Do girls with Aspergers experience the same symptoms as boys?
The male to female ratio for referrals for a diagnostic assessment is about 10 males to each 1 female. However, the epidemiological evidence indicates the ratio is 4:1. This is the same ratio as occurs with Autism.
So far there have not been any studies that specifically investigate any variation in expression of features between males and females with Aspergers, but males tend to have a greater expression of social deficits with a very uneven profile of social skills and a propensity for disruptive or aggressive behavior, especially when frustrated or stressed. These characteristics are more likely to be noticed by moms/dads and educators who then seek advice as to why the youngster is unusual.
In contrast, females tend to be relatively more able in social play and have a more even profile of social skills. Females with Aspergers seem more able to follow social actions by delayed imitation. They observe the other kids and copy them, but their actions are not as well timed and spontaneous. There is some preliminary evidence to substantiate this distinction from a study of sex differences in Autism.
Females with this Aspergers are more likely to be considered immature rather than odd. Their special interests may not be as conspicuous and intense as occurs with males. Thus, they can be described as the "invisible" youngster (i.e., socially isolated), preoccupied by their imaginary world, but not a disruptive influence in the classroom. Although females are less likely to be diagnosed, they are more likely to suffer in silence.
An important issue for females is that during adolescence the usual basis for friendship changes. Instead of joint play with toys and games using imagination, teen friendship is based on conversation that is predominantly about experiences, relationships and feelings. The female teen with Aspergers may want to continue the playground games of the primary school and starts to reduce her contact with previous friends. They no longer share the same interests. There is also the new problem of coping with the amorous advances of teen males. Here conversation is acceptable, but concepts of romance and love as well as physical intimacy are confusing or objectionable.
In an attempt to be included in social activities, some Aspergers females have described how they have deliberately adopted a "mask-like” quality to their face. To others at school, they seem to continuously express a smile - but behind the mask – they are experiencing anxiety, fear and self doubt. They are desperate to be included and to please others, but cannot express their inner feelings in public.
Females with the classic signs of Aspergers in their primary school years usually progress along the Autism/Aspergers continuum to a point where the current diagnostic criteria are no longer sensitive to the more subtle problems they face. These females have a better long-term prognosis than males. They appear to be more able to learn how to socialize and to camouflage their difficulties at an early age.
The Aspergers Comprehensive Handbook