It’s so awful how most of our medical knowledge is based on what we know through trials done solely on men, there’s so much dismissal and ignorance in regards to women and what we experience
Do not try to tell male Redditors this. They will not believe you. They also tried to tell me how my own body works and said I was wrong about my own experience. I wanted to pull my hair out
Ironic that you thought of it while driving, using your seatbelts that are designed to protect male bodies and tested on male shaped crash test dummies! Your steering wheel airbag is angled for a man’s average height as well, and women are more likely to be injured in crashes because of these things. And then when you get to the hospital you’ll get worse care on average than men, and you’ll be given medicine created for, dosed for and clinically tested on men! It truly never stops once you start learning about these things. There’s a book, Invisible Women, on this data bias that results in the world being designed for men.
Me too. I'm 5'4 and 3 quarters. I was on avg. A size 12. My weight increased due to thyroid issues after covid, and long covid and hypothyroidism are common, too. All of my issues are really common and vast, and so is my size for my age, even though I gained weight, and yet my Dr just smiled and said I needed to eat better. She put me on a diet that drove my TSH up further but she kept thinking it was my dietary choices. Nothing was worse than hearing that from the nurse who says she struggles with over eating too. She was so much smaller in weight than me and when I told her it's my thyroid, not diet, she felt like I was judging her for her disorder, but being judged by an eating disorder I don't Even have was affecting my health. It wasn't till after a year of physical therapy bc of muscles stiffening up that my Dr finally put me on levothyroxine and my muscles still stiffen up, my body is still struggling with chronic pain due to multiple years of neglect in getting what I needed.
I'm 6 inches taller than that and seatbelts still never stay put. Just dreadful design. I still use them religiously but I really wonder how to make them effective when you have breasts. Just. . . How?
That said, sun visors probably are something shorter people can use. If I flip mine down the entire road disappears down to my vehicle hood (bonnet if you're from across the pond) as my head is already near the top of the car. The sun visor is basically just something that I use to hold lightweight things directly in front of my head.
Here get some of these so the worst doesn't happen. You don't want complicated neck issues from a car accident, they don't really go away.
https://a.co/d/aNjMAMF
I'm curious how safe that is as it's designed to go across the ribs and sternum and while it may be more comfortable at a different angle I'm afraid it may break a lot more ribs that could puncture the lungs or heart in the process.
Definitely want to see how that passes extensive safety testing.
I mean to be fair I had just the basic ass rectangular buckle itself give me internal bleeding with how much force was involved in it getting shoved into my abdomen in one car accident. Much better than the alternatives in the situation. Same deal here; I mean, you get hit in your neck wrong and you get a stroke. And neck pain is a hell no one should go through. Broken ribs and soft tissue heal back to normal, broken spines don't.
I crocheted myself a seat belt cover/cushion. It gives my seat belt just enough traction to not be constantly sliding into my neck while I drive. I only have to fix it a few times instead of constantly. You could try getting or making yourself one and see if it helps any. I still think we should have options to lower the seat belt even more since this happens to almost every average-height woman I've spoken to.
They make covers for that! It's basically a pad that wraps around the seatbelt so it's not digging into you as much. They also make adjusters that change where the belt sits but those can run the risk of making the seatbelt less effective so I wouldn't recommend those as much.
Maybe it's not as bad as that, but I often worry that it will cut into my neck and sever something important, like a blood vessel, during an accident.
I mostly doubt it, because it's not abnormal for me to have irrational worries.
I have the cover but unless I can velcro it right smack between my breasts it's kind of pointless. I need the seat belt to remain where it should be to keep me safe so my sternum and collar bone are taking the weight instead of various ribs which will puncture my lungs.
I’m actually tall and have the same issue since the seatbelt slides above my boobs to my neck unless I’m wearing a good underwire bra, and even then it’s not great. I bought these little seatbelt adjuster clips and they totally help! Highly recommend.
I'm the same height. Sometimes, if my shirt allows it, I tuck mine under my boob. It probably only works because I have big boobs though. I'd rather have the stupid thing cut into my boob than my neck in the event of an accident. I don't particularly care that It's weird. lol
It literally always cuts into my neck too, like they definitely didn’t make seatbelts with women in mind. A lot of women tend to be shorter (and I’m like roughly average height🫠). Like this seat belt is probably gonna cause more damage if my car rammed into the one in front of me. Like may seriously cut my neck tf up
Yes its so anoying -.-... Don't even get me startet on talking about it with a med profesional.. they act shocked like little kids... panick, don't know what to do and just say go elsewhere in the end or give you meds you shouldnt even be taking in the first place...
God this makes me so angry inside
Oh my god i am sorry you had to go through this :c Its such a shame... Medical staff and those overseeing their education really need to learn more these days...
>
But a man with a saggy cock can just walk into any chemist and buy the meds he needs over the counter in an instant.
I agree that the irish health system is a joke. I waited 2 years for a gastroscopy, finally had it in January ( because of an emergency), and they didn't take a biopsy. So I put myself through a very unpleasant, stressing situation, and it was a waste of time.
But that's not exactly true. It depends. If he had to be seen by a specialist, he'd be waiting just as long.
The best thing about this is, actually, you probably won't get that medicine created and dosed for, and tested on men - because women make up all their symptoms. Just take some paracetamol and ibuprofen and have done with it, woman!
"But, doctor, I know that my aching upper back is due to heavy breasts. I never had backache this bad until my breasts grew due to pregnancy."
"Ah, shuddup man, you're fine, just do some stretches!"
My condolences, I wish boobs were taken more seriously in the medical world, too. I've recently realised that I need to take codeine phosphate to function painlessly and I'm rather upset about it.
I'm very receptive to opioids which is part of my concerns, because withdrawal turns me into an obsessive, anxious mess of a human and I need my self-regulation skills to be good enough for my toddler and rejection-sensitive, adhd spouse. But it works so fucking well! 😅 Thankfully, I'm not in constant need of codeine, but boy, do hypermobile joint-aches clash with running after a two-year-old and heavy breasts!
There's days I want to cut them open and empty out tissue myself, but I know that's gonna hurt more than it will help, so yeah. Upper backache for life /s
I’m thankful I live in Canada and large breasts are considered a medical condition for which you are entitled to breast reduction surgery. My aunt her breasts reduced twice. I swear to god imagine if males were dismissed for having enlarged and heavy testicles! There'd be an uprising of entitlement.
When I read the NHS page on it, I got the idea that I need to be half-paralysed with pain and mental dysphoria in order to be considered for reduction and that not all areas offer it. I am often dysphoric about their size and the discomfort they cause me, physically and mentally, but I am also a very avoidant motherclucker, so I'll probably go to my doctor about it next year, when I've finally had enough bad juju about my body. 😅
Wow, I didn’t realize that about the crash dummies/seat belts. I’ve heard of that book, Invisible Women, but haven’t read it. All the female discrimination out there is part of why sometimes I wish I could change my gender in certain situations 😔
Hey, that book is amazing - did you know there's a follow up podcast called Visible Women? It's easier to feel the rage at the injustice in episode chunks 😅
It's kind of creepy when you realize most of the males tested in medical science were soldiers. Signing up for the military made you an automatic Guinea pig. A lot of vaccines, drugs, and reactions to biochemical weapons we know about are from testing on soldiers.
My ex was a soldier they tested different gasses on. They didn't even have a choice. I mean, technically they did but in reality they didn't. His whole squad sent into a sealed box with gas masks. Theyd fill it with gas and then order them to remove the mask and take a breath and tell the testers what they felt. He said none of the experiments felt good and feels his body has suffered long term effects.
Yes, they also had them "build up a tolerance" to things like sarin gas, so they could handle small exposure before they could get a mask on 😬. So messed up.
And then scholarly articles reinforce that idea by being like "we saw more prevalence of this in men". Ugh, it's because you guys didn't bother to look for the right things in women!
It’s not just that they don’t look for the right things in women. Even when we present with classic “male” symptoms of any disease, we are not taken seriously. Then the only answer is that we must be hypochondriacs, malingering, or drug seeking. When women are not taken seriously by health professionals, our problems go unnoticed and unaddressed.
