With the awareness of neurodivergent symptoms in women and nonbinary people increasing in online discussions, generations of people are coming to better understand themselves and their lives. But many wonder: If autism spectrum disorder is so prevalent in individuals assigned female at birth, where have they been all this time? Gina Rippon’s Off the Spectrum: Why the Science of Autism Has Failed Women and Girls presents a comprehensive exploration of how gender-based scientific bias has systematically erased autistic women from research, diagnosis and, ultimately, care. A cognitive neuroscientist, Rippon unpacks the history of autism studies, exposing how generations of researchers—including herself—have fixated on classifying autism as a “male disorder,” leaving countless people undiagnosed and unsupported.
Off the Spectrum is an incredible resource for anyone looking to learn more about autism, including how it may be classified, signs to look for, historical research on the disorder and ways that over half the world’s population have been left out of the conversation for so long. Both scientifically rigorous and accessible, the book recounts case studies, research from other scientists and testimonies from autistic women, parents and teachers alike. One of the most eye-opening sections explores how parents have been brushed off when they attempt to get autism testing for their daughters. Girls who displayed autistic social symptoms, for example, might be seen as “just shy” or “late bloomers.” Moreover, they are more readily misdiagnosed with anxiety or personality disorders.
Rippon exposes how social attitudes toward gender lead to medical bias and educational barriers, to the detriment of children. Teachers and doctors are often the gatekeepers to autism assessment, and even when boys and girls exhibit identical behaviors, they are often given completely different diagnoses. This leads autistic girls to adapt with camouflaging behaviors, known as masking, to better navigate the world. Rippon also shares interesting gender identity research, with one report noting that autistic people assigned female at birth tend to see gender beyond the binary of conformity; in that study, 26.5 percent of them identified as nonbinary or with another gender identity, leading readers to ponder how the construct of gender could be further evaluated if more study was applied to neurodivergent people.
Ultimately, Off the Spectrum leaves the reader with a hopeful outlook for the future, as awareness of autism beyond men and boys continues to grow. It’s an urgent read, necessary for parents, educators, doctors and, most importantly, autistic women and nonbinary people themselves who may gain solace and a sense of belonging from the text.
