Bloomwave Practice

Tag: Identity

  • Gender differences in autism

    Gender differences in autism

    If you’ve been on social media lately, you may have come across more and more people talking about autism and how it affects them.

    Autism spectrum disorder is a neurodevelopmental condition (meaning it starts in childhood) that affects how people communicate and socialize with each other and how they perceive and interact with the world around them.

    Traditionally, autism has been defined by:

    • Difficulties in social interaction and sharing emotions (such as missing social cues or trouble relating to peers)
    • Challenges with nonverbal communication (including facial expressions and eye contact)
    • Restricted or repetitive behaviors or interests (the so-called special interests)

    This is what we often think of when we hear the word autism. And if I asked you to imagine an autistic person, how many of you would imagine them to be male?

    Autism exists on a spectrum, meaning it can look very different from one person to another. More severe cases are usually diagnosed early, while those on the milder end of the spectrum might be missed by the healthcare system. What’s more, it can look very different in women than in men, and it is diagnosed about 4 times as often in males then in females.

    However, many researchers believe the disorder is not actually more common in men, it’s just that the its female presentation is different, and therefore under-diagnosed.

    This post aims to explore the reasons behind this, and ends with what you can do if you suspect you might have autism.

    Genuine gender differences

    First, let’s take a look at reasons why autism may actually be less common in women. These reasons are still being studied, but several hypotheses exist:

    1. Biology and genetics – The ‘Female Protective Effect’ theory posits that women may require a higher level of genetic risk for autistic traits to be expressed.
    2. Hormonal differences – Some research links prenatal testosterone levels to autistic traits. This has led to the theory that autism may represent an “extreme” version of certain cognitive patterns more commonly associated with males.
    3. Brain connectivity differences – There is also evidence that differences in brain connectivity patterns may play a role.

    How autism can look different in women

    1. Social motivation: wanting connection

    One key difference is that autistic women often show higher social motivation than autistic men. This is partially due to socialization, as female children are often encouraged to play more with others, and their activities in general tend to be more community-based.

    This means that:

    • They may want friendships and connection
    • They may put significant effort into fitting in
    • They may appear more socially engaged on the surface

    Because of this, their social difficulties can be less obvious to others, even though they are very much present.

    2. Different types of interests

    Autistic traits are often identified through “special interests.” But what counts as noticeable can be biased. Autistic men may have interests in topics like technology, systems, or mechanics, while autistic women often have interests that appear more socially typical, such as:

    • Animals
    • Books or fictional characters
    • Psychology or relationships

    The difference is not in intensity, but in how socially acceptable the interest appears. This can lead to girls being overlooked.

    3. Internalizing vs. externalizing

    Autistic women are more likely to experience internalizing difficulties, such as:

    • Anxiety
    • Depression
    • Eating disorders
    • Self-harm

    These struggles are often less visible than external behaviours (like aggression or hyperactivity), which are more commonly seen in boys and more likely to trigger assessment.

    As a result, many women are first diagnosed with anxiety or depression, while autism remains unrecognized.

    The role of masking

    One of the most important concepts in understanding gender differences in autism is masking. Masking refers to consciously or unconsciously:

    • Copying social behaviors (by observing others, watching movies, etc.)
    • Rehearsing conversations
    • Forcing eye contact
    • Suppressing natural responses (such as stimming or talking about a special interest)

    How to know of you are masking:

    • You feel very tired and drained after social interactions
    • You often find yourself practicing or rehearsing what you’re going to say in advance
    • You frequently copy others’ behaviors, speech patterns, or facial expressions
    • You deliberately stop yourself from stimming or other behaviors that feel natural to you in public settings
    • You feel like you can’t be your true self around others and constantly adjust your behavior to meet social expectations

    Research shows that autistic women are significantly more likely to engage in masking. While this can help them “blend in,” it comes at a cost:

    • Exhaustion and burnout
    • Loss of identity and feeling confused about who you truly are
    • Increased mental health difficulties, such as anxiety, stress, depression or low self-esteem

    Many women report feeling like they are “performing” rather than being themselves.

    Why are women underdiagnosed?

    1. Diagnostic criteria are based on male presentations

    Most autism research has historically focused on boys. As a result:

    • Diagnostic tools, such as the adult autism quotient (AQ) may miss female presentations
    • Clinicians may look for “male-typical” traits

    This creates a systemic bias in assessment, making it more difficult for women to access the understanding, treatment or accommodations they may need.

    2. Social expectations play a role

    From a young age, girls are often socialized to be polite, emotionally aware and focus on social relationships. Because of this, autistic girls may learn to compensate earlier and more effectively.

