Might a late ASD diagnosis help future recognition of masking in women?
September 9, 2023 1:52 PM   Subscribe

I’ve been reading about ASD symptoms in women and gradually remembering making adjustments to some of them when I was young that I hardly notice now. But so many of the symptoms seem so ordinary in the context of my family circumstances and childhood I’m a little puzzled, like surely those are very common quirks?

Moreover most of the things i feel are seen as a bit weird in me, are things I've always understood as a result of being bi-cultural, or as a percieved mismatch between being small and fragile-looking while being rather hard-assed. But as info about women with autism comes more to the fore there are specific incidents in my life that have made me wonder. I've had a long time to arrange my life so that I don't encounter things that make me uncomfortable any more (touching, phone calls etc. and the necessary social skill of lying is something I've come to an accommodation with.)

Growing up there wasn’t really family pressure not to be weird because they were all damn weird! And had a lot of license to be so through being good at their jobs. But there was societal pressure, because I come from a place where social convention is very strong.

Lately I’ve been making lists of things I’ve never not done, which I won’t include here, to do with touch, sex, eye contact, stims, overstimulation - and some of those memories come with also remembering making the effort to reverse the effect. I mean, I doubt I would ever get through a screening for the condition but the more I read about women with ASD the more it chimes with me and I remember taking steps to solve some of the problems associated.

For instance the trait that made me take most notice was alexithymia, because I kept reading about it but only recently looked up what it means. I'd almost forgotten that I consciously made a decision in late adolescence, time of passionate crushes and hormone storms, to monitor myself by externals in order to know what I'm feeling. Now it's second nature. But the thing that made me think I couldn't possibly be on the spectrum is that i have a very good idea what other people are thinking and feeling, so much so it's like they are invading my barriers, my psyche. It's one of the things that makes company tiring.

I understand why ASD is defined as a disorder. I am not disabled in any way. My quirks of processing and behavior are things I developed ways of coping with over a lifetime, to the extent that many of them are almost invisible now. There remains some degree of existential angst but isn’t that the human condition?

Is there any point at this age (close to 70) of looking for a diagnosis, since I have arranged my life the way I like it? No one has ever mentioned ASD as likely to me in my life but I’m well aware many find me a bit strange, a bit blunt, and I’ve been chased round the room for familial goodbye hugs which in retrospect was actually pretty shit not to mention disrespectful. I think many many people may be on the spectrum in a way that doesn’t interfere with conventional life milestones or require further support: is there an argument for research into them? Would it usefully add to the knowledge of how AS presents, and the adaptations people make to having it? Wouldn’t it be useful, particularly for further understanding of women with ASD, who are so undiagnosed, and for whom any diagnosis and support is a very recent thing, to really explore the diversity of strategies people use to practice masking, and what is successful, and what may be damaging and not worth the effort, and what makes the difference between the two?

And another question, who is or might be doing research on this?
posted by anonymous to Society & Culture (17 answers total) 10 users marked this as a favorite
 
It sounds like you are asking if you personally were to get a diagnosis, would that affect the overall course of research?

It's very unlikely that researchers would be clamoring to study you in particular.

You could write a book, start a blog, get on TikTok, etc., if you feel that sharing your personal experience would be helpful to others. This is something you can do whether you have a diagnosis or not.
posted by yohko at 2:09 PM on September 9, 2023


But the thing that made me think I couldn't possibly be on the spectrum is that i have a very good idea what other people are thinking and feeling, so much so it's like they are invading my barriers, my psyche. It's one of the things that makes company tiring.

I’m on the spectrum (diagnosed very young) and I get this, too. I don’t always know what people expect from me, but I know exactly how they’re feeling, no matter how hard they try to hide it. It’s one of the reasons I prefer to be alone most of the time - I can’t tune out other people’s moods and it’s exhausting.
posted by wheatlets at 2:31 PM on September 9, 2023 [11 favorites]


younger people in your family might benefit from knowing your diagnosis, to better know themselves.
posted by homodachi at 2:58 PM on September 9, 2023 [7 favorites]


“Is there any point at this age (close to 70) of looking for a diagnosis, since I have arranged my life the way I like it?”

I think this is like asking if there is any point in you going to Iceland, if you’ve never been there before and don’t have an overwhelming desire to go. It’s a personal preference. No one else will be much impacted one way or the other; it’s up to you.
posted by samthemander at 5:54 PM on September 9, 2023


Is there any point at this age (close to 70) of looking for a diagnosis, since I have arranged my life the way I like it?

At close to 40, I did a full neuropsychological evaluation and I was diagnosed with ADHD. I needed this diagnosis before my health insurance provider would consider prescribing me medication for ADHD, which is why I pursued one. I'm still working through red tape, so, no word yet on if medication will work for me... But the systems I've developed to deal with my disorder just aren't cutting it.

I tried getting diagnosed a few years ago, but I was only offered a simple screener. Given that I'm one of those twice exceptional type of people - the simple screener wasn't sufficient for a diagnosis. I would also say, if you do seek a diagnosis, it might be worth getting tested for everything - then you understand the bigger picture - don't just try to get screened for ASD alone.

