What is the prevalence of autism in women?

Estimated prevalence shows about one woman with autism for every four males; women frequently receive later diagnoses and often require more intensive support.

Why are women with autism often diagnosed later?

Diagnostic delays occur due to subtler social masking, atypical presentations, and reduced recognition of female autistic traits, leading to underidentification and postponed support.

Which behaviors characterize autism in women?

Common behaviors include social withdrawal, prolonged crying, self-injury (nail‑biting, hair‑pulling, cutting), risky actions like starting fires, emotional dysregulation, and difficulty prioritizing tasks.

What are executive functions and their role in autism in women?

Executive functions are cognitive processes that coordinate planning, inhibition, memory, flexibility and multitasking; their deficits worsen fear, conflict, decision-making and social adaptation in women with autism.

Which executive functions are most affected in women with autism?

Processing speed, inhibition, working and verbal memory, cognitive flexibility, planning, and branching (multitasking) are commonly impaired, causing slowed responses, poor prioritization and higher stress.

How can the community support women with autism?

Community support includes education, empathy, clear social expectations, family advocacy, accessible services, and inclusive practices that recognize neurodivergence and reduce participation barriers.

Autism in Women and Executive Functions

Autism in women

Statistics say that one in 66 people lives with autism and that there is one woman with autism for every 4 males. Likewise, the data show that women take longer to be diagnosed when they require help. And, moreover, when they need help, the help they need is often greater than that required by males. As can be expected, the information available on this aspect is ambiguous and, at best, gives a general idea.

The social aspect is what denotes this condition with or without a diagnosis. In this regard, the skills that make up the executive functions play a very important role in managing fear and conflict that generally accompany a woman living with autism.

Autism, a sea of realities

The sea is blue, bright, sometimes calm and peaceful and other times dark, stormy and tempestuous. The same happens with autism, which is why the color blue has been associated with the condition. The female sex was identified with the color pink for a long time. Currently this social practice has faded. In this case, it will be used to develop an idea and address an important topic going beyond the title. The topic of inclusion can always be addressed at another time.

The sea shines when it is somewhat calm and reflects the sun. Fear, anxiety and even depression make that calm disappear in anyone, giving way to behaviors that are not only disruptive but dangerous. Locking oneself in the bedroom, in the closet, pantry, trunk; collapsing into the beanbag wanting to sink until disappearing, “playing” by starting a fire, biting nails, pulling out hair, eating ignoring satiety, laughing, crying… can become “classic” for a girl who has had a very bad day.

Distinctive characteristics of autism in women

Autism in women goes beyond the classic emotional reaction due to the peculiarity that exists in inhibitory control because of the speed of stimulus processing in the cerebral amygdala where the emotions provoked by the situation and the reaction are located. So, locking oneself away is only the first step in the start of a chain of dramatic actions such as crying for hours, accumulating tissues or leafing through her photo album to curse the day she was born.

Autism in women makes sinking until disappearing so necessary that they do not notice the time they spend in the attempt. In addition, the ability to prioritize tasks is deficient; they forget responsibilities, commitments, tasks and duties.

For women with autism, “playing” by starting a fire is not a game; they begin by turning on the stove burning what is in sight, sometimes causing a real tragedy, since their cognitive inflexibility keeps their stress level elevated and lowers tolerance to frustration, exacerbating anguish and fear.

Autistic women bite their nails frequently, exceeding what any neurotypical girl would do, sometimes making their fingers bleed. Pulling out hair until removing large chunks, pinching their arms or engaging in cutting and then regretting it without stopping are clear signs of a failure in decision making. In autism in women, eating while ignoring satiety is common; obesity is a frequent and difficult issue to address when following a nutritional plan; laughing out loud and then crying profusely has come to be considered a form of self-regulation because of the calm they experience once the “crisis” has passed.

Fear

Frequently, fear and thought infiltrate, creating a vulnerability that contributes to imbalance. This is because an image can be created within oneself, which gives rise to any negative thought or emotion that is amplified in women with autism given their mental inflexibility.

Conflict

In autism in women it would seem that everything generates conflict both for them and for the rest of the world they interact with. The clothes they have to wear if they attend school or work in a company where the uniform is made of a certain type of fabric can quickly cause irritation, having to deal with discomfort for hours and with a bad mood. Adhering to social protocols can also cause difficulties when these are not explicit, and people may look at them strangely and prefer to avoid them. Most often, they are not able to decipher facial, bodily and even verbal expressions, generating an inappropriate or even null response since their processing speed is decreased.

The community surrounding women with autism

Wherever we are and whoever we are, we must focus on assuming the responsibility of our society in general. Empathy goes beyond putting ourselves in their shoes; it implies knowing the condition and its peculiarities. In fact, information reduces the barriers that limit their learning and participation. The family of a woman living with autism should not give up nor sit and wait for society to be as we wish it to be.

Being limited by roles, notions, concepts and ways of being in autism in women is not very useful. Often, others want to collaborate with us or vice versa, because we see a deep part of ourselves in the mirror of their excellence.

What are executive functions?

Executive functions work like a musical orchestra, they are processes that are activated to enable a person to adapt effectively to the context in which they find themselves. These skills sometimes activate individually, depending on the situation and its demands and at other times they activate in an intertwined manner.

Types of executive functions

The skills that make up these functions are:

Processing speed

It has to do with metacognition, an important intellectual process that monitors and controls one’s own thoughts which, when limited or weak as occurs in women with autism, generates confusion when establishing any methodology to carry out tasks.

Working memory

It helps to retain key information and when there is a deficit as often exists in autism, there is a difficulty in solving novel problems since there is a reduced capacity for understanding.

Inhibition

Basically it is the ability to stop before acting, either motorically or verbally, in response to a given external or internal stimulus. When this skill is not strengthened, it is very likely that risky behaviors will be experienced like those seen in autism in women.

Verbal memory

It has to do with the speed and accuracy in searching for information. In autism in women, deficits in this skill give way to limitation due to time pressure.

Dual-task performance

Working in parallel with two processes, even if they are different, with the ability to pay attention to both equally. A skill diminished in women with autism.

Cognitive flexibility

Ability to formulate different hypotheses to solve a problem, different criteria to categorize the world, organize things, to make predictions or anticipations. Deficits in this skill not only limit creative thinking, but also increase anguish and fear, the level of stress and reduce tolerance to frustration. It creates greater difficulty for women when interacting with someone or performing a function in the social sphere.

Planning

It has to do with integrating, following and concluding steps to achieve something. A skill that presents difficulties in autism in women, generating poor time and space management.

Branching (multitasking)

It is the ability to carry out several tasks at the same time and alternate them; an almost impossible mission in women with autism, as well as decision making since it is always related to emotion, making it difficult for them to establish priorities. Intuition is part of this skill, as is the ability to decide on an objective and the plan to carry it out.

Conclusions

As human beings, we cannot be identical to one another, context and our skills define and place us in a specific location. A lot of resilience and patience is needed while the executive functions are fully strengthened in autism in women because it involves breaking a monolithic image that actually does not fit.

True community is based on a bond of affection that begins with recognition of neurodivergence and the respect it deserves.

By reconciling the internal conflict when someone “hurts” us while speaking and acting sincerely as many women who live with autism do, we perform a real act of inclusion.

References

Carnero-Pardo, C. Thematic press conference with Javier Tirapu Ustárroz: Executive functions [online]. Circunvalación del Hipocampo, May 2020 [Accessed: August 2, 2021]. Available at: https://www.hipocampo.org/Press Conferences/JavierTirapuUstarroz.asp