mask as ever-present, exhausting, and oftentimes directed at her by other women. She writes, “All I wanted was to find out how to be like other girls and it felt increasingly impossible” (71). A 2023 study found that women who are aware of their own social differences, like Brady, are more likely to engage in masking behaviors. Furthermore, researchers argued that medical professionals were generally “not familiar enough to diagnose adult ASD, particularly those who camouflage” (Javad Alaghband-rand et al., “Camouflage and masking behavior in adult autism,” Frontiers in Psychiatry 2023). In Strong Female Character, these medical blind spots are shown to have a profoundly negative impact on individuals like Brady, who go undiagnosed and unsupported.

Until very recently, the issue of underdiagnosis for women with autism went largely unrecognized. Now that there is a widespread conversation happening about it, both in the medical field and in the wider public discourse, there is an ongoing push to conduct relevant research and achieve better health outcomes. Krishnan emphasizes that even at a later stage of life, diagnosis can be an essential form of affirmation for women with autism: “Autistic females who are diagnosed later in life often report feeling profoundly different than their peers, and so getting diagnosis can be extremely validating and give them a sense of self-identity” (Question of the Week Podcast). Strong Female Character affirms this finding, alongside hundreds of other personal accounts of women with late diagnoses made public on social media platforms and in other forums. Brady highlights the importance of these platforms for shedding light on the issue of underdiagnosis, writing that creators with autism have “disregarded the potential judgement and mockery of others to share vital information online in order to fill the complete void where health services and post-diagnostic support should be” (287). In the digital landscape of the twenty-first century, women with autism have been able to transcend the invisibility imposed on them by a historically gender-biased medical field and draw attention to the pressing issue of their health needs.