Influence of gender bias in the diagnosis of autism spectrum disorder: a review

Abstract

The prevalence of autistic spectrum disorder (ASD) has increased in recent years, partly due to improvements in detection methods and partly to the modifications in the definition that have been incorporated into diagnostic manuals. This increase has caused the prevalence rate by gender to be currently of 1.4 / 1, according to some authors, or up to 15.7 / 1 according to others, with a much higher number of barons who receive the diagnosis compared to the number of women who receive it. The different explanations that have been given to this question point to certain gender differences in the symptomatic manifestations of the disorder, together with the fact that the evaluation techniques that have been used have been mostly designed with a sample of barons in mind and, therefore, with a greater precision for the detection in the case of them. Likewise, a phenomenon of camouflage has been argued to occur among women with the disorder, especially in cases of high cognitive capacity, who tend to have greater abilities to compensate for communication and social interaction difficulties typical of ASD. All this could be leading to the occurrence of false negative cases among women who may have ASD and who are not diagnosed. The objective of this research is to explore these gender differences in relation to the expression of the symptoms of ASD and to verify if this is faithfully transferred to the gender differences in the diagnosis, as well as to investigate the possible causes that could be behind this phenomenon. To this end, a theoretical review of the scientific literature published from 2009 to the present has been carried out and its most important conclusions which could help to clarify these issues have been selected and presented.