National Geographic

The Sexual Politics of Autism

Imagine you walked down the street and asked random people what autism is. What would they say? My guess: They’d talk about social skills, and the rising prevalence, and probably the vaccine nonsense. And they’d almost certainly mention that it happens to boys.

The idea that autism is a mostly male disorder is pervasive in the news, pop culture, and scientific circles. And it’s not just an academic curiosity. Last year a popular fertility clinic in Sydney, Australia, reported that about five percent of couples went through in vitro fertilization just so they could select a female embryo and thus lower the kid’s risk of developing autism.

The sex skew in autism is real: A diagnosis of autism is almost five times more common in 8-year-old boys than in 8-year-old girls, according to the latest statistics from the CDC.

But it’s not that simple. Most people don’t realize, for example, that autism’s sex bias changes dramatically depending on the severity of the disorder, with so-called high-functioning autism (a problematic term that usually means having an IQ above 70 or 80) showing a ratio more skewed towards boys. The ratio also varies wildly depending on who’s calculating it.

Two quick examples: A 2008 study of children in South Carolina found that among kids with IQs above 70, boys outnumbered girls 4.9 to 1. But among kids with IQs less than 70, the ratio was 2.4 to 1. And in the group of kids with the most intellectual impairments — IQs less than 34 — there were just as many girls as boys.

A 2010 study of children in the U.K. found the same trend but very different numbers. Among all children with autism, the male-female ratio was about 7 to 1, whereas among those with Asperger syndrome — characterized by high verbal and cognitive ability — it was 12 to 1.

I’ve just rattled off a bunch of numbers, and you might be wondering why you should care. But these numbers, as I learned this week, are powerfully charged.

Asking the question of why there’s a sex bias in autism brings up a host of messy social issues. Talking about autism’s sex ratio means talking about the challenges involved in diagnosing brain disorders, and the differences in the way we raise boys and girls, and possible differences between “male” and “female” brains, and the gender disparity in math and science fields.

It’s all so…uncomfortable. But I’m going to wade into the muck, anyway, with the hope of generating a meaningful and provocative discussion.

I’m thinking about all this now thanks to a paper published this week in the journal BioSocieties. In it, science historian Sarah Richardson of Harvard University and her colleague Eva Gillis-Buck argue that autism’s male bias has been greatly exaggerated. What’s more, they say, autism’s purported sex differences are often exploited by scientists outside of the autism field who want to take advantage of the recent influx of funding directed specifically at autism research.

And this whole situation, Richardson and Gillis-Buck worry, is not only bad for our understanding of autism, but is fueling unfounded cultural stereotypes. “Giving the gloss of scientific integrity to claims that autism is a disorder of gender I think contributes, mostly unintentionally, to negative stereotypes about women’s innate capacity for math and science,” Richardson says.

Some autism researchers take great umbrage at these claims. I’ll get to their rebuttal, but first I think it’s worth describing some of the intriguing historical context outlined in the new paper.

Extreme males
Boys took center stage in the first scientific reports of autism. Child psychiatrist Leo Kanner’s first description of the disorder, published in 1943, included 11 cases, 8 boys and 3 girls. In a later paper of 100 children Kanner reported a 4:1 male-female ratio.

Hans Asperger, who first described Asperger disorder in 1944, noticed it, too. “It is fascinating to note that the autistic children we have seen are almost exclusively boys,” he wrote. The reason, he explained, was in the difference between male and female intelligence:

“In general, girls are the better learners. They are more gifted for the concrete and the practical, and for tidy, methodical work. Boys, on the other hand, tend to have a gift for logical ability, abstraction, precise thinking and formulating, and for independent scientific investigation.

…In general, abstraction is congenial to the male thought processes, while female thought processes draw more strongly on feelings and instincts. In the autistic person abstraction is so highly developed that the relationship to the concrete, to objects and to people has been largely lost.”

There was (and is) little evidence for this inherent distinction in male versus female thinking. (And as a side note, Asperger’s reasoning there assumes a very narrow conception of autism — you could say, after all, that many people with autism thrive on “tidy, methodical work”.)

Asperger was writing in a different era, of course, when these gender bifurcations were commonly accepted. But these ideas haven’t disappeared with modernity, thanks in large part to the work of psychologist Simon Baron-Cohen, one of today’s most famous autism scientists.

More than a decade ago, Baron-Cohen debuted a theory to explain the sex bias in autism. The so-called ‘extreme male brain’ theory says that autism’s primary characteristics are just an exaggeration of typical differences between men and women, and that they’re caused by excessive exposure to male sex hormones in the womb.

Baron-Cohen’s theory, as well as the methods of his studies that bolster it, have many scientific critics. (Cordelia Fine’s book, Delusions of Gender, gives a great overview.) And yet it has received an enormous amount of public attention. That’s partly because of how Baron-Cohen has trumpeted what he sees as its real-world implications.

The theory, he contends, explains many of the gender disparities between men and women. Take what he wrote in his 2003 book, The Essential Difference: “People with the female brain make the most wonderful counsellors, primary-school teachers, nurses, carers, therapists, social workers, mediators, group facilitators or personnel staff.”

Or this snippet from a column he wrote for the BBC in 2009:

“Males, maths and autism. On the face of it, these three things don’t appear to be linked. And yet they are.

Males are much more likely to apply to university to study maths, for example.

In 2007, three quarters of applicants to read maths at Cambridge were male, as were 90% of applicants for the computer sciences degree.

Cambridge is not unique in this way. So why are males so attracted to studying maths?

And why, in over 100 years of the existence of the Fields Medal, maths’ Nobel Prize, have none of the winners have ever been a woman?”

Why, indeed. Baron-Cohen’s column goes on to cite genetics and hormones. Unfortunately he makes no mention of the well-known social drivers of these gender differences.

