I’ve been planning to write about gender and autism for a while now. Months ago, I wrote a personal reflection piece. It got two emphatic thumbs down in beta, so I let it languish in my drafts folder. Then, after some feedback from commenters here, I decided I would write a more informative companion post as context for the personal reflections, but that never happened. Then I cannibalized the personal reflections piece for something I was invited to submit to an anthology, which took me weeks to write because apparently everything takes me weeks to write lately.
Which left me still wanting to write about gender and autism here. As a first attempt, I’ve surveyed some of the ideas that people have put forth about gender and autism over the years, starting with Asperger himself.
Note: I’ve linked to a bunch of articles in this post, many of which I don’t agree with. However,I want to share the background information that I used so you can make your own decisions. Also, most references here are to binary gender and gender norms because that is the way most of the research is framed.
The Original Gender Link
In his paper describing his case studies, Hans Asperger hypothesized that autism must be a sex-limited or sex-linked condition because he had only observed it in boys. However, he also noted that some mothers of boys at his clinic who had autistic traits, which he found puzzling given the lack of girls who fit his model. His explanation for why there might be autistic women but not autistic girls was to suggest that autistic traits develop in females only after puberty.
He went on to state that he’d studied over 200 additional autistic children and had concluded from his observations that the autistic personality is an extreme variant of male intelligence. It’s important to note here that Asperger’s model was developed based on case studies of 4 boys who had been referred to him for behavior problems in school. All of them were considered to be uneducable in the traditional school system, creating a very specific profile on which Asperger based his observations.
It’s interesting to contrast Asperger’s idea of male versus female intelligence with Simon Baron-Cohen’s male and female brain models. Asperger believed that females were better learners with a tendency toward concrete practical thinking and tidy methodical work. He thought that males, on the other hand, were naturally gifted with logical ability, abstraction, precise thinking and formulating, and were predisposed to excel at independent scientific investigation.
He does go on to say that female thought processes draw more strongly on feelings and instincts while males are better at abstraction, but this observation is more of an afterthought and follows his general summation of what believes to be the primary gender differences. Asperger based his extreme male intelligence on his belief that autistic people have little to no ability for concrete thinking due to the highly abstract nature of their thought process, which he thought was a male trait.
Baron-Cohen took the extreme male variant idea and transformed it into something quite different from Asperger’s original concept.
The Extreme Male Brain
Simon Baron-Cohen’s extreme male brain theory has gotten a lot of attention, both from the media and the scientific community. Just about every scientific study on autism and gender done in the past 5+ years will at least mention it. In the popular media, it’s often boiled down to a simplistic “engineers and mathematicians are more likely to have autism” story, which makes for catchy headlines. The actual theory is a little more complicated and less clear cut than that.
The basic concept of the extreme male brain theory is that human thinking styles can be classified as either predominantly empathizing or predominantly systemizing. Baron-Cohen believes that empathizing is a female trait and systemizing is a male trait, because typical females tend to score higher on measures of empathy and typical males tend to score higher on measures of systemizing (categorizing/cataloging information and logic-based thinking).
Based on those assumptions, he then developed the concept of the Extreme Type-S personality, whose systemizing scores are above average and whose empathizing scores are below average. According to his research, 65% of autistic people are Extreme Type-S, indicating that autism is a form of extreme male thinking. Other researchers have used this theory to suggest that being female has a protective effect against autism.
There are a lot of holes in the EMB theory. It bases maleness and femaleness on a single pair of traits, which aren’t even mutually exclusive. It subscribes to outdated gender stereotypes of men as less nurturing and women as less logical/intellectual. It uses questionnaires designed by the researcher to prove the researcher’s point. It fails to even acknowledge the existence of nonbinary gender identity (which is especially significant in autistic populations, as mentioned later in this post). It completely ignores the possibility that females are simply underdiagnosed, which undermines the protective effect line of thinking. It uses characteristics of autism as a proxy for gender traits, thereby “proving” a link between gender and autism.
I could easily write an entire post on all of the problems with the Extreme Male Brain theory, but I’ll leave it at that. There are valid issues around the intersection of autism and gender, but this isn’t one of them.
Biological Differences in Autistic Adults
Gender dimorphism–observable differences between the males and females of a species–is a known biological phenomenon. It shouldn’t be surprising that there are some observable gender differences in autistic people as well.
For example, a recent study found that women on the spectrum have more white matter in their brains than their typical female peers. The autistic men in the study had a similar volume of white matter as their nonautistic peers. The study used this finding as “proof” of the “neurological masculinization” of autistic women’s brains. Conclusions like this make it obvious how much influence Baron-Cohen’s EMB theory has in current autism/gender research. The more interesting finding (to me), buried deep in most of the news coverage, is that there may be fundamental structural differences between the brains of males and females on the spectrum.
