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Q&A with Corrie McLean - Girls and autism: a hidden minority?

Posted on 25 August 2021 by Jennifer Drummond (updated 24 May 2022)

Too often, girls and young women with autism are overlooked and struggle to get a diagnosis until they reach crisis point.

A first person account published recently in Metro (click to read) shared the experience of a young woman who as a girl struggled with times tables and ‘basic’ instructions at school, experienced social anxiety, bullying, a lack of understanding and mis-diagnosis by professionals. She was finally diagnosed with autism at the age of 19, after years of difficulty.

Corrie McLean, of Three Sisters Consultancy (pictured), says we have an opportunity to do things differently, and that listening to girls and young women should be at the centre of our approach.

What was it about this account, published by Metro last month, that resonated with you?

It just really hit home. It’s telling the same story that we hear over and over again of feeling isolated, of feeling different, of feeling “othered”. When that young person seeks help and are told that they’re “just a bit different”, that’s because there isn’t awareness of how autism can present itself.

Several studies have suggested that girls with autism consistently receive a much later diagnosis than their male peers. Why do you believe this is?

There are a lot of factors that come into play. The stereotypical indicators for autism and the assessment criteria for a diagnosis are very male centric meaning that practitioners who are working with autistic girls may be used to supporting and diagnosing based on the more male characteristics. Also, there’s the societal aspect of gender norms and expectations. Often females are able to “mask” their struggles, but this can then lead to deteriorating mental health. We have spoken to a lot of autistic girls and women through our work who have said they have only been diagnosed once their mental health is in serious decline and they’re in crisis.

What is the key difference between boys and girls with regards to autism?  

When talking about key differences we need to take into account the individuality of people, and also acknowledge the gender spectrum.  Stereotyping can limit our ability to personalise our approach, however we do have some research that helps us better support our girls.

Often girls are perceived to be able to imitate others’ behaviours and mask their sensory sensitivities more effectively. Girls may be seen as shy or quiet rather than anti-social or withdrawn. These societal expectations of girls mean autistic traits in females are often missed.

Special interests may seem more “socially acceptable” than the stereotypes you get with males. I was speaking to an autistic young woman a few months ago whose special interest was horses. She lived in a rural area and because many of her peers also enjoyed time at the stables, her level of interest and depth of knowledge wasn’t seen as different from her peers. If she’d had an in-depth knowledge of a less “typical” interest, it might have been picked up earlier.

I also recently spoke to a small group of teenage girls who told me all they wanted to do was to fit in. This meant often they were masking their true feelings and not expressing their identity, which long term can be harmful.

What do you think needs to change to ensure girls with autism aren’t overlooked?

Speaking to, acknowledging and learning about the female experience from autistic women and girls, needs to be our priority. Making them the centre of our approach has to be the most important thing we do. Working with autistic girls directly and helping them understand their own autism is also key to supporting their growth, helping them to identify reasonable adjustments that we can put in place to support them and their mental health.

Raising awareness of autistic traits that are not male centric is also important, and supporting families and practitioners to identify how autism may present and affect our girls.

You are running training with us on Girls with Autism in August. What will you cover and why is this important?

We will look at what the current research tells us about the prevalence of girls on the spectrum and how being autistic may affect girls differently. We will also explore the experience of adolescence and the issues our autistic girls may face, with a focus on puberty. Most importantly, we will be looking at practical skills that either we have used in our practice, or tools autistic women and girls have told us have helped them.

Corrie McLean is co-founder of Three Sisters Consultancy

Interview by Catherine Bromley