Why are Boys Diagnosed With Autism More Than Girls?

Font Size

“Catelyn?  What happened?  Why are those girls talking to their mom and pointing to you?”

“I don’t know,” she said with a shrug and walked away.

Every time we came to a playground, Catelyn would stand at the base of the park and count, “1, 2, 3, 4 new best friends!  I am going to go play with them.  Bye mom!”

She was excited to play and to interact.  Great!

Yet every time, her new best friends left their interaction with Catelyn upset or bewildered.  What had Catelyn done?

After Catelyn was diagnosed with High Functioning Autism (HFA), I looked back through the years and saw all the signs that we overlooked.

Catelyn was a difficult child.  She was happy!  She was exuberant!  But boy, she was hard.

The signs were all there.  But it wasn’t until Catelyn’s behavior began to affect her day to day life and she became depressed that we decided to seek out help for her.


Which led me to wonder – I have learned HFA is easy to overlook.   I sure of heck would have not seen autism in Catelyn if her therapist didn’t point it out to me.  And then I saw it, plain as day!  Is this something that happens frequently?  Why?

Why are Boys Diagnosed with Autism Spectrum Disorder (ASD) More Than Girls?

Boys are 5 times more likely to be diagnosed with Autism Spectrum Disorder (ASD).

For years, autism was primarily seen as a male disorder (Sarris, 2013).

Does autism look different in girls than it does in boys?  Are Doctor’s looking at girls to have the same problems as boys?  Should they?

In the article, “Gender and Autism” by The National Autistic Society there are many reasons discussed as to why autism may look different in girls, than in boys.  These reasons include:

  • Women/girls are better able to mask their difficulties
  • Women/girls are expected to be more social
  • Women/girls have more active imaginations and engage in pretend play more often by nature
  • Restricted/Repetitive Behavior patterns look differently in boys than in girls. Girls tend to like the same things as other girls.  Their like of those items is just more intense.
  • Women and girls TEND to act more typical in social settings as they have had to spend more time in a social setting and have learned social rules.  At least they have learned ways to mimic appropriate social behavior, but may not always understand it.

Gender Differences

Gender differences come into play as well which make it harder for girls to be diagnosed with autism

As much as we like to dress our baby girls in pink and our baby boys in blue, we create gender stereotypes about the behaviors we expect to see.

Researcher Simon Baron-Cohen and others discussed the person with autism’s brain is geared towards ordering things (male trait) and not empathy (female trait).  Since the male will require more treatment to learn empathy, as it does not come naturally to him, he will require more support.

If a girl has difficulty making eye contact, it is easy to dismiss as the girl is probably “shy.”

Women/girls have better verbal skills.  Boys do better at Visuo-Spatial tasks

Girls and Boys With ASD Also Present Differently

Researchers from a Swedish study found there were many differences between boys and girls with ASD:

Boys tended to lack a best friend.

Girls were more likely to avoid demands placed on them

Girls care less about their aesthetic, appearance and dress

Girls are more determined

Girls tend to interact mostly with younger children

Boy will present with a robot-like voice.  Girls with a high-pitched voice

Girls with ASD are far less aggressive than their male counterparts

Girls with ASD are more likely to be passive, anxious or depressed.  Boys with ASD tend to have more energy, be busy or angry.

Girls with ASD tend to allow themselves to be mothered by a same age friend.  Helping them navigate social situations.




One of my favorite quotes in researching this topic came from the Sarris article, “Not Just For Boys: When Autism Spectrum Disorders Affect Girls.”  Dr. Costantino, Professor of Psychiatry and Pediatrics at Washington University in St. Louis, discussed the need to use a different measurement tool to detect autism in females and stated “A girl, who is very tall for a girl, may not look that tall if measured with the boys’ growth chart. In the same way, a girl who scores very high for a girl as far as ASD traits may not look that impaired when compared to a boy with ASD. But she is still scoring extremely high compared to the rest of the girl population, and may benefit from clinical help and support.”


One of my major findings in doing this research was that girls with High Functioning Autism are quite possibly being overlooked due to their symptoms not exactly mirroring those of males.  Why is that?

This is an area I intend to look at that in my next post



Sarris, Marina, “NOT JUST FOR BOYS: WHEN AUTISM SPECTRUM DISORDERS AFFECT GIRLS.” Interactive Autism Network at Kennedy Krieger Institute, 13 February 2013. 17 January 2017

“Gender and Autism,” The National Autistic Society, The National Autistic Society 2016, 17 January 2017



10 thoughts on “Why are Boys Diagnosed With Autism More Than Girls?

    1. Thank you! I was surprised too – it really helped to see what might look different (because those are the things I see) and also that professionals are starting to recognize there are differences. Thanks again!

  1. My daughter has Asperger’s, as does her male cousin. Boys and girls most definitely present different symptoms. Unfortunately for my daughter, many peers just see her as “weird.” Luckily she doesn’t care (nor does she care what she looks like…and she’s 18 and attending college)

    1. Thank you for sharing! I definitely know Catelyn has some unique traits – like her voice is ear piercing when she becomes emotional (good or bad emotion). That is not something they put for a general charateristic, but her therapist and other material point this trait out. So interesting to learn the differences! Thanks for reading!

    1. Doing something new brings out the anxiety here – or having to do a non-preferred activity like going to the dentist. How we deal with the anxiety can be hard to figure out!

Comments are closed.