Autism and ADHD: How does biological sex alter the affected?

As described on the CDC's internet database, autism includes “persistent deficits in each of three areas of social communication and interaction, plus at least two of four types of restricted, repetitive behaviors”. This criteria expounds upon a failure to fully understand or develop social relationships and nonverbal cues, heavily repetitive behaviors or forms of speech, intensive daily rituals or interests, and a severity of focus or lack of attention toward sensory stimuli. ADHD, which is also listed on the CDC's webpage, portrays “a persistent pattern of inattention and/or hyperactivity that interferes with functioning or development”. Certain symptoms include the excessive urge to fidget when restless, the inability to hold full attention over long periods of time, the inclination to become easily distracted or forgetful, and the tendency to not register crucial social cues or instructions.

While these diagnoses may seem fairly straightforward, the reality is that both autism and ADHD lie on a vastly expansive spectrum. Throughout the years, a countless number of professionals have invented more and more unique labels in which to identify, including “high/low-functioning", "Asperger’s syndrome”, “Rett’s syndrome”, and even a list of various categories for ADHD. In the widely controversial case of Asperger's syndrome, which was withdrawn as an official diagnosis in the US from 2013 onwards, children diagnosed were often provided less resources than those with other forms of autism, citing the high intelligence and functionality portrayed on its criteria. More often than not, females were classified under this specific designation–even when it was incorrect–if they were taken seriously enough for a diagnosis in the first place.

Dating back to the early 1900s, many psychiatrists and physicians have attempted studies on both autism and ADHD, resulting in countless groundbreaking discoveries and medical findings. Sadly, most of the trials performed were largely biased through societal preferences toward certain sexes and ethnicities. More specifically, any research conducted largely centered around males and their certain behaviors, causing a lack of attention toward the mental capacities and struggles of women.

According to Medical News Today, men were more likely to have “externalizing disorders”, or symptoms that are more easily recognized and identified by other people. Biological males were also found to be more prone to persistent outbursts and inattentiveness, causing a means of diagnosis to become easier to achieve. Through the systemic inequality within the psychiatric evaluation system, females were found to be diagnosed with ADHD up to nine times less often than males, while community findings developed a smaller sex ratio of 3:1. Autism, on the other hand, is medically assumed to be placed at a ratio of 4:1, while it is evident that the actual ratio is 3:1.

As autism and ADHD can begin presenting as early as infancy, the adolescent years of those affected are especially crucial. For those already experiencing a life with onset autism and ADHD, puberty largely intensifies their social and behavioral symptoms. While this occurrence may increase the chances of being professionally diagnosed in some, most individuals are not accounted for due to “hormones'’ or “being a teenager”. With this lack of validation in mind, those with internalizing symptoms (more often than not females), are potentially misdiagnosed with various mood disorders, such as anxiety, depression, or even bipolar disorder. While comorbidity between mood disorders and neurodivergency is often found in patients, this is not always the case.

Time and time again, women have been wronged along their paths to full mental understanding and finding a place within an increasingly conformist world. For centuries, females have served as the doormats in western society, forced to abide by a motto of “being seen and not heard”. Though fairly recent reforms have been introduced in the psychiatric field to improve conditions, many women still find life easier to navigate through “masking”, or camouflaging, their neurodivergent symptoms around others. Masking includes consciously or unconsciously finetuning social behavior towards neurotypical standards through mimicking peers, controlling natural impulses, or internally rehearsing how to seem "normal" or fit-in within a group setting.

Sadly, through the practice of masking, a neurodivergent diagnosis becomes even harder to obtain, resulting in a vicious cycle within the lives of female autistic and ADHD individuals. Many psychiatric professionals lack the ability to register the barriers a skilled woman has built up, and as a result fail to recognize the symptoms that were desired to be validated in the first place. While masking may seem beneficial in a daily life setting, visibility in the eyes of those trained to help only takes place by showcasing the truth behind their patient's existence. In order to defy the odds, women must become self-advocates and fight for affirmation in a world that is not built for them.

Our youth deserve a fair chance to grow into adults and be taken seriously as valuable human beings along the way, no matter the identities they find themselves comfortable in. Even with the negative connotations that come along with disability diagnoses, adult figures must be prepared to love and support the children in their lives who may not present as “socially acceptable”. This includes research through verified sources, seeking out opportunities for professional aid and sponsored growth, and finding a like-minded community where it is safe for the child to express themself. Younger individuals also must stick up for themselves and work together with the guardians in their life to ensure the best outcome along the path towards full acceptance. Neurodivergency is a gift, so allow yourself to see past the obstacles and into a future where your condition is not considered a hindrance, and in reality serves as an advantage.