To review the historical bias in the diagnosis of Autism Spectrum Disorder (ASD) towards a male-centered model and its implications for women and gender-diverse individuals.
Approach:
Historical Analysis: The article examines the origins of the male-centered diagnostic model of ASD and its impact on equity in diagnosis and treatment.
Contemporary Review: It discusses contemporary manifestations of this bias and the implications for clinical, social, and mental health equity.
Key Findings:
ASD has historically been diagnosed four times more frequently in males than females, according to various studies.
Recent studies suggest that the sex ratio of ASD diagnoses may converge to nearly 1:1 by early adulthood, as indicated by a nationwide longitudinal study in Sweden.
Women often experience delayed diagnosis due to differences in symptom presentation and social camouflaging strategies, which have been documented in multiple studies.
The male-centered model has led to misdiagnosis and a lack of appropriate support for women and gender-diverse individuals, as evidenced by historical research.
Interpretation:
The article discusses gender bias in autism diagnosis as a structural constraint rooted in the historical and epistemological construction of autism, affecting diagnostic tools and research priorities.
Limitations:
There is no consensus on the definition of 'late diagnosis' in autism.
The historical focus on male samples in research has contributed to ongoing diagnostic inequities.
Conclusion:
The paper advocates for a reevaluation of diagnostic practices to address gender disparities in autism diagnosis and improve equity in support and interventions.
