A ROMANTIC UNDERSTANDING:

EXPLORING THE LIVED EXPERIENCES OF BBIPOC WOMEN WITH AUTISM

SPECTRUM DISORDER

Dissertation presented to the Faculty of the

California School of Professional Psychology
Alliant International University
Los Angeles

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In partial fulfillment of the requirements for the degree of
Doctor of Psychology
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Amanda Crystal Robles Alonzo M.S.
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2023
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Approved by:
Nicole Gutierrez, PsyD, Chairperson
Rajeswari Natrajan-Tyagi, PhD
Dumayi Gutierrez, PhD
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Dedication
This is dedicated to my son James. Without you, this wouldn’t exist. You reminded me to

continue to follow my dreams and show the world that we belong in these spaces. I will never

forget that walk. I did this for you. I followed my dreams, thank you for that reminder.

James Quirino Robles: “But this is your dream, you can’t give up on your dream. You told me

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that people like us can do this.”

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Acknowledgements
Many people contributed to making this possible. I am forever grateful for my family.

My son who told me to never give up on my dream of getting my doctorate, who reminded me of

who I am and what I am capable of doing. To my husband who saw the strength in me and

continued to believe in me even when I struggled to believe in myself. To my baby brother who

helped hold me together and supported me daily to get me to the finish line. To my mother and

father who without their determination I wouldn’t even have had the opportunity or privilege to

attempt this journey. To my two sisters who continued to hold space for me even when I couldn’t

be as present throughout this journey, thank you.

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I would like to acknowledge and thank my entire dissertation committee. Thank you Dr.
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Rajeswari Natrajan-Tyagi and Dr. Dumayi Gutierrez for being a part of my committee and

seeing the importance of this research. I would like to especially acknowledge the role of my
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Committee Chair, Dr. Nicole Gutierrez. I am deeply grateful beyond words for the guidance,

patience, and most importantly the kindness she provided me throughout this process. Without
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that guidance I don’t think I would have made it to the finish line. The empathy and kindness

that my chairperson showed me throughout this process was so deeply appreciated more than

words can convey.

This journey has not been an easy one. I hope I can extend to others the love, kindness,

encouragement, guidance, and support that I received throughout my academic journey.

Temple Grandin: “I am different, not less.”

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Abstract

The purpose of this transcendental phenomenological study was to describe the experiences of

Black, Brown, Indigenous, or other Persons of Color (BBIPOC) adult women diagnosed with

autism spectrum disorder (ASD) in a romantic relationship. The theory guiding this study was

critical disability theory (CDT). The CDT model (Siebers, 2011; Sztobryn-Giercuszkiewicz,

2020), was suitable for this study since it aims to embrace people with disabilities instead of

viewing them as a weakness that must be fixed. BBIPOC women with ASD are a seldom-studied

population, and as such it is important to understand the lived experiences of these women in

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romantic relationships. Five themes emerged from the data analysis process: 1) Effects of ASD

on romantic relationships, 2) Effects of relationships on women with ASD, 3) Effects of ASD on

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other relationships, 4) Culture and ASD, and 5) Suggestions for Therapists. The findings of this

study showed that BBIPOC autistic women in romantic relationships are affected by their ASD
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and by gendered cultural and societal expectations for women in romantic relationships. This

study may contribute to the current research and shape practical application by providing
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understanding of how BBIPOC women with autism describe their experiences in romantic

relationships.
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Table of Contents:
Dedication ii
Acknowledgements iii
Abstract iv
List of Tables viii
List of Figures ix
CHAPTER I: Introduction 1
Statement of the Problem 6
Significance of the Study 7
Definition of Terms 7
Theoretical Framework 9

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Statement of the Researcher (Epoche) 11
CHAPTER II: Literature Review IE 15
Gender Differences 15
Late Diagnosis of Women with Autism 17
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Autism in a Relational Setting 20
Understanding Intimacy in Relationships 21
Understanding Communication and Social Cues 22
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Understanding Romantic Relationships 24