Another biological difference that’s been the subject of significant study is testosterone levels in autistic individuals. A few years ago, there was a popular theory that high levels of fetal testosterone and the cognitive profile of autism were somehow linked. A couple of years later, another group of researchers extended the theory to a gene called RORA, which is inhibited by testosterone and stimulated by estrogen. RORA levels have been found to be lower in autistic people. Since RORA is tasked with “turning on” a number of other genes, it’s possible that there is a link between testosterone levels, RORA levels and certain genes not being expressed. There are a lot of leaps that have to be made for the testosterone-genetics-autism link to pan out under this theory and much of is based on the study of either mice or cells in petri dishes as opposed to actual autistic humans.
In general, the evidence on elevated levels of testosterone in adults on the spectrum is mixed. Some studies have found that autistic adults of both genders had elevated levels of testosterone, but more recent research found that only autistic women have elevated testosterone levels. The study with mixed results, however, found that autistic individuals of both genders were more likely to have more androgynous body characteristics. Of course, the rating of how masculine or feminine a person’s facial features or voice are is subjective and based on binary gender norms.
Perhaps a more interesting line of inquiry is how autistic people themselves feel about their gender.
Gender Coherence and Autism
The link between gender dysphoria and autism is increasingly being studied. Research done this year in the UK found that among adults with gender dysphoria, the rate of ASD (5.5%) was more than twice that of the general population. Another study involving a larger group of adolescents with gender dysphoria found an even greater prevalence of ASD (7.8%).
There’s an interesting paper that attempts to explain these results by hypothesizing that autistic adults in general are more physically androgynous than their nonautistic peers and characterizes autism as a gender defiant disorder. I think the responses to our gender and body image survey added anecdotal evidence to this idea. Many of us mentioned some degree of gender dysphoria or an atypical relationship with gender norms.
This raises the question of what role being autistic might play in the formation of our personal experience of gender. For example, autistic children are less sensitive to social cues than typical children and may not make friends with or become part of groups of same-gender peers. If we’re not tuned in to what the social norms for children of our gender are, we’re less likely to adopt them early in life.
There may also be an aspect of autistic-related body dysmorphia in general that factors into gender dysphoria for some autistic individuals. Many autistic people have difficulty feeling connected to their physical selves or being physically comfortable with their body.
Finally, there is the issue of sensory sensitivities. Dressing or presenting androgynously may be a result of gender dysphoria or it may be related to avoiding sensory triggers associated with certain types, textures or styles of clothing.
Clinical Impact of Gender Differences
One of the reasons girls are diagnosed less often than boys is because many autistic females present differently than autistic males, on whom the diagnostic models are based. The most recent version of the DSM acknowledges this and it’s increasingly becoming the focus of scientific research.
While it’s interesting in an academic context to look at potential biological differences or the possibility that autistic people are more likely to have a more androgynous presentation, gender differences that may lead to more accurate diagnosis are where the rubber meets the road right now. It would be nice to see more research dollars being spent on developing a female model or a broader overall model of autism rather than trying to prove a link between autism and a “masculine” brain or other concepts that do little to improve the lives of people on the spectrum.
Musings of an Aspie 
A great, informative post! In particular I’ve a personal interest in any link between autism and GD and found this most interesting.
There is more research on GD than what I linked to here but hopefully those studies will be helpful. I thought their findings were really interesting.
Thank you for this – I value your reflections so much. This is very timely for me as I’ve been reflecting on gender identity, social roles etc in relation to my 19 yo autistic son. I am pretty certain that his autism in combination with ‘learning disability’ has ‘protected’ him from society’s channelling of men and women into particular gender roles. I find this liberating – he can live his life freed from some of the gender constraints which for many of us are overly-conscious of perhaps. I agree that our personal experience of gender is the thing that matters – I’d certainly be interested in research looking at the way autism may impact on our experience of social and gender role. Once again, big thanks for your musings, Liz.
I’m so glad to hear this is helpful for you. It was interesting to research the various theories and try to put things together in a way that makes sense from an autistic perspective. I didn’t come across any research specifically on gender/social roles as related to autism but I agree that would make a great study.
What a fascinating post. It’s always interesting to see how people’s deep set ideas about gender identity tend to seem into the research literature. It was also nice to see a more nuanced portrayal of the Extreme Male Brain theory (still sounds pretty gender essentialist, but at least you explained it in a way that makes sense).
“seep [not seem] into the research”
It was hard to write about the EMB theory without, you know, ranting but I wanted to at least try to create a balanced explanation.
Reblogged this on humanitysdarkerside.
Thank you for the reblog 🙂
It has always irritated me when people try to put women and men in the same context. The woman almost always loses. I was in the military back in 1995 and they were talking about making the grading system the same for women and men in the physical aptitude test. I about blew a gasket. Men have larger organs, by 20%, than women of the same height. If their lungs and heart are bigger, they are going to be able to run faster than me. Then, physiologically, out hips are completely different. Men can run with a hip pivot that is back and forth whereas, women have to pivot their joint in a crescent motion, making the distance of moving the leg greater for the same step. There was no way I was going to be on the same grading scale as the guys. No thank you.
