External vs Internal: moving away from gendered profiles in autism.

External vs Internal: moving away from gendered profiles in autism.

There are problems inherent in the way that ‘female autism’ is being researched. Curiously, they appear to be the same problems that occurred in the initial research and diagnosis of aspergers. The same language and biased research issues that led to the missed diagnoses of so many autistic women looks set to repeat unless we become aware of the implications of gendering a condition.

Understanding that females can also be autistic is an understanding long overdue. The misconception that autism and aspergers were conditions that ‘belonged’ to males was caused by a focus on males as research participants, and lack of understanding in how autism presents in different individuals.

As researchers and diagnosticians continue to build a ‘female profile’ of autism, we should be cautious of the suggestion that this presentation only occurs in females. It doesn’t. Just as some autistic women have a textbook ‘male’ presentation, so too do autistic males display symptoms that are currently considered ‘female’.

Therein lies the danger. By qualifying a set of symptoms as either ‘male’ or ‘female’, we encourage diagnosticians to disregard a potential diagnoses because it does not fit the assigned sex of a person. Those who research their particular presentation before seeing a therapist may feel there is something extra ‘broken’ about their brain if the ‘gender’ of their symptoms does not match their own gender expression.

Instead, I propose an alternative way of classifying the two autistic profiles that escapes gendered language.

Through my research and personal experience, I believe in every person (autistic or otherwise) there is a particular factor that describes how that person will react to most situations. As autistic people frequently find themselves in situations that are at ‘odds’ with ‘normal’ culture, how that person views their place in relation to the world is highly important.

It comes down to this: external versus internal.

External autism is how I would describe the textbook ‘male’ presentation. When the individual discovers a difference between how they operate and how the world operates, that individual is likely to come to the conclusion that they are right, and everyone else is wrong. This leads to a more open and authentic presentation of their autistic symptoms. They display more obvious social disconnect, are more likely to act in appropriately, less likely to bow to social convention, and often have a level of self-assurance in all that they do.

Internal autism (or the basis of the ‘female profile’) is the opposite. An individual of this presentation, when faced with a disconnect, believes the world is right and they are wrong. They are more likely to ‘learn’ social rules as a means of becoming ‘right’, to be crippled with self-doubt, to mask behaviours in a way that complies with social conventions, and are often misdiagnosed or missed completely due to their ability to play the part.

Both sides of the autistic coin are weighted with their own pros and cons, and through this lens of internal and external we can see how typical autistic behaviours manifest differently.

An externally autistic person, upon being caught in a conversation they find utterly boring, may well just say “You’re boring me now” and end the conversation with little understanding (or desire) of how to politely exit a conversation. An internally autistic person caught in the same situation may instead ‘play along’, nodding as they feel appropriate.

The externally autistic person takes charge of the situation as they believe they are correct, while the internally autistic person lets majority rule.

I would love to hear your thoughts regarding this classification of autism. On the mark, or miles away? How else would you classify autistic types?

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