Loneliness and Social Relationships 25
Comorbid Mental Health Challenges 29
Cultural Differences in the Perception and/or Treatment of Autism 30
Culture, Disability, and Women 32
Critical Disability Theory and Autism 34
Summary 34
CHAPTER III: Methods Section 37
Research Question 38
Participants 38
Inclusion Criteria 38
Sampling Procedures/Recruitment 41
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Participant Demographics 42
Data Collection Procedures 43
Data Analysis Procedures 44
Credibility and Trustworthiness 47
CHAPTER IV: Results 49
Findings 52
Theme One: Effects of ASD on Romantic Relationships 53
Sub-Theme: Benefits of ASD on Romantic Relationships 53
Sub-Theme: Drawbacks of ASD on Romantic Relationships 54
Theme Two: Effects of Romantic Relationships on Women with ASD 54
Sub-Theme: Benefits of Romantic Relationships on Women with ASD 54

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Sub-Theme: Drawbacks of Romantic Relationships on Women with ASD 55
Theme Three: Effects of ASD on Other Relationships
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Theme Four: Culture and ASD 56
Sub-Theme: Cultural Expectations in Relationships and ASD 56
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Sub-Theme: Cultural Messages about ASD 57
Sub-Theme: Culture and ASD Proximity to Whiteness 57
Theme Five: Suggestions for Couples Therapists 58
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Summary of Themes 59
Research Question Responses 59
CHAPTER V: Conclusion 62
Summary of Findings 62
Implications of the Study 65
Theoretical 65
Research Implications 68
Clinical Implications 70
Limitations of the Study 72
Impact of the Study on the Researcher 72
Conclusion 73
References 75
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APPENDIX A. Informed Consent 88

APPENDIX B. Demographic Questionnaire 92
APPENDIX C. Semi-Structured Interview Questions 96
APPENDIX D. Recruitment Email 98
APPENDIX E. Recruitment Flyer 101
APPENDIX F. Sample Script for Screening Participants 103
APPENDIX G. Resources and Referrals 106

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List of tables
Table 1. Demographics 43

Table 2. Research Questions to Interview Questions 45

Table 3. Quotes Supporting Themes and Sub-Themes 46

Table 4. Themes and Subthemes Including Number of Participants (X/6) 52

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List of Figures
Figure 1. DSM-IV-TR Classification of Separate Disorders 4
Figure 2. DSM 5 Autism Spectrum Disorder and Social Communication Disorder 5

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Chapter I

Introduction

The diagnosis autism spectrum disorder (ASD) has gone through many changes over the

years, from a diagnostic perspective and a societal perspective. It is important to understand the

spectrum that encompasses autism not only from an individual viewpoint but also a systemic

one. By understanding how a person with autism relates and interacts with the world we can also

begin to help the world interact with autistic individuals. Understanding autistic individuals on a

systemic level can allow support structures to be implemented so they are able to not just

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survive, but fully thrive within their personal relationships and society. As with most groups

there are subgroups who are further marginalized, and the autistic community is no different.
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Women and girls with autism are diagnosed at an even lesser rate than men and boys, with males

being three times more likely to receive a diagnosis than females who are on the spectrum
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(Loomes et al., 2017). Girls and women of color are even less likely to receive an autism

diagnosis than their white counterparts. For example, according to Cutler et al. (2023), compared
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to non-Hispanic White residents in eight states in the United States, the prevalence of an autism

diagnosis was lower amongst non-Hispanic Black, Hispanic, Asian/Pacific Islander, and

American Indian/Alaska Native residents of these states. According to the same study the

prevalence of an autism diagnosis was also higher in boys in all eight US states (Cutler et al.,

2023) According to Roman-Urrestarazu et al. (2022), lower rates of occurrence of autism were

found in Asian, Black, and Chinese girls compared with White girls. Not receiving a diagnosis

translates to not being able to access resources that can be lifechanging for these females. The

disparity goes even further when we take race/ethnicity into consideration. In addition to gender

and race/ethnic disparities in diagnosis, resource provision, and research focus, the vast majority
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of studies on autism are conducted by neurotypical researchers who do not have ASD, which

may contribute to further “othering”, pathologizing, and stigmatization of people of all genders

with ASD.

