Name: 自閉症為何常被婦女和女孩忽視 | Kate Kahle | TED (Why Autism Is Often Missed in Women and Girls | Kate Kahle | TED)
Uploaded: 2025-03-30T21:06:12.000Z
Duration: 13 min 17 s

As a young woman, I've had some pretty cool opportunities.

作為一名年輕女性，我曾有過一些很酷的機會。

One that I'm most proud of is having my art displayed at the DMA before I turned 17.

我最引以為豪的一件事是，在我 17 歲之前，我的藝術作品就在 DMA 展出了。

副詞型分詞構句

When I was in the auditorium with all the other young artists being honored for our achievements, I couldn't think of how proud I was of myself.

當我和其他年輕藝術家一起在禮堂裡接受表彰時，我不禁為自己感到驕傲。

All I could think about was the velvet upholstery of the chairs touching the back of my arms and legs.

我滿腦子想的都是天鵝絨椅背觸碰我的胳膊和腿的感覺。

For me, the sensation of touching velvet is unbearable.

對我來說，觸摸天鵝絨的感覺是無法忍受的。

You may be thinking, I don't like certain textures either, but there's more to this story you need to know.

你可能會想，我也不喜歡某些紋理，但你需要知道的故事還不止這些。

I'm Kate Kale, I'm 20 years old, and I'm autistic.

我叫凱特-凱萊，今年 20 歲，患有自閉症。

When I was a freshman in high school, my family noticed that I was having difficulty connecting with my peers.

在我讀高一的時候，家人發現我很難和同學們打成一片。

I had also developed severe anxiety and it showed up in unexpected ways.

我還患上了嚴重的焦慮症，並以意想不到的方式表現出來。

I had always had autistic traits and struggles, but I just thought I was weird.

我一直有自閉症的特徵和掙扎，但我只是覺得自己很奇怪。

My parents took me in for an evaluation where we learned I was autistic.

我的父母帶我做了評估，得知我患有自閉症。

We were all shocked because I'm not what people would typically think of as an autistic person.

我們都很震驚，因為我不是人們通常認為的自閉症患者。

Autism is diagnosed when social expectations for neurotypical behavior begin to outweigh the person's ability to perform those behaviors.

當社會對神經典型行為的期望開始超過患者的行為能力時，就可以診斷為自閉症。

Autism Spectrum Disorder, or ASD, is a lifelong developmental disability that can cause deficits in communication, social interaction, emotional awareness, and it can cause sensory issues among other symptoms.

自閉症譜系障礙（ASD）是一種終身發育障礙，可導致溝通、社會交往、情感意識等方面的缺陷，並可引起感官問題和其他症狀。

The reason it's lifelong is that autism is not a disease and it can't be cured.

之所以是終身制，是因為自閉症不是一種疾病，也無法治癒。

It's a neurodivergency, which means that the autistic brain works differently than the No one is sure why some people have autism.

這是一種神經畸形，也就是說，自閉症患者大腦的工作方式與正常人不同。 沒有人知道為什麼有些人會患上自閉症。

One of the criteria for diagnosis is that symptoms must be present from birth or early childhood, which means that it's not caused by poor diet, bad parenting, vaccinations, and it's not contagious.

診斷標準之一是症狀必須從出生或幼兒期就出現，這意味著它不是由不良飲食習慣、不良養育方式、疫苗接種引起的，也不會傳染。

Evidence has shown that autism can be passed down genetically, which means it may run in  I found that a lot of neurotypical people and even some autistic people struggle with the concept of the autism spectrum.

有證據表明，自閉症可能會遺傳，這意味著它可能會遺傳給下一代。我發現，很多神經質的人，甚至一些自閉症患者都很難理解自閉症譜系的概念。

This is partially because I think it's poorly named, but also partly because the way that experts and researchers think about autism is changing all the time as they do more research.

這一方面是因為我認為自閉症的名稱不恰當，另一方面也是因為隨著研究的深入，專家和研究人員對自閉症的看法也在不斷變化。

In the past, autism had three categories, mild, moderate, and severe.

過去，自閉症分為輕度、中度和重度三類。

Later, it was thought of more as a continuum like this, from high-functioning to low-functioning, with high-functioning also being called Asperger's syndrome.

後來，人們更多地將其視為這樣一個連續體，從高功能到低功能，高功能也被稱為阿斯伯格綜合症。

You may think that as long as a person experiences the same symptoms, what you call their disorder doesn't matter.

您可能會認為，只要一個人有相同的症狀，您怎麼稱呼他的失調症並不重要。

Here's why I don't prefer the term Asperger's syndrome.