If you look at the information on heart attacks, it’s all based on male physiology. The symptoms for women are totally different and chest pain is a very poor indicator in women. Women are continually under diagnosed with heart attacks and are a leading health problem for women. Most women who express concerns for the symptoms they are experiencing are told it’s PMS, anxiety, or something of the like. Getting proper medical treatment is very difficult.
If these two examples are a good way of viewing the medical system, it is reasonable to assume that they will unintentionally have a gender bias. Men and women can have the same medical problem or participate in the same physical, cognitive activity and be different in results. We are not the same.
Those are both great examples of biological differences that have practical impacts on outcomes for women. I think even more discouraging to me than the innate bias is the distracting focus on stuff like a “male brain” being a trait of autism. There are so many more important things that could be studied to improve the lives of autistic people in practical ways.
Most drug studies are on men and then applied to females. An interesting fact is that the medical community cannot do good studies on pregnant women because of the harm to the fetus. Which is why most drugs are labeled, “might cause birth defects”. They don’t know if they will or not. This is a huge blind spot for the medical community. The history of obstetics is horrifying. X-rays on pregnant women resulting in fetal abnormalities. Mass anti-depressants and other now-banned drugs in pregnancy given out in the 50s causing birth defects (this is an interesting case for epigenetics where autism might have some serious roots – what the grandmother took during pregnancy having a direct effect on the grandchild because it effected the proto sperm in boys and the eggs in girls while developing in the womb).
Many thanks for this. Have you read this paper yet? I found it very helpful for thinking about how to talk about these issues, and think about them in my own life.
http://www.academia.edu/3669296/Gender_Copia_Feminist_Rhetorical_Perspectives_on_an_Autistic_Concept_of_Sex_Gender
I haven’t but now I’m going to. 🙂 Thank you for sharing the link.
Physical androgeny is more common in ASD people. What about mental androgeny? What I really want to know is if anyone else has different sex organs in erotic dreams, sometimes male, sometimes female, etc.
Good question. I have no idea but perhaps others will reply.
Thanks for your perceptive, thoughtful and articulate post.
‘It would be nice to see more research dollars being spent on developing a female model or a broader overall model of autism rather than trying to prove a link between autism and a “masculine” brain or other concepts that do little to improve the lives of people on the spectrum.’
I SO agree with you!
From the UK, see –
Gould, J., & Ashton-Smith, J. (2011). Missed diagnosis or misdiagnosis? Girls and women on the autism spectrum.
‘Questions in the Diagnostic Interview for Social and Communication Disorders (DISCO) Wing et al 2002 highlight the differences in the girls for all aspects of the Triad and routines / interests’ (2002….!)
‘Dale Yaull-Smith National Autistic Society Communication 2008
The fact that girls with undiagnosed autism are painstakingly copying some behaviour is not being picked up on and therefore any social and communication problems they maybe having are also overlooked. This effort of mimicking and repressing their autistic behaviour is exhausting, perhaps resulting in the high statistics of women with mental health problems.’
This last statement says it all!
Yes! I’m familiar with Judith Gould’s work and that of the Lorna Wing Centre. I hope that it continues to get lots of attention internationally. 🙂
I have gender dysphoria but don’t have erotic dreams where I am my desired gender. I do have a somewhat androgynous body which is helping in my gender transition because the clothes fit! But mentally I’m not androgynous: I identify strongly as female.
Congratulations on your transition.
(I hope that’s an appropriate thing to say. What I mean is, I’m happy for you. 🙂 )
It seems perfectly appropriate to me. Thank you Cynthia. 😀
Does it apply to those (like me) who consider themselves as agender (without gender)?
Another good question to which I have no answers. 🙂
I definitely dream of myself as male on occasion, and those dreams are usually of an erotic nature. They don’t feel like “omg look at myself with a penis” though. It’s just a natural, normal thing in those dreams. I don’t experience gender dysphoria in waking life but I do not conform to expected feminine behavioral standards, even though my appearance is very feminine (I love love love wearing dresses and high heels).
That sounds like what I experience. I am physically female, I identify as female and I like it. Sometimes I am male in my dreams, sometimes female, either feels perfectly normal and natural. I have never dreamed I was anything other than the two. I am always heterosexual in my dreams.
I have never dreamed of myself as male. Typically, when I dream, I dream of myself as agender. Not “ambiguous gender” – no gender at all.
I do have some degree of body dysphoria, and I would prefer a more androgynous-appearing build (I have hated having breasts ever since I developed them – I choose the word intentionally). I oddly want to have a more masculine body, despite IDing as a woman.
Gender is weird.
These are such great perspectives to consider, Cynthia!
Thank you! 🙂 Something more formal will be winging your way eventually.