There has been a substantial increase in people who were diagnosed with ASD, especially

between the years 2000 and 2014. Beginning in the year 2000, 1 in 150 children were diagnosed

with autism, a rate that had increased to 1 in 59 children by 2014 (Center for Disease Control,

2020). According to Baio et al. (2018), 1 in 54 children are now estimated to have ASD.

Currently one percent of the population is diagnosed with ASD (American Psychiatric

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Association, 2013). There is limited research on why there has been a recent increase in the

diagnosis of ASD, but there is much anecdotal speculation. While the increased prevalence has
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yet to be fully explained, there are four factors that are supported by empirical evidence:

diagnostic definition, diagnostic accretion and expansion, increased awareness of signs and
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symptoms of autism, and individual-level risk factors that have increased in frequency (Keyes et

al.,2011). The diagnostic definition for autism has expanded to include four other disorders
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(American Psychiatric Association, 2013). In regard to diagnostic accretion, the practices for

diagnosing autism have changed, and this change has led to over a quarter increase of the

diagnosis, specifically for those who may have previously been diagnosed with only mental

retardation (King & Bearman, 2009). Several environmental variables, including advanced

parental age, assisted reproductive technologies, dietary issues, maternal illnesses and disorders,

ambient pollutants and toxicants, medicines, and other circumstances, have been explored in

terms of ASD risk (Emberti Gialloreti et al., 2019). According to Keyes et al. (2011), some

research suggests that the primary causes of the rise in autism diagnoses include variables that

have increased linearly year over year, such as birth cohort composition and characteristics that
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affect people with higher levels of functioning more severely than people with lower levels of

functioning. (Keyes et al., 2011). More research needs to be done to understand why there has

been an overall increase of autism over the years but until then we are left with hypotheses and

educated guesses.

Autism Spectrum Disorder is categorized as a neurological disorder. According to the

American Psychiatric Association’s (2013) Diagnostic and Statistical Manual of Mental

Disorder’s (5th ed.; DSM-5) the essential characteristic of ASD is persistent impairment with

social communication and interaction. Additional characteristics include restricted and repetitive

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behavior, interests, or activities (American Psychiatric Association; APA, 2013). ASD symptoms

become present in early childhood and can either limit or impair everyday functioning (APA,
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2013). There has been changes to the diagnosis of ASD recently, which as previously mentioned

may be related to the increase in prevalence rates. The DSM-IV-TR (APA, 2021) definition of
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ASD was split up into five different categories: Autistic disorder, Asperger’s disorder, Rett’s

disorders, childhood degenerative disorder, and pervasive developmental disorder (PDD). The
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DSM-5 (APA, 2013) consolidated four of the disorders (Autistic Disorder, Asperger’s Disorder,

Childhood Degenerative Disorder, and Pervasive Developmental Disorder) into what we now

know as Autism Spectrum Disorder, and a new disorder called Social Communication Disorder

was added. Not only were the subtypes all condensed into one disorder, but certain aspects of

the diagnostic criteria changed. The DSM-5 changed the onset criteria and created a broader

definition of when symptoms are to be presented: in the DSM-IV, the age of onset was specified

to be before 36 months, whereas now it is stated more broadly to be in early childhood (Vivanti,

et al., 2013). This change may account for some of the increased prevalence. Another crucial

change that was made was the addition of repetitive behaviors, as this criterion is the defining
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difference between Social Communication Disorder and ASD (Vivanti, et al., 2013). Lastly,

another key difference between the DSM-IV and the DSM-5 is that if a child meets criteria for

other disorders, they can now be diagnosed with multiple disorders (Vivanti, et al., 2013). The

reason for the consolidation of multiple diagnoses into ASD was explained to improve the

understanding and the specifics of the criteria for the diagnosis of (American Psychiatric

Association, 2013). The changes made have left some confusion specifically with taking out

Asperger’s Syndrome and adding in Social Communication Disorder. There is a lack of

understanding what the changes mean and how to assist those who have the prior diagnosis what

their diagnosis is now. The changes in the DSM diagnosis that helped the autism community are

