“Only Boys Can be Autistic”: A Qualitative Exploration of Gender Stereotype and Socialization on the Diagnostic Journey

Background: Prior research exploring phenotypic gender differences in autism suggests that females are less likely to meet the Diagnostic and Statistical Manual of Mental Disorders , Fifth Edition, criteria and receive a diagnosis. Recent findings also propose camouflaging and gendered expectations impact diagnostic rates for those who were not socialized as males, suggesting a male-oriented stereotype and bias within the diagnostic system. As such, this article explores how the male stereotype of autism impacts the diagnostic trajectory of autistic adults. Methods: In total, 24 autistic individuals, consisting of 14 genderqueer, 8 female, and 2 male participants, shared their experiences with the diagnostic system through interviews. The research team conducted a reflexive thematic analysis using theories of gender socialization and feminist disability models. Results: Themes revealed that the male gender is inexplicitly tied to diagnostic representation of autistic individuals, failing to encompass the difficulties experiences of those socialized as females. Clinicians and family members often gave a differential interpretation of symptoms for those who did not identify as male, leading to late or missing diagnoses. Lastly, participants discussed how their socialization as a female directly led to the suppression of their autistic traits. Conclusion: These findings shed light on the pervasive impact of gender stereotypes on diagnosis and recognition of autism.