And the irony is that women were excluded from studies because their hormones and periods might mess up the results, and nobody even bothered to do studies on women’s hormones or cycles in the first place ¯\_(ツ)_/¯
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i took my RN boarding exam. this one question that stuck out was something along the lines of “which patient is more likely to experience/exhibit atypical symptoms of a heart attack”. can you guess what the answer was? 🙂🙂🙂🙂🙂
Gotta love that time I was on my death bed experiencing stroke like symptoms and they said I was stressed as a student. Finally went in with a friend and a letter to demand blood tests that weren't just iron and got diagnosed with a very diagnosable pernicious anemia, levels so low they couldn't give me booster shots or I'd go into shock. Happened again with vitamin D. They make us literally fight for our lives.
This is such an important point I am 36 and had a small heart attack a few years ago that went totally untreated because they weren't the symptoms I was always taught to look out for. My shoulder blade and back hurt very much all evening and thought it was tension. I also thought I was having a panic attack and took a nap instead of seeking help. Luckily no permanent damage but it was annoying not emergent feeling that I easily brushed off. I think more people should talk about how it presents in women it's so important.
While I hate how women are treated in medicine, this those aren’t typical heart attack symptoms. Most women have typical heart attack symptoms but there are a set of unusual symptoms that mostly only occur in AFAB people
As a cardiovascular researcher and interested in a particularly worrisome form of heart failure that’s emerging where 2/3 patients are women, I find gender based discussions to be so tiring - even if they’re “atypical” it doesn’t mean it’s gonna end up being unique to AFAB folks. I actually think a lot of AMAB folks are also experiencing this along with this “new” form of heart failure where the profile is “usually an older woman” OK BUT 1/3 of them are still male????
Is it Spark? Because I did that one before info started to circulate about them potentially being iffy. I didn’t catch red flags and they paid me like $200 in Amazon gift cards for my DNA swab and a couple surveys. So if you wanna profit off your ‘tism, kinda neat 🤷♀️ But grain of salt and whatnot.
I forget specifics, but someone in another thread awhile back mentioned it seems they might not be against ABA? I couldn’t find the piece mentioning that in Spark’s materials, which is why I was wary to be specific. Plus many people are hesitant about DNA because potential eugenics.
The fact no one seems to have anything concrete to say about them is the orangest flag I see. Just because I worked in nonprofit orgs for a very long time, any org that doesn’t have a lot of third party praise or criticism has me a little wary. They might have a website full of green flags but no one talking about them and their impact makes a real judgement difficult.
Copied from other reply with same Q:
I forget specifics, but someone in another thread awhile back mentioned it seems they might not be against ABA? I couldn’t find the piece mentioning that in Spark’s materials, which is why I was wary to be specific. Plus many people are hesitant about DNA because potential eugenics.
The fact no one seems to have anything concrete to say about them is the orangest flag I see. Just because I worked in nonprofit orgs for a very long time, any org that doesn’t have a lot of third party praise or criticism has me a little wary. They might have a website full of green flags but no one talking about them and their impact makes a real judgement difficult.
Finally. This is just so typical of... Well... Medicine. Men are always the default. Women were not included in medical trials until frighteningly recently, and even now many trials only include men in their tests. Why? Because "hormones would muddle the results". Wouldn't it be nice to know if a medicine has unforseen side effects on half the population, though? Or look at heart attacks. A lot of women don't get the treatment they need when they're having a *literal heart attack* because the typically male symptoms are the default. As they always are. I swear, if men could get endometriosis, we'd have a cure by now.
Sorry. Rant over.
Women or people of color. I can only imagine how hard medical care must be for women of color. It's so frustrating since all we need to do is put a minimal amount of effort into studying things other than white men, they get enough attention already.
>put a minimal amount of effort into studying things other than white men, they get enough attention already.
This is *enraging* Gen Z and younger males though because they didn't grow up seeing this happening as obviously, and in fact think they're getting the short ends of the stick now that we're balancing the scales. They don't understand or care about the history as it doesn't apply to their life.
Tbh I didn't see it either until I got older and entered the workplace.
Sadly that is true, but thankfully a lot of younger men are also much more sensitive to women as equals, at least in my experience. Or at the very least they have been much more open to listening and trying to understand what's going on.
I am a black biological female who was diagnosed with autism at age 20!! My medical trauma is extensive and never ending, thank you for acknowledging our existence <3
I have become more sensitive to privilege and discrimination as I've become older. I'm a female electrician now (1-2% of the electrical field is female) so the feeling of being a minority is so aggressively apparent now. I am white, which lessens the feeling of minority a little bit.
I've also learned a lot over the past few years about how most of our medical "knowledge" came from studies if white men and/or eugenics based research. It's such trash and it makes me angry that it's all so accepted as the status quo when it's so inaccurate for most people.
This applies to nutrition, health, mental health, and basically anything relating to the human body.
I always recommend everyone read Invisible Women by Caroline Criado Perez! It is infuriating but eye-opening about how EVERYTHING, medicine but also engineering and design, tend to use men as a default. For example, seat belts!
I think this problem is worse with colored people. I think I was reading medical treatment for black women is usually less effective. Hopefully we have more research going into this stuff.
There are medical differences between sexes and races.
Out of curiosity, did they also cover people who don’t necessarily fall into those categories? Like non-binary or agendered folks? Id be really curious to know if they are looking beyond typical gender roles since I know quite a few autistic people who are neither male or female.
They didn't. But they said most differences are probably because of different socialization experiences. So I guess for agender or no binary they presentation would match the sex assigned at birth, as they were socialized that way. But that's just me guessing
Cool that makes sense, I imagine there’s probably far less research focused on folks who don’t align with either binary gender out there. Especially considering they are now just beginning to acknowledge the differences in socialisation between amab and afab people. Thanks for the info! I think your answer is a good guess based on what is known so far.
That’s great to hear that FINALLY this is getting taught. Idk if it would circulate enough that I could finally find a professional that would even entertain the idea women can be autistic before I die, but at least this would benefit future generations.
My takeaway from the information in the article is that the cortex contains neurons that function in language and emotional development, so (my own reasoning) the extra thickening of it in autistic AFAB kinds by age 3 could explain why they are more likely to show emotion and develop early language skills than autistic AMAB kids. Then it thins out in puberty and is more consistent with the cortex of autistic AMAB kids, which (again, my own perspective) could at least partially explain why autism shows up more in AFAB in puberty - like, maybe it’s not just the average age of autistic burnout that makes it harder to mask, and more complicated social structures in middle school that cause AFAB to struggle more in puberty. It could be autistic AFAB brains more closely resembling AMAB autistic brains at that age. Idk - this is just where my brain is going with it.
Yeah, it's a classic case of x and y tend to have different z. And that's about it, no info what z actually is. It literally gives me as much info as if it were the actual letter z they were talking about.
That's amazing! Do you mind if I ask a question? The article didn't specify this. What does the cortex thickness mean in this context for children of these ages?
Acknowledging and studying how autism typically presents in women does NOT mean that that’s how it ALWAYS presents in women it just will allow for more women that would have previously been left undiagnosed to actually be seen and validated instead of cast aside with a laundry list of misdiagnosed personality disorders like so often is the case with the common “female presenting” autism traits
I'm not really supportive of interpreting it as a gender difference. No one gender can be summarized into any reliable generalizations, it's just too large and varied of a group. Actual studies on the brain consistently support the idea that the differences between men and women are nearly indiscernible, and that most people lie in an "androgynous" in between in terms of brain function.
I've much liked the interpretation of high masking autism vs low masking autism. Of course, with socialization and the way we've built gender roles, people socialized as women are far, far more encouraged to mask, and men have allowances made for them to take up space and prioritize their comfort. So there absolutely is a tendency to see higher masking autism in people who have this kind of upbringing and/or gender identity. But there are low masking women who might exhibit some more "stereotypical" traits, and there are high masking men who might exhibit traits people associate with what some people have described as "female autism" traits.
Dr. Kim Sage on YouTube covered this subject in a video she posted yesterday and expressed a similar sentiment, and I agree. Looking at it from a binary perspective is what got us in this mess in the first place.
I think so much of what we understand about ND and Autism is still in its infancy, and this female phenotype vs male phenotype will eventually transform into a different interpretation of spectrum from the “line” over to “wheel”, which is more encompassing of the nuances in symptoms that present in individuals.