這就是我不喜歡阿斯伯格綜合症這個詞的原因。

Hans Asperger was a medical doctor and early researcher on autistic kids who he called autistic psychopaths.

漢斯-阿斯佩爾格爾（Hans Asperger）是一位醫學博士，也是早期研究自閉症兒童的專家，他將自閉症兒童稱為自閉症精神病患者。

He believed in eugenics and sent many of the kids he worked with to the Third Reich's child euthanasia and sterilization programs.

他信奉優生學，並將許多與他共事的孩子送往第三帝國的兒童安樂死和絕育項目。

While not the Nazis' main targets, autistic people were considered a threat to the Third Reich goal of a genetically pure society.

雖然自閉症患者不是納粹的主要目標，但他們被認為是對第三帝國建立純種社會目標的威脅。

When people use the term Asperger's syndrome, they're unknowingly reinforcing the idea that autistic people have no value to society.

當人們使用 "阿斯伯格綜合症 "這個詞時，他們在不知不覺中強化了 "自閉症患者對社會沒有價值 "的觀念。

This is why I prefer my disorder be referred to as autism spectrum disorder or autism instead of Asperger's syndrome.

這就是為什麼我更願意把我的病症稱為自閉症譜系障礙或自閉症，而不是阿斯伯格綜合症。

Nowadays, the spectrum is thought of more like this.

如今，人們對光譜的看法更像這樣。

This shows some of the struggles that autistic people can have and the varying degrees to which each person can struggle with those particular issues.

這說明了自閉症患者可能會遇到的一些困難，以及每個人與這些特殊問題鬥爭的不同程度。

Autism can have many symptoms and they vary widely from person to person.

自閉症有很多症狀，而且因人而異。

Some symptoms you might think of when you think of autism are struggling to make eye contact, poor communication, sensory issues, and obsessing over special interests.

說到自閉症，您可能會想到一些症狀，如目光接觸困難、溝通不暢、感官問題和對特殊興趣的痴迷。

But there are also a lot of other symptoms you might never have thought of before, like heightened emotions, making too much eye contact, or high effective empathy.

但還有很多其他症狀你可能從未想到過，比如情緒高漲、眼神交流過多或有效移情。

A lot of these less commonly thought of symptoms are more common in women and girls with autism.

很多這些不常見的症狀在患有自閉症的女性和女孩中更為常見。

Here, you can see a spectrum that I filled out to reflect my experiences.

在這裡，你可以看到我填寫的反映我的經歷的光譜。

As you can see, I have lots of sensory issues with textures and sounds.

如您所見，我在質地和聲音方面有很多感官問題。

I focus a lot on my special interests and I have high effective empathy which allows me to easily communicate with others.

我非常關注自己的特殊興趣，而且我有很強的同理心，這讓我很容易與他人溝通。

After the initial shock of my diagnosis, it began to make a lot of sense.

診斷結果讓我最初感到震驚，之後我開始明白了很多道理。

I finally realized why I had struggled to pick up on other people's negative emotions like when they're sad or frustrated.

我終於明白，為什麼我一直難以捕捉到別人的負面情緒，比如他們悲傷或沮喪的時候。

This affected my relationships for the first 15 years of my life.

這影響了我生命中最初 15 年的人際關係。

I'm very grateful for my diagnosis because it allowed me to understand and accept myself and I was very lucky to get it.

我非常感謝我的診斷，因為它讓我瞭解並接受了自己，我很幸運能得到它。

For every four boys diagnosed with autism, only one girl is diagnosed.

每四個被診斷患有自閉症的男孩中，只有一個女孩被診斷患有自閉症。

Studies that have followed children since birth show that the natural ratio of males to females with autism is closer to three to one.

對兒童出生後的跟蹤研究表明，自閉症患者的男女自然比例接近三比一。

The discrepancy between this diagnostic rate and the actual rate of autism between males is likely due to the way autism has been defined and studied and the tests used to diagnose it.

這一診斷率與男性自閉症實際發病率之間的差異很可能是由於自閉症的定義和研究方式以及用於診斷自閉症的測試所致。

The tests used to diagnose autism are still based on studies done on white autistic boys which likely leads to lower and misdiagnosis in women.

用於診斷自閉症的測試仍以對白人自閉症男孩的研究為基礎，這很可能導致對女性的診斷率降低和誤診。

I would like to add that this is not only an issue for women but also minorities.

我想補充的是，這不僅是婦女的問題，也是少數民族的問題。

White children are 19% more likely than black children and 65% more likely than Hispanic children to receive an autism diagnosis.

白人兒童接受自閉症診斷的機率比黑人兒童高 19%，比西班牙裔兒童高 65%。

Males who outwardly display mild symptoms of autism are diagnosed on average two years earlier than women who display similar symptoms.

