Sex Differences in Internalizing Problems During Adolescence in Autism Spectrum Disorder.

The team tracked 102 autistic kids from . Every year the teens filled out the same mood and anxiety checklists. The researchers then split scores by sex and by grade level to see when problems spike.

Girls with ASD scored much higher on depression scales in grades 6-8 than boys with ASD or typical girls. By grades 10-12 both sexes showed more separation anxiety and panic, but the early-teen girl gap had already formed.

Germani et al. (2014) saw no girl-boy mood gap in younger, high-functioning children. The same kids a few years later now look like M et al.’s teens, showing the risk appears after puberty starts.

Day et al. (2021) helps explain why: autistic girls who ‘mask’ traits report the sharpest rise in depression. Camouflaging may be the daily pressure that turns the late-elementary null finding into the early-adolescent surge.

Howard et al. (2023) adds that poor sleep and weak social ties predict later depression in autistic teens. Together the papers flag both social strain and biology as fuel for the sex difference M et al. first captured.

You can’t wait for obvious signs. Screen autistic girls for depression as soon as they hit middle school. Add brief sleep and social-check questions, then teach self-advocacy and masking-reduction skills before low mood hardens into major episodes.