There are many holes in the extreme male brain theory. To mention just one: Many studies have shown that people with Asperger’s aren’t particularly good at math and tend to have better verbal skills (a supposedly “female” trait). Based on my autism reporting over the past seven years I’d say the theory is not, by any stretch, a mainstream view among autism researchers. “On the other hand,” Richardson points out, “you see it cited everywhere.”

Funding for autism has skyrocketed over the last decade or so. In 2009, the National Institutes of Health spent $196 million on autism, compared with $186 million on Parkinson’s disease and $22 million on Down syndrome. In her new paper, Richardson takes a close look at hundreds of grant applications and published studies related to autism and sex differences. Many grant applications cite autism’s rising prevalence as prime motivation. But they also frequently site the sex bias and Baron-Cohen’s theory. Richardson describes grant proposals investigating autism’s sex bias through the lens of genetics, epigenetics, gene-hormone interactions, brain anatomy, chemical exposures, rat brain cells, and even the nervous system of worms.

She also found 442 studies related to autism and sex differences that have been published since 1980. Of these, 86 percent came out after 2001, and 10 percent were authored by Baron-Cohen. The rest came from laboratories in a variety of fields, including endocrinology, genetics, brain imaging, and molecular biology. Since 2001, animal research on this topic has exploded.

This is all evidence, Richardson says, that autism has become a “biomedical platform” for scientists of all stripes who are looking for funding, particularly in this era of shrinking science budgets.

“We show how, over time, researchers have begun to link their very basic research — even if it’s on nematodes — to frame it as a contribution to autism,” she says. “In the funding and publication structure, there’s been a real shift toward opportunistically using extreme-male-brain-type theories to gain research funding.”

Diagnostic dilemma
But is this a bad thing? I asked Richardson. Our society has evidently decided that autism is a pressing public health problem, and most of basic medical research is publicly funded. So isn’t it a good thing that all of these labs doing sex research are suddenly turning their attention to autism?

Richardson stresses that she is not arguing that sex difference research shouldn’t be done. But she does think it needs to be looked at with a more critical eye, particularly at the funding stage.

What’s more, she says, the growing obsession with autism’s sex bias is ultimately bad for our understanding of the disorder. “With this focus on the extreme-male-brain model,” she says, “you’re contributing to a kind of archetypal thinking about autism that obscures autism’s reality for many people.” It leads researchers to neglect boys with autism who don’t fit the math-geek stereotype, as well as girls with autism.

She makes a valid point there. Many autism researchers have decried the dearth of research on girls with autism, who tend to have a different symptomatic profile than boys do. That’s almost certainly due, at least in part, to differences in the way adults treat girls and boys. (One study, for example, found that mothers tend to talk more to young daughters than to their sons.) These gender differences in autism symptoms mean that many girls are missed by standard diagnostic tests. Even when symptoms are the same in boys and girls, it could be that parents, teachers and doctors don’t notice them in girls with a mild version of the disorder, but are primed to seek them out in boys.

Perhaps unsurprisingly, the autism scientists I contacted about this paper were not too happy about its claims.

They pointed out that many people studying sex differences in autism don’t accept the premises of the extreme male brain theory, and say it’s not relevant to the growing scientific interest in the disorder.

“The primary reason for funding in autism has nothing to do with sex differences in prevalence,” says Thomas Frazier of the Cleveland Clinic, who studies sex differences in children with autism. “It has to do with the massive functional impairment that most individuals experience, regardless of their sex or measured IQ.”

Lauren Weiss, a geneticist at the University of California, San Francisco, whole-heartedly agrees that autism scientists need to bring more girls into their research — she wrote a commentary about it for SFARI.org a few years back. But Weiss also says that Richardson puts too much emphasis on the extreme male brain theory, and doesn’t give enough credit to other studies suggesting that autism’s sex bias might indeed have biological underpinnings.

For instance, a genetic theory known as the ‘female protective effect’ says that girls carry some kind of (as yet mysterious) genetic variant that protects them from autism. In 2011, two studies found that among kids with autism, girls are more likely to carry genetic variants dubbed CNVs than boys are, and that the girls’ CNVs tend to be larger. This might mean that girls only get autism when their genomes take a major “hit”.

A study Weiss published earlier this year offers a different kind of genetic lead. She and her colleagues analyzed autism traits in people with four different genetic syndromes related to autism. These syndromes are all caused by a single gene, and none of them show a sex bias—girls are just as likely to have them as boys are. Intriguingly, though, Weiss found that for some of the syndromes, autism traits showed up differently in boys and girls, suggesting some kind of gene-sex interaction.

All that said, Weiss agrees that diagnostic bias may also play a role in autism’s sex skew. But the only way to tease apart cultural and biological factors, she says, is with more research on animal models and human patients.

“Just as evidence of biological genetic underpinnings helped to divert public opinion from the ‘refrigerator mother’ theory of autism etiology,” Weiss says, “scientists should encourage and not discourage biological understanding of sex differences that might be relevant to autism in order to refute any unfounded and damaging stereotypes about sex differences and in order to ensure that females as well as males with autism get appropriate care.”

A lot of the issues raised by Richardson’s paper may be obvious to autism researchers. But I do wonder about the general public. My sense is that when people hear (over and over again) about a sex bias in autism, their first thought is not about differences in the way the disorder presents itself in boys and girls, or about diagnostic biases. They think it means there must be an innate difference between boy brains and girls brains.

And perhaps there is. But the point is that nobody quite knows. If you come away with anything from this (very long!) post, I hope it’s this: Autism isn’t just a boy thing.

*

This text has been changed from the original to reflect that Leo Kanner’s first description of autism had 11 cases, not 10, and 3 girls, not 2. Thanks to Michelle Dawson for alerting me of the error.

There are 41 Comments. Add Yours.