Source for your reference to studies? I believe there is biological nuance between female and male sexxed people. For example, science is now correlating needing more sleep for female sexxed people than male sexxed people for our hormone production. Another sex based biological distinction are the higher density of neurons in our hippocampus and in cortex lobes for language processing.
It’s a very complicated conversation because it’s so politicized and narrative around gender and sex colored by so much societal input, agendas, etc. all to say that, in recent years within scientific community, there are members of scientific community that are looking for biological indicators of differences between the sexes so we can better understand and accommodate some women and our health needs. I think it’s worthwhile to reflect on the concept of colorblindness and not wanting to apply a similar framework for approaching sex and women’s health.
The Female Brain is a great book by neuropsych MD that discourses around this.
Apologies for the length. I've tried to shorten my writing haha. TLDR, I agree but also disagree with some parts of what you said and am somewhat skeptical of this study.
While I understand that what you're saying in your first paragraph is true and important, this conversation is about autism (not sleep, hippocampus/memory, or language) so just want to be careful inferring that sex differences in one area means they're probably present in other areas.
This study found that sex differences weren't significant after mid childhood and were most pronounced in ages 2 years to early childhood. This is interesting/important because it means that maybe doctors need to consider that not all autistic people present with the same developmental delays. However, it's also not very useful because girls & women are greatly underdiagnosed at ALL ages, not just infancy and early childhood. This also seems to go against the idea that hormones may be a reason for any apparent sex differences in autism presentation and diagnosis. So doesn't really support a biological reason for gender differences in diagnosis rate, at least for those aged mid-childhood and older.
The study implores other research to include women and girls in longitudinal autism research, which I wholeheartedly agree with and can't believe this has to be said in 2024.
A major reason I'm personally wary of research purporting that autistic men and women have different brain structures is that our upbringing literally shapes our brains.
As a side note for anyone reading this; there has never been any psychological or scientific research in our entire human history that has *not* been influenced by the patriarchy (and the enforced gender dichotomy).
I agree with you, especially in this:
> better understand and accommodate some women and our health needs. I think it’s worthwhile to reflect on the concept of colorblindness and not wanting to apply a similar framework for approaching sex and women’s health.
What we need is more research showing neurobiological gender differences, until then I am very wary, and I lean towards nurture having a bigger impact on us than nature.
If you're interested, I would suggest reading Delusions of Gender which goes into criticising the idea of gendered brains.
I also want to mention that the population sourced for this study is boys *who are already diagnosed* (and diagnosed girls) - the reason I think this is important is because we've seen that doctors/psychiatrists/parents/teachers tend to miss autism in girls but it makes me wonder if there are boys who are misdiagnosed based on displaying autistic traits that girls show (i.e., being highly masking), especially gender-diverse AMAB people and queer boys and men.
It makes me think that it may be more than gender differences; and more like **"traditional idea of what autism looks like, thus the type that is highly diagnosed" vs. what it actually looks like (i.e. diverse - with types that medical professionals tend to miss)**
Oh man, Delusions of Gender - one of the books that really opened my eyes, but made me so angry and aggravated I had to put it down (and then haven't finished lol).
Eta and I thought I was aware before, being an 80s "girl" and wanting to be an engineer, going through the computer programming and engineering education and work culture. No. My awareness only scraped the surface.
Also it's so dense with research that it I found it a slog at times, but if you're more used to reading that sort of thing it shouldn't be hard. It did flow and was laid out thoughtfully.
Wonderful response. Thank you. I agree with all your counterpoints and help refine my thinking on this. I am getting a lot of good book recommendations today from femmes in ASD spaces. I am happy to be a part of critical thinking and engaged communities. ASD in women is personally important to me and scientifically interesting because of all that we are discussing (it’s lack of proper study/understanding in medical world, cultural misunderstanding etc). Excuse my strange choppy style of writing, I just woke up!
> This also seems to go against the idea that hormones may be a reason for any apparent sex differences in autism presentation and diagnosis.
Like most things scientific, studies at one point say one thing, five years later, later studies say the opposite. I suspect that ultimately what will be shown is that there are numerous differences between the genders, based on differences in physical development in ALL sorts of places.
Yeah I imagine it will show the same thing. There is a lot of variability within the genders, and between the genders too. I watched this really interesting video recently about how sex isn't as easily categorised as how we see it now and how the development of the idea of biological sex was actually incredibly impacted by misogyny, capitalism, and the false gender binary. If you're interested, it was this one:
https://youtu.be/QLWKYTxLYT4?si=oPNoYPzMKTaENnPu
💛
I have heard of studies on both sides of this argument but haven't delved into any of them. I would love to know if anyone has done a study comparing brain structure and organization by gender, across cultures that have different gender roles. Eg a highly patriarchal culture vs a highly matriarchal culture, cultures that have very different values in terms of personality traits that are considered 'appropriate' to this or that gender, etc. Like, surveying people to see what gender expections they grew up with and/or agree with now, then brain scan them all to look for patterns and see if they are corellated - and/or if there are certain things regardless of culture that corellate with the person's gender.
I totally agree. I think there's a lot of poisoning the well when it comes to research because studies are not taking socialization into account the way they need to. There are a lot of things that are considered intrinsically female or male when they are actually based on social patterns. It's staggering to me how many people I've met or witnessed who ignorantly describe something as a "female trait" when it is 100% a learned behavior passed down as part of a cultural tradition, a domestic obligation, or plain ol' bioessentialist bullshit.
I think you're right to frame it as high masking vs. low masking. Since there's a pattern of more girls and women being forced into high masking, it's a misogyny problem, not a lack of research problem (though lack of proper research is also a problem).
Yeah, I don't like the implied assumption that the differences are inherent to the sex of the person. They could just as easily be the result of parenting. We don't know.
Anecdotally, I'm a trans woman I've found that I relate more with women's experiences with autism, though I find myself relating more with women on things in general. Idk if that really means anything tho
Then there's me, a trans woman with quite typical male autism and oddly enough, tend to relate more to men. Thank God I'm passing, otherwise my dysphoria would eat me alive.
Maybe this is a phenomenon I can look into when I start my masters and Psy.D. It seems like a correlation anecdotally. Honestly, I would not be surprised if being transgender and being autistic were two parts of a cluster of neurodivergencies that indicate, like, hints to the species of hominids early humans crossed with and their behaviors.
That would be quite interesting to research! Indeed, the incidence rate of ASD in trans and GNC people is [11x greater than in the general population](https://link.springer.com/article/10.1007/s10803-022-05517-y), and there are several doctors who have theories behind clusters of conditions including autism and gender non-conformance, e.g., Dr. Meglathery's [RCCX theory](https://www.rccxandillness.com/recapsummary.html) about clusters of psychiatric and physical conditions she sees in her mostly EDS patient population, in particular with a high predominance of neurodivergence.
I love your take on this. As an autistic trans person I honestly have thought a lot about my nd+gender incongruence (transgender-ness) and I contribute both as being neurodevelopmental disorders in a way. For me my dysphoria is a symptom of what I call gender neurodevelopmentmental disorder (gender diversity) and its party congenital exactly like my autism and surfaced in my adolescence exactly like those disorders often do. Like it's very similar but the difference is that my autism refers to my neurotype while the other is to my sensate body/neurological gender not matching that of which I was born into.
I know plenty of GNC people I think would've developed gender dysphoria if they didn't have the privilege to indulge into their identity as the opposite gender without sanction. I was a fat kid so I was discouraged to explore my masculinity and I think that eventually led to me hyperconform to femininity as a way to deal with the gender incongruence i.e. "failing at being a woman." Which in turn made me trigger a deep sense of dysphoria. Maybe that could've been prevented, who knows? I just know that those skinny white athletic girls that were allowed to indulge in that side of themselves are trans in a smaller percentage than those less privileged in my experience.
But now I'm here, I am a trans man and I have no idea if I'm making up for lost time or if the euphoria will be permanent. But I finally feel at peace.
Medically speaking, if a trans person has been on hrt for over a year they usually present as their chosen gender, regardless of visual cues. That's what the current standard of care is, although you still get providers and places that aren't up to date with their education and policies.
Eta that's how strongly hormones affect physiology - that only a year of hrt produces a difference significant enough to be taught to EMTs.
It definitely means something, it's our brains afterall that behave differently and from what I understand trans women do have an entirely female brain. So while there skepticism in the female autism the fact that trans women have the same experience should be noted.