    They may also be:

    • Seen as shy , quiet or withdrawn (or a pleasure to have in class by teachers)
    • Overlooked as ‘functioning well’ when they withdraw or struggle with internalizing disorders, such as anxiety

    3. Different social experiences

    Research suggests that while autistic boys are more often overtly rejected, autistic girls are more often overlooked or socially excluded in subtle ways that they may not even recognize themselves as rejection.

    Girls tend to have more social contacts, but these relationships can be:

    • Less stable (switching friends or friend groups often)
    • More superficial (casual friendships instead of deep emotional connections)
    • Take more effort to maintain (they may find socializing very exhausting)

    Why this matters

    When autism in women goes unrecognized, it can lead to:

    • Late diagnosis (often in adulthood)
    • Misdiagnosis (e.g., anxiety, borderline personality disorder)
    • Lack of appropriate support or accommodations
    • Long-term mental health struggles
    • A constant feeling that something is off, but being unable to place it

    For many women, receiving an autism diagnosis later in life can be both validating and overwhelming, finally making sense of years of feeling different. This can also be a pathway to increased understanding and coping for both herself and her loved ones, and becoming able to access supports and accommodations at university or work.

    Towards a more inclusive understanding of autism

    Autism is not one single presentation, and understanding gender differences helps us:

    • Recognize more diverse presentations
    • Reduce diagnostic bias
    • Provide better and more tailored support
    • And perhaps most importantly: help people feel seen and understood.

    There is a lot of nuance in this topic, especially since I have not covered intersex, agender, non-binary or transgender people.

    However, if you are a woman, AFAB person, or someone who was raised as a woman, and you feel you have:

    • Difficulties with social interactions – difficulties making friends, superficial relationships, etc.
    • Difficulties with communication – trouble understanding language, jokes or sarcasm, taking things literally, etc.
    • Sensory issues – overstimulation, increased sensitivity to certain sensory inputs, or conversely, sensory seeking (such as spinning around), etc.
    • Emotional overwhelm – emotional meltdowns or shutdowns, overreactions to minor changes, etc.
    • Intense interests and repetitive behaviors or rituals
    • Coping mechanisms that include masking or performing

    It might be useful to investigate this further, and seek help from a professional, such as a psychologist or psychiatrist.

    References

    Bargiela, S., Steward, R., & Mandy, W. (2016). The experiences of late-diagnosed autistic women

    Baron-Cohen, S. et al. (2015). Prenatal testosterone and autistic traits

    Hull, L. et al. (2017, 2020). Camouflaging in autism

    Lai, M. C. et al. (2015, 2017). Sex/gender differences in autism

    Loomes, R. et al. (2017). Male-to-female ratio in autism

    Robinson, E. B. et al. (2013). Female protective effect

    Sedgewick, F. et al. (2016). Social relationships in autistic girls

  • Self-Objectification – How Seeing Ourselves Through Other’s Eyes Harms Mental Health

    Self-Objectification – How Seeing Ourselves Through Other’s Eyes Harms Mental Health

    If you’ve ever felt ashamed of your body, you are not alone. Body image issues are not just personal struggles, they are rooted in larger cultural systems. Shame is a powerful emotion – and a tool for social control – if we’re too busy being ashamed of ourselves, how can we show up for others

    Objectification is the act of treating a person primarily as a sexual object, rather than as an individual with a rich inner world. Unfortunately, being objectified in our patriarchal society is a universal problem, especially among women, AFAB and female-presenting individuals. It is also worth noting that body shame is more common in queer than in straight and cisgender men. Objectification experiences include sexually suggestive comments, harassment, catcalling, assault and exposure to hyper-sexualized images and messages online. Take, for example, the young girl being sent home from school because their clothes are seen as ‘too revealing’, effectively reducing her access to education that day.

    Self-objectification is the act of internalizing these ideas – seeing yourself (and your body) as something to be harshly judged and evaluated. This often begins already in early childhood, without us even noticing. And before you know it, you’re 21 years old and constantly monitoring your body, exercise and food intake – and comparing yourself to others, in real life and online.

    How does self-objectification harm us?

    Of course, you can think of the usual suspects – body shame, sexual problems, disordered eating or eating disorders and constant comparison with others, which may also lead to symptoms of depression and anxiety, and difficulty taking part in social activities, such as dinners out, or maybe an inability to deviate from a strict workout regime to join a friend’s birthday party.

    However, its effects can be even more insidious. There is research suggesting that increased levels of self-objectification may lead to worse performance on math tests, reduced assertiveness in communication, and even decreased likelihood of political activism. Therefore, being objectified, and internalizing this not only makes you feel unhappy as an individual, but can also hamper social change!

    Resisting objectification and learning to make peace with your body is therefore a form of activism, especially if you belong to a minority group.

    How can we help ourselves and each other?