  1. David Bump
    July 11, 2014

    I’ve suspected for some time that if they had been looking for and handing out labels to people with “high functioning Asperger’s” or a “shadow” of it. If there is a difference in diagnosis based on sexual perceptions and cultural factors, I wonder if there aren’t some people being “diagnosed” who simply think in slightly different ways than others, and maybe have other reasons for being extra shy and awkward in social situations. And … there’s really NO reason to think there’s a difference between brains of boys and girls, other than cultural nurturing effects? I could have sworn I’ve seen reports stating there are studies showing even babies react to things differently or even have chemical differences. Men and women do have differences in different hormone levels and such, don’t they? Wouldn’t that have some effect or other on various functions, including that of the brain? Maybe I just remember wrong or maybe those studies have all been proven biased or at least “controversial” according to some opinions that Ms. Hughes considers of sufficient weight to counterbalance the reports.

    Perhaps at any rate, it shows how … “complicated” and uncertain certain areas under the currently expanded umbrella of “science” can be.

  2. gina rex
    July 11, 2014

    Not this again! I am one of those elusive and exotic adult FEMALE ASPERGER’S. We do exist, and I for one got so fed up with the mythology that passes for psychology, that I have written a blog with 72 informative posts that reveal an Asperger female’s POV. We’re right here in front of you: you don’t have to talk about us, just ask! It’s the polite thing to do. I won’t post a link: I’m sure that’s verboten, but google Gina Rex and an obvious blog title will appear.

  3. Maurine Meleck
    July 11, 2014

    who really cares about all this? Certainly autism families don’t nor do people that are having b abies and are worried about their child becoming autistic, especially from vaccines. This article is simply another diversion from the real issue. A diversion like autism is caused by fat mothers, old fathers, television sets, odd looking lungs etc. The real issue is why the numbers are 1 in 50 children now diagnosed on the spectrum How to stop the epidemic and how to cure those already affected. Maurine Meleck SC

  4. Sander Z.
    July 12, 2014

    Great article! I myself are probably autistic, but I get your point. It isn’t that black and white as some might like to see it.

  5. Kathryn
    July 12, 2014

    We exist.

    I suggest that you try living in this clanging, flashing, high-speed world with the diagnosis of Asperger’s (now defunct, as of the latest DSM) as a female. I am 62 years old, and for the life of me, I could never figure out why I *never* fit in. I was attractive enough to model, smart enough to attend a top-ranked college, yet work as hard as I can, the jobs end early. I’m always at the bottom of the ladder, working those ” menial” jobs, you know, the ones that no one supposedly wants.

    If you read sites for Asperger’s folk, you will find an absolutely astonishing number of older women, as well as some younger, who, as I, have lived unstable lives, frequently homeless. There is no safety net for female Aspie adults (this is what happens to adults on the spectrum, parents). We simply don’t exist, and we’re left gasping for air between waves of intense despair.

    You can’t imagine being an outcast everywhere you go, because you can’t do those things that “normal” women are apparently instilled with, you know, reading facial expressions, picking up on fleeting facial expressions and tones of voice and body language, those things that hold the entire substance of of communication with other humans. It leaves one wondering what’s wrong, and finally, you realize that it’s YOU.

    We who are older are left to bumble and degrade ourselves, rarely achieving much of anything. We are are often used until it sinks in, that, once again, it’s time to move on. We are so different, and now, with age, we are invisible and we who have dragged ourselves on and on are just tired. What do you want from females on the spectrum?

    We don’t often marry or have children, and our families reject us. I’m a good person, but I am so very weird, and constantly live in fear of homelessness, yet again. What do you want?

    I am not a bum to run from. I’m clean, immaculately dressed, yet, at a campground, while talking with a young man carrying his young son on his shoulders, as he explained how he named his dog after a Greek mythological character, his father looks over at me and calls his son to come over immediately … and then I saw it. This man was afraid of me. All 115 pounds. He was truly afraid, and it made me ill.

    Again, please, what do you want?

    We exist.

  6. Trudy
    July 12, 2014

    I am a female Asperger’s. I come from a family who has about 50% with autistic traits, although not all of those people actually diagnosed. Of those with autism, the split is pretty even between males and females. I don’t believe gender has anything to do with autism, but that a lot of females are slipping through the cracks and not getting the help they need, just because they may be better at hiding their autism than males.

  7. Bruce Fett
    July 12, 2014

    I have two adult sons with autism. I have had a lot of interaction with people in a variety of circumstances. I notice a lot of details. I have read the comments. You definitely have an extremely important point and I believe without a doubt that what you are suggesting is absolutely true.

  8. Autologous Homologous
    July 12, 2014

    I am 58 this year, I was ‘diagnosed’ with Asperger’s at age 53; First point: Ironic ain’t it. 53 years thinking I was just having a bad trip due to the death of my Mother to Cancer when I was 6½. Turns out I was denied a normal life because I have a disorder. A high IQ disorder. I’m not as dumb as you are. Oh, the tragic irony. You’ll be laughing out the other side of your faces soon enough though.

    Second point: Paragraph 3:
    ” those with Asperger syndrome — characterized by high verbal and cognitive ability —”.
    Described further on as ‘A Disorder’ and of course classified in the International Classification of Diseases Index European Edition 2010, as ‘A Disease’.

    Another case of the Ironic really isn’t it. And I’ve given up on this crap. I don’t ever mention it to anyone. The working masses are as always GENETICALLY open to the idea of seeking out those apparently different than the mob, hence inferior. So don’t ever mention it unless you’re needing to dodge a beating, or explaining to an official in a courtroom how you ended up in this mess.

    What’s the point? It’s a joke. A statistics manipulation game for preservation of jobs for penpushers and the expansion of Global Welfare, not that I’m opposed to a good days’ work you understand. I’ve just spent 2-days breaking myself to clear my garden of years’ frantic growth. I love working but not for the predatory dumb-as-dogmuck retards that run society.

    And it means that these dumb as dogmuck out there, who make up 85% of the earth’s ‘normal’ undiseased, un-disordered masses can attempt to look down on the sons and daughters of the middle-classes conveniently if that’s where, as in my case, ones’ parents dwelt.

