The Extreme Male Brain Theory of Autism and the Potential Adverse Effects for Boys and Girls with Autism
- 3.7k Downloads
Autism, typically described as a spectrum neurodevelopmental disorder characterized by impairments in verbal ability and social reciprocity as well as obsessive or repetitious behaviours, is currently thought to markedly affect more males than females. Not surprisingly, this encourages a gendered understanding of the Autism Spectrum. Simon Baron-Cohen, a prominent authority in the field of autism research, characterizes the male brain type as biased toward systemizing. In contrast, the female brain type is understood to be biased toward empathizing. Since persons with autism are characterized as hyper-systemizers and hypo-empathizers, Baron-Cohen suggests that, whether they are male or female, most possess an “extreme male brain profile.” We argue that Baron-Cohen is misled by an unpersuasive gendering of certain capacities or aptitudes in the human population. Moreover, we suggest that this may inadvertently favour boys in diagnosing children with Autism Spectrum Disorders. If this is correct, it could also have rather serious consequences for treatment and services for girls (and women) on the Autism Spectrum.
KeywordsAutism Gender Sex Brain Stereotyping Diagnosis Empathy
Thanks to Susan Sherwin and the Novel Tech Ethics research team for feedback on previous drafts of this paper as well as audience members who attended an oral conference presentation on the topic at the American Society for Bioethics and Humanities annual conference in 2009. Funding for this project was provided by the Canadian Institutes of Health Research, NNF 80045, States of Mind: Emerging Issues in Neuroethics.
Statement of Competing Interests
The authors have no competing interests to declare.
- Abbeduto, L., and A. McDuffie. 2007. Language learning and use as embedded social activities: Evidence from autism and fragile X syndrome. In Language disorders from a developmental perspective: Essays in honor of Robin S. Chapman, ed. R. Paul and R.S. Chapman, 195–214. Mahwah: Lawrence Erlbaum Associates.Google Scholar
- American Psychiatric Association and Task Force on DSM-IV. 2000. Diagnostic and statistical manual of mental disorders, DSM-IV-TR. Washington, DC: American Psychiatric Association.Google Scholar
- Anonymous. 2005. Girls’ autism “under-diagnosed.” BBC News. http://news.bbc.co.uk/go/pr/fr/-/1/hi/health/4630705.stm. Accessed August 18, 2010.
- Baron-Cohen, S. 1995. Mindblindness: An essay on autism and theory of mind. Cambridge: MIT Press.Google Scholar
- Baron-Cohen, S. 2003. The essential difference: Men, women and the extreme male brain. London: Penguin.Google Scholar
- Baron-Cohen, S. 2005a. Autism—“Autos”: Literally, a total focus on the self? In The lost self: Pathologies of the brain and identity, ed. T.E. Feinberg and J.P. Keenan, 166–180. Oxford: Oxford University Press.Google Scholar
- Baron-Cohen, S. 2005b. The empathizing system: A revision of the 1994 model of the mindreading system. In Origins of the social mind: Evolutionary psychology and child development, ed. B.J. Ellis and D.F. Bjorklund, 468–492. New York: Guilford Press.Google Scholar
- Baron-Cohen, S. 2005c. The male condition. The New York Times. http://www.nytimes.com/2005/08/08/opinion/08baron-cohen.html. Accessed August 15, 2010.
- Baron-Cohen, S. 2009. Coevolution of language and theory of mind. Do sex differences in empathy account for sex differences in language acquisition? Interdisciplines—European Science Foundation. http://www.interdisciplines.org/coevolution/papers/7/4. Accessed August 18, 2010.
- Baron-Cohen, S., H. Tager-Flusberg, and D.J. Cohen. 1993. Understanding other minds: Perspectives from autism. Oxford: Oxford University Press.Google Scholar
- Brasic, J. R. 2011. Autism. Medscape Reference. http://emedicine.medscape.com/article/912781-overview. Accessed August 13, 2011.
- Bryson, S.E., S.J. Rogers, and E. Fombonne. 2003. Autism Spectrum Disorders: Early detection, intervention, education, and psychopharmacological management. The Canadian Journal of Psychiatry 48(8): 506–516.Google Scholar
- Caplan, P.J., and J.B. Caplan. 1999. Thinking critically about research on sex and gender. New York: Addison-Wesley Longman.Google Scholar
- Cowley, G. 2003. Girls, boys and autism. Newsweek. http://www.newsweek.com/id/59999/output/print. Accessed August 18, 2010.
- de Villiers, J. 2000. Language and theory of mind: What are the developmental relationships. In Understanding other minds: Perspectives from developmental cognitive neuroscience, ed. S. Baron-Cohen, H. Tager-Flusberg, and D.J. Cohen, 83–123. Oxford: Oxford University Press.Google Scholar
- Donvan, J. 2008. “Underdiagnosed” girls with autism struggle to fit in. ABC News. http://abcnews.go.com/print?id=4177353. Accessed August 18, 2010.
- Downs, E. 2008. Girls’ autism signs miss early diagnosis. The Journal Gazette. http://www.journalgazette.net/apps/pbcs.dll/article?AID=/20081214/FEAT/812140310. Accessed August 18, 2010.
- Faherty, C. 2002. Asperger’s syndrome in women: A different set of challenges? Autism Today. http://www.autismtoday.com/articles/Aspergers_in_Women.htm. Accessed August 18, 2010.