While reading this, a question «popped» in my mind. The androgynous «presentation» of ASD people is about which criteria? Is it physical, like mensuration and biological stuff like the form of the skull, organs, height… or because of clothing and way of acting? Both? I’m wondering because physically I am far from being androgynous (even through I wish I was) but psychologically and clothing speaking, I consider myself to be agender.
Interesting read!
The androgynous presentation reference points in the study I cited were primarily voice (low/high) and facial features, which were evaluated on a predetermined scale that wasn’t described in great detail in the study. I don’t believe presentation in terms of dress was considered as a factor.
This is so interesting, and you explain everything very well. The EMB theory is kind of hard to stomach, but I do find it interesting how the researcher’s limited view of gender affects their work – not very scientific, really. Scientists don’t even fully understand the gender differences in neurotypical brains, so it’s dangerous to make such bold claims about autistic brains. I’m glad that it at least looks like things are slowly moving away from the EMB theory.
Personally, I’ve always been very happy being female. I love fashion and beauty (in a way that won’t overload my senses), and am usually in skirts, dresses, or other girly clothes. I also wear makeup and jewelry, and have my hair dyed. I also love cute things and animals. That said, I also have some stereotypical male qualities too: I have a serious personality, I’m not very expressive, I’m intellectual, I love technology, and I’m not much of a nurturer. So I guess overall I do have an “atypical” gender expression.
I really, really hope that science and society at large start looking at gender as a fluid spectrum, rather than a simple binary. So many people don’t fit into that binary, and it’s sad that they’re pressured to or considered “wrong” when they don’t.
I couldn’t agree more. I’ve been called “the third gender” to my face, which to me says more about the binary way those people see gender than it says anything about me.
Yes, definitely. And that’s rather rude that took the liberty of appointing you with a gender! That’s yours and yours alone.
I agree. That is rude to assign you a gender!
I do think things are starting to move away from EMB as the primary gender-autism model. The study on autism as a gender defiant condition is actually described in the title and abstract as a response to the EMB (and characterizes itself as a refutation/alternative approach). It really would be helpful for there to be more consideration of gender as a fluid concept, especially in studies where one of the primary concerns of the study is gender.
I have an atypical gender presentation and am finally becoming comfortable with it. Interestingly, being diagnosed with AS has played a big role in that, I think.
The gender defiant thing is interesting, and autistic people in general don’t conform to gender stereotypes as much. But, a lot of aspects of autism can’t be explained that way (sensory issues, clumsiness). I’ll have to give that one a read when I get a chance.
I’m really glad that you’re finally starting to accept your own gender expression – that seems like it would be very freeing.
They use “gender defiant” strictly in terms of gender-related traits rather than as an overall explanation. (And also as a refutation of autism as being somehow “more male”.) I should have made that more clear.
It has been very freeing to finally let go of norms and stereotypes and feel like I’m being me. 🙂
Ohh, okay, that makes more sense. Thanks for clarifying. Now I want to read that paper even more 🙂
I’ve always been so gender nonconforming that when genders self-segregate for family activities, the women refer to me as one of the guys and send me off with the men, who accept without question that I’ll go with them. Family members when they think they’re being funny will refer to me as “he”.
That said, I identify as a woman.
That sucks that people make assumptions about your gender and then think it’s a valid source of amusement.
I was often referred to as the son my father never had and I’m still quite comfortable being one of the guys. If I had to put myself on a continuum, I’d say more female than male, but I’m also discovering that gender fluid feels like it fits as well.
I’m comfortable being one of the guys, too. It’s just… why do I have to be “one of the guys” to like guy things? Why can’t I be a woman who prefers helping with farm chores over going shopping?
You should totally be able to be a woman who prefers farm chores. I didn’t mean to imply otherwise. I think I’m more one of the guys in a gender fluid sense than in a woman who does guy stuff sense (although sometimes I’m that too) so I was approaching it from that POV.
I get you there. It was more my aggravation with my family speaking. They hold very gender essentialist views, which I find problematic. It’s okay that I’m a woman who likes video games and hard physical chores, just like it’s okay for my partner to be a man who likes cooking and more traditionally feminine chores (he does the floors and the dishes and clutter).
Yes! My husband is a whiz with a mop and loves to cook has zero expectations of who does what around the house based on gender roles.
And I’ve seen you share some of the icky things your family says to you with respect to gender. Gah.
This is something I think about a lot, because I can’t get a diagnosis, and my hubby is also an aspie. Between the two of us, there is a great deal of overlap and juxtaposition in gender traits. For example, though we are both very male in some ways, he is often the more affectionate one in the relationship, and needs frequent reassurance of my love.
Same here. My husband is way more sensitive, emotional, sentimental and generally caring than I am. I’m sure if he took the EMB tests, he’d score as extreme Type E. But he also has a lot of traits that are traditionally associated with being male and strongly presents as male. I think these stereotypes that people put forth in the name of research are mostly silly and outdated.