    Overall it’s a farce. I’m setting up my own electronics business, I’m not relying on such a shoddy system promising me anything in the long-term. Are you kidding!!!?? Hopefully something will come of my huge investment in time and resources. I’m self taught since age 9, and know my stuff, so to speak.

    The diagnosis of stuff you clearly don’t have either the education or open-mindedness to understand beyond statistical advantage, should be left to people with more than a Socialist Welfare Agenda. Because once you’ve got those benefits, they leave you on your own to be bullied, beaten up, have bay windows broken twice, as all has happened to me since 2009 when I was diagnosed, and not a word did I utter to bring it on. Coincidence? Obviously but the masses don’t understand the logic of cause and effect, they just act them out. They don’t need a reason or an explanation; understand. These people: These ‘normals’, as I’m supposed to box them? They just act out their programming anyway.

    I’ve already turned the tables on this system. I’ve figufed the working-class (who may not have worked for 3-generations [60-yrs]) out. And I can predict what you do next. Fortunately what I do can always be that much smarter, intelligent, helpful to the ascent of humanity and mankind in general and less entertaining of crass ignorance.

    I hope you did understand a word of that.
    That’s part of the problem right? I have always been able to out-think ‘the thinkers’, the social-strategists and politicians with all their propaganda and lies.

    That’s what makes me the problem I clearly am to ‘The Establishment’ and the dumb-as-dog-muck, as I have continuously and so-eloquently put it.

    I wrote this in 15-mins and already I regret it, because of all the Post-Snowdon Revelation Data Snooping and Global Exabyte Info-storage of every detail of our every thought. What elements of the nefariously DUMB-AS-DOGMUCK crowd seeks to archive all this information, and to what purpose? Certainly it’s not to help calm things down in the grand debate on privacy or even a right to such a thing.

    You’re all in dog-muck creek folks but at least I’m preparing for whatever comes next.

    Good night.

  9. Eileen Riley Hall
    July 12, 2014

    Autism is not a just a “boy thing.” There are many girls on the spectrum – they are just dismissed, ignored, overlooked, and misdiagnosed. I wish the hogwash “extreme male brain” theory could be tossed once and for all. My Caroline has autism and she is the most girly-girl I have ever met. She loves Disney princesses, hair bows, dresses, and the color pink. There is nothing male about her brain, and she has autism. So there, world!

    Visit our site and listen to adult women with autism, girls with autism and their families. We are here – someone just needs to notice!

    https://www.facebook.com/AutismGirls

  10. bepatienz
    July 12, 2014

    Maurine Meleck asked, “who really cares about all this?”

    The answer is, of course, that anyone who cares about the causes of ASD will care about the results of ASD-related research.

    Recent results strongly support the hypothesis that ASD begins in early to mid gestation. That’s a bitter pill for anti-science, anti-vaccine wackos, but that’s just the way it is.

    I wonder how Maleck and her fellow-travelers will address the fact that the placentas of children who go on to develop ASD differ from the placentas of children who do not develop ASD. Etc.

  11. Tertia
    July 13, 2014

    I care. I am the mother of a beautiful daughter who has autism. I care very much. Thank you for an enlightening article.

  12. Elly
    July 13, 2014

    My daughter and I (partly diagnosed) both have ASD. My daughter’s far more obvious and with many additional needs, as she also has a chromosome disorder. I read somewhere that girls/women learn more and ask questions so they learn how to ‘hide’ or ‘live with ASD’ whereas men tend to retreat – I believe there is some validity about this. I am told by my friends – that’s odd, you shouldn’t ask that. What are you doing. Where as men just get laughed at or ignored. Not sure I think it’s an interesting debate and we need to look at both sexes. I think in school teachers can cope better sometimes with girls then boys so don’t see it as such a problem.

  13. Emily Paige Ballou
    July 13, 2014

    Maureen asks who really cares about this.

    The answer, Maureen, is autistic women and anyone who cares about us. Your question about why the numbers have risen so quickly to 1/50 (actually 1/68 at last count) is, ironically enough, intimately related to this very topic, in that it is most likely NOT an increase in the actual percentages of autistic people, but in better and more widespread diagnosis. Many, many more autistic women than men have gone undiagnosed their entire lives. We see the reported rates of autism increase as, among other factors, more girls and women are accurately diagnosed.

    The average age of diagnosis for boys is 6. For girls it’s 20. That means we go our entire childhood and adolescence without critical understanding and educational supports. That’s why we care.

  14. MWetherbee
    July 13, 2014

    I know there is some backlash from the article stemming from all corners. But I for one thank you for writing it. We have a daughter with autism. (which is not my point here) I probably have autism, but because of my sex was never diagnosed or even looked at, I was accused of being mildly retarded(sorry their words not mine) unfortunately for them( teachers in the 70’s) social awkwardness and weird behaviors are not cardinal signs of MR, autism definitely a more plausible diagnosis. What if I have been diagnosed with autism, what if I was able to access all of the social supports I needed as a child and what if i wasn’t held back because I has not “getting it”?… yeah what if.. Virginia is on to something Autism is not a sex linked issue (or if it is we do not know actually how many girls/females are out there with autism, we simply do not know!!! All we have is biased scientific reports… its a flagrant misuse of the scientific process and unethical data collection. So yeah my daughter has autism, she is one of the lucky ones who was diagnosed early and has and will have multiple supports in place for her..my girls are both really cool funny intelligent people. For the record if anyone is curious my official IQ score is in the high 120’s. ..the one who is living with autism is probably going to be a wicked mathematician or scientist.. as she seems to have a natural inclination toward” logical ability, abstraction, precise thinking and formulating, and for independent scientific investigation.”.. Thank Ms. Virginia..