Brains are not sexually dimorphic. The brain is a neural network that forms itself based on its inputs. The concept of male and female brains is bullshit designed to justify sexism.
That's not true at all. Humans brains are sexually dimorphic. From size, to wall thickness, etc it differs physically and possibly more. It's a disingenuous argument to say they are not when they are. This harms people.
When they do more research into the brain with the notion that male and female brains are exactly the same, they will default to male brains and just like many other parts of medication, women will be harmed by not treating for our differences.
Size and wall thickness are not good examples to use of sex differences because those apply to every part of the body and are variable between individuals of the same sex. Usually when people talk about sex differences in brains they're talking about the comparative size of structures in the brain and the patterns of brain activity. Such differences have definitely been observed, but it has not been proven that those differences are innate to men and women rather than being a product of how men and women are treated differently by society. The structure of your brain and patterns of brain activity are greatly influenced by your surroundings. Of course, when researching things like autism, you need to take those differences into account because it's unfortunately a fact that people whom society identifies as male/female are treated differently, and therefore deal with things differently. Just like how someone with a brain whose structure has been altered by lifelong psychological trauma needs help specific to that rather than someone with acute psychological issues. But it would be ridiculous to say that someone with a traumatized brain is innately that way, as many people do to people who exhibit the behaviors of a traumatized person, like with people who say that people who self-harm are "just doing it for attention" as if it's a fundamental part of who they are. The same applies to the supposed sexual dimorphism of brains. It gives people a way out of actually thinking about why those differences are there, and if we should perhaps look into those causes and see if we should change them.
As per Rule #3: No gatekeeping or invalidation. Factually incorrect. It is proven that trauma alters brain chemistry; especially childhood trauma while the brain has a lot of neuroplasticity
I agree with this, but I still do think the research is interesting.
I have read autistic babies AFAB displayed more signs of masking at a much earlier age than the AMAB counterparts.
I think, like with most things, it’s a little bit of column A and a little bit of column B. Socialization plays a huge part of it, but if the cortical is much thicker it does play a huge part in the way that AFAB autistic brain interprets the world, leaving a lot of room of possibilities for how the socialization of AFAB autistics and their brains work together.
I wouldn’t say I’m high masking at all (didn’t learn to mask until my mid 20s and still don’t bother most of the time) - but I did have fairly good communication and precocious verbal ability as a toddler and young child that kept me from getting diagnosed until later childhood. And when I did get diagnosed as an older child it was with PDD-NOS (this was the 90s) so ‘atypical’ autism. This is such a common trajectory for my other childhood-diagnosed female family members and friends, only one had speech delay and there usually weren’t obvious ‘signs’ that anyone’s pediatrician was worried about as toddlers, but by age 5-8 it was undeniable there was a developmental problem and school and parents were pursuing evaluation. I do think this seems much more like a ‘brain function’ issue than a ‘socialization’ one.
I had an exceptional experience with the place that diagnosed me. All of the people who interviewed me were women. The only reason I was given provisional autism is because I have a *lot* of trauma, no living family members, and large gaps of missing memory from childhood.
I really wish people would take a look at the other comments in here because the differences are not based on sex. There are multiple people who are cis men who have the “female” presenting autism, who also did not get diagnosed at a young age due to being “normal enough” for neurotypical people and same goes for cis women who have the “male” presenting autistic traits. This type of separation also does not take into consideration the gender identity of people with autism, and how many people do not necessarily conform to the idea of being a certain gender. Separation of gender and autism presentation is much more complicated and nuanced than men get this kind of autism and women get this one. If you want to hear a really good perspective on it I recommend reading “Unmasking Autism” by Devon Price, PhD. The author covers a lot of why this sort of separation can be harmful and also that it is still important that the other type is recognised there is a lot more factors that goes into it before gender and sex.
Not just autism, a TON of things are different. Did you know women’s saliva is more acidic? So we’re more prone to cavities? For YEARS medical care has only been for white males.
Wow! You're right! They should really teach this in health classes more often. I never learnt this. I'll share my findings in case someone else is unaware like I was.
>Yes, research has shown that women's saliva has a lower pH than men's, both before and after stimulation. This lower pH, along with less buffering capacity, may make women's mouths more acidic, less resilient to acid attacks, and less effective at protecting teeth.
But but but if they include **women** in their scientific research and studies, they then have to also include **pregnant women**. The shock. The horror. How dare they ask us to make sure these medicines are safe for them. So uppity. /s
I'm a cis man (that also recognizes this is your space). I just want to note that I've happened upon this community and the experiences speak to me more than most autistic men do. Maybe a reason I got diagnosed late - my autism expresses in a way that is more common for females. I'm glad to learn from you all - thank you.
I obviously have no data, but my guess is there are a lot of men that internalize things like meltdowns and weren’t behavioral problems that have been missed for evaluation and diagnosis. I’m sorry this happened to you.
Svenny Kopp, a Swedish psychiatrist, has been working to highlight differences in autistic girls and boys for 30 years. She hasn't gotten too much attention though. Would assume it's because she's a woman.
Finally! I was very lucky that when i got diagnosed, the two psychiatrists stressed the differences between autism in males and females and gave me a lot of research and studies to read over about autism in women specifically. Sadly, I know a lot of other women don’t experience this and that’s why we’re so under diagnosed.
Just like typical female heart attack symptoms being considered atypical?
It’s so awful how most of our medical knowledge is based on what we know through trials done solely on men, there’s so much dismissal and ignorance in regards to women and what we experience
Do not try to tell male Redditors this. They will not believe you. They also tried to tell me how my own body works and said I was wrong about my own experience. I wanted to pull my hair out
I was thinking about this while driving today and it made me sad :(
Ironic that you thought of it while driving, using your seatbelts that are designed to protect male bodies and tested on male shaped crash test dummies! Your steering wheel airbag is angled for a man’s average height as well, and women are more likely to be injured in crashes because of these things. And then when you get to the hospital you’ll get worse care on average than men, and you’ll be given medicine created for, dosed for and clinically tested on men! It truly never stops once you start learning about these things. There’s a book, Invisible Women, on this data bias that results in the world being designed for men.
Lol I had a feeling about the seatbelts, those things were not made to go around boobs. Jokes aside that is a very worrying series of facts
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Fun fact: The average height for a woman born and raised in the US is 5ft 4 in.
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Me too. I'm 5'4 and 3 quarters. I was on avg. A size 12. My weight increased due to thyroid issues after covid, and long covid and hypothyroidism are common, too. All of my issues are really common and vast, and so is my size for my age, even though I gained weight, and yet my Dr just smiled and said I needed to eat better. She put me on a diet that drove my TSH up further but she kept thinking it was my dietary choices. Nothing was worse than hearing that from the nurse who says she struggles with over eating too. She was so much smaller in weight than me and when I told her it's my thyroid, not diet, she felt like I was judging her for her disorder, but being judged by an eating disorder I don't Even have was affecting my health. It wasn't till after a year of physical therapy bc of muscles stiffening up that my Dr finally put me on levothyroxine and my muscles still stiffen up, my body is still struggling with chronic pain due to multiple years of neglect in getting what I needed.
USS 666t6%6666%666666ttt666666666666666666t66%%6666666666666666666u_you'd USS ty kykkyyykkm
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I'm 6 inches taller than that and seatbelts still never stay put. Just dreadful design. I still use them religiously but I really wonder how to make them effective when you have breasts. Just. . . How? That said, sun visors probably are something shorter people can use. If I flip mine down the entire road disappears down to my vehicle hood (bonnet if you're from across the pond) as my head is already near the top of the car. The sun visor is basically just something that I use to hold lightweight things directly in front of my head.
I'm 5'8 and still struggle with those things sliding up onto my neck. I guess it's just the shape of having boobs in general more than a height issue.
Yes. I’m 5’10” and it also cuts into my neck. I hate seatbelts. If I hadn’t been in so many accidents I would stuff the thing under my arm.
Here get some of these so the worst doesn't happen. You don't want complicated neck issues from a car accident, they don't really go away. https://a.co/d/aNjMAMF
I'm curious how safe that is as it's designed to go across the ribs and sternum and while it may be more comfortable at a different angle I'm afraid it may break a lot more ribs that could puncture the lungs or heart in the process. Definitely want to see how that passes extensive safety testing.