On the research question, you might find the News and Research section at ADDitude worth reading - as it also covers related conditions like autism. They have a podcast where they have conversations with researchers and some of those episodes might also be relevant to you.

For what it's worth, having a diagnosis feels different to me and I'm glad that I did it.
posted by skunk pig at 6:30 PM on September 9, 2023 [4 favorites]


I don’t have a formal autism diagnosis for legal reasons - I don’t want it on my record because of the social stigma and difficulty getting insurance where I live currently. If I change countries I would consider it again if a formal assessment meant additional support. For school age children/adults it can mean a significant amount of additional support is unlocked.

I talked to my psychiatrist who agreed with my approach and I feel confident enough to be open about it in my family and some friends. Most of all it’s let me feel ok exploring other accounts - especially by women - on autism and to try different accommodations that I felt weirdly shameful about like - I only prefer certain foods, so I will figure out the nicest recipes for them and just say no at restaurants to anything I don’t want to try instead of berating myself for being so picky. My next big project is colour coding my house - I already number label things so I know where they go, but I want to have each room colour coded so I know what belongs where sorted.

I would love to read a blog by an older woman with autism!
posted by dorothyisunderwood at 7:00 PM on September 9, 2023 [5 favorites]


Perfect timing - Inside an Autistic Mind episode of the BBC's the documentary series just became available, with Sue Nelson, a science journalist, exploring her late diagnosis at 60. It's a very good listen.
posted by dorothyisunderwood at 7:28 PM on September 9, 2023 [6 favorites]


I'm autistic and AFAB, I realised that I was autistic at 50, about a year ago. My self diagnosis is supported by my psychiatrist and my psychologist.

You don't have an obligation to get diagnosed in order to be a data point in potential research.

Self diagnosis is accepted in the autistic community and by neurodivergent affirming therapists and researchers.

If you self diagnose as autistic, anyone doing any meaningful research into autism will include you in their research as autistic.

The diagnostic criteria is unscientific and so the process is still very biased.

*Knowing* that you're autistic is more important than being diagnosed as autistic. And being formally diagnosed is not necessary for you to know.

Here are some pieces I've written on this topic.

if you're wondering whether autistic self diagnosis can ever be accurate

Autism is like a fever
posted by Zumbador at 8:51 PM on September 9, 2023 [6 favorites]


Thank you so much everybody. I would have replied earlier but I had to sort a sock account out.

homodachi, part of the impetus for my ask here is because it’s been suggested that one of my grandchildren, unhappy in school and with themself, may have autism. Looking at my parents, siblings, children and grandchildren, I can think of several who dont and didn’t seem particularly neurotypical one of whom had a lot of difficulties and lived unhappily. Was that just life or was it the ASD? Well it might have been ASD, considering the knock-on effects of things she found particularly difficult.

Rather than a visit to Iceland when I’m not interested in it, I’d say it’s more like… I have terrible migraine headaches (which I don’t) that include wonderful visions which are really interesting to experience and sometimes reveal geometric repeating patterns which help me solve problems at work. Should I 1. Aim to stop the headaches? 2. Get the headaches investigated because they are painful and scary? 3. Continue to live in fear that I’ll have a stroke one day with half my mind wiped out, because of the headaches? or 4. Continue to find ways to deal with the headaches (darkened room etc) while getting the doctor to prescribe painkillers? And that would mean part of the question here is: Am I right about the reality of both my headaches and my visions, like am I actually getting headaches? Am I just a big hypochondriac? Are these visions actually happening? Am I just kidding myself? And another part is, Should I go look for the painkillers and would they be any better than what I'm doing already?

Sorry, thats really histrionic. I enjoy the way the mind works but there really are social consequences to it and it’s not only me that gets hurt.

wheatlets, thank you for that comment. It has helped me understand one of the things I’m trying to ask here: if the diagnostic criteria for AS are widening due to taking gender differences into account, as the increase in women and people socialized as women, with late diagnoses, would suggest, where is the work being done to revise what the criteria are, and what does it consist of? who’s doing it and how are they doing it? And I do believe narrative and autobiography will be an important part of this work but there’s a catch 22, in that how are undiagnosed people on the spectrum ever going to be part of the research? But the more stories and testimonies from Autistic people are collected the better for understanding, surely? Particularly, masking and the strategies autistic people have used for it over time, will contribute to a more comprehensive picture of the workings of the condition. And those strategies, once they are discovered and recorded, will be as diverse, as conditional and contingent, and as contextually dependent, as people are.

And thanks dorothyisunderwood, I think that’s a best answer.*

I'll apologise for writing an unclear question which isn't particularly precise even now.

*sorry I would have done best answer but can't find how
posted by sockeye salmon at 3:48 AM on September 10, 2023


Many neurodivergent people find that getting a diagnosis is really helpful to them. But you have to remember that the diagnosis gives you an overarching label for the various traits, differences and difficulties you already have. It doesn't give you the traits, differences and difficulties. Choosing not to pursue an ASD diagnosis doesn't prevent you from having ASD / being on the autistic spectrum. What you experience is real in and of itself, the only question is whether it meets the criteria for a particular diagnosis.

