For example, there is evidence that autistic girls need higher levels of autism traits and more co-occurring difficulties to come to clinical attention than boys on the spectrum. It is time to strengthen the message that women on the spectrum risk going undiagnosed. In the past five years, researchers have documented that many people on the spectrum learn to camouflage their traits.They may consciously suppress stimming behaviors in public or deliberately learn how to use certain gestures in social interactions.But the evidence is not strong enough yet to code it in the DSM.
Girls were more likely than boys to show this developmental profile.
If future research supports this idea, the DSM-5 might be amended to include features that show up in adolescence and are especially characteristic of the female autism phenotype.
Thus, the DSM-5 nicely captures an apparent paradox emerging from longitudinal studies of autism gender differences.
On the one hand, the female phenotype is characterized by features that present in childhood but become less obvious over time due to camouflaging.
These circumspect statements represent an important step toward redressing a historic tendency in our field to overlook autistic women.
In the five years since the publication of the DSM-5, research into autism and gender has burgeoned.
The current version of the “Diagnostic and Statistical Manual of Mental Disorders,” the DSM-5, acknowledges how gender shapes autism more than any previous version of the manual has.
‘Gender-related diagnostic issues’ is its own section in the manual — but it is only two sentences long.
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