3rd EU-AIMS Webinar

Why are sex and gender important for understanding autism?

September 27, 2017 at 4.30pm CEST / 3.30pm BST

Speaker: Dr. Meng-Chuan Lai (University of Toronto)

Title: Why are sex and gender important for understanding autism?

Autism has long been perceived as a male-predominant condition. Studies from clinical samples typically find a male:female prevalence ratio of 4-5:1, whereas population-based studies with active case ascertainment find a ratio closer to 3:1. These sex/gender ratios suggest sex/gender-related liability to developing autism, but the difference in clinical versus population estimates suggest some degree of ascertainment and diagnostic bias. Overall this may have resulted in male-biased identification and understanding of autism to date. Understanding autism in the light of sex and gender informs their moderating roles in both the presentation and emergence of this condition.

First, understanding how sex and gender moderate the presentation of behavioural characteristics of autism will inform why males are more likely to be identified. Females with autism tend to be under-recognized owing to higher likelihood of subtler and partially different behavioral presentation, and possible biases on the interpretation of their behaviours by the source of referral or the clinician.

Second, clarifying how variables related to sex and gender contribute to the male-predominance of prevalence will inform the diverse aetiologies and developmental mechanisms of autism. This may involve particularly the convergence of developmental pathways between the emergence of autism characteristics, typical sexual differentiation and gender socialization.

The optimization of supports for girls and women with autism is best based on the understanding of their needs and characteristics considering the moderating roles of sex and gender, targeting at resilience and person-environment fit, and taking into account the influences of gendered social-cultural contexts. This involves not only skill-building and graded exposure for the individual, but more importantly, the adjustment of the social and physical environments.