Wow, just wow…to all of it. Thinking of my Aspie mother…I can remember hearing her say things all my life that fit right in with this. I definitely identify “female,” but while reading these comments, I can see where I have also had “male” traits and even fantasies and dreams. And my two Aspie daughters…I see this in them as well. I have been HUNGRY for the “female on the spectrum” research. I think it would be fascinating and validating. Considering we have a male Aspie in the house, too, we could be our own little case study!!
You could do a case study! I’ve enjoyed reading the comments here and also the responses to the gender survey question. It’s very validating to discover that others have the same thoughts and experiences. 🙂
Lately I have been wondering more and more about gender, and my gender. I seriously dislike all those things that are expected of me as a woman, and get increasingly annoyed by the overt and implicit sexism in our society. Reading about male brain theory and related issues again confirms to me that society and as a result science are so occupied with dividing the world in 2 genders.
There’s definitely an influence of autism in that. As you mentioned, we may not be entirely tuned in to the social cues, but on the other hand we may take some rules too seriously. I’ve only relatively recent been thinking about these things. To me ‘behaving like a girl/woman’ is on par with having to look people in the eyes and stopping for red trafic lights. All that is the world as I have to navigate it.
I’ve never been as female as most women around me, but I did try to a certain extent. I have flatly refused to ‘just get used to’ wearing high heels and ‘walk the blisters off’, and I dislike make-up, but I have done the whole shaving thing and trying to look attractive, or at least until recently. When it comes to sexual norms and sexual behaviours I’ve only stopped trying to be sexual despite my lack of interest, because it led to some traumatic situations. But I’ve always felt bad about my lack of interest, because as a woman I’m supposed to want to be with a guy and get aroused by whatever he does. I mean, that’s what the media tell me, so I believed that. (lack of parental guidance in this didn’t help)
So I think the autism can play a role both in disregarding gender norms and overly conforming to gender norms.
“Many autistic people have difficulty feeling connected to their physical selves or being physically comfortable with their body.”
This is making more and more sense to me. There is an element of discomfort I have with various body parts, including the female parts, but not exclusively. I had been wondering about being trans, but I suppose I just wish there was more of a neutral type of body I could have, without all that fuss about being female or male.
“Finally, there is the issue of sensory sensitivities. Dressing or presenting androgynously may be a result of gender dysphoria or it may be related to avoiding sensory triggers associated with certain types, textures or styles of clothing.”
Well, that, and I think also, or at least for me, there’s also an element of safety. If I don’t dress that feminine, men don’t try to flirt so much, thus decreasing the need to deal with that. In general, it feels like the more neutral I dress, the less I have to deal with certain expectations. I feel I’m giving off the signal: not really interested in girly stuff, not interested in dating, which suits me fine.
All in all, I would say I am increasingly realizing I identify as more androgynous, and I just really want to not care about gender at all, because it’s just even more fuss. I think being autistic makes it even more of a fuss.
You raise a lot of really good points here. Thank you for taking the time to go into so much detail. It sounds like in addition to realizing that your gender identity leans toward androgynous, you may also be asexual, which is separate from gender identity. However, I also get what you’re saying about women being expected to be highly sexualized as part of being feminine and how not fitting that social expectation can make a person feel less feminine/female.
I also get what you mean about dressing neutrally to fend off unwanted advances. Which shouldn’t have to be the case, but in reality often is. I see that my daughter, who lives in a big city, is constantly dealing with catcalls and other harassment simply for walking down the street. She’s chosen a different response, which is dressing the way she chooses (which is quite stylish and feminine) and confronting her harassers.
Recently I’ve kind of given up on gender norms and started doing what I feel like doing, which is very liberating, even if it does earn me the occasional snide remark or odd look.
I hate anything about autism and gender, it’s all so sexist, transphobic and binarist.
I hate with a passion anything about a female model of autism, there is no female type of autism, what happens is that autism is not so limited as people think and autistic people are affected by the social norms they are raised in, in this society people assigned as women are raised differently from those assigned as men, so we get more differences between those groups and a lot of people who don’t fit that are simply erased or changed, same ways that boys who act more like girls from any neurotype are going to change and face hostility to the point where they change, same for girls, this doesn’t disappear because of autism, not to mention the hostility nonbinary people face.
Autism is really not so limited as people think, there is a broader set of ways to be autistic, because of the way children are raised to force themselves to ideas of gender both autistic and nonautistic end up with a set of acceptable gendered behaviours, not everyone fits on those boxes. Autism has no male model or female model. Those lists and articles about autistic women and girls are only talking about different ways to be autistic, not about gender, they shouldn’t have the word female, women or girl in them but explain that the way we are raised changes us. Autistic people who are not women or male exist.
