Findings regarding sex differences in autism spectrum disorder (ASD), as far as core symptoms and psychiatric comorbidities (PC) are concerned, are inconsistent, inconclusive, or conflicting among studies. The lower prevalence of ASD in females than in males and the age and intelligence quotient (IQ) heterogeneity among samples made it difficult to investigate these differences. This case–control study tries to deepen the impact of sex differences on core symptoms of autism and PC in 214 preschoolers with ASD (mean age, 45.26) without impairment in non-verbal IQ (nvIQ ≥70). A total of 107 ASD females (mean age, 44.51 ± 13.79 months) were matched one by one with 107 males (mean age, 46.01 ± 13.42 months) for chronological age (±6 months) and nvIQ (±6 points). We used the Autism Diagnostic Observation Schedule 2 (ADOS-2) and the Child Behavior Checklist (CBCL) 1.5–5 to explore autism severity and PC. The results highlight that ASD females did not significantly differ from ASD males regarding the severity of autism. Statistically significant lower levels of emotionally reactive (p = 0.005, η² = 0.04), anxious-depressed (p = 0.001, η² = 0.05), internalizing problems (p = 0.04, η² = 0.02), and DSM-Oriented Scales anxiety problems (p = 0.02, η² = 0.04) in ASD females than in ASD males were also detected. Our findings of no difference in the autism severity and lower internalizing problems in females than males with ASD extend the knowledge of autism in females during preschool years. Compared to other similar studies on this topic, we can state that these results are not supported by differences in nvIQ between sexes nor by the presence of cognitive impairment. It confirms the need for clinicians to consider sex differences when describing autism psychopathology.

就核心症状和精神病合并症（PC）而言，关于自闭症谱系障碍（ASD）性别差异的发现在研究之间不一致，不确定或冲突。女性中ASD的患病率低于男性，并且样本之间的年龄和智商（IQ）异质性使得调查这些差异变得困难。这项病例对照研究试图加深性别差异对214名无言语智商（nvIQ≥70）没有损害的ASD（平均年龄，45.26）学龄前儿童的核心症状的影响。总计107位ASD女性（平均年龄44.51±13.79个月）与107位男性（平均年龄46.01±13.42个月）按时间顺序（±6个月）和nvIQ（±6分）相匹配。我们使用自闭症诊断观察时间表2（ADOS-2）和儿童行为清单（CBCL）1.5-5来研究自闭症的严重程度和PC。结果表明，自闭症的严重程度与ASD女性没有明显差异。统计上较低的情绪反应水平（p= 0.005，η ² = 0.04），焦虑-抑郁（p = 0.001， η² = 0.05），将问题内在化（p = 0.04， η² = 0.02）和面向DSM的量表焦虑问题（p = 0.02， η在ASD女性中，也检测出² = 0.04）。我们发现自闭症严重程度无差异，女性自闭症的发生率低于男性自闭症，这扩大了学龄前女性自闭症的知识。相较于该主题的其他类似研究，我们可以指出，男女之间nvIQ的差异以及认知障碍的存在均不支持这些结果。它证实了临床医生在描述自闭症心理病理学时需要考虑性别差异。