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the functioning labels. The functioning labels have made it easier to understanding the support
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needs that an autistic person may have. The focus transitions to low and high support needs as

opposed to the previous high/low functioning levels (see Figure 1 and 2).
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Figure 1

DSM-IV-TR Classification of Separate Disorders

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DSM-IV-TR

Autistic disorder

Asperger’s disorder

Rett’s disorders

childhood degenerative disorder

pervasive developmental disorder

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Figure 2
DSM 5 Autism Spectrum Disorder and Social Communication Disorder

DSM-5
Autism Spectrum Disorder: Persistent
impairment with social communication and
interaction; additional characteristics include
restricted and repetitive behavior, interests,
or activities.
Social Communication Disorder: Persistent
impairment with social communication and
interaction.

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It is important to note that the European classification system continues to utilize the
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diagnosis PDD, because a lack of consistency between usage of the ASD diagnosis and lack of a

cross national definition can have a detrimental effect on research pertaining to ASD (Vivanti, et
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al., 2013). Mental health providers and researchers have to be cognizant in new research

regarding ASD as across the globe the diagnosis for ASD is not entirely agreed upon. Apart
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from medical and research implications in combining diagnoses, there are also cultural

implications to consider when seeking to understand the autistic community. For example, while

the DSM may have eliminated Asperger’s as a distinct diagnosis, according to Vivanti, et al.

(2013), many people with Asperger’s consider themselves as part of a community with their own

“Aspie” culture as opposed to having a disability, and very much continue to identify with the

term. Therefore, it is important to separate the medical diagnosis from the cultural or personal

identity of individuals in this community. There are many different factors to take into

consideration when understanding ASD and the changes made by the DSM-5.
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Statement of the Problem

As noted previously,1 in 54 children are currently estimated to have ASD (Baio et al.,

2018; Maenner et al., 2020), and ASD is diagnosed more than four times as frequently in boys as

it is in girls (American Psychiatric Association, 2021). There is no general consensus in the field

as to precisely why these gender differences in prevalence rates exist (Loomes et al., 2017). For

example, these prevalence rates could be related to a variety of factors, including differences in

gender socialization and gender role expectations, different presentations of traits in males vs.

females, as well as biases amongst clinicians who are assessing for and/or administering mental

health diagnoses, and lack of understanding of the etiology of the disorder. While there is an

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abundance of research on autism, most of the research is on children and males; there is less
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research on adults with autism, and little research that focuses specifically on adult females who

have been diagnosed with ASD (Cridland et al., 2013). There is also not a lot of research that
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explores cultural differences in perceptions of autism (Freeth et al., 2014; Maenner et al., 2020;

Matson et al., 2017; Tek & Landa, 2012) and even fewer studies that focus on the intersection of

gender and culture in the presentation of and relational implications of ASD. The problem is that
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little is known about Black, Brown, Indigenous, or other Persons of Color (BBIPOC) adult

women with autism in general and even less so in regard to how the experience of autism affects

the relationships of these women.

The present qualitative phenomenological study seeks to understand the lived experiences

of adult BBIPOC women with autism, and the relational and cultural implications of their

diagnosis. The central research question is What are the lived experiences of adult BBIPOC

women with autism spectrum disorder in romantic relationships? Sub-questions include: 1) How

does having ASD affect adult BBIPOC women’s romantic relationships?, 2) How do the
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romantic relationships of adult BBIPOC women with ASD affect their experience of ASD?, and

3) How do culture and cultural gender role expectations affect the experience of ASD in adult

BBIPOC women in romantic relationships?

Significance of the Study

This research may contribute to the present body of knowledge on ASD in that it can

provide BBIPOC adult women diagnosed with autism an opportunity to describe their

experiences with autism in the context of their culture and their relationships. There is a need to

better understand the experiences of women with autism in order to better serve this population

in clinical practice (Bargiela et al., 2016). The present study hoped to illuminate a new

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dimension of how BBIPOC women with autism experience relationships: it can provide insight
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on how being autistic impacts their romantic relationships and how their relationships impact

their coping with the diagnosis. Significant others, family members, and friends of those with
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autism may benefit from this research as the study may provide them better insight into how to

support their loved ones with autism. The study may also benefit those in the mental health field

by providing information to assist clinicians and other healthcare providers in better supporting
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their clients who are experiencing relational issues from a more culturally aware perspective.