Autistic people are affected by social norms about genders, it’s just different, that’s why we get so many autistic men who treat women badly, because they took social norms in literal ways and that’a how society says women are supposed to be treated (not all are like this of course), many men with less social skills end up like that, they also do it because of insecurity of not fitting in the acceptable male ideas.
Please be careful when writing about autism and gender, most of the material out there is full of prejudice against women and trans people.
I understand what you are saying, using “female” in this context can be just as limiting. But I think we need to acknowledge that the symptoms that are universally recognised by professionals as being on the autism spectrum are overwhelmingly biased towards white heterosexual cisgendered males. (The reason why I include heterosexual is because professionals are more likely to take seriously a woman’s complaints about their husband’s “aloof” or “unemotional” behaviour than they are likely to do so with another man’s complaints about their husband). When you look at the DSM criteria dispassionately, there is nothing in there that is overtly gendered. But the way the criteria are interpreted, the examples that professionals are taught to look for, those definitely have an extreme bias. We need to make people aware that the expression of the DSM criteria can be very different depending on cultural background and conditioning, whether that is based on race or gender or sexuality. There seems to be some awareness that males with ASD can express themselves differently on the spectrum, but we need to extend that awareness to other groups as well. And the easiest way to do that is by showing examples. Which is what this post is about.
I think you have more faith in the system than I do. While I fully support the idea of an expanded set of criteria, I have grave doubts about whether it would actually be applied to anyone other than the demographic it’s already being applied to. Which would probably catch some of the boys who have a hard time getting diagnosed due to being more social. But unless the criteria are specifically presented as targeted to those who are underserved, those groups will continued to be underserved by default. As autisticook points out, there isn’t overtly gendered language in the DSM but the way the criteria are applied is based on biased examples that have been handed down anecdotally for decades.
Having said that, I agree that it’s hard to talk about gender and autism in any way that isn’t frustrating because so much of the research is inherently biased in the ways you point out.
Well done! I like your mix of background information and new thoughts, it made for smooth reading with just enough challenge, so again, well done and thank you for writing this. I’m off to take a look at the new DSM now.
Thank you! 🙂 If you have a good link for the DSM-5 criteria online, would you share it here? I haven’t come across one yet.
Sadly nothing besides Wikipedia and some random snippets on the internet, and there are some online sources for which one would need an account (medical databases or something like that). I should check if our university offers online access.
That’s the same problem I’ve been having with finding a publicly accessible version. It’ll show up eventually.
I just thought of another incredibly insidious way in which gender bias can colour research.
I think it was in one of the links posted here that I read that women diagnosed with ASD have higher levels of testosterone than their non-autistic peers, and that this might provide an interesting avenue of research within the “extreme male brain” theory, even though their male counterparts did not show elevated levels of testosterone.
Sounds interesting doesn’t it? Pretty straightforward. Women with ASD have more testosterone. Why?
Maybe because women with higher levels of testosterone present enough “male” characteristics in their behaviour to fit within the narrow, male-oriented ideas of the people doing the diagnosis. In other words, women with high testosterone are not more autistic, they’re just more likely to get diagnosed. Women with low testosterone and just as much ASD slip under the radar.
Cause and effect. Even scientists get it wrong.
Oh, that’s a really interesting point. I hadn’t thought of it in that context.
I have read your thoughts on the EMB theory and I jumped up and down from happiness. And relief. YES, FINALLY someone said it. I am not crazy! (I always go there when I notice something others don’t, because I always thing “but how do they not see it???”) I am an aspie myself, a year ago I discovered my aspieness and I try to find out a way to get officially diagnosed and I am also doing a master’s in autism. In fact, I have an assignment due tomorrow that engages with females and autism. Because of that I’ve read a lot of Baron-Cohen’s studiesa and. I. just. don’t. like. that. guy!!!!!!! You are spot on with ALL your observations! We aspies need to come together when it comes to things like these and do/say something!!!! And the sad part is that his research is funded by the one of the biggest, if not the biggest, charity organisations in UK, when so many other things could be done with all that money!!! I wanna share with you two parts of my assignment, which you with your post convinced me keeping as they are:
“The attempt to explore the level which the EMB theory explains the female phenotype of ASC is rather intriguing. Females with HFA often report having systematising habits of any form and content, even in their “girlie” habits. “I connect with and understand male thinking, and that my thought process feels more male. However, I am chemically very female. I like clothes, I like make up, I like “chick flicks.” I’m girly! […] But the way I execute my femininity is very autistic. I love clothes, but I also love to collect them and arrange them. I am sensory seeking when it comes to colours, patterns and sparkles… […] What’s really funny is I don’t get around to wearing most of them.. it is because of sensory issues and rituals.” (Guedes, 2012).
