“I Thought About Whether My Answers Represent What I Am Like”: Hong Kong Autistic Females’ Perspectives on Autism Spectrum Quotient (AQ)

Abstract

One argument for the more frequent diagnosis of autism in males than females is the gender bias inherent in understanding and identifying autism. Despite the widespread use of standardized autism assessment tools, their relevance to the experience and needs of autistic females is rarely examined. There is also scant research focusing on the cultural responsiveness of these tools in non-Western contexts. In this study, we interviewed 13 autistic females in Hong Kong were interviewed about their experience with completing the Autism Spectrum Quotient (AQ) and interpreting the items. Results from thematic analysis revealed participants resisted the stereotypical definitions of autism depicted by the assessment tool. They elaborated on how the neurotypical world contributed to their challenges. They attempted to adjust their behaviors or even hide their autistic self to adapt to the expectations of the neurotypical society. The AQ was critiqued for its contents, translation, and administration formats. This study has implications for better understanding and meaningfully representing diverse presentations of autism in both research and clinical practice. Autism assessment tools should be improved and tailored to meet the specific needs of different genders and cultural subgroups.