Are There Sex or Gender Differences in Autistic Characteristics? An Umbrella Systematic Review.

PURPOSE: The aim of this umbrella systematic review was to synthesise evidence about sex/gender differences in autism across existing systematic reviews, meta-analyses, and scoping reviews. METHODS: MEDLINE, Embase, Embase Classic, CINAHL, and APA PsycINFO were searched for peer-reviewed articles focused upon sex/gender differences in autistic children, adolescent, or adults, and published in English or Turkish. RESULTS: Analysis of 34 studies showed no conclusive evidence of sex/gender differences in social communication, friendships, play behaviours and motor stereotypies in autistic children, adolescents, and adults. There was evidence that autistic females had fewer restricted and repetitive behaviours and were more capable in their use of camouflaging although autistic males also engaged in camouflaging. There was weak evidence to suggest that autistic male children have superior visuospatial skills, and evidence to indicate sex/gender differences in some aspects of brain development. Chronological age and general intellectual functioning appear to interact with some of these sex/gender differences. CONCLUSION: There was evidence that sex/gender differences amongst autistic people are similar to those seen amongst the general population and are not autism specific. More studies involving equal numbers of both autistic and non-autistic individuals of different sexes/genders are needed to draw more conclusive evidence.