On the other hand, a high level of empathy can often also be observed in the behaviours of females with ASC. Simone (2010) describes the ability of females with AS to relate to other peoples’ emotions almost as a kind of “sixth sense”. Furthermore, Holliday-Willey (1999) a mother with AS who has a daughter with AS mentions in terms of her daughter’s ability to spot whenever she is unintentionally mimicking somebody else: “…no one else has ever noticed (my pretence) as quickly and as completely as my AS daughter does. She recognizes the moment I bend my voice or my motions to match someone else and it drives her to distraction. In no uncertain times she will demand I stop acting like whomever, that I quit walking this way or that, that I stop pretending to be someone I am not. Though she does not fully understand the weight of her words, there is little that keeps me from comprehending the fact that she is right on track with her observation. Funny that she, another Aspie, is often able to see my pretence before I am.” One can’t help but wonder whether this example could be considered a form of empathising, since empathy is defined as the ability to identify another person’s emotions and thoughts, predict the other person’s behaviour and caring about how they feel (Brosnan et al., 2010).
A lot of my personal interactions with women with Asperger’s Syndrome are consistent with the aforementioned observations. I have often encountered them describe feeling paralysed by the weight of another person’s emotions or experiences, an emotion that they cannot easily discard and can keep them drained for days. Moreover, they often express panicky reactions when they feel that their reciprocity skills do not rise to the emotional level of an occasion. One of them was even diagnosed with AS after having been hospitalised for psychosis, which was the result of an emotional breakdown. In a study conducted with a sample from the general female population in order to explore the characteristics of an Extreme Female Brain (EFB), Brosnan et al. (2010) propose a relation between extreme empathising and psychosis. It would be rather interesting, therefore, to explore the extent in which the female phenotype of ASC is described by the EMB theory and whether the existence of an EFB theory would explain some of the female traits more accurately. ”
“EMB theory has also been used to explain certain characteristics in girls on the autism spectrum. Knickmeyer et al. (2008) recorded the impact of the EMB theory on the sex-typical play of children with ASC via a parental questionnaire. They hypothesised that due to brain masculinisation the girls would present more sex-atypical play. Parents reported that girls with ASC did not show interest in non-pretend sex-typical play. From the items of the questionnaire (listed in the appendix), however, the only female sex-typical non-pretence games present were skipping rope/skipping, dancing and playing with hair (brushing hair). It could be argued that other reasons, non gender specific, might contribute to the girls’ disinterest in those games such as co-ordination difficulties (for skipping rope and dancing) or sensory issues (brushing hair). This could be consistent with the second finding of this research, that the girls with ASC showed interest in sex-typical pretend play more than the boys did.”
Thank you for sharing the excerpts from your paper – really interesting stuff. And I’m so happy to see someone with AS who is specializing in autism. We need more people on the spectrum in the field! I hope your paper is well received. 🙂
(Apologies if I’m rambling. I just learned something pretty major here and I’m still trying to figure out what it all means.)
“Many autistic people have difficulty feeling connected to their physical selves or being physically comfortable with their body.”
Wow. This settles it. If this is true, my species dysphoria has to be related to my Asperger’s diagnosis, because this fits me perfectly, and I can see autistic traits in my reasoning behind it. There are times when I’m so uncomfortable with my body that I’m unable to do anything else at all until the feeling passes, and I certainly don’t feel much of a connection to my physical self. I can look in the mirror and not even recognize the face I see. It’s not a matter of gender for me though; I don’t relate to humans at all, regardless of gender, and a lot of “normal” human body features are things that I find repulsive or strange.
I couldn’t say why I find the dragon body shape more appealing, but it could be as simple as not having an example I don’t relate to. If dragons don’t physically exist, how would I be able to find a lack of connection with one? Yet, that doesn’t explain why I don’t find a gryphon body appealing, or the body of any other creature of myth or fantasy. I could identify features that I would expect a dragon to have, like wings, a tail, scales, and horns; all of these are things that a human doesn’t have. I also would expect dragons to be egg-laying, so there’s none of that gross “period” stuff human women go through. But again, what’s to say gryphons wouldn’t have most of these traits too? Maybe it’s the fur, or the feathers, or even how it looks like someone went Dr. Frankenstein on a couple of animals. I don’t think I could ever get used to having hair, so why would I want even more? Yeah, I don’t think I’d be comfortable in any body that didn’t conform to a dragon’s physical features.
But dragons don’t physically exist, so how would I ever hope to become one? Barring entirely too much money spent on research into the creation of a new species from scratch, I’m probably looking at robotics, prosthetics, and other technological replacements for parts of the human body. Thankfully, research is already underway on enabling the brain to remotely control additional robotic limbs using a brain-computer interface (BCI), and we already have bionic limbs available commercially to replace missing limbs, if you have the money for it. There has even been a successful experiment of an Avatar-style interface with a humanoid robot, so it’s not hard to see how one could apply those things towards what I’m looking for. Cost is still a factor, but it would be significantly cheaper than the hundreds of billions of dollars I’d need to even have a chance at a flesh-and-blood surrogate body.