In addition, unlike ADHD there's no symptom management treatment for ASD. Your brain is wired differently and that's how it is. In your migraine analogy there are no painkillers that can be prescribed.
posted by plonkee at 6:41 AM on September 10, 2023 [3 favorites]


I think you might be misunderstanding how psychology research works. If you pursue a diagnosis, your data will go into your medical record, but it won’t go anywhere else. It will not add to a greater understanding of autism except perhaps by providing experience to your practitioner. Autism researchers (university faculty, mainly) recruit research subjects who have already been diagnosed and also meet whatever criteria they set for their particular studies. So, if you’d like to participate in research, diagnosis would be a first step, but it wouldn’t be sufficient. (It’s ’s possible someone is doing research on those who have self-diagnosed with autism. In that case, feel free to see if you could participate. They may or may not be willing to accept participants who actively seek them out, for reasons of needing their methods to be consistent.)
posted by Comet Bug at 11:49 AM on September 10, 2023 [1 favorite]


In your migraine analogy there are no painkillers that can be prescribed.
That's a pity. I was hoping there might be some other effective thing than the darkened room aka flumping; which is detatching from everyone for a while and does bring a fear of failures of care on my part, or of breakdown of relationships, or of alienation from cultural background.

No, I know nothing about how psychology research works. But providing experience to a practitioner is still something.
posted by sockeye salmon at 12:46 PM on September 10, 2023


You don't need a diagnosis to read Niamh Garvey's excellent book Looking After Your Autistic Self.
posted by heatherlogan at 12:54 PM on September 10, 2023 [1 favorite]


Sorry about the really terse answer; I had to run out the door unexpectedly.

I thought of Garvey's book (which I'm currently most of the way through) because she describes recovery strategies including (but not limited to) the darkened room, as well as energy and sensory management strategies that can reduce the need for recovery.

As for a formal diagnosis -- I think whether it would be useful or not depends strongly on what jurisdiction you live in and what legal "doors it would open" in terms of accommodations. You may be able to get everything you might need through self-knowledge and asking without a formal diagnosis.

The main area for which it might be relevant to think about is health-care accessibility and possibly future elder-care situations. There's been some important work done recently in the UK about health-care accessibility for autistic people.
posted by heatherlogan at 1:56 PM on September 10, 2023 [1 favorite]


(and so as not to abuse the edit window:)

But so many of the symptoms seem so ordinary in the context of my family circumstances and childhood I’m a little puzzled, like surely those are very common quirks?

Yes, I thought this too! After I figured out (at age 44!) that I'm autistic, we've gradually come to realize that my entire family is almost certainly also autistic, which is why I was considered perfectly normal in that context. Autism is genetic and runs in families. We are also something like 3% of the population, so not all that rare.
posted by heatherlogan at 2:00 PM on September 10, 2023 [5 favorites]


I was hoping there might be some other effective thing than the darkened room aka flumping;

Understanding yourself better can lead to finding new tools/methods of coping with situations you find challenging. Or to deciding not to get yourself into as many of them. So for example, you might find you do better with noise-cancelling headphones in some spaces, or wearing particular kinds of fabrics, or spending time researching new locations you need to visit. Someone I know with a recent adult diagnosis finds that their ability to cope with life is vastly improved by regularly swimming, ideally in cold water. Finding spaces where you are allowed to be much more yourself, without adjusting or masking is something a lot of people appreciate.
posted by plonkee at 2:07 PM on September 10, 2023 [3 favorites]


I've been away from my laptop for a bit but I did want to come back here and thank everyone for their answers. Thank you everyone! When I first contacted the mods about my question I was thinking it might be part of the fundraising chatfilter but they felt noone wanted to fundraise off someone's actual problem, which, fair enough. The back and forth has been great though and it has helped me get a hold of what it is I'm asking a bit more exactly, and it's been a bit like the process that happens when I'm finding out what I'm feeling.

deciding not to get yourself into as many of them
I think I do this now, and that's what I mean by the darkened room as a migraine remedy. I did start this Ask by stating I'm perfectly ok, I live and have lived well, family life continues, the way I think and feel has not significantly derailed my life BUT

partly through thinking about the answers here, and partly because that has brought back buried memories from 40, 50, 60 years ago, there were so many times when I might not have been able to recover myself. Final exams not attended. Crucial people to contact not contacted. Places not gone too because it was a bit too much. Phone phobia at the wrong time! Weird slips of comprehension and communication that might have gone terribly wrong instead of a little bit wrong. All a little bit more than, oh, I'm just not that good at networking. So I think I have been incredibly lucky and I'm thankful for it.

I don't yet know if I'll pursue a diagnosis or even whether I really think I might be asd, it's kind of beside the point because the conversation has been useful and affirming - and I think being this way is pretty normal in my family whatever the label turns out to be. Neurodiversity is good! *bangs crossed arms on chest*
posted by sockeye salmon at 11:39 AM on September 13, 2023 [2 favorites]


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