Autistic girls' brains work differently than boys'.

Autism, or more accurately, autism spectrum disorder (ASD) It is a neurodevelopmental condition that affects communication, social interaction, and behavior in affected individuals. It manifests itself differently in each person and may include restricted interests and repetitive patterns of behavior, although these are not always present. It is estimated that there are around 75,000 people affected in Catalonia., around 160,000 in the Catalan Countries as a whole, which represents around 1.23% of the population.

For decades, it has been considered a predominantly male condition, since of every five children diagnosed, four were boys and only one was a girl. However, a recent set of studies, which the journal New Scientist has been grouped together in a study by British neuroscientist Gina Rippon, revealing that the way in which behaviors associated with ASD manifest are different in boys and girls, and that the tests used to detect it are primarily focused on male characteristics. This has meant that, until now, many girls and women with ASD have remained undiagnosed or have been misdiagnosed and, therefore, have not received the necessary support, with significant consequences for their lives.

They 'camouflage' the symptoms

One of the main reasons why ASD is often not detected in girls is their ability to camouflage Symptoms. Many girls with autism develop strategies to adapt socially, such as imitating the behavior of their peers or forcing themselves to maintain eye contact with others, even if this is uncomfortable. These adaptive skills can make their symptoms go unnoticed by parents, teachers, and even health professionals. At school, for example, a boy with ASD often plays alone, away from his peers. A girl with ASD also plays alone, without interacting with other children, but instead, she doesn't stay away from the rest of the group but usually blends in with them. Furthermore, they often show very intense but socially acceptable restricted interests, such as reading or animals, while affected boys often display more unusual interests. All of this contributes to the underdiagnosis of girls.

In terms of neural activity, ASD also tends to manifest itself slightly differently in the brains of girls compared to boys. For example, research led by the University of Virginia in the US used functional magnetic resonance imaging to observe brain activity during social interactions. The results showed that girls with autism use different brain regions than girls without autism, and these differences do not match those observed between children with and without autism.

Specifically, girls with ASD show reduced brain activation in areas such as the right ventral premotor cortex, the primary motor cortex, the parietal white matter, the putamen, the bilateral dorsolateral prefrontal cortex, and the central operculum. These brain regions play important roles in social interaction, movement, and cognitive processing, and explain why some individuals with ASD engage in repetitive movements, have difficulty understanding gestures and faces, display sensory hypersensitivity, and experience difficulty regulating emotions, among other behavioral aspects.

Genetically, it has also been discovered that girls with ASD have a greater number of gene variants associated with this condition compared to boys, which could explain why they have a greater capacity to camouflage. With the same number of gene variants involved in ASD, children would manifest it with greater intensity.

"I don't fit in"

All of this has meant that, until relatively recently, many of the diagnostic instruments were developed primarily with data from children, which makes it impossible to adequately capture the typical female behavioral patterns associated with autism. This lack of appropriately adapted tests has led to a large number of erroneous or late diagnoses, leaving many girls and adolescents without the necessary support during crucial stages of their development, with significant repercussions. Many women diagnosed in adulthood report being told that they "didn't fit in" or that there was "something wrong" with them and in them during their childhood. This lack of understanding often leads to problems with self-esteem, anxiety, and depression, which further hinder social relationships and negatively affect their emotional well-being and even academic performance.

Finally, Gina Rippon's work calls for greater public awareness of ASD in both girls and boys, to reduce the stigma it often still carries and to promote early detection that is equally valid for both sexes, ensuring that all affected individuals, regardless of gender, receive appropriate support and recognition.