ASD is affecting more females than people realise – we're just better at compensating for it, like I did with Asperger's syndrome, says Hannah Belcher
What led to you being diagnosed so late, when you were 23?
I'd had a lot of isolated problems that nobody had really pieced together as I was growing up. I was in therapy when somebody finally said: "I think all these difficulties you've been having could actually be autism rather than mental illness."
How did you react to that idea?
It was a massive shock. Despite studying autism in my psychology degree, I had never considered I might have a form of it. That's also when I realised that there is a big issue with diagnosis in general.
Did things make sense to you at that point?
Definitely. At first I thought: I have friends, I socialise, it can't possibly be that. But underneath I'm having the same problems: a lot of anxiety, especially in social situations, and problems like sensory overload. I realised I'm just masking it a lot.
So that led to your current research?
Yes, I wanted to find out how many other females are out there who are also masking their symptoms and so haven't been discovered yet, just because what they are displaying isn't stereotypical autism spectrum disorder (ASD) behaviour. My research involves a nationwide screening project and anybody, male or female, can take part at psychscreen.co.uk.
How might women be masking symptoms?
Females are placed under a lot of pressure to fit in, and I think that drives us to develop coping mechanisms. I read a paper on memory that said female brains are naturally better than male ones at storing up scripts in social situations. When I was growing up, I would observe people around me, see how they were behaving, and develop a script to get myself through it. Also, when females with ASD get an obsession it's not typically with the same things that males with ASD get into. I've never been interested in trains or timetables – I'm not collecting information. I was obsessed with more normal things.
What do you get obsessed with?
When I was younger it was music – I would listen to the same song over and over and drive everyone up the wall. Now I'm obsessed with psychology.
What would an earlier diagnosis have meant?
I dropped out of school when I was 14 because I couldn't cope with the pressures. With a diagnosis, that wouldn't have happened – I would have had the correct support. I think a lot of undiagnosed females develop other mental health conditions because of the pressure they are under. Only a fifth of girls with ASD are diagnosed before the age of 11, compared with over half of boys with it, so I think there are probably more girls with ASD than we realise.
Having left school so young, how did you manage to turn yourself into a researcher?
I'm not very good in a group or at understanding people, so I found it easier to teach myself. I taught myself GCSEs, A levels and most of my degree. It was just second nature to me.
This article appeared in print under the headline "When autism wears a mask"
Profile
Hannah Belcher is a PhD student in psychology at Anglia Ruskin University, UK, who was diagnosed with Asperger's syndrome at age 23. She is conducting an online survey to better understand possible misdiagnoses in females
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