Males are diagnosed with autism spectrum disorder more frequently than females.
Multiple clinical studies, reviews, and meta-analyses consistently confirm that autism spectrum disorder is diagnosed significantly more frequently in males than in females, with ratios typically cited around 4:1, though researchers emphasize that diagnostic biases and female camouflaging contribute to under-recognition in women.
Every retrieved paper corroborates the well-established epidemiological finding that males are diagnosed with autism spectrum disorder more frequently than females, with several papers discussing the underlying reasons such as diagnostic tools, phenotypic differences, and underdiagnosis in females rather than disputing the prevalence disparity itself.
H. Young, M. Oreve, M. Speranza. Clinical characteristics and problems diagnosing autism spectrum disorder in girls.. 2018. https://doi.org/10.1016/j.arcped.2018.06.008
Paper [0] acknowledges the historical male-to-female ratio of four to one while discussing potential diagnostic and gender biases.
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Sara Cruz, Sabela Conde‐Pumpido Zubizarreta, A. Costa, Rita Araújo, Júlia Martinho, M. Tubío-Fungueiriño, A. Sampaio, Raquel Cruz, Á. Carracedo, M. Fernández‐Prieto. Is There a Bias Towards Males in the Diagnosis of Autism? A Systematic Review and Meta-Analysis. 2024. https://doi.org/10.1007/s11065-023-09630-2
Paper [1] confirms that autism is more frequently diagnosed in males through a systematic review and meta-analysis.
Rae Brickhill, Gray Atherton, A. Piovesan, Liam B. Cross. Autism, thy name is man: Exploring implicit and explicit gender bias in autism perceptions. 2023. https://doi.org/10.1371/journal.pone.0284013
Paper [2] notes that males are around three times more likely to possess an autism diagnosis than females.
C. Tseng, Camila Canales, Rachel E Marcus, Anjali Parmar, Baileigh G. Hightower, Jennifer E. Mullett, Meena M. Makary, Alison U. Tassone, H. Saro, P. Townsend, K. Birtwell, Lisa Nowinski, Robyn P Thom, Michelle L Palumbo, C. Keary, C. Catana, C. McDougle, Jacob M. Hooker, N. Zürcher. In vivo translocator protein in females with autism spectrum disorder: a pilot study. 2024. https://doi.org/10.1038/s41386-024-01859-6
Paper [4] states that sex-based differences in ASD prevalence are well-documented with an approximate 4:1 male-to-female ratio.
Zachary J Williams. Race and Sex Bias in the Autism Diagnostic Observation Schedule (ADOS-2) and Disparities in Autism Diagnoses. 2022. https://doi.org/10.1001/jamanetworkopen.2022.9503
Paper [5] utilizes a male-to-female ratio of approximately 4:1 in its discussion of diagnostic disparities.
Haoran Mao, Lulu Cheng, Yu Zhang, Fang Zhang. Gender Differences in Autism Spectrum Disorder: A Systematic Review of Diagnosis, Intervention, and Outcomes. 2024. https://doi.org/10.1515/gsgs-2024-0007
Paper [6] references the widely cited 4:1 male-to-female ASD diagnosis ratio while exploring underlying underdiagnosis in females.
Benjaporn Bhusri, S. Sutheeworapong, W. Kittichotirat, K. Kusonmano, Chinae Thammarongtham, Supatcha Lertampaiporn, P. Prommeenate, V. Praphanphoj, Wiranpat Kittitharaphan, Sudarat Dulsawat, Prasobsook Paenkaew, Supapon Cheevadhanarak. Characterization of gut microbiota on gender and age groups bias in Thai patients with autism spectrum disorder. 2025. https://doi.org/10.1038/s41598-025-86740-2
Paper [7] notes a higher ratio of males to females in the global prevalence of ASD.
Yuan Tian, Hui Qiao, KathrynAnn E. Odamah, Ling-Qiang Zhu, Hengye Man. Role of androgen receptors in sexually dimorphic phenotypes in UBE3A-dependent autism spectrum disorder. 2025. https://doi.org/10.1016/j.isci.2025.111868
Paper [8] highlights a remarkable sex difference in ASD with a 4:1 male-to-female prevalence ratio.
Yuan Tian, Hui Qiao, Ling-Qiang Zhu, Hengye Man. Sexually dimorphic phenotypes and the role of androgen receptors in UBE3A-dependent autism spectrum disorder. 2024. https://doi.org/10.1101/2024.05.02.592248
Paper [9] points to the well-known 4:1 male-to-female prevalence ratio in autism spectrum disorders.
Ana Muiño Tato. Systematic Review of Autism in Women: Invisibilised Profiles and Gender Bias. 2026. https://doi.org/10.31083/RN49367
Paper [10] identifies a pronounced sex disparity in autism diagnosis with ratios up to 4.6:1.
Lara S Schaeffer. The Urgency of Addressing the Underdiagnosis of Autism in Females. 2023. https://doi.org/10.37191/mapsci-jpn-1(1)-002
Paper [11] discusses the frequent oversight and underdiagnosis of autism in females, contributing to the observed diagnostic gap.
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