Definition of Terms

There are many important terms that are specific to ASD research and/or the ASD

cultural community. It is important from a clinical perspective to use the preferred language of

the client. For the purpose of research, the terms that are most widely understood either in the

literature or in the ASD community will be used throughout. For example, some people in the

community prefer to use person first language, such as a person with autism, whereas other

people in the community find this to be an ableist denial of an important aspect of who they are.
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These people prefer to use the language Autistic, or, on the spectrum. Throughout this

manuscript both person first and diagnosis first language will be used in order to honor the

diversity of preference within the autism community. Other important terms that are essential for

understanding the central phenomenon will be defined here.

Autism Spectrum Disorder (ASD) - According to the American Psychiatric Association’s (APA;

2013) Diagnostic and Statistical Manual of Mental Disorder’s (5th ed.; DSM-5), autism spectrum

disorder is a neurological disorder, characterized by having chronic difficulty in social

communication and social interaction as well as limited, repetitive patterns of behavior, interests,

or activities.

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Asperger’s Syndrome (AS) – The DSM-IV defined Asperger’s Disorder as a manifestation of a
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Pervasive Developmental Disorder (PDD) (Attwood, 2015). A person who would have been

previously diagnosed with Asperger’s Syndrome would now be classified as autism spectrum
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disorder (ASD) without language or cognitive impairment. The key features of Asperger’s

Syndrome are deficits in social comprehension, including difficulty establishing and keeping

friends, detection of social and emotional signals, emotional understanding and control, and
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capacity to recognize others' thoughts and feelings (Attwood, 2006). Communication and

conversational difficulties, as well as the person's proclivity to create areas of expertise and

specific interests, are also identified as features of AS (Attwood, 2006).

High functioning autism – High functioning autism is not and was never a diagnosis. It is a term

used to describe individuals diagnosed autism that have typical intellectual abilities/no cognitive

impairments, which is now known as level one autism spectrum disorder (Ghaziuddin &

Mountain-Kimchi, 2004). High functioning autism also is sometimes used synonymously with

Asperger’s Syndrome (Attwood, 2015).

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Neurodiversity – A group of people who are considered to have a wide variety of different

neurological capabilities and presentations (Kathleen & Zimmerman, 2020). Neurodiversity is

thought to be an inclusive, depathologizing perspective on the broad range of neurocognitive

experiences in the general population.

Neurotypical – Those without cognitive deficiencies or neurocognitive challenges. Those

described as cognitively typical (Kathleen & Zimmerman, 2020).

Neurodivergence - Any biological or trauma-induced disorder that shows variations in cognitive

function, processing, sensory processing, or stimulus response as compared to the cognitively

normative (or neurotypical) demographic is known as neurodivergence (Kathleen &

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Zimmerman, 2020).
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Camouflaging- Strategies for helping people with autism adjust to social situations and conceal

characteristics that may stand out to people without autism (Milner et al., 2022).
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Masking- The suppression of autistic behaviors, such as refraining from lengthy conversation on

a given subject or mastering the art of looking someone between the eyes to simulate eye contact

(Milner et al., 2022).

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Theoretical Framework

The conceptualization of this study was influenced by Critical disability theory (CDT),

which is a contemporary theoretical framework for studying and analyzing disability issues.

Disability studies is a multidisciplinary field of social and political research that straddles

disciplines including sociology, social policy, political science, literary theory, history, and

philosophy (Mladenov, 2014). Critical Disability Theory states that in research and in practice

one should consider ableist societal norms that permeate all systems of interaction, and how

these norms can privilege able bodied and neurotypical people and disenfranchise cognitively or
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physically disabled people (Sztobryn-Giercuszkiewicz, 2020). When addressing disabilities in

research and clinical practice, the researcher and/or clinician should directly address the

discourses that marginalize disabled people. For example, clinicians who are not aware of their

ableist biases may not assess sexual satisfaction in clients who are disabled because it does not

occur to them that disabled people have active sex lives just like their able-bodied clients do.