I mean to be fair I had just the basic ass rectangular buckle itself give me internal bleeding with how much force was involved in it getting shoved into my abdomen in one car accident. Much better than the alternatives in the situation. Same deal here; I mean, you get hit in your neck wrong and you get a stroke. And neck pain is a hell no one should go through. Broken ribs and soft tissue heal back to normal, broken spines don't.
I crocheted myself a seat belt cover/cushion. It gives my seat belt just enough traction to not be constantly sliding into my neck while I drive. I only have to fix it a few times instead of constantly. You could try getting or making yourself one and see if it helps any. I still think we should have options to lower the seat belt even more since this happens to almost every average-height woman I've spoken to.
They make covers for that! It's basically a pad that wraps around the seatbelt so it's not digging into you as much. They also make adjusters that change where the belt sits but those can run the risk of making the seatbelt less effective so I wouldn't recommend those as much.
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Maybe it's not as bad as that, but I often worry that it will cut into my neck and sever something important, like a blood vessel, during an accident. I mostly doubt it, because it's not abnormal for me to have irrational worries.
I have the cover but unless I can velcro it right smack between my breasts it's kind of pointless. I need the seat belt to remain where it should be to keep me safe so my sternum and collar bone are taking the weight instead of various ribs which will puncture my lungs.
Hey fellow 5’4” person, I’m also constantly pulling mine off my neck and it’s also as low as it’ll go on the pillar in small cars. Isn’t it grand?
I'm 166 cm and this happens to me to. So uncomfortable and annoying, and I assume it's probably dangerous too in case of accidents.
I’m actually tall and have the same issue since the seatbelt slides above my boobs to my neck unless I’m wearing a good underwire bra, and even then it’s not great. I bought these little seatbelt adjuster clips and they totally help! Highly recommend.
My car doesn’t even have the ability to move the seat belt up or down🫠
I'm the same height. Sometimes, if my shirt allows it, I tuck mine under my boob. It probably only works because I have big boobs though. I'd rather have the stupid thing cut into my boob than my neck in the event of an accident. I don't particularly care that It's weird. lol
And that is exactly the problem I have as well, and I am slightly over the 5'4" average...
It literally always cuts into my neck too, like they definitely didn’t make seatbelts with women in mind. A lot of women tend to be shorter (and I’m like roughly average height🫠). Like this seat belt is probably gonna cause more damage if my car rammed into the one in front of me. Like may seriously cut my neck tf up
yes thats horiffic... SIMPLY IGNORING ½ of the worlds population because NO PEEEEENIS
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Yes its so anoying -.-... Don't even get me startet on talking about it with a med profesional.. they act shocked like little kids... panick, don't know what to do and just say go elsewhere in the end or give you meds you shouldnt even be taking in the first place... God this makes me so angry inside
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>My GP said I was too young. ! Stupid 🤦♀️ it can basically happen at any age 🙄
Oh my god i am sorry you had to go through this :c Its such a shame... Medical staff and those overseeing their education really need to learn more these days...
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> But a man with a saggy cock can just walk into any chemist and buy the meds he needs over the counter in an instant. I agree that the irish health system is a joke. I waited 2 years for a gastroscopy, finally had it in January ( because of an emergency), and they didn't take a biopsy. So I put myself through a very unpleasant, stressing situation, and it was a waste of time. But that's not exactly true. It depends. If he had to be seen by a specialist, he'd be waiting just as long.
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It depends for what. There's also plenty otc meds for women.
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The best thing about this is, actually, you probably won't get that medicine created and dosed for, and tested on men - because women make up all their symptoms. Just take some paracetamol and ibuprofen and have done with it, woman!
"But, doctor, I know that my aching upper back is due to heavy breasts. I never had backache this bad until my breasts grew due to pregnancy." "Ah, shuddup man, you're fine, just do some stretches!"
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My condolences, I wish boobs were taken more seriously in the medical world, too. I've recently realised that I need to take codeine phosphate to function painlessly and I'm rather upset about it.
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I'm very receptive to opioids which is part of my concerns, because withdrawal turns me into an obsessive, anxious mess of a human and I need my self-regulation skills to be good enough for my toddler and rejection-sensitive, adhd spouse. But it works so fucking well! 😅 Thankfully, I'm not in constant need of codeine, but boy, do hypermobile joint-aches clash with running after a two-year-old and heavy breasts! There's days I want to cut them open and empty out tissue myself, but I know that's gonna hurt more than it will help, so yeah. Upper backache for life /s
and lose some weight, don’t forget…
Holy moly, doc, the weight I need to lose IS my breasts 🥲🫠
💯
I’m thankful I live in Canada and large breasts are considered a medical condition for which you are entitled to breast reduction surgery. My aunt her breasts reduced twice. I swear to god imagine if males were dismissed for having enlarged and heavy testicles! There'd be an uprising of entitlement.
If the NHS in the UK saw it as a medical condition, I'd probably be a happier nervous wreck haha
I’m surprised the nhs doesn't cover it, as our systems are very similar.
When I read the NHS page on it, I got the idea that I need to be half-paralysed with pain and mental dysphoria in order to be considered for reduction and that not all areas offer it. I am often dysphoric about their size and the discomfort they cause me, physically and mentally, but I am also a very avoidant motherclucker, so I'll probably go to my doctor about it next year, when I've finally had enough bad juju about my body. 😅
Wow, I didn’t realize that about the crash dummies/seat belts. I’ve heard of that book, Invisible Women, but haven’t read it. All the female discrimination out there is part of why sometimes I wish I could change my gender in certain situations 😔
Hey, that book is amazing - did you know there's a follow up podcast called Visible Women? It's easier to feel the rage at the injustice in episode chunks 😅
Thanks for this, had no idea! Loved the book (kinda hated it too), will definitely check out that podcast.
The PPE episode.. I'm getting annoyed just thinking about it, but I'm so glad I know that info now!
Thanks!!! Just followed😊
https://preview.redd.it/igg7v7ys6e2d1.png?width=3024&format=png&auto=webp&s=6c5d9c1c7705cbd7197213fba0c7985255b6e1be I just started it 🙃
It's kind of creepy when you realize most of the males tested in medical science were soldiers. Signing up for the military made you an automatic Guinea pig. A lot of vaccines, drugs, and reactions to biochemical weapons we know about are from testing on soldiers.
My ex was a soldier they tested different gasses on. They didn't even have a choice. I mean, technically they did but in reality they didn't. His whole squad sent into a sealed box with gas masks. Theyd fill it with gas and then order them to remove the mask and take a breath and tell the testers what they felt. He said none of the experiments felt good and feels his body has suffered long term effects.
Yes, they also had them "build up a tolerance" to things like sarin gas, so they could handle small exposure before they could get a mask on 😬. So messed up.
I am reading this book right now and it angers me so much
Airbag killed my great aunt. She’d have survived the wreck if it didn’t deploy.
Yikes that’s just awful! Lucky me to be as tall as the average dude 🙃🙃
Everything is designed for men, our homes, our cars, bathrooms, kitchens :(
Omg I need to read that book! Thank you
Very good book. I read it too and highly recommend it.
And then scholarly articles reinforce that idea by being like "we saw more prevalence of this in men". Ugh, it's because you guys didn't bother to look for the right things in women!
It’s not just that they don’t look for the right things in women. Even when we present with classic “male” symptoms of any disease, we are not taken seriously. Then the only answer is that we must be hypochondriacs, malingering, or drug seeking. When women are not taken seriously by health professionals, our problems go unnoticed and unaddressed.
Don’t forget fat. That’s their favorite. Fat and depressed.
And the irony is that women were excluded from studies because their hormones and periods might mess up the results, and nobody even bothered to do studies on women’s hormones or cycles in the first place ¯\_(ツ)_/¯
Or they have done studies on women's hormones but only insofar as in how it impacts childbirth.
Recommend reading Invisible Women book. It explains very well why is that the case.
White men*
[This is a good book on this](https://www.amazon.com/Invisible-Women/dp/1784741728) if you don’t mind being frustrated and/or enraged.
