Girls and Women with Autism Spectrum Disorders in the Family Context: Co-occurrence of Gender Dysphoria and Non-Suicidal Self-Injury
 
 
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Faculty of Pedagogy and Psychology, Jan Kochanowski University, Kielce, Poland
 
 
Submission date: 2025-05-15
 
 
Acceptance date: 2025-07-20
 
 
Online publication date: 2025-09-26
 
 
Corresponding author
Krystian Ferenc   

Wydział Pedagogiki i Psychologii, Uniwersytet Jana Kochanowskiego, Krakowska 11, 25-029 Kielce, Polska
 
 
 
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ABSTRACT
Aim. The purpose of this thesis is to introduce readers to the characteristics of the female clinical profile of autism spectrum disorder, both the frequently co-occurring diagnoses of gender dysphoria and non-suicidal self-injury, in the context of the interrelation of these conditions determined on the basis of the scientific literature review conducted by the author. The clinical presentation of autism in girls and women differs from the commonly accepted profile. The family environment plays a crucial role in their functioning, influencing the diagnostic process, care, and support. The failure to recognise difficulties and the delayed diagnosis in females are associated with an increased risk of issues related to gender dysphoria and non-suicidal self-injury. The study also highlights the connection between family systems and the functioning of girls and women with ASD. Methods and materials. The article presents a theoretical approach based on an analysis of Polish and international source materials. Results and conclusion. The review suggests that there are some correlations among the areas of interest presented in the article. The presence of a gender dysphoria diagnosis increases the likelihood of self-injuries, and among individuals with ASD, the incidence of gender dysphoria is even higher. The psychological difficulties and burdens faced by women are reflected in their higher rates of reported self-injury compared to men, which is associated with the more frequent presence of gender dysphoria in females. Increased masking is associated with mental and physical health costs contributing to psychopathology and impacting family functioning.
REFERENCES (56)
1.
Baron-Cohen, S. (2002). The extreme male brain theory of autism. Trends in Cognitive Sciences, 6(6), 248–254. https://doi.org/10.1016/s1364-....
 
2.
Bejerot, S., Eriksson, J. M., Bonde, S., Carlström, K., Humble, M. B., & Eriksson, E. (2012). The extreme male brain revisited: Gender coherence in adults with autism spectrum disorder. The British Journal of Psychiatry, 201(2), 116–123. https://doi.org/10.1192/bjp.bp....
 
3.
Bresin, K., & Schoenleber, M. (2015). Gender differences in the prevalence of nonsuicidal self-injury: A meta-analysis. Clinical Psychology Review, 38, 55–64. https://doi.org/10.1016/j.cpr.....
 
4.
Carter, C. S. (2007). Sex differences in oxytocin and vasopressin: Implications for autism spectrum disorders? Behavioural Brain Research, 176(1), 170–186. https://doi.org/10.1016/j.bbr.....
 
5.
Cassidy, S., Bradley, L., Shaw, R., & Baron-Cohen, S. (2018). Risk markers for suicidality in autistic adults. Molecular Autism, 9, Article 42. https://doi.org/10.1186/s13229....
 
6.
Cooper, K., Smith, L. G. E., & Russell, A. J. (2018). Gender identity in autism: Sex differences in social affiliation with gender groups. Journal of Autism and Developmental Disorders, 48(12), 3995–4006. https://doi.org/10.1007/s10803....
 
7.
Craig, M. C., Zaman, S. H., Daly, E. M., Cutter, W. J., Robertson, D. M., Hallahan, B., Toal, F., Reed, S., Ambikapathy, A., Brammer, M., Murphy, C. M., & Murphy, D. G. (2007). Women with autistic-spectrum disorder: Magnetic resonance imaging study of brain anatomy. The British Journal of Psychiatry, 191(3), 224–228. https://doi.org/10.1192/bjp.bp....
 
8.
Dell’Osso, L., Toschi, D., Carpita, B., & Amatori, G. (2024). Female autism: Grunya Sukhareva’s pioneering description reinterpreted in light of DSM-5-TR and the concept of camouflaging. Italian Journal of Psychiatry, 10(1), 1–3. https://doi.org/10.36180/2421-....
 
9.
Dora, M. (2022). Niezgodność płciowa w najnowszej klasyfikacji chorób ICD-11 [Gender incongruence in the latest ICD-11 classification of diseases]. Przegląd Psychologiczny, 65(2), 35–40. https://doi.org/10.31648/przeg....
 
10.
Dora, M., Grabski, B., & Dobroczyński, B. (2021). Gender dysphoria, gender incongruence and gender nonconformity in adolescence — changes and challenges in diagnosis. Psychiatria Polska, 55(1), 23–37. https://doi.org/10.12740/PP/On....
 