Similarly, able bodied and neurotypical researchers may approach research on disabled

communities from the lens that intervention is needed within these communities to support them

in assimilating to ableist expectations of functionality rather than considering ways in which the

privileged groups can better accommodate, normalize, and represent physical disabilities and

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neurodiversity. There are three intertwined goals of Critical Disability Theory (Siebers, 2011).
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First, it seeks to include ability/disability as an interesting factor of diversity in conversations

about critical and cultural theory. Secondly, it seeks to directly acknowledge the disabled body
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which allows for representation and challenges ableist discomfort around disability. The third

goal is to have disability be conceptualized in the literature as a minority identity with unique

qualities that can contribute to the progress of minority studies as a whole (Siebers, 2011).
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In extending CDT to autism specifically, we are expanding the concept of observable

disabilities (which are more often physical disabilities) to the less visible or even invisible

neurocognitive disabilities. The hope in conceptualizing autism from the perspective of CDT is

that it will help challenge misconceptions about those who are on the spectrum from a deficit

driven worldview (Glynne-Owen, 2010). CDT accepts diversity in all aspects, including ability,

as a natural occurrence that should be appreciated and respected, rather than seeing disabilities as

undesirable qualities to be eradicated (Siebers, 2011). Despite the fact that autism is

a neurological disorder, few researchers have employed CDT as a theoretical framework for
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understanding people with ASD (APA, 2013). The present study sought to assist in filling that

gap. In 2010 critical autism studies emerged out of CDT to address the need to reframe

commonly held, deficit-based conceptions of ASD (O’Dell et al., 2016). Instead of

concentrating on the impairments associated with autism, CDT embraces the neurodiversity of

autism as a sequence of strengths rather than weaknesses (O’dell et al., 2016). From a CDT lens

late diagnosis can lead to increased systemic inequities experienced as a result of not having

access to resources and accommodations that become available upon diagnosis. Late diagnosis

may also be the result of ableist gender biases about ASD symptoms in girls and women, which

can put undue pressure on these BBIPOC girls and women to develop strengths and resilience

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out of a need to cope with the world around them that is not adjusted to accommodate them.
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Reviewing CDT has impacted my worldview regarding all abilities but has especially influenced

the way that I conceptualize autism in both personal relationships and clinical practice. The
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present study was informed by CDT in that it seeks to depathologize and destigmatize the adult

woman with autism and aims give a platform for participants to talk about their lived experiences

in relationships (what is helpful, what is not so helpful).

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Statement of the Researcher (Epoche)

This research will be conducted with the hopes of gaining a deeper understanding of how

women with autism experience romantic relationships. As a Latina woman with autism raising a

Latino son with autism, I have always wondered about the experiences of other women with

autism in their relational settings. Through raising my son, I have gained an in-depth crash

course on how autism can affect a family system from the perspective of the parent. With my

own late diagnosis of autism, I came to understand my own struggles and the effect autism has

had on my family system and romantic relationships from the perspective of the person on the
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spectrum. It is important to also address the intersection of my Latina ethnicity and my diagnosis

of autism because that adds a layer onto my lived experiences with the diagnosis. When I was

first diagnosed as an adult and was searching for information to help me learn about my own

neurodiversity, I was keenly aware that much of the information I came across was directed

toward parents of children on the spectrum (rather than adults on the spectrum themselves), or it

was largely derived from the experiences of males with autism, and/or the information came

from a cis gendered white male perspective. Most of the information I initially encountered on

autism did not represent me or my experiences as an adult Latina woman. This lack of

information of what autism looks like in BBIPOC females is why I suspect my diagnosis went

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unnoticed for so long. My mom had concerns for me at a very young age but they were
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dismissed due to oldwives tales in my culture and a lack of being able to have access to doctors.