表現出輕微自閉症症狀的男性比表現出類似症狀的女性平均早兩年被診斷出來。

This might be because female special interests are generally more socially accepted than male special interests.

這可能是因為女性的特殊利益通常比男性的特殊利益更容易被社會接受。

When non-autistic people think about autism special interests, the thing that usually comes to mind is trains.

當非自閉症患者想到自閉症的特殊興趣時，通常會想到火車。

When I was a kid, my special interest was in insects.

小時候，我對昆蟲特別感興趣。

The people in my life saw this as just a healthy interest in the sciences and it was never really flagged as an autistic trait.

在我生活中的人看來，這只是一種對科學的健康興趣，從來沒有人把它當作自閉症的特徵。

While my special interests were an autistic trait that was largely ignored, my other autistic traits were hidden because I was skilled at masking them.

我的特殊興趣是一種自閉症特質，但這種特質在很大程度上被忽視了，而我的其他自閉症特質則被隱藏了起來，因為我善於掩蓋它們。

Masking is a behavior by which autistic people try to camouflage and seem like they're not autistic.

掩飾是自閉症患者試圖偽裝的一種行為，讓人覺得他們不是自閉症患者。

Hearing this for the first time, neurotypical people might think that autistic people are insecure or manipulative for trying to hide our symptoms.

第一次聽到這種說法的神經正常人可能會認為，自閉症患者試圖隱藏我們的症狀，是缺乏安全感或操縱他人。

The real reason an autistic person would mask is because of a natural human desire to fit in, connect with others, and achieve social and professional success.

自閉症患者會戴面具的真正原因，是人類天生渴望融入社會、與他人建立聯繫，並在社交和職業上取得成功。

Masking behaviors can include forcing eye contact, mimicking others' behaviors, expressions, and gestures, and even memorizing scripts for small talk and common conversations.

掩飾行為包括強迫眼神接觸，模仿他人的行為、表情和手勢，甚至背誦閒聊和普通對話的腳本。

Some people are more skilled at masking than others.

I'm really good at masking and people tell me that all the time whether they know it or not.

我真的很擅長蒙面，人們總是這樣告訴我，不管他們知道與否。

When someone says to me that they never would have known I was autistic if I hadn't told them, or even that I don't seem autistic, what they're really telling me is that I'm good at masking.

當有人對我說，如果我不告訴他們，他們永遠不會知道我是自閉症患者，或者甚至說我看起來不像自閉症患者時，他們真正想告訴我的是，我善於掩飾。

A lot of people see this as a really positive thing.

很多人都認為這是一件非常積極的事情。

It's something that allows me to live a normal life.

And while it's true that some things can be easier when people can't tell you're autistic, it's impossible for a person with ASD to not be heavily affected by it.

雖然當人們看不出你是自閉症患者時，有些事情確實會變得容易些，但自閉症患者不可能不受自閉症的嚴重影響。

It colors the way we think, interact with others, and see the world throughout our life.

它影響著我們一生的思維方式、與人交往的方式和看待世界的方式。

This isn't something that can be turned off with masking.

It simply gets pushed down to a level below that at which other people can see it.

它只是被壓低到低於其他人能看到的水準。

This pushing down of our true self takes a lot of work.

這種壓抑真實自我的做法需要付出很多努力。

When you're having a conversation with somebody, you're doing a lot of things at once.

當你與人交談時，你會同時做很多事情。

You have the correct posture, the right distance away from them, you're using the right facial expressions, you're modulating your tone, you might be gesturing, you're making the right amount of eye contact.

你要有正確的姿勢，與他們保持適當的距離，使用正確的面部表情，調節你的語調，你可能會做手勢，進行適量的眼神交流。

You're not not looking them in the eyes, but you're not looking them in the eyes so much that it's creepy.

你不是不看他們的眼睛，但也不是看他們的眼睛多到讓人毛骨悚然。

And you're predicting what the other person is going to say and do next.

你在預測對方接下來會說什麼、做什麼。

For neurotypical people, all of these things come naturally.

對於神經正常的人來說，所有這些事情都是自然而然的。

You guys don't even have to think about them.

But for me, I have to think about all of those things at once.

但對我來說，我必須同時考慮所有這些事情。

Over the years, I've learned how to juggle all of these things.

多年來，我學會了如何兼顧所有這些事情。

But it's a Herculean task, and for some, its complexity makes it impossible.

但這是一項艱鉅的任務，對於某些人來說，它的複雜性讓他們無法完成。

The difficulty of masking can often lead to secondary mental health challenges.