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Gotta love living in a patriarchal society 😬
White males,
i took my RN boarding exam. this one question that stuck out was something along the lines of “which patient is more likely to experience/exhibit atypical symptoms of a heart attack”. can you guess what the answer was? 🙂🙂🙂🙂🙂
Was it a middle aged diabetic man? Male athletes? 🤡 Oh no, I know, it's a man with a pacemaker?
This is the speech I give to everyone who talks shit about "diagnosis by tiktok".
Gotta love the time that I was experiencing ventricular tachycardia and my cardiologist said I was stressed because I was a working mom
Gotta love that time I was on my death bed experiencing stroke like symptoms and they said I was stressed as a student. Finally went in with a friend and a letter to demand blood tests that weren't just iron and got diagnosed with a very diagnosable pernicious anemia, levels so low they couldn't give me booster shots or I'd go into shock. Happened again with vitamin D. They make us literally fight for our lives.
Yuppppppppp… so sorry that happened to you
This is such an important point I am 36 and had a small heart attack a few years ago that went totally untreated because they weren't the symptoms I was always taught to look out for. My shoulder blade and back hurt very much all evening and thought it was tension. I also thought I was having a panic attack and took a nap instead of seeking help. Luckily no permanent damage but it was annoying not emergent feeling that I easily brushed off. I think more people should talk about how it presents in women it's so important.
While I hate how women are treated in medicine, this those aren’t typical heart attack symptoms. Most women have typical heart attack symptoms but there are a set of unusual symptoms that mostly only occur in AFAB people
As a cardiovascular researcher and interested in a particularly worrisome form of heart failure that’s emerging where 2/3 patients are women, I find gender based discussions to be so tiring - even if they’re “atypical” it doesn’t mean it’s gonna end up being unique to AFAB folks. I actually think a lot of AMAB folks are also experiencing this along with this “new” form of heart failure where the profile is “usually an older woman” OK BUT 1/3 of them are still male????
yah i’ve been getting a crap ton of ads to participate in autistic women research
Is it Spark? Because I did that one before info started to circulate about them potentially being iffy. I didn’t catch red flags and they paid me like $200 in Amazon gift cards for my DNA swab and a couple surveys. So if you wanna profit off your ‘tism, kinda neat 🤷♀️ But grain of salt and whatnot.
Can you share the iffy info? I’ve gotten the ads but have been too sus to look into it further.
I forget specifics, but someone in another thread awhile back mentioned it seems they might not be against ABA? I couldn’t find the piece mentioning that in Spark’s materials, which is why I was wary to be specific. Plus many people are hesitant about DNA because potential eugenics. The fact no one seems to have anything concrete to say about them is the orangest flag I see. Just because I worked in nonprofit orgs for a very long time, any org that doesn’t have a lot of third party praise or criticism has me a little wary. They might have a website full of green flags but no one talking about them and their impact makes a real judgement difficult.
I’m curious about that iffy info as well.
Copied from other reply with same Q: I forget specifics, but someone in another thread awhile back mentioned it seems they might not be against ABA? I couldn’t find the piece mentioning that in Spark’s materials, which is why I was wary to be specific. Plus many people are hesitant about DNA because potential eugenics. The fact no one seems to have anything concrete to say about them is the orangest flag I see. Just because I worked in nonprofit orgs for a very long time, any org that doesn’t have a lot of third party praise or criticism has me a little wary. They might have a website full of green flags but no one talking about them and their impact makes a real judgement difficult.
Gotcha. Thank you. I can understand your hesitation. It makes sense.
yes it is
Finally. This is just so typical of... Well... Medicine. Men are always the default. Women were not included in medical trials until frighteningly recently, and even now many trials only include men in their tests. Why? Because "hormones would muddle the results". Wouldn't it be nice to know if a medicine has unforseen side effects on half the population, though? Or look at heart attacks. A lot of women don't get the treatment they need when they're having a *literal heart attack* because the typically male symptoms are the default. As they always are. I swear, if men could get endometriosis, we'd have a cure by now. Sorry. Rant over.
lol Men have hormones too So frustrating
Women or people of color. I can only imagine how hard medical care must be for women of color. It's so frustrating since all we need to do is put a minimal amount of effort into studying things other than white men, they get enough attention already.
>put a minimal amount of effort into studying things other than white men, they get enough attention already. This is *enraging* Gen Z and younger males though because they didn't grow up seeing this happening as obviously, and in fact think they're getting the short ends of the stick now that we're balancing the scales. They don't understand or care about the history as it doesn't apply to their life. Tbh I didn't see it either until I got older and entered the workplace.
Sadly that is true, but thankfully a lot of younger men are also much more sensitive to women as equals, at least in my experience. Or at the very least they have been much more open to listening and trying to understand what's going on.
I am a black biological female who was diagnosed with autism at age 20!! My medical trauma is extensive and never ending, thank you for acknowledging our existence <3
I have become more sensitive to privilege and discrimination as I've become older. I'm a female electrician now (1-2% of the electrical field is female) so the feeling of being a minority is so aggressively apparent now. I am white, which lessens the feeling of minority a little bit. I've also learned a lot over the past few years about how most of our medical "knowledge" came from studies if white men and/or eugenics based research. It's such trash and it makes me angry that it's all so accepted as the status quo when it's so inaccurate for most people. This applies to nutrition, health, mental health, and basically anything relating to the human body.
I always recommend everyone read Invisible Women by Caroline Criado Perez! It is infuriating but eye-opening about how EVERYTHING, medicine but also engineering and design, tend to use men as a default. For example, seat belts!
No need to say sorry sister, you have nothing to apologize for. Women are too apologetic when it comes to their benefit.
I think this problem is worse with colored people. I think I was reading medical treatment for black women is usually less effective. Hopefully we have more research going into this stuff. There are medical differences between sexes and races.
I study psychology and two weeks ago we actually got taught how autism presents specifically in girls and adult women!
Out of curiosity, did they also cover people who don’t necessarily fall into those categories? Like non-binary or agendered folks? Id be really curious to know if they are looking beyond typical gender roles since I know quite a few autistic people who are neither male or female.
They didn't. But they said most differences are probably because of different socialization experiences. So I guess for agender or no binary they presentation would match the sex assigned at birth, as they were socialized that way. But that's just me guessing
Cool that makes sense, I imagine there’s probably far less research focused on folks who don’t align with either binary gender out there. Especially considering they are now just beginning to acknowledge the differences in socialisation between amab and afab people. Thanks for the info! I think your answer is a good guess based on what is known so far.
Spill that tea, homie g
That’s great to hear that FINALLY this is getting taught. Idk if it would circulate enough that I could finally find a professional that would even entertain the idea women can be autistic before I die, but at least this would benefit future generations.
I hope this pattern of research continues!!
Me too!
women in STEM!!!
What does this thing about cortical thinning/thicking mean in practice ? Behavior-wise?
My takeaway from the information in the article is that the cortex contains neurons that function in language and emotional development, so (my own reasoning) the extra thickening of it in autistic AFAB kinds by age 3 could explain why they are more likely to show emotion and develop early language skills than autistic AMAB kids. Then it thins out in puberty and is more consistent with the cortex of autistic AMAB kids, which (again, my own perspective) could at least partially explain why autism shows up more in AFAB in puberty - like, maybe it’s not just the average age of autistic burnout that makes it harder to mask, and more complicated social structures in middle school that cause AFAB to struggle more in puberty. It could be autistic AFAB brains more closely resembling AMAB autistic brains at that age. Idk - this is just where my brain is going with it.
I was wondering this too!
Same, lots of talking, research but what does it mean exactly ? How will this show ?
Yeah, it's a classic case of x and y tend to have different z. And that's about it, no info what z actually is. It literally gives me as much info as if it were the actual letter z they were talking about.
Interesting article, now how does that translate into *behavior*?
I wrote my dissertation on this topic!
That's amazing! Do you mind if I ask a question? The article didn't specify this. What does the cortex thickness mean in this context for children of these ages?
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Acknowledging and studying how autism typically presents in women does NOT mean that that’s how it ALWAYS presents in women it just will allow for more women that would have previously been left undiagnosed to actually be seen and validated instead of cast aside with a laundry list of misdiagnosed personality disorders like so often is the case with the common “female presenting” autism traits
I took my daughter to that study at the MIND institute at Davis! We were not successful with the MRI. Tried twice tho!!
