When I was first referred to CAMHS (Child and Adolescent Mental Health Services), I was 13 years old, and it was for anorexia. It wasn’t until after about 18 months of therapy, it was decided I should be tested for autism, and up until that point, no one had ever suggested it before.
I was doubtful and so were most people I knew. When we thought of autism, we thought of boys who struggled to express emotion and were obsessed with science – that wasn’t me. However, once I was diagnosed, the autistic label started to make sense. I had always felt slightly different from my friends; I had no time for small talk and found maintaining eye contact difficult. Looking back, I can see how this led to me developing anorexia, as with many autistic girls, I felt like I didn’t fit in, and changing my body was what I thought would fix that.
Autism and gender
It’s not uncommon for a girl to be diagnosed in her teens like me, or even adulthood, whereas boys are more likely to be identified as autistic as a young child. This is because the symptoms that teachers look for are typically experienced by males: special interests in something like trains or planes, repetitive behaviors, inability to express emotion or cope with change, and many more.
Autistic girls can go unnoticed (receiving a diagnosis at a 4 x lower rate than boys) because this is not how their autism manifests itself. They are much more likely to mask their symptoms and mimic the behavior of those around them – creating a false impression that they experience the word in the same way as their peers. Subsequently, girls continue to fly under the radar when it comes to diagnosis, and they spend much longer periods of time unable to understand themselves in comparison to boys.
Autism and mental health
Once again, my experience is not uncommon. Unfortunately, a lot of girls don’t receive their diagnosis until they are already being treated for mental illness. In fact, rates of mental illness within the autistic community are unusually high. 40% experience symptoms of anxiety compared to only 15% of the population, and OCD and depression are also more prevalent. In addition to this, around 23% of people suffering from eating disorders also have autism, whereas only 1.1% of the general population is autistic. This clearly shows that autistic people are disproportionately vulnerable – especially girls – and the fact they are diagnosed so late in life could be an explanation for this.
While I recognize it isn’t possible to eradicate all mental illnesses autistic girls will face, purely by diagnosing their autism earlier, I do believe it would help. At the very least, they would have the tools to face the anxiety caused by trying to fit into a world that isn’t designed for them. Researching how autism presents itself in girls and then working to pick up on it earlier really is a simple solution. Whichever way you look at it, one thing is clear, waiting until girls are facing immense mental illness to assess them for autism is a dangerous and unacceptable way of doing things.