11.
Drożdżowicz, L. (1999). Ogólna teoria systemów [General systems theory]. In B. de Barbaro (Ed.), Wprowadzenie do systemowego rozumienia rodziny (2nd ed., pp. 9–17). Wydawnictwo Uniwersytetu Jagiellońskiego.
 
12.
Dugdale, A.-S., Thompson, A. R., Leedham, A., Beail, N., & Freeth, M. (2021). Intense connection and love: The experiences of autistic mothers. Autism, 25(7), 1973–1984. https://doi.org/10.1177/136236....
 
13.
Emich-Widera, E., & Kazek, B. (2023). Rozpowszechnienie, czynniki ryzyka autyzmu [Prevalence and risk factors for autism]. In E. Emich-Widera, B. Kazek, & J. Paprocka (Eds.), Autyzm u dzieci: Wiedza kliniczna (pp. 13–22). PZWL Wydawnictwo Lekarskie.
 
14.
Frith, U. (2023). Autyzm [Autism]. Wydawnictwo Uniwersytetu Łódzkiego.
 
15.
George, R., & Stokes, M. A. (2018). Gender identity and sexual orientation in autism spectrum disorder. Autism, 22(8), 970–982. https://doi.org/10.1177/136236....
 
16.
Gołaska, P. (2013). Etiologia zaburzeń ze spektrum autyzmu: Przegląd wybranych koncepcji [Etiology of autism spectrum disorders: A review of selected concepts]. Psychiatria & Psychologia Kliniczna, 13(1), 8–14.
 
17.
Hendrickx, S. (2025). Kobiety i dziewczyny w spektrum autyzmu: Od wczesnego dzieciństwa do późnej starości [Women and girls on the autism spectrum: From early childhood to old age] (2nd ed.). Wydawnictwo Uniwersytetu Jagiellońskiego.
 
18.
Holliday Willey, L. (2018). Udawanie normalnej: Życie z zespołem Aspergera (zaburzeniami ze spektrum autyzmu) [Pretending to be normal: Living with Asperger’s syndrome (autism spectrum disorder)]. Wydawnictwo Edukacyjne.
 
19.
Holt, V., Skagerberg, E., & Dunsford, M. (2016). Young people with features of gender dysphoria: Demographics and associated difficulties. Clinical Child Psychology and Psychiatry, 21(1), 108–118. https://doi.org/10.1177/135910....
 
20.
Hopkins, N., Iles, J., & Satherley, R. (2023). The experience of raising girls with autism spectrum disorder: A systematic review of qualitative research studies. Review Journal of Autism and Developmental Disorders, 1–16. https://doi.org/10.1007/s40489....
 
21.
Hull, L., Petrides, K. V., Allison, C., Smith, P., Baron-Cohen, S., Lai, M. C., & Mandy, W. (2017). ”Putting on my best normal”: Social camouflaging in adults with autism spectrum conditions. Journal of Autism and Developmental Disorders, 47(8), 2519–2534. https://doi.org/10.1007/s10803....
 
22.
Hull, L., Petrides, K. V., & Mandy, W. (2020). The female autism phenotype and camouflaging: A narrative review. Review Journal of Autism and Developmental Disorders, 7(4), 306–317. https://doi.org/10.1007/s40489....
 
23.
Hull, L., Stark, I., Lundberg, M., Ahlqvist, V. H., Nordström, S. I., Ohlis, A., Hadlaczky, G., Rai, D., & Magnusson, C. (2024). Sex differences in self-harm and suicide in young autistic adults. Acta Psychiatrica Scandinavica, 150(4), 223–233. https://doi.org/10.1111/acps.1....
 
24.
Jones, R. M., Wheelwright, S., Farrell, K., Martin, E., Green, R., Di Ceglie, D., & Baron-Cohen, S. (2012). Brief report: Female-to-male transsexual people and autistic traits. Journal of Autism and Developmental Disorders, 42(2), 301–306. https://doi.org/10.1007/s10803....
 
25.
Kahn, N. F., Sequeira, G. M., Reyes, V., Garrison, M. M., Orlich, F., Christakis, D. A., Aye, T., Conard, L. A. E., Dowshen, N., Kazak, A. E., Nahata, L., Nokoff, N. J., Voss, R. V., & Richardson, L. P. (2023). Mental health of youth with autism spectrum disorder and gender dysphoria. Pediatrics, 152(6), Article e2023063289. https://doi.org/10.1542/peds.2....
 