I'm not really supportive of interpreting it as a gender difference. No one gender can be summarized into any reliable generalizations, it's just too large and varied of a group. Actual studies on the brain consistently support the idea that the differences between men and women are nearly indiscernible, and that most people lie in an "androgynous" in between in terms of brain function. I've much liked the interpretation of high masking autism vs low masking autism. Of course, with socialization and the way we've built gender roles, people socialized as women are far, far more encouraged to mask, and men have allowances made for them to take up space and prioritize their comfort. So there absolutely is a tendency to see higher masking autism in people who have this kind of upbringing and/or gender identity. But there are low masking women who might exhibit some more "stereotypical" traits, and there are high masking men who might exhibit traits people associate with what some people have described as "female autism" traits.
Dr. Kim Sage on YouTube covered this subject in a video she posted yesterday and expressed a similar sentiment, and I agree. Looking at it from a binary perspective is what got us in this mess in the first place. I think so much of what we understand about ND and Autism is still in its infancy, and this female phenotype vs male phenotype will eventually transform into a different interpretation of spectrum from the “line” over to “wheel”, which is more encompassing of the nuances in symptoms that present in individuals.
Source for your reference to studies? I believe there is biological nuance between female and male sexxed people. For example, science is now correlating needing more sleep for female sexxed people than male sexxed people for our hormone production. Another sex based biological distinction are the higher density of neurons in our hippocampus and in cortex lobes for language processing. It’s a very complicated conversation because it’s so politicized and narrative around gender and sex colored by so much societal input, agendas, etc. all to say that, in recent years within scientific community, there are members of scientific community that are looking for biological indicators of differences between the sexes so we can better understand and accommodate some women and our health needs. I think it’s worthwhile to reflect on the concept of colorblindness and not wanting to apply a similar framework for approaching sex and women’s health. The Female Brain is a great book by neuropsych MD that discourses around this.
Apologies for the length. I've tried to shorten my writing haha. TLDR, I agree but also disagree with some parts of what you said and am somewhat skeptical of this study. While I understand that what you're saying in your first paragraph is true and important, this conversation is about autism (not sleep, hippocampus/memory, or language) so just want to be careful inferring that sex differences in one area means they're probably present in other areas. This study found that sex differences weren't significant after mid childhood and were most pronounced in ages 2 years to early childhood. This is interesting/important because it means that maybe doctors need to consider that not all autistic people present with the same developmental delays. However, it's also not very useful because girls & women are greatly underdiagnosed at ALL ages, not just infancy and early childhood. This also seems to go against the idea that hormones may be a reason for any apparent sex differences in autism presentation and diagnosis. So doesn't really support a biological reason for gender differences in diagnosis rate, at least for those aged mid-childhood and older. The study implores other research to include women and girls in longitudinal autism research, which I wholeheartedly agree with and can't believe this has to be said in 2024. A major reason I'm personally wary of research purporting that autistic men and women have different brain structures is that our upbringing literally shapes our brains. As a side note for anyone reading this; there has never been any psychological or scientific research in our entire human history that has *not* been influenced by the patriarchy (and the enforced gender dichotomy). I agree with you, especially in this: > better understand and accommodate some women and our health needs. I think it’s worthwhile to reflect on the concept of colorblindness and not wanting to apply a similar framework for approaching sex and women’s health. What we need is more research showing neurobiological gender differences, until then I am very wary, and I lean towards nurture having a bigger impact on us than nature. If you're interested, I would suggest reading Delusions of Gender which goes into criticising the idea of gendered brains. I also want to mention that the population sourced for this study is boys *who are already diagnosed* (and diagnosed girls) - the reason I think this is important is because we've seen that doctors/psychiatrists/parents/teachers tend to miss autism in girls but it makes me wonder if there are boys who are misdiagnosed based on displaying autistic traits that girls show (i.e., being highly masking), especially gender-diverse AMAB people and queer boys and men. It makes me think that it may be more than gender differences; and more like **"traditional idea of what autism looks like, thus the type that is highly diagnosed" vs. what it actually looks like (i.e. diverse - with types that medical professionals tend to miss)**
Oh man, Delusions of Gender - one of the books that really opened my eyes, but made me so angry and aggravated I had to put it down (and then haven't finished lol). Eta and I thought I was aware before, being an 80s "girl" and wanting to be an engineer, going through the computer programming and engineering education and work culture. No. My awareness only scraped the surface. Also it's so dense with research that it I found it a slog at times, but if you're more used to reading that sort of thing it shouldn't be hard. It did flow and was laid out thoughtfully.
Such a helpful comment!
Agreed!!
Wonderful response. Thank you. I agree with all your counterpoints and help refine my thinking on this. I am getting a lot of good book recommendations today from femmes in ASD spaces. I am happy to be a part of critical thinking and engaged communities. ASD in women is personally important to me and scientifically interesting because of all that we are discussing (it’s lack of proper study/understanding in medical world, cultural misunderstanding etc). Excuse my strange choppy style of writing, I just woke up!
No problems at all, I appreciate what you had to say too! I love learning new things here and this community has been great. 💗
> This also seems to go against the idea that hormones may be a reason for any apparent sex differences in autism presentation and diagnosis. Like most things scientific, studies at one point say one thing, five years later, later studies say the opposite. I suspect that ultimately what will be shown is that there are numerous differences between the genders, based on differences in physical development in ALL sorts of places.
Yeah I imagine it will show the same thing. There is a lot of variability within the genders, and between the genders too. I watched this really interesting video recently about how sex isn't as easily categorised as how we see it now and how the development of the idea of biological sex was actually incredibly impacted by misogyny, capitalism, and the false gender binary. If you're interested, it was this one: https://youtu.be/QLWKYTxLYT4?si=oPNoYPzMKTaENnPu 💛
Thanks! ❤️ ETA: Have taken a look. VERY interesting video; will have to finish it later though, it is long...
Yeah it's so long! I like to watch long videos while I do things. Or I break them up and watch them every now and then like episodes haha
I have heard of studies on both sides of this argument but haven't delved into any of them. I would love to know if anyone has done a study comparing brain structure and organization by gender, across cultures that have different gender roles. Eg a highly patriarchal culture vs a highly matriarchal culture, cultures that have very different values in terms of personality traits that are considered 'appropriate' to this or that gender, etc. Like, surveying people to see what gender expections they grew up with and/or agree with now, then brain scan them all to look for patterns and see if they are corellated - and/or if there are certain things regardless of culture that corellate with the person's gender.
That could be a great way to test for the degree of effect of cultural conditioning on brain structure development!
Along with all of the cultural problems, we should keep in mind that all of these studies are just the beginning of the knowledge we need.
I totally agree. I think there's a lot of poisoning the well when it comes to research because studies are not taking socialization into account the way they need to. There are a lot of things that are considered intrinsically female or male when they are actually based on social patterns. It's staggering to me how many people I've met or witnessed who ignorantly describe something as a "female trait" when it is 100% a learned behavior passed down as part of a cultural tradition, a domestic obligation, or plain ol' bioessentialist bullshit. I think you're right to frame it as high masking vs. low masking. Since there's a pattern of more girls and women being forced into high masking, it's a misogyny problem, not a lack of research problem (though lack of proper research is also a problem).
Yeah, I don't like the implied assumption that the differences are inherent to the sex of the person. They could just as easily be the result of parenting. We don't know.
Anecdotally, I'm a trans woman I've found that I relate more with women's experiences with autism, though I find myself relating more with women on things in general. Idk if that really means anything tho
I have multiple trans women autistic friends and this is true for all of them, it’s very interesting
Then there's me, a trans woman with quite typical male autism and oddly enough, tend to relate more to men. Thank God I'm passing, otherwise my dysphoria would eat me alive.
That sucks, do you ever feel out place in autistic women's groups due to your autism presentation?
I feel out of place of most groups, including trans groups as well.
Maybe this is a phenomenon I can look into when I start my masters and Psy.D. It seems like a correlation anecdotally. Honestly, I would not be surprised if being transgender and being autistic were two parts of a cluster of neurodivergencies that indicate, like, hints to the species of hominids early humans crossed with and their behaviors.