難以掩飾往往會導致繼發性心理健康問題。

Depression can stem from working so hard and still not being accepted, while anxiety can come from the stress of having to mask for a good portion of the day every single day for a good portion of your life or risk being discriminated against and ostracized.

抑鬱可能源於努力工作卻仍不被接受，而焦慮則可能源於一生中每天都有相當多的時間必須戴面具，否則就有可能受到歧視和排斥。

These secondary mental health challenges are a particular issue for women and girls. 34% of women with autism have depression, and 36% have anxiety.

對於婦女和女孩來說，這些繼發性心理健康挑戰是一個特殊的問題。34% 的自閉症女性患有抑鬱症，36% 患有焦慮症。

While these secondary mental health challenges are a big issue, the biggest problem masking causes for autistic people is late and missed diagnoses.

雖然這些繼發性心理健康挑戰是個大問題，但掩蓋自閉症患者病因的最大問題是診斷過遲和漏診。

If someone is really good at masking, they may never be diagnosed at all.

如果有人非常善於掩飾，他們可能根本不會被診斷出來。

Men and children are the groups seen to be least skilled at masking, and they're also the groups diagnosed with autism spectrum disorder most often.

男性和兒童是最不擅長掩飾的群體，也是最常被診斷出患有自閉症譜系障礙的群體。

Case studies show that women are more skilled at masking, and this is likely a huge factor that contributes to their late and missed diagnoses.

病例研究表明，女性更善於掩飾，這很可能是導致其診斷晚期和漏診的一個重要因素。

The earlier a person is diagnosed with autism, the earlier they can receive specialized care and treatment that can help them in almost every aspect of their life.

自閉症患者越早確診，就能越早接受專業護理和治療，這對他們生活的方方面面幾乎都有幫助。

Care for autistic people gets better all the time as more research is done, but unfortunately, it's rare to find a therapist or other people who assist autistic people that recognize the extra challenges that come with being a woman.

隨著研究的不斷深入，對自閉症患者的照顧也越來越好，但遺憾的是，很少有治療師或其他幫助自閉症患者的人能夠認識到女性所面臨的額外挑戰。

When you struggle socially as a female, learning to succeed socially as a male just isn't enough.

當你作為女性在社交中掙扎時，僅僅學習作為男性在社交中取得成功是遠遠不夠的。

Womanhood is a unique and challenging experience all its own.

女人是一種獨特而又充滿挑戰的經歷。

The rules of female friendship, how to talk about romance, menstruation, and even how to stay safe from sexual predators are all obstacles that autistic women face but do not receive support for.

女性交友規則、如何談戀愛、月經，甚至如何遠離性侵犯者，這些都是自閉症女性面臨的障礙，但卻得不到支持。

While it's tempting in our society to say that gender is something small, obsolete, or insignificant, the truth is gender does matter, and when it comes to autism, it matters a lot.

雖然我們的社會很容易說性別是渺小的、過時的或無足輕重的東西，但事實是性別確實很重要，而且在自閉症方面，它非常重要。

The difference comes in with the vast disconnect between the lived experiences of men and women.

男女生活經歷的巨大差異就在於此。

All autistic people are born autistic, but from birth, girls are thrust into a more socially rigorous environment that increases the pressure to mask and the challenges an autistic person faces daily.

所有自閉症患者都是天生的自閉症患者，但女孩從一出生就被推入一個更加嚴格的社會環境，這增加了自閉症患者的面具壓力和每天面臨的挑戰。

For any autistic person, but especially women and girls, the part of their autism you can see is not what that person is actually experiencing.

對於任何自閉症患者，尤其是女性和女孩，你能看到的自閉症部分並不是他們的真實經歷。

It's impossible for someone with a limited outside perspective to label someone else's autism, be that labeled mild, moderate, Asperger's, high-functioning, or any other label.

一個外部視角有限的人不可能給別人的自閉症貼上標籤，無論是輕度、中度、阿斯伯格、高功能還是其他標籤。

You can see me up here right now talking to you and try to label me to differentiate me in your mind from another autistic person you may have met, such as maybe a little boy having a sensory meltdown in the mall.

你可以看到我現在在這裡和你說話，並試圖給我貼上標籤，在你的腦海中把我和你可能遇到過的其他自閉症患者區分開來，比如可能是一個在商場裡感官崩潰的小男孩。

You can try to label me in your mind to differentiate us, but the feelings that we're having on each other are so much more similar than you would think.

你可以在心裡給我貼上標籤，把我們區分開來，但我們對彼此的感覺比你想象的要相似得多。

I've just learned to mask them after years of pressure and practice.

經過多年的壓力和練習，我才學會了掩蓋它們。