    1. Avoid participating in the objectification of others yourself. Do not make comments about others’ bodies. Notice when judgement comes up.
    2. Try to also not talk negatively about your own body. This has been shown to breed insecurity in both yourself and your conversation partner.
    3. Notice your internalized objectification. Challenge and reframe your thoughts.
    4. Practice setting form boundaries and assertiveness – speak up against objectifying or negative body comments (when it’s safe to do so, of course!). Gently call out your friends or family.
    5. Limit media exposure. Especially in the age of social media, it is very easy to constantly get exposed to unhealthy beauty standards and sexualized content. Of course, we can’t completely prevent this, but try to notice when certain content is not serving you, and unfollow or mute the account.
    6. Seek therapy if you’re having a hard time navigating this on your own – it can be very challenging!

    How therapy can help

    Unlearning deep-seated beliefs can be very challenging, especially if you have to do it alone. A therapist can help you notice self-objectification and give you techniques to combat it. For example, you can learn to use cognitive-behavioral therapy techniques to challenge and reframe your thoughts about your body. Schema therapy helps you identify deep-rooted beliefs about yourself, and work towards not only seeing where they come from, but neutralizing them as well. In addition, you can work on self-compassion and learn to set boundaries with others.

    Self-objectification is not a personal or moral failing – it’s learned. And unlearning it can give you so much more freedom, peace and energy to demand change.

    References

    Butler (1990). Gender Trouble, Feminism and the Subversion of Identity.

    Fredrickson et al. (1998). That swimsuit becomes you: Sex differences in self-objectification, restrained eating, and math performance.

    Schaefer et al. (2018). Self-objectification, body shame, and disordered eating: Testing a core mediational model of objectification theory among White, Black, and Hispanic women.

  • Cultural Lens of the Therapist

    The cultural lens refers to the way a therapist’s own cultural background, values, and lived experiences influence their perspective on mental health, relationships, and emotional well-being. No one operates in a vacuum—both therapists and clients bring their unique cultural identities, beliefs, and biases into the therapeutic space.

    When these factors align well, therapy can be a transformative and deeply validating experience. When they don’t, misunderstandings can occur that impact the therapeutic relationship and treatment outcomes. While of course, your therapist does not need to share your cultural background, it might help if they do, and if you’re lucky enough to find one, it can be a better experience than, for example, speaking to someone who has no personal experience with it. However, this is not always possible, which is why finding a culturally competent therapist is so important, someone who is aware of and adapting to your specific needs.

    This lens affects:

    ✔ How mental health symptoms are understood (e.g., is distress framed as an individual issue, a relational problem, or a societal challenge?)
    ✔ How emotions and coping strategies are perceived (e.g., is crying seen as a healthy release, or a sign of dysfunction?)
    ✔ What is considered “healthy” or “normal” in different cultural and psychological contexts
    ✔ How therapy techniques are applied (e.g., an emphasis on self-exploration vs. practical solutions)

    A self-aware therapist acknowledges their own cultural lens and how it might shape their biases and therapeutic approach. They are able to adjust their framework to better understand and support their clients’ unique experiences rather than imposing their own perspectives onto the client.

    Why This Matters

    🔹 Alignment of values can enhance connection. If a therapist and client share similar values or life experiences, it can create a natural sense of trust and understanding.

    🔹 Unexamined biases can create disconnect. If a therapist unconsciously views a client’s way of thinking or coping as “wrong” based on their own worldview, the client may not feel heard.

    🔹 Cultural self-awareness improves adaptability. A therapist who is aware of their own assumptions and biases can be more flexible and responsive to clients with different perspectives.

    Common Cultural Gaps in Therapy (And How to Bridge Them)

    Sometimes, therapists and clients come from very different cultural or psychological perspectives, which can create misunderstandings. Below are some common cultural gaps and ways therapists can bridge them.

    1. Different Views on Emotional Expression

    In Western psychology, verbalizing emotions is often seen as healing, but in some cultures, keeping emotions private is a sign of strength. A therapist needs to therefore recognize when emotional expression is helpful and when it is uncomfortable for a client.

    🔹 Bridge the gap: Instead of assuming clients should “open up” in a certain way, therapists can explore different methods of expression, such as journaling, creative arts, or mindfulness practices.

    2. Individual vs. Collective Worldview

    Some clients (especially from Western cultures) prioritize self-exploration, independence, and personal growth. Others (from collectivist cultures) may prioritize family, community, and social harmony over individual needs. A therapist unfamiliar with these values might push for “self-discovery” when the client actually wants guidance on navigating relationships and responsibilities.

    🔹 Bridge the gap: Therapists can explore how clients define well-being and adjust interventions accordingly, rather than applying a one-size-fits-all approach.

    3. Stigma Around Therapy

    In some cultures, seeking therapy may be seen as a last resort for severe illness, rather than a proactive step toward well-being. Some clients may therefore feel hesitant or guilty about seeking support.