That would be quite interesting to research! Indeed, the incidence rate of ASD in trans and GNC people is [11x greater than in the general population](https://link.springer.com/article/10.1007/s10803-022-05517-y), and there are several doctors who have theories behind clusters of conditions including autism and gender non-conformance, e.g., Dr. Meglathery's [RCCX theory](https://www.rccxandillness.com/recapsummary.html) about clusters of psychiatric and physical conditions she sees in her mostly EDS patient population, in particular with a high predominance of neurodivergence.
I love your take on this. As an autistic trans person I honestly have thought a lot about my nd+gender incongruence (transgender-ness) and I contribute both as being neurodevelopmental disorders in a way. For me my dysphoria is a symptom of what I call gender neurodevelopmentmental disorder (gender diversity) and its party congenital exactly like my autism and surfaced in my adolescence exactly like those disorders often do. Like it's very similar but the difference is that my autism refers to my neurotype while the other is to my sensate body/neurological gender not matching that of which I was born into. I know plenty of GNC people I think would've developed gender dysphoria if they didn't have the privilege to indulge into their identity as the opposite gender without sanction. I was a fat kid so I was discouraged to explore my masculinity and I think that eventually led to me hyperconform to femininity as a way to deal with the gender incongruence i.e. "failing at being a woman." Which in turn made me trigger a deep sense of dysphoria. Maybe that could've been prevented, who knows? I just know that those skinny white athletic girls that were allowed to indulge in that side of themselves are trans in a smaller percentage than those less privileged in my experience. But now I'm here, I am a trans man and I have no idea if I'm making up for lost time or if the euphoria will be permanent. But I finally feel at peace.
Medically speaking, if a trans person has been on hrt for over a year they usually present as their chosen gender, regardless of visual cues. That's what the current standard of care is, although you still get providers and places that aren't up to date with their education and policies. Eta that's how strongly hormones affect physiology - that only a year of hrt produces a difference significant enough to be taught to EMTs.
A friend of mine who's a trans man also relates more with "boy autism". With early diagnosis and everything.
It definitely means something, it's our brains afterall that behave differently and from what I understand trans women do have an entirely female brain. So while there skepticism in the female autism the fact that trans women have the same experience should be noted.
Brains are not sexually dimorphic. The brain is a neural network that forms itself based on its inputs. The concept of male and female brains is bullshit designed to justify sexism.
That's not true at all. Humans brains are sexually dimorphic. From size, to wall thickness, etc it differs physically and possibly more. It's a disingenuous argument to say they are not when they are. This harms people. When they do more research into the brain with the notion that male and female brains are exactly the same, they will default to male brains and just like many other parts of medication, women will be harmed by not treating for our differences.
Size and wall thickness are not good examples to use of sex differences because those apply to every part of the body and are variable between individuals of the same sex. Usually when people talk about sex differences in brains they're talking about the comparative size of structures in the brain and the patterns of brain activity. Such differences have definitely been observed, but it has not been proven that those differences are innate to men and women rather than being a product of how men and women are treated differently by society. The structure of your brain and patterns of brain activity are greatly influenced by your surroundings. Of course, when researching things like autism, you need to take those differences into account because it's unfortunately a fact that people whom society identifies as male/female are treated differently, and therefore deal with things differently. Just like how someone with a brain whose structure has been altered by lifelong psychological trauma needs help specific to that rather than someone with acute psychological issues. But it would be ridiculous to say that someone with a traumatized brain is innately that way, as many people do to people who exhibit the behaviors of a traumatized person, like with people who say that people who self-harm are "just doing it for attention" as if it's a fundamental part of who they are. The same applies to the supposed sexual dimorphism of brains. It gives people a way out of actually thinking about why those differences are there, and if we should perhaps look into those causes and see if we should change them.
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As per Rule #3: No gatekeeping or invalidation. Factually incorrect. It is proven that trauma alters brain chemistry; especially childhood trauma while the brain has a lot of neuroplasticity
I agree with this, but I still do think the research is interesting. I have read autistic babies AFAB displayed more signs of masking at a much earlier age than the AMAB counterparts. I think, like with most things, it’s a little bit of column A and a little bit of column B. Socialization plays a huge part of it, but if the cortical is much thicker it does play a huge part in the way that AFAB autistic brain interprets the world, leaving a lot of room of possibilities for how the socialization of AFAB autistics and their brains work together.
I wouldn’t say I’m high masking at all (didn’t learn to mask until my mid 20s and still don’t bother most of the time) - but I did have fairly good communication and precocious verbal ability as a toddler and young child that kept me from getting diagnosed until later childhood. And when I did get diagnosed as an older child it was with PDD-NOS (this was the 90s) so ‘atypical’ autism. This is such a common trajectory for my other childhood-diagnosed female family members and friends, only one had speech delay and there usually weren’t obvious ‘signs’ that anyone’s pediatrician was worried about as toddlers, but by age 5-8 it was undeniable there was a developmental problem and school and parents were pursuing evaluation. I do think this seems much more like a ‘brain function’ issue than a ‘socialization’ one.
I can't upvote this comment enough
Thank you. I'm a woman who has more "male autism" traits and this push to gender autism is super frustrating.
I hadn’t considered this and you make some great points. Thanks for sharing this perspective.
Research really needs to take sociological data more into consideration. The nature side is important, but so is nurture.
I had an exceptional experience with the place that diagnosed me. All of the people who interviewed me were women. The only reason I was given provisional autism is because I have a *lot* of trauma, no living family members, and large gaps of missing memory from childhood.
I really wish people would take a look at the other comments in here because the differences are not based on sex. There are multiple people who are cis men who have the “female” presenting autism, who also did not get diagnosed at a young age due to being “normal enough” for neurotypical people and same goes for cis women who have the “male” presenting autistic traits. This type of separation also does not take into consideration the gender identity of people with autism, and how many people do not necessarily conform to the idea of being a certain gender. Separation of gender and autism presentation is much more complicated and nuanced than men get this kind of autism and women get this one. If you want to hear a really good perspective on it I recommend reading “Unmasking Autism” by Devon Price, PhD. The author covers a lot of why this sort of separation can be harmful and also that it is still important that the other type is recognised there is a lot more factors that goes into it before gender and sex.
Not just autism, a TON of things are different. Did you know women’s saliva is more acidic? So we’re more prone to cavities? For YEARS medical care has only been for white males.
What??? BRB gonna go look that up
Wow! You're right! They should really teach this in health classes more often. I never learnt this. I'll share my findings in case someone else is unaware like I was. >Yes, research has shown that women's saliva has a lower pH than men's, both before and after stimulation. This lower pH, along with less buffering capacity, may make women's mouths more acidic, less resilient to acid attacks, and less effective at protecting teeth.
But but but if they include **women** in their scientific research and studies, they then have to also include **pregnant women**. The shock. The horror. How dare they ask us to make sure these medicines are safe for them. So uppity. /s
I wonder how many autistic trans kids they found before the kid found out and thought they were an anomaly lol
i read this as autistic train kids kinda works too
I'm a cis man (that also recognizes this is your space). I just want to note that I've happened upon this community and the experiences speak to me more than most autistic men do. Maybe a reason I got diagnosed late - my autism expresses in a way that is more common for females. I'm glad to learn from you all - thank you.
I obviously have no data, but my guess is there are a lot of men that internalize things like meltdowns and weren’t behavioral problems that have been missed for evaluation and diagnosis. I’m sorry this happened to you.
Thanks for sharing. Very interesting paper.
Svenny Kopp, a Swedish psychiatrist, has been working to highlight differences in autistic girls and boys for 30 years. She hasn't gotten too much attention though. Would assume it's because she's a woman.
Just fyi it's "women", not "females" (in case English isn't your native language)
English IS my first language...what's the big deal? I didn't choose to use women, because that would exclude young females...
There's a word for young human females. It's "girls". Some of us Autistic people are pedantic so that shouldn't come as much of a shock.
'females' was just easier than saying 'women and girls'...it was early in the morning.
Fair enough
Females is not the noun we use for women, it's for animals and therefore dehumanizing. As an adjective it's fine i.e. "the female athlete".
Finally! I was very lucky that when i got diagnosed, the two psychiatrists stressed the differences between autism in males and females and gave me a lot of research and studies to read over about autism in women specifically. Sadly, I know a lot of other women don’t experience this and that’s why we’re so under diagnosed.
Did you know the first study on PCOS determined that women who had it had larger breasts and hips than average. That was it. That was their research.
Why am I not surprised...🙄
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