Let’s say I got one, and I wanted to see how well I could interact socially without censoring myself. Of course, the immediate response to a dragon walking in the room might earn me some strange looks, but if I’m doing this, I’m not going to care about that. What I’d care about is the long-term, and especially how much I’d have to repress my natural tendencies. Who would expect a dragon to behave exactly like a neurotypical human would? Even if they would, I couldn’t imagine them doing so for very long after witnessing my autistic quirks for any length of time. If the invisibility of Asperger’s has had any effect on how I’m treated by others, a dragon body would surely fix that. For that matter, what’s autistic for a human could even be seen as neurotypical for a dragon, as long as I didn’t try to hide it. Not having to restrict myself in accordance with the “How To Be Human” rules could just as easily extend to not having to hide autistic traits. I like the thought of that.
And what about more practical purposes? For one, a robotic body means that I’d have a greater ability to augment or change it. I’m light-sensitive, so I could give my dragon body eyes that adjust for that sensitivity. People are also working on technology to help autistics detect and understand body language, so I could implement that feature into my dragon self too. I could even incorporate augmentations to make up for my poor executive functioning, such as a built-in AI assistant that, like Siri or Google Glass, could jot down notes for me or, going further, help me record what I’m seeing and hearing, given that I’m sure to forget the experience ever happened ten minutes later. For that matter, maybe I could have it save the last hour of whatever I was doing just in case I forgot to tell my AI companion that it was important. With a surrogate body, nobody would even have to know I’m doing any of this because I could even do it by thought alone. That’s not even getting into what it could do to ease my driving anxiety. Why would I drive if I could just fly to where I need to go? Everything I’d need to improve on my deficiencies could be found right here, and if given the choice, I’ve already decided to take it.
All I need is time, money, and a doctor willing to agree with me that it’s medically necessary. Thankfully, none of these things are out of reach.
This is such a great post as a female aspie, I have been very suspicious of Baron-Cohen’s theory. I feel it is a bit sexist and harkens to the ’50s more that than current societal thinking and scientific knowledge . From experience girls are better at mimicking and it has become fairly okay to be seen as a tomboy. Also I did get along better with boys based on the fact that social standards and behavioral acceptance bars are set lower. Plus boys did more hands on interactive fun stuff. I don’t have dysphoria but identity is something I have always struggled with especially in this society.
It does feel very outdated and biased.
I don’t have dysphoria but identity is something I have always struggled with especially in this society.
This sums up exactly how I feel. I’ve slowly made my way toward being comfortable with the idea of gender fluidity and that’s been a good development.
Excellent post! I hope you don’t mind if I link to it.
Of course not! Links are always welcome.
Thank you for doing all of this. Really interesting and I especially appreciate it now when I’m dealing with the concept of gender and trying to understand (or de-understand?) it.
Fantastic blog and I concur with all of the responses. As a late diagnosis Aspie, gender confusion was one of the many apparently disparate issues I struggled with since childhood. The revelation of diagnosis at 48 suddenly accounted not only for the many previously disconnected but typical features associated with autism, but also explained why I had always had a problem with gender. The way I explain this to self and others, is that autism and (in simplistic terms) it’s extreme logic thinking, makes one relatively blind to many social boundaries and artificial societal constructs such as age, status, ethnicity, I won’t bore you with the list. Gender IS a false societal or cultural construct and is just one of the many I fail to recognise clearly. Tho’ born male I’ve never considered myself male, nor have I thought of myself as female. Rather some middle ground of indeterminate gender. Correspondingly, I don’t perceive others as either male or female unless or until they identify clearly their preference. I just think of everyone as ‘people’. I have never had the desire to dress in ‘traditionally’ feminine clothes such as a dress, but have never understood why I do not have the social freedom to do so. I have always wanted to wear androgynous clothing, such as for example one-piece jumpsuits, which in my culture are only worn casually by females. I happen to be heterosexual but am predominantly drawn to androgynous females. Since diagnosis, my greater understanding of autism and myself has enabled me to embrace the non-binary gender that I believe strongly is merely another feature of my autistic profile. I suffered ridicule in my younger years for many reasons related to undiagnosed autism, but one was that I was never ‘one of the lads’ and always associated with the girls, strongly disliking traditional male pursuits and socialising and often being mistaken for being gay, not that this ever bothered me. There’s no dispute about gender dysphoria being disproportionately represented in autism, but altho’ the proportion is still a minority, it may perhaps not be such a minority as it might appear. I have a slight advantage in being a medical professional – this has assisted rapid learning about my own condition. I work in clinical forensic medicine and my caseload contains a high proportion of developmental disorders. I frequently encounter patients with high functioning autism and anecdotally a surprisingly high proportion identify as gay or gender fluid in some way, yet many have not heard that gender dysphoria ‘can’ be a feature associated with autism. I completely agree with those questioning the research based on traditional binary gender parameters and stereotypes. Unfortunately, in a world where most do not even understand the simple distinction between sex and gender, this will be an uphill struggle.