  15. Karla McLaren
    July 13, 2014

    Another 2010 study from the University of Exeter found a clear gender bias in diagnosis. Misdiagnosis, non-diagnosis, or late diagnosis is fairly common for autistic girls and women, due to their different presentations of autistic traits and to a gender bias in diagnosis; “even with the severity of autistic traits held constant, boys were still significantly more likely to receive an ASD diagnosis than girls” (University of Exeter, 2010): http://www.sciencedaily.com/releases/2010/11/101117094029.htm

  16. Autologous Homologous
    July 13, 2014

    Hello,

    I’m a male, let’s get this straight and out in the open. Going back to sexual politics, (now there’s term I hated when young) a concept I superseded recently with my own: “Everything is Politics; therefore Politics is everything”.

    Of course there are fortunately greater things in life than either sexuality or politics although some of us may be sufficiently conditioned to fail to see thus otherwise. Anyway, when I got my diagnosis at age 53, I described to the Psychiatric Consultant who was the ‘big chief’ in the field for this area at the time, being Socialist Scotland rather than Private medicine land, that I believed my Childhood Bereavement was a prime component in my problems of my self-diagnosed ‘Depression’. And this is partly what got me my diagnosis of Asperger Syndrome (“which (professional psychiatrists) prefer to call ‘a difference’ rather than a disease or disorder”. [Unquote] The psychiatric consultant told me that they believed (this was 2009) “Autism Spectrum Symptoms can be brought on by a variety of factors, and which may include loss of a parent, since most of this is about a childhood Developmental Disorder” – which does not preclude therefore MRM vaccinations side-effects by the way. So I had relayed to him my version of how the loss of a mother in early childhood development might bring on such developmental disorder FX such as AS, and he agreed that this was quite possible.

    One factor I dwelt upon during our discussion(s) / meetings was that I thought that maybe the trauma of losing my mom is what makes it so hard for me to develop relationships with females. I’m good looking, fit; very fit, I can run 100m in 19seconds still, in my 58th year, I don’t feel or look that age, not really. In fact I can consciously make the effort (see epigenetics) to change how I feel and look, [big hoo-ha], yes anyone probably can. So why the problem with women; and why did my lifelong AS play such a major part in my not getting together, which I always believed I ought to do, to procreate and have healthy developing children on a normal scale of human activity? I’m still struggling with this and I’m not giving up. The minute I accept that Prejudice or some 6th sense on the part of most women that I have some minor developmental ‘problem’, then I will no longer be able to get up at 7am and work till I collapse of exhaustion.

    It’s for THESE “SEXUAL POLITICS” reason that I add to the mix, that I believe there needs to be a proper getting together of heads … before it’s too late and access to a great gene pool is lost for all time …. There is a women who moved into my street who intentionally undertook the sterilisation operation rather than continue suffering the period-pains, and there are numerous others who don’t want kids; and who never did want children …

    This is some scary, although not in the least new type scary, stuff to me. I just don’t care to adapt to it, as the new respectable ‘normal’. I don’t want this sexual politics ‘normal’. I wish to opt out; even I can’t practically, if the prejudice overrules my whims.
    I just wanted a normal life. Just to be human Do you people understand that. I’m genuinely a good looking, smart, funny, and getting smarter by the day I hope, dude, but women are looking at me more and more as some item of furniture that is expected one day to break and fall over…. Uh-uh, aint’ gonna happen ladies not for you, and not for no-one else or any other crazy ideas. I hope you get that plain and clear.

  17. Neha
    July 14, 2014

    The story of Sonya Shatalova is a story of a girl with muteness and autism. For Sonya, this film is the only way to share her vision and insights into the things that she sees and knows, that are not seen or known by others.

    The documentary is based on her diaries and poems. She wants to transmit a revealing and touching message, a message that may not be accepted by all the Russian society.

    IN AUT means to be out of the game, to be in the middle of nowhere, lost in time, with neither past nor future, and with a hazy perception of reality. The documentary raises this question: who is IN AUT, Sonia, and those who call themselves ordinary people?

    Watch online at cultureunplugged (dot) com/play/50596

  18. Robert C Brooke
    July 14, 2014

    I have a sister whose son and daughter both have autism.

  19. Mike
    July 14, 2014

    I love how Sarah Richardson and Lauren Wiess just exploited every holes in those bullshit “extreme male brain” and “female productive effect” theories! :) The media just needs to stick to what they know (i.e. celebrity gossip, crimes), stay away from the politics, and leave the adult topics to us.

  20. Alison Meyer
    July 14, 2014

    A nicely written analysis of the gender bias in autism research. As a woman with ADHD, I’ve found the same problem with ADHD research, and end up yelling at the screen every time I see articles about how it’s different in boys and girls, or how it’s more prevalent in boys than girls, with their broad generalizations based mostly on studies done on boys over the past several decades.

    Even though I think that genetic and epigenetic studies will provide the most useful information on the causes of these disorders, I was taken aback by the “extreme male brain” studies. It seems like a conclusion is being made without benefit of studying all the relevant information.

  21. Dena Gassner
    July 14, 2014

    THERE IS NO DIFFERENCE.
    People are still looking for a male profile. If you dig deeper, you find the intensity of special interest (even if gender appropriate) is still there. If you dig deeper, you find that while we may be more socially connected than our male peers, we are still distanced socially from our female peers. If you dig deeper, you will find that no private practice practitioner who works specifically (but not exclusively) with women, will affirm that they have fewer women than men. We do not see that difference. We can do better.