26.
Kapinos-Gorczyca, A. (2023). Koncepcja autyzmu na przestrzeni dziejów: Od baśni o wróżkach do neuroróżnorodności [The concept of autism throughout history: From fairy tales to neurodiversity]. In E. Emich-Widera, B. Kazek, & J. Paprocka (Eds.), Autyzm u dzieci: Wiedza kliniczna (pp. 1–11). PZWL Wydawnictwo Lekarskie.
 
27.
Lai, M.-C., Lombardo, M. V., Chakrabarti, B., Ruigrok, A. N., Bullmore, E. T., Suckling, J., Auyeung, B., Happé, F., Szatmari, P., Baron-Cohen, S., MRC AIMS Consortium. (2018). Neural self-representation in autistic women and association with compensatory camouflaging. Autism, 23(5), 1210–1223. https://doi.org/10.1177/136236....
 
28.
Lai, M. C., Lombardo, M. V., Pasco, G., Ruigrok, A. N., Wheelwright, S. J., Sadek, S. A., Chakrabarti, B., MRC AIMS Consortium, & Baron-Cohen, S. (2011). A behavioral comparison of male and female adults with high functioning autism spectrum conditions. PLoS One, 6(6), Article e20835. https://doi.org/10.1371/journa....
 
29.
Lai, M. C., Lombardo, M. V., Ruigrok, A. N., Chakrabarti, B., Auyeung, B., Szatmari, P., Happé, F., Baron-Cohen, S., & MRC AIMS Consortium. (2016). Quantifying and exploring camouflaging in men and women with autism. Autism, 21(6), 690–702. https://doi.org/10.1177/136236....
 
30.
Lai, M. C., Lombardo, M. V., Suckling, J., Ruigrok, A. N., Chakrabarti, B., Ecker, C., Deoni, S. C., Craig, M. C., Murphy, D. G., Bullmore, E. T., MRC AIMS Consortium, & Baron-Cohen, S. (2013). Biological sex affects the neurobiology of autism. Brain, 136(9), 2799–2815. https://doi.org/10.1093/brain/....
 
31.
Leibowitz, S., & de Vries, A. L. (2016). Gender dysphoria in adolescence. International Review of Psychiatry, 28(1), 21–35. https://doi.org/10.3109/095402....
 
32.
Lemon, J. M., Gargaro, B., Enticott, P. G., & Rinehart, N. J. (2011). Brief report: Executive functioning in autism spectrum disorders: A gender comparison of response inhibition. Journal of Autism and Developmental Disorders, 41(3), 352–356. https://doi.org/10.1007/s10803....
 
33.
Loomes, R., Hull, L., & Mandy, W. P. L. (2017). What is the male-to-female ratio in autism spectrum disorder? A systematic review and meta-analysis. Journal of the American Academy of Child and Adolescent Psychiatry, 56(6), 466–474. https://doi.org/10.1016/j.jaac....
 
34.
Maddox, B. B., Trubanova, A., & White, S. W. (2016). Untended wounds: Non-suicidal self-injury in adults with autism spectrum disorder. Autism, 21(4), 412–422. https://doi.org/10.1177/136236....
 
35.
Makowska, I., & Gmitrowicz, A. (2018). Samookaleczenia bez intencji samobójczej a zachowania samobójcze [Non-suicidal self-injury vs. suicidal behaviour disorder]. Psychiatria & Psychologia Kliniczna, 18(2), 173–179. https://doi.org/10.15557/PiPK.....
 
36.
Margasiński, A., & Marianowicz-Szczygieł, A. (2024). “The gender reassignment” controversy–between affirmation and kind restraining. Quarterly Journal Fides et Ratio, 57(1), 31–47. https://doi.org/10.34766/fetr.....
 
37.
Michel, A., Mormont, C., & Legros, J. J. (2001). A psycho-endocrinological overview of transsexualism. European Journal of Endocrinology, 145(4), 365–376. https://doi.org/10.1530/eje.0.....
 
38.
Mitchell, H. K., Keim, G., Apple, D. E., Lett, E., Zisk, A., Dowshen, N. L., & Yehya, N. (2022). Prevalence of gender dysphoria and suicidality and self-harm in a national database of paediatric inpatients in the USA: A population-based, serial crosssectional study. The Lancet Child & Adolescent Health, 6(12), 876–884. https://doi.org/10.1016/S2352-....
 
39.
Moseley, R. L., Gregory, N. J., Smith, P., Allison, C., & Baron-Cohen, S. (2020). Links between self-injury and suicidality in autism. Molecular Autism, 11(1), Article 14. https://doi.org/10.1186/s13229....
 