Due to my lack of speech my mom thought I was deaf until the age of 4. I was put in speech
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classes in school because even the school recognized I was delayed but it was dismissed as

anything other than the school thinking English was my second language (even though they were

informed it wasn’t). Being a quite Latina female growing up wasn’t viewed as abnormal, even
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into adulthood those same stereo types persisted. In basic training my sergeant made me and

another Latina stand in front of our unit and pointed out how ‘Latina’s struggle with eye contact

and speaking up’, in the military eye contact and a loud commanding voice were essential. These

are just a few of my experiences that I believe attributed to being undiagnosed until adulthood. It

wasn’t until my son was diagnosed that my family system even knew about and understood what

autism was.

I am currently a licensed marriage and family therapist with my own private practice, and

I work with adults who are on the spectrum. Through this clinical work, my interest in autism
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research has deepened even more. Through my work with my adult clients who are autistic, I

have seen the struggles my clients have had when attempting to gain support from their

significant others. I have witnessed their stories and their challenges and have often wondered if

the struggles for women with autism are always so similar; it seemed like there were many

similarities in the stories that I heard, but all I had to go off of were anecdotes. Hearing the

stories of my clients is what motivated me to conduct this research, and I felt as though it would

be important to contribute to the field of autism research specifically as a woman of color who is

actually on the spectrum.

While my own experiences give me insight regarding the experience of a woman on the

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spectrum, I am aware of how my own biases may impact the way I conduct this research. For
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example, my own experiences with masking in romantic relationships has shaped the way I

communicate my emotions in my present relationship. I might assume that all of my participants

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are able to mask or masked in the same manner as me. Also, my experiences within my own

culture and late diagnosis, such as my symptoms of autism being dismissed as old wives’ tales

can also lead me to assume all BBIPOC women experienced cultural challenged in a similar
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regard. Another instance would be because I struggled to cope with my diagnosis, I may also

assume that others struggled to cope with their own diagnosis.

I must be careful of any projections or countertransference that may occur toward my

participants. One way that I will deal with this issue will be to constantly and consistently check

in with myself through a reflexive journaling process. I did so throughout the proposal process of

this study and continued to evaluate my self-of-the-researcher experiences and potential biases

with my dissertation chair throughout the data collection and analysis stages as well. I answered

my interview questions in a reflection process with my chair in order to further bracket out my
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biases and identify my assumptions about the phenomenon, this research is important to me on

multiple levels, and I believe that qualitative research conducted by those who are members of

the community that experience the phenomenon in question can add an incredible amount of

value to the research. My hope is that this study will potentially benefit the lives of those living

with autism, and that it will add representation of diverse voices in autism research.

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CHAPTER II

Literature Review

There is a breadth of research on ASD that largely focuses on prevalence and treatment

of the diagnosis. The treatment of autism typically focuses on assisting autistic people in

assimilating their behavior to fit the dominant neurotypical cultural norms. Because the

phenomenon of interest for this study was the cultural and relational experiences of BBIPOC

autistic women from a Critical Disability Theory perspective, the literature review will focus

mostly on research that has attended to gender, culture, and relational impacts of the diagnosis,

rather than intervention. A more in-depth application of CDT as it applies to autism research will

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also be included.

Gender Differences
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We know that more people are becoming aware of what autism is and are seeking
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services as a result (Keyes et al., 2011). We know that there is a racial gap that continues to

persist amongst ASD diagnosis (Cutler et al., 2023). There also continues to be a gender gap, as
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a diagnosis of ASD is three to four times more common amongst boys than girls (APA, 2013;

Baio et al., 2018). Studies on women and girls with a diagnosis of autism are extremely limited.

The reason for limited research may be due to girls being diagnosed less frequently than their

male counterparts, and as such sex/gender-related differences in functioning or clinical

presentation is difficult to research. The last twenty years of autism research does, however,

show a slight decrease in male predominance (Cridland et al., 2013). According to the DSM-5

(APA, 2013) in clinical samples, females diagnosed with ASD are more likely to have an

intellectual disability, which suggests that females who are diagnosed tend to be on the higher

end of the severity spectrum. Females without an intellectual disability or language delay may go

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