  22. DeWayne / Jane Knight
    July 14, 2014

    As an aspiring TV writer who has wanted to get into Hollywood since age 13 (in 1978), I will turn 50 next year and still looking for my big break because the entertainment industry is not fond of autistic people, let alone transgenders or people older than 30. To my recollection, the only autistic person who has made a career of screenwriting has been Australian scribe Donna Williams, who has written Nobody Nowhere and Somebody Somewhere. My gender dysphoria came in early childhood, when I saw Adam West and Burt Ward of Batman dress in clothing I thought were more appropriate for women (tights with underwear worn outside). During school, I performed badly in maths but did quite well in English and broadcasting classes and even wanted to change my gender, something my family disallowed. Over the years, I have been impressed with how women have made inroads into society while I have been ashamed of my own gender, as typified by male “role models” such as Homer Simpson, who are lambasted on a daily basis. Recently I wanted to portray Jane Jetson in the new live-action Jetsons movie. Only she wouldn’t be using a vacuum cleaner–she would be rocking out with a guitar! Unfortunately, the movie got nixed by Warner Brothers because of political controversy…

  23. franz
    July 15, 2014

    My my my…
    The stupidity of some feminists… visibly you have no clue about autism, it’s not some nice thing that happily makes you good at math that you need to take away from the hands of the male chauvinist pigs ! If you want my aspergers, I can give it to you, just like my facial hair, bald pate, heavier frame. Those many times I’m at a loss to understand social situations, those times when I teach a class, think they’ve followed ok, only to realize at the exam most were lost…I gladly give you my estranged childhood, my painful teen years never understanding why every one was invited but me… I give you my non verbal Kanner son, all the efforts to make communicate with us even at the most basic of levels… I give you the pain, the exclusion, the social stigma, the people who don’t get it. I give it all to you, but that will not make a great female physicist our mathematician, sorry. The mark of the great minds (many of them autistic, for sure) is that they are impervious to social expectations, to stereotypes. Lower scores in math test for the average kid could be explained by bias. That no longer totally true when you discuss the average academic, and becomes totally irrelevant when speaking geniuses !

    Now, sure enough it seems that girls with autism are better at hiding the negative (social) effects than boys, but when you have strong autism, do you even care ? I think not.

  24. Philip
    July 15, 2014

    I am a high function autistic with three children. My son is autistic as is my daughter. My other daughter does not share my DNA nor is she autistic.
    The daughter that is autistic has not been officially diagnosed as autistic. My take on that is because many of the traits exhibited by autistics are acceptable in women. My mother and grandmother were also autistic while my father’s side were not.
    I find the bias to be from the expectations of the researchers, not in any difference in the subjects.

  25. Gorman Ghaste
    July 15, 2014

    I think a more likely option is that females are under-diagnosed. Their behaviors are less likely to be perceived as problematic, both because of differing gender expectations and because of more social skill training.

  26. Hector Manuel Ramirez
    July 15, 2014

    What an important conversation to have. Virginia Hughes articulates a very good cross path between methodology and pedagogy as they relate to the condition of autism. In the absence of medical bio markers to diagnose this condition we are bound by narratives and observations that don’t often include the gender and cultural environments of the people who are being diagnosed.
    Gender disparities in autism help to continue highlight disparities in the science community. This link can be traced back to the disparities in education, work, and health care that women have are made to endure.

  27. Missy
    July 16, 2014

    I am yet another girl on the spectrum. There are a whole host of things I don’t understand about social interaction. Add in to the mix that I cannot lie (at all) and sometimes conversations don’t go as planned.
    The reason I don’t understand social interactions is that they are often highly illogical.
    Lets take a classic question (amongst girls). “Do you like my new top?” You can substitute ‘top’ for any item of clothing you wish. Now people will mostly answer yes, regardless of how hideous the item of clothing might be and the person wearing the item of clothing appears to believe that everyone likes it. Lets call the girl with the new top Carly and the girl who told her she liked it Alice.
    Setting aside the fact that I think it would be kinder to tell Carly that the item of clothing does not flatter her, Alice will show up in a new item of clothing of her own at some point. She will then ask Carly if she likes the new item of clothing. Carly will say yes. Alice will believe her. Despite the fact that Alice lied to Carly about liking Carly’s new top before.
    I don’t understand the point of asking the question if nobody’s being truthful. I also don’t understand the point of asking how someone is and walking away as if you’ve just said ‘hi’.

    What I’d also like to say is that I don’t want to be neurotypical. I have a very logical, analytical mind. Consequently I spot things that others don’t. Communication can be difficult, yes. I say precisely what I mean but people look for hidden meanings where there are none. I would not trade my brain for a non-autistic one. It would change who I am. In addition, people make no sense.
    Temple Grandin once said that if there were no autistic genes, people would still be sitting outside the cave talking about creating fire. The girl’s got a point.

    • Autologous Homologous
      July 16, 2014

      Missy commented on “The Sexual Politics of Autism:”.

      I was in town yesterday and met many people, it’s the first time I’ve been in this local ‘cosmopolitan’ Scots town for two-years. For me, a latent ability to understand & assimilate culture and manners is vital to getting on with folks, though not essential. ‘Be yourself’, talking-cure counsellors people might say, which is not always a good idea nor possible. I spent years trying to emulate those around me, in order to fit in, this got me in deepwater eventually of course, from loss of ego identity but now I can employ the technique if needs be to reflect how I perceive others, in a good humoured manner, as they clearly don’t always see it themselves. This is not important however.

      So, the first thing that happened to me in town was unusual, a young lady approached me, talking music, and travel and then it turned out she was a family member survivor of one of the big recent terrorist attacks in the UK and had worked for the same company as I, long in the past. So, both these both being subjects of interest for me, especially the survivors and their tales; I hope we got off on a good start. Anyway, she without a prompt finished by asking for my number. That’s the first time that’s happened for a long-long time. I recommend your getting out when the time is ripe.

      Thanks for the good wishes and open minded thinking because my being extremely analytic, can render me neither very popular with nor particularly outgoing, towards others. Though, when I was young I made huge efforts to burst the bubble I was clearly trapped in following the death of my Mom which we’ve agreed probably brought on the outwardly visible symptoms of a latent developmental disorder (broad spectrum of autism), spurred on by Post Traumatic Stress as documented in the 1975 Yale University psychiatric ‘Bible’ for the bereaved: “A Child’s Parent Dies” by Erna Furman. A book very much back in print now, and something I will push as a must read for any adult wanting to understand better how childhood parental death can prompt such developmental Autistic Spectrum Disorders.