    🔹 Bridge the gap: A therapist can normalize therapy by framing it as a strength-based process and emphasizing its role in personal growth, stress management, and resilience-building.

    Finding a Culturally Competent Therapist

    If you’re seeking therapy, consider:

    ✅ Does this therapist understand my background and values?
    ✅ Do they seem open to different ways of thinking and healing?
    ✅ Are they self-aware about their own perspective and potential biases?
    ✅ Do I feel seen, respected, and understood in our sessions?

    Therapists don’t have to share your exact identity or experiences to be effective—but they do need to be culturally aware, adaptable, and committed to understanding your perspective.

    So, if you’re looking for a psychologist in The Netherlands who emphasizes cultural humility and an individualized approach—Bloomwave has you covered. Whether you’re dealing with symptoms of depression, anxiety, overwhelm or conflict in your relationships, help is available.

  • Why Expats Benefit from Therapy

    Why Expats Benefit from Therapy

    So you made the courageous decision to move abroad – packed up your life and found yourself in a completely new situation. Living as an expat, or immigrant, in the Netherlands can be an incredibly enriching and rewarding experience, especially in beautiful student cities like Leiden or Delft, but it also brings a new set of unique challenges that many expats may find difficult to navigate. You might struggle with the language barrier, miss friends and family back home, or find it difficult to adjust to the Dutch way of living. Therapy can provide essential mental health support to help you bloom in your new home.

    Especially if your move is permanent (or just more longer-term), you may grapple with the ramifications of leaving behind your old life, friends and family. Parents and grandparents get older, children in the family grow up, and this is something you no longer can witness as closely as you used to be. You might feel torn: on one hand, you really want to focus on building a new life and future for yourself in your new environment, and on the other hand, really miss what you left behind, and feel the desire to be close to family as they age. All of this is very complicated, and feeling alone in the dilemmas can easily become overwhelming.

    Here are five reasons why therapy can be invaluable for expats:

    1. Navigating cultural adjustment

    Moving abroad often means having to adjust to different social and cultural expectations, language barriers, and even the weather. You may find that people in the Netherlands are a bit more direct than you’re used to or struggle with finding housing or arranging healthcare, for example. These frustrations may snowball into feelings of depression, anxiety or loneliness. This is where a culturally-informed English-speaking therapist can come in to help. At Bloomwave, we know first-hand what’s it like to be an expat in the Netherlands, and have experience in navigating many of the practical challenges you may be facing as well.

    2. Managing loneliness

    Becoming an expat of course means leaving your old support system of friends, family and other loved ones behind, and being faced with the task of forming a new social network and keeping long-distance relationships alive. Loneliness is one of the most common mental health problems among expats, and especially in the Netherlands, you may find it difficult to integrate into already-formed Dutch social systems. Therapy can help you work through these feelings of isolation and learn new ways of coping with them. Additionally, therapy helps you improve your communication and relationship skills that are invaluable in finding community abroad, but also in strengthening your relationships with people back home.

    3. Exploring your identity

    Moving abroad might also challenge your identity in both positive and negative ways – you may start to question old values or develop new beliefs. You may not feel like you’re from anywhere, for example, and this leads to a lot of confusion. At Bloomwave, we believe in the power of therapy in really helping you understand yourself and what it is you want out of life. Through various methods, such as Acceptance and Commitment Therapy, we can help you make sense of your new identity and empowers you to live more fully.

    4. Addressing mental health stigma

    For many expats, seeking therapy can feel like stepping into uncharted territory, particularly if they come from cultures where mental health support is stigmatized. The Netherlands, however, offers a progressive and inclusive environment where therapy is widely accepted and accessible.

    At Bloomwave, we’re dedicated to creating a welcoming, nonjudgmental space where you feel safe to explore and grow. Our intersectional, anti-racist, anti-ableist, and LGBTQ+ affirming approach ensures that therapy is tailored to your needs and values. We can even address internalized stigma and help you normalize seeking support during our sessions.

    5. Coping with work or study stress

    On top of navigating new cultural environments, expats in the Netherlands often experience higher levels of work or study stress. Balancing studies with personal life may often lead to feelings of anxiety and overwhelm. Likewise, adapting to a new job and work culture, or dealing with career insecurity is a common challenge for expats. If unmanaged, these issues can lead to burn-out. In therapy, you can work on adjustment to new challenges, building routines that work for you on an individual level and learning new stress management techniques.

    Becoming an expat is a challenging experience – you should not have to face this alone. Through therapy, you can learn valuable skills to make the most of your life in the Netherlands and turn your challenges into success stories.

    References

    Platanitis, P. (2018). Expatriates emotional challenges and coping strategies: A qualitative study

    Djundeva, M., & Ellwardt, L. (2020). Social support networks and loneliness of Polish migrants in the Netherlands