Autism in girls

Boys with autism tend to be less social than their peers and display prominent and obvious areas of obsessive interests and compulsions. Girls with autism, however, are more able to follow or imitate social actions. When they are younger, they can mimic socially appropriate behaviour without understanding what they are doing or why they are doing it. This can have the effect of masking their difficulties. 

Girls with autism often feel the need to interact socially. They can join in play but are often led by their peers. They may not initiate social contact and can appear socially passive or odd. They feel that they would like to have friends but do not understand how to make friends. This can cause considerable unhappiness and feelings of isolation. Social cues, recognising facial expressions and understanding social hierarchies can be difficult, and girls may not understand why people communicate in certain ways or expect particular responses. This can mean other people’s reactions are surprising and bewildering, causing problems at school, and in wider society. 

Often neurodivergent girls have a good imagination, and compared with boys with autism are relatively good at pretend play. They can spend a long time indulging in elaborate fantasy worlds, which can be complex and full of detail, and are often sustained over long periods of time. Their fantasy world can dominate play; girls might be able to talk about their world in depth, and often the line between fantasy and reality can become blurred. 

Girls with autism often have special interests. When they are young these interests can include age-appropriate topics such as horses or animals, boy bands or certain films. This in itself is not unusual. It is the intensity of their interest and how long the special interest lasts that tends to be different. As other girls move on to other areas of interest, girls with autism often do not. This causes gaps to appear between their social development and that of their peers. 

Sensory needs can also add to an already complicated picture. Autistic girls may be particularly sensitive to loud noises, bright lights or touch; may hate wearing tight clothing or particular fabrics; or conversely, may love to be dressed in super tight clothes, or need to have their hair tied back in a tight ponytail. 

Eating can also be a battleground, with girls only prepared to try certain foods and textures. Not eating or controlling their food intake is another characteristic, and there is ongoing research into the prevalence of anorexia amongst women and girls on the autistic spectrum. There is also growing evidence to support a link between gender dysphoria and autism in girls.