Might it come -1:2 or even 1:1 ratio ASD women:men?

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"There is a growing consensus among neuroscientists that the number of autistic women has been vastly underrepresented due to the assumption that it is primarily a male condition.[34]"

ASD runs in my family mores so amongst the women. We are "Twice Exceptional" (2e) and we're underrepresented in today's diagnostic numbers despite our attempts. It makes me so sad how much we suffered alongside numerous misdiagnoses that in some cases made it worse. I am sad that all of us have self-harmed or been ill with the stress, many of us life-threatening and one died. I want biases to move aside or diagnostic criteria to be modified so ASD can be recognized in the more "social" women, men, and non-binary folks to facilitate support. I am fortunate that despite my daughter's lack of ASD diagnosis (not for lack of trying), we've been able to obtain sufficient support for now.

I hear some studies suggest the ratio is now 1:3, down from 1:4. I think it has far to go based on the continued lack of diagnosis and misdiagnosis I observe in the ASD community for women, as well as the more social men and non-binary folks. I don't want women to have ASD, but I want women who do to receive support.

"Compared to men, women are generally required to be more impaired by their autism[21] or have more cognitive or behavioral conditions[22] than their male counterparts to meet autism spectrum criteria. There is evidence of increased incidence of social anxiety,[13] anorexia nervosa[23][24] and self-harm in autistic females..."

RIP my beloved cousin. (undiagnosed)

source which references other sources: https://en.wikipedia.org/wiki/Sex_and_g ... _in_autism

I don't know what CAST is, but I do know I was under the clinical threshold for ASD for ADOS-2 (as are up to 30% of women according to a few studies), but other factors were compelling so I received my diagnosis.

Folks in my ASD support group obtain executive function support as EF worsens with age. I have an ASD-specialized therapist who is fantastic. I got my diagnosis 3 years ago. Since then I've attended a very useful Anxiety intensive workshop. I qualified for employment resources and although they didn't quite know what to do with a Twice Exceptional client, ultimately it was useful and helped me secure a new job. I have yet to pursue the referral to pediatric OT for ASD, since there isn't any available for adults, but will at some point. I've enjoyed the online and in-person support groups; I get referrals to ASD-friendly medical offices, services, apps etc (and know which ones to avoid). I live between a big city and a progressive smaller city, so there is a lot here. I need lots of support to live "big" like I do (with many daily demands -from an ASD perspective). My BFF is undiagnosed and lives "small" (with very few demands) so doesn't need the support in that way at this time.

I hope more resources become available in your area that would be useful for you.

I was diagnosed Level 2 in 2018, when I was already on permanent Long Term Disability from my career because of catastrophic PTSD (primary) and stroke (secondary). I'm not certain if my ASD diagnosis would have qualified me for LTD on its own, but I forwarded my diagnosis to the insurance people anyway when they asked for updates.

Here's my blurb about support:

The assessment itself cost me close to $2000. I pay out of pocket $500 / month for private insurance which includes psychologists, but I can only claim $1500 / year for psychology. I had to forgo a year of trauma therapy with my trauma psychologist, so I'd have enough of a balance available to cover (most of) my ASD assessment.

My report had two pages of recommendations which I'd happily screenshot for you but my name is throughout it and I can't be arsed to blank it out repeatedly. I'm not working or in school so it didn't list those types of accommodations. Basically, they recommended OT, Speech, and CBT, as well as a bunch of sensory products and workarounds. They gave me the names of ASD-specific OT and SLP providers. They didn't put a name for a CBT provider since I hate CBT and I already had a trauma therapist. I didn't want another therapist and couldn't afford one on my benefits anyway.

OT: I didn't use the ASD-one whom they recommended because she was too far away. I found one myself. Any OT can provide OT to a paying customer based on their needs whether they're autistic or not. They'll do an intake assessment and go from there. Mine assessed my Sensory Integration Disorder and did over 200 hours of sensory work with me for Interoception and stimming-related stuff. She was great, but she was almost $200 / hour. It was covered on my insurance but lots of people don't have private insurance and could never afford that type of treatment.

SLP: Same as OT -- I didn't choose the one they recommended. I found my own, told her I was autistic, and told her what I wanted help with. It was up to her to figure it out. Again, anyone can hire an SLP if they want to pay for it.

Therapy: I actually ended up finding an ASD-trained Social Worker who I liked, who was covered in a separate fund from my trauma psychologist. I found her through my ADHD assessment in 2020. She was pretty good but again, if I didn't have insurance it would have been cost-prohibitive. I found her myself so it's not like the ASD doctor or the government handed her to me on a silver platter.

Then my trauma psychologist retired so I had my psychology money freed up. I found a psychologist who was supposedly an expert with ASD and ADHD. It ended up being a bunch of CBT nonsense and costing $255 / 45 minutes, so I gave up on her.

Now I have no therapist for trauma, ASD, or ADHD. I've given up trying to find anyone who understands ND.

As for the issue of women being underdiagnosed, I can't really comment. I believe women who say they've had a hard time. In my case it was cut and dry the first time I went for an assessment. She told me straight-out I was L2 autistic at the end of a 12 hour meeting. I've posted my clinical scores on here several times and they're really bad. My daughter was diagnosed HFA from a different place, but hers was also straight-forward with no dispute. That's why it's hard for me to speak about the gender divide from personal experience, but I'm not saying it doesn't happen.

There are (undx) autistic men and women in my family on both sides, going back generations. I tend to think there's been more men than women, but I'm not sure. As for my kids they also have their dad's DNA so I'd have to look at his family. One of his sisters has Downs and there are a few other very autistic-seeming people, including one niece in particular who was hospitalised most of her life in paediatric mental health, for what I can only assume is autism based on the descriptions I've heard from my daughter. To be inpatient for years, she must have comorbids too.

^ Good (and hard) stuff there. You are very resourceful!

I forgot about SLP (speech); I'm interested in that for myself.

désastre comparatif

and yes Bear too