40.
Nock, M. K. (2010). Self-injury. Annual Review of Clinical Psychology, 6, 339–363. https://doi.org/10.1146/annure....
 
41.
Nydén, A., Hjelmquist, E., & Gillberg, C. (2000). Autism spectrum and attentiondeficit disorders in girls: Some neuropsychological aspects. European Child & Adolescent Psychiatry, 9(3), 180–185. https://doi.org/10.1007/s00787....
 
42.
Oliver, M., Poysden, Z., & Gillespie-Smith, K. (2024). A qualitative systematic review and meta-synthesis of mothers’ experiences of parenting autistic women and girls. Review Journal of Autism and Developmental Disorders, 1–22. https://doi.org/10.1007/s40489....
 
43.
Pawłowska, B., Potembska, E., Zygo, M., Olajossy, M., & Dziurzyńska, E. (2016). Rozpowszechnienie samouszkodzeń dokonywanych przez młodzież w wieku od 16 do 19 lat [Prevalence of self-injury performed by adolescents aged 16–19 years]. Psychiatria Polska, 50(1), 29–42. https://doi.org/10.12740/PP/36....
 
44.
Pohl, A., Cassidy, S., Auyeung, B., & Baron-Cohen, S. (2014). Uncovering steroidopathy in women with autism: A latent class analysis. Molecular Autism, 5, Article 27. https://doi.org/10.1186/2040-2....
 
45.
Pohl, A. L., Crockford, S. K., Blakemore, M., Allison, C., & Baron-Cohen, S. (2020). A comparative study of autistic and non-autistic women’s experience of motherhood. Molecular Autism, 11, Article 3. https://doi.org/10.1186/s13229....
 
46.
RSK [Rejestr Systemów Kodowania]. (n.d.). Międzynarodowa Statystyczna Klasyfikacja Chorób i Problemów Zdrowotnych – ICD-11 – polska wersja językowa [International Statistical Classification of Diseases and Related Health Problems — ICD-11 — Polish language version]. https://rsk3.ezdrowie.gov.pl/r....
 
47.
Rynkiewicz, A., Janas-Kozik, M., & Słopień, A. (2019). Dziewczęta i kobiety z autyzmem [Girls and women with autism]. Psychiatria Polska, 53(4), 737–752. https://doi.org/10.12740/PP/On....
 
48.
Rynkiewicz, A., & Łucka, I. (2018). Autism spectrum disorder (ASD) in girls: Cooccurring psychopathology: Sex differences in clinical manifestation. Psychiatria Polska, 52(4), 629–639. https://doi.org/10.12740/PP/On....
 
49.
Simone, R. (2016). Aspergirls: Siła kobiet z zespołem Aspergera [Aspergirls: The power of women with Asperger’s syndrome]. Wydawnictwo Harmonia.
 
50.
Szmania, L. (2015). Etiologia zaburzeń spektrum autyzmu – przegląd koncepcji [Etiology of autism spectrum disorders — a conceptual overview]. Interdyscyplinarne Konteksty Pedagogiki Specjalnej, 11, 93–123. https://doi.org/10.14746/ikps.....
 
51.
Świerczyńska, J., & Pawłowska, B. (2022). Coping with stress of mothers of children with disorders belonging to autism spectrum. Current Problems of Psychiatry, 23(1), 1–12. https://doi.org/10.2478/cpp-20....
 
52.
Urban, M. (2009). Transseksualizm czy urojenia zmiany płci? Uniknąć błędnej diagnozy [Transsexualism or delusions of sex change?:\ Avoiding misdiagnosis]. Psychiatria Polska, 43(6), 719–728.
 
53.
van der Miesen, A. I. R., Hurley, H., Bal, A. M., & de Vries, A. L. C. (2018). Prevalence of the wish to be of the opposite gender in adolescents and adults with autism spectrum disorder. Archives of Sexual Behavior, 47(8), 2307–2317. https://doi.org/10.1007/s10508....
 
54.
Walsh, B. (2014). Terapia samouszkodzeń [Self-harm therapy]. Wydawnictwo Uniwersytetu Jagiellońskiego.
 
55.
WHO [World Health Organization]. (2008). Międzynarodowa Statystyczna Klasyfikacja Chorób i Problemów Zdrowotnych ICD-10: Rewizja dziesiąta: Tom I [International Statistical Classification of Diseases and Related Health Problems ICD-10: Tenth revision: Volume 1]. https://klasyfikacje.stat.gov.....
 
56.
Ziółkowska, B., & Wycisk, J. (2019). Autodestruktywność dzieci i młodzieży [Selfdestructiveness of children and adolescents]. Difin.
 
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