      And of course my Non-Visual communication skills are allegedly bereft, so excuse me if this post reply seems unrelated to Missy’s particular subject, I can’t see your faces gawking in disbelief. Yes, in good humour I do agree, that Missy may be hypothetically correct in postulating that without autistics the human race might be still poking sticks into mud trying to figure-out what it all could possibly mean; though I know very well my own limits, both physically and mentally, and I do have very real tangible limits, and I give 110% respect to those more doted in either attribute than myself. I have always, as a Christian, Scientist and Humanist, sought to understand what I see, and to give as good as I get, if I can get it at all!

      And in my dotage (young-56) I prefer to be appreciated as someone that truly understands what’s going on but this can only ever really come about from experience, perhaps repeated experience, so we can validate the theory. It’s chaos out there folks and a maturely developed yet humbled by experience Asperger’s person might hypothetically in some rare instances bring enrichment into peoples’ lives in this terribly troubled world. We can at least analyse clearly, given the facts simply put, how things got so bad; – since no effort was made to prevent such situations arising in the first place, for instance.
      However, let’s not allow the Media to ever push the idea that we’re somehow blessed with either ‘The Gift’ or ‘The Lurgy’.

      Sic transit Gloria Mundi.
      – (Latin, look it up).

    • David Bump
      July 17, 2014

      When I read that some people with high-functioning autism spectrum disorder or Asperger’s were having success with social interactions by the use of short “scripts” that they could practice, I realize that I had been doing something similar in my head. It helps to suppress your natural tendency to simply answer social questions in a perfectly honest, thorough way if you think of the interaction as part of a play or a game where what people say or ask is just a cue or a code indicating it is your turn to recite your line or give the correct countersign. “How are you feeling?” “Fine, thank you!” (I’m really not too sure about either my emotional or physical state, and could describe the various mixed signals I’m getting, or maybe I’m not feeling very well but it’s nothing major.) “How are you feeling?” “I have a cold.” (I have a whole list of symptoms I’d be happy to describe, but that’s not how the game is played [nobody wants to hear all that]). Unfortunately there seems to be little I can do (practice helps some) about my difficulty in trying to read subtle clues, or to be overly sensitive to very strong expressions of emotion, or to match faces and names when I see people I “know” but in a different context/environment or haven’t seen in a long time.

  28. Janet
    July 16, 2014

    Interesting article! The only thing I want to say is I never really thought about the “sex” of autism before… but now that I do, I can’t think of a single person with it that is female! And that baffles me! I do not know much about Asperger’s… I am still learning about that one. I appreciate all the info, and the interesting comments as well! Thanks!

  29. Twyla
    July 16, 2014

    Autism is a broad spectrum, and is not defined by etiology. Those on the more severe end of the spectrum have much more than a “male brain” issue, and often have multiple medical conditions related to an overactive immune system such as IBD, seizures, inflammation of the brain, autoantibodies to the myelin basic protein coating nerve cells, inflammatory cytokines in the spinal fluid, imbalance between Th-1 and Th-2 cells…
    “The Immune System’s Role in the Biology of Autism”
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2898160/

    Caltech Researchers Find Evidence of Link between Immune Irregularities and Autism
    http://www.caltech.edu/content/caltech-researchers-find-evidence-link-between-immune-irregularities-and-autism

    Cytokine aberrations in autism spectrum disorder: a systematic review and meta-analysis
    http://www.nature.com/mp/journal/vaop/ncurrent/full/mp201459a.html
    Meta-analysing cytokine involvement in autism
    http://nblo.gs/XR6Pd

    Higher rates of conditions such as mitochondrial disorder and oxidative stress have been reported among people with autism. These may be related to exposure to toxins, together with some kind of genetic susceptibility.

    The “extreme male brain” does not explain insomnia, inability to speak, seizures, and more.

    Even people with Aspergers sometimes benefit from treatments such as nutritional supplements and dietary intervention, and may have some of the same biological issues even if possibly milder than some of those on the more severe end of the spectrum.

    Boys are definitely more at risk for autism than girls. It’s not just better diagnosis. This isn’t only about the brain, but about the ability to detoxify environmental exposures. Perhaps females over the eons of evolution developed superior detox ability (at least in some respects) due to being the ones who become pregnant — this is just total speculation on my part. But it is not speculation that mercury harms males more than females – that is documented scientific and historical fact. Boys are more susceptible to harm from mercury than girls.
    http://m.safeminds.org/pubs/autism-a-novel-form-of-mercury-poisioning-bernard-et-al-2001.pdf

    Although about 80% of autism diagnoses are in males, that means about 20% of autism diagnoses are in females, and these girls/women should not be ignored and are worthy of study. Autism may sometimes/generally present somewhat differently in females, and different modes of treatment may tend to be more effective.

    Any generalities about “the male brain” and “the female brain” are just that – generalities. When I was in elementary school, my female friend Cori and I were the two math brains in our grade, out of about 125 kids. In high school my math teachers were amazed at my intuition for geometry. I did not pursue math partly because of cultural influences, not because of my “female brain”.

    It is hard to talk about gender differences without promulgating stereotypes. Still, it is important to talk about those differences.

  30. Lyn Kendall
    July 18, 2014

    In my experience, as a teacher and psychologist working with autistic kids in a mainstream school setting, girls tend to get diagnosed later. Girls’ social communication difficulties tend to be noticed more when they hit puberty.

  31. Linda McCarthy
    July 19, 2014

    I have a 25 year old son who is severely autistic and non-verbal. He was in autism specific education since the age of 4 1/2 and now lives in residential care but with many visits home. He needs two carers to support him in the community and his care home fees are £3000 a week! His siblings adore him. My issue is that the autism label is too wide; to include high functioning Aspergers under the same umbrella as people such as my son is mis-guiding and confusing for people who do not understand the condition.

    • Autologous Homologous
      July 19, 2014

      Linda McCarthy Said: “I have a 25 year old son who is severely autistic and non-verbal” …”

      I fully agree with what you say although there may be some genetic pointers implying similarity though I doubt very much they have anything to tell us of constructive use.
      I was once called “autistic” at school, probably aged about 11. I looked at the kid, as if he was a moron trying to take the Mickey, I thought, and still do: “Is it all a joke, a part of a 1930’s Soviet like attempt to have all ‘different’ or ‘difficult’ people labelled as ‘mentally ill’ as Stalin actually did. I have read 3 of the 7 volumes, is it of The Gulag Archipelago, recently, like last year.

      Yes indeed and possibly, quite, yes indeed very possibly this is all true, the categorisation and classification conveniently of all that is not understood. Thing is, I do scare people by being different, (aspies) and this has brought out the worst in them, as if that needed any coaxing. I think Aspergers’ (High Functioning Autism) should be changed if what the ‘Boffins’ really mean is “A difference, which we don’t well understand in humans, which promotes similar reactions from ‘Normals’ as does Hard-Core Autism”. If so, some work will have to be done, however, I need the money they give me so I can set up my business because I’m TROUBLE. If I see something I don’t like, you’ll soon know about it and that makes me an impossible employee in the UK. NO! Really! For real! Remember, I’ve been around, and all around Europe. People (normals) find me, when either intelligent or rebellious as very scary. You can’t handle me at all. I kinda like that. Cos I don’t care that much for people either.

      You might however consider my association with the wider label of “autistic” helpful in the future if things do get out of control in this manner. I’m a fighter, and I’m one of those difficult people that stand up for what is wholesome and goodly and I tend to get results by hook or by crook.

      I’m getting stronger in this respect as I grow older.

      Freak!

      Perhaps!

      In this respect I am completely fine with being put under a blanket label with all the other establishments’ useless eaters and lower grade DNA degenerates. Maybe I’m the John Connor kind of guy you’ll need around one day?

      Seriously though, a brave new world has long been with us already, I can assure you. Meanwhile back in ‘the real-world’
      “Study Finds a Genetic Link to Autism, Researchers Hope to Find More”

      http://singularityhub.com/2014/07/16/study-finds-a-genetic-link-to-autism-researchers-hope-to-find-more/

      — (lots of vague scientific and biological promises ensuring R&D funding for another generation).

      Now that little annexed comment would already have lost me a job prospect, if I’d said it in an interview or similar. 110% sure. Because I’ve seen it happen time and time again.

      Good Luck, there’s a storm coming in. In fact it just passed through ‘a little ways back’, here today, or a brief glimpse perhaps!?

      Again; I’m all for changing the name Aspergers (Ass Burgers – are you serious?) That’s why I don’t ever mention in face-to-face communications, or ever now. At least give me an appropriate handle, like ‘Hell-Raiser Syndrome’ or something.

  32. Jay
    July 20, 2014

    According to your numbers there is a huge difference in the numbers of males and females with autism.

    But it’s sexist to notice this.

    And of course you live in Brooklyn.

    • Virginia Hughes
      July 20, 2014

      Thanks so much for reading. Always nice to have such thoughtful readers.

    • David Bump
      July 20, 2014

      It can be hard to tell with plain text — no voice inflection or facial visual cues — but I do believe our boy Jay is being facetious (lightly sarcastic, joking). But you all didn’t need me to tell you, right? Okay, ‘scuse me, love ya, bye-bye!

  33. Laura S.
    July 22, 2014

    This is a very good recap article about some of the particular trends in the current medicine. While reading it, I was just thinking how lucky we are that research like on the climate change or nanotechnology cannot be biased by the gender.

    As we can see, long established patterns of behavior are still not recognized by the scientists and professionals. It is indeed hard to diagnose properly some of the mild versions of the autism, and I can see why girls are generally concerned less in such regard. It would be really interesting to read full research paper on the problematic of the established gender perception and its impact on diagnosing mental illnesses.

  34. Married to Aspie
    July 25, 2014

    Thank you for bringing the problem of analysis to our attention. I was going to comment on the subject matter at hand, but then it dawned on me. If scientists were indicating that it was a substantially worse problem for females, would the funding be there at the same level? Would it not be more acceptable to somehow suggest that women are more defective?
    We cannot know this, but it is curious.

    My primary interest at the moment though is in how to manage the effects of being married to an older (age 59) Aspie where living together means living in a small foreign country, on a sparsely populated (6,000 people) island, where the people are so inwardly-focused that some have suggested there may be a predisposition for nationals to be autistic (high functioning). It left and tried to find work in the U.S. but as an over-50 job seeker, was skipped over time and time again, despite my excellent work history.

    So when you write that article, please let me know! 8)

  35. Sekhmes
    July 27, 2014

    Same thing happened with ADHD! It’s only recently that researchers have been recognising that the gender divide wasn’t a matter of incidence but a matter of diagnosis. And in adulthood, it’ was very close to 50-50. Enough with this crap. When researchers are studying anything with a gender disparity, instead of automatically assuming it is due to gender, they should ask themselves whether it is due to different diagnoses. Sure, yes there will be disorders where it is definitely a gender disparity but that conclusion should not be the first one reached.
    Also I would like to see more research on non western Asperger people who have not grown up in the West. I also think the diagnosis not only is it skewed towards male but also towards Westerners.

  36. Catje
    August 5, 2014

    Interesting article. My daughter was diagnosed at age 5 with “Pervasive developmental disorder–not otherwise specified”. Her school was delighted and called it “autism” as they could receive funds for their program with this diagnosis. Later it was called “Asperger’s-type autism”, but not Asperger’s as she was female. She is high functioning and very intelligent, but was not very sociable as a child. However, now she is 23, she has begun to make friends and will initiate conversations with people. She is the only one of my children with autism, and the only one in my family that I know of.

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