- Fausto-Sterling, A. 1985. Myths of gender: Biological theories about women and men. New York: Basic Books.Google Scholar
- Fausto-Sterling, A. 2000. Sexing the body: Gender politics and the construction of sexuality. New York: Basic Books.Google Scholar
- Fine, C. 2010a. Delusions of gender: How our minds, society, and neurosexism create difference. New York: W.W. Norton.Google Scholar
- Fine, C. 2010b. Response to Simon Baron-Cohen. CordeliaFine.com. http://www.cordeliafine.com/Fine_Response_Psychologist_December_2010.pdf. Accessed August 10, 2011.
- Flora, C. 2006. An Aspie in the city. Psychology Today, November/December. http://www.psychologytoday.com/articles/index.php?term=pto-20061103-000002&print=1. Accessed August 18, 2010.
- Frith, U. 1989. Autism and “theory of mind”. In Diagnosis and treatment of autism, ed. C. Gillberg, 29–52. New York: Plenum Press.Google Scholar
- Gillberg, C., and M. Coleman. 2000. The biology of the autistic syndromes. London: Mac Keith.Google Scholar
- Gillberg, C., and M. Rastam. 1992. Do some cases of anorexia nervosa reflect underlying autistic-like conditions? Behavioural Neurology 5(1): 27–32.Google Scholar
- Hill, A. 2009. Doctors are “failing to spot Asperger's in girls.” The Guardian—The Observer. http://www.guardian.co.uk/lifeandstyle/2009/apr/12/autism-aspergers-girls. Accessed August 18, 2010.
- Jordan-Young, R.M. 2010. Brain storm: The flaws in the science of sex differences. Cambridge: Harvard University Press.Google Scholar
- Kindlon, D.J., M. Thompson, and T. Barker. 1999. Raising Cain: Protecting the emotional life of boys. New York: Ballantine Books.Google Scholar
- Kitayama, S., and D. Cohen. 2010. Handbook of cultural psychology. New York: Guilford.Google Scholar
- Lloyd, G. 1984. The man of reason: “Male” and “female” in Western philosophy. London: Methuen.Google Scholar
- Minshew, N.J., and J.A. Meyer. 2006. Autism and related conditions. In Patient-based approaches to cognitive neuroscience, ed. M.J. Farah and T.E. Feinberg, 419–431. Cambridge: MIT Press.Google Scholar
- Nash, A., and G. Grossi. 2007. Picking Barbie’s brain: Inherent sex differences in scientific ability? Journal of Interdisciplinary Feminist Thought 2(1): 1–23.Google Scholar
- North, A. 2009. Asperger’s underdiagnosed in girls, says expert. Jezebel. http://jezebel.com/5210227/aspergers-underdiagnosed-in-girls-says-expert. Accessed September 3, 2011.
- Paechter, C.F. 2007. Being boys, being girls: Learning masculinities and femininities. Maidenhead: Open University Press.Google Scholar
- Pâerez Pereira, M., and G. Conti-Ramsden. 1999. Language development and social interaction in blind children. Hove: Psychology Press.Google Scholar
- Powers, M., and R.R. Faden. 2006. Social justice: The moral foundations of public health and health policy. Oxford: Oxford University Press.Google Scholar
- Rooney, P. 1994. Recent work in feminist discussions of reason. American Philosophical Quarterly 31(1): 1–21.Google Scholar
- Schick, B., J. de Villiers, P. de Villiers, and B. Hoffmeister. 2002. Theory of mind: Language and cognition in deaf children. The ASHA Leader, December 3. http://www.asha.org/Publications/leader/2002/021203/f021203.htm. Accessed August 18, 2010.
- Sherwin, S. 1992. No longer patient: Feminist ethics and health care. Philadelphia: Temple University Press.Google Scholar
- Skuse, D.H., W. Mandy, C. Steer, et al. 2009. Social communication competence and functional adaptation in a general population of children: Preliminary evidence for sex-by-verbal IQ differential risk. Journal of the American Academy of Child and Adolescent Psychiatry 48(2): 128–137.PubMedCrossRefGoogle Scholar
- Smith, T. 2002. Sexual differences in Pervasive Developmental Disorders. Medscape Psychiatry & Mental Health eJournal. http://www.medscape.com/viewarticle/431135. Accessed August 18, 2010.
- Stobbe, M. 2007. Autism “epidemic” may be all in the label—behaviors were as common years ago, but definition, diagnosis have shifted. MSNBC.com. http://www.msnbc.msn.com/id/21600784/. Accessed August 18, 2010.
- Tager-Flusberg, H. 1993. What language reveals about the understanding of minds in children with autism. In Understanding other minds: Perspectives from autism, ed. S. Baron-Cohen, H. Tager-Flusberg, and D. Cohen, 138–157. Oxford: Oxford University Press.Google Scholar
- Tavris, C. 1998. The science and politics of gender research: The meanings of difference. In Gender and motivation, ed. D. Bernstein, 1–24. Lincoln and London: University of Nebraska Press.Google Scholar
- Thompson, T., M. Caruso, and K. Ellerbeck. 2003. Sex matters in autism and other developmental disabilities. Journal of Learning Disabilities 7(4): 345–362.Google Scholar
- Traustadóttir, R., and K. Johnson. 2000. Women with intellectual disabilities: Finding a place in the world. London: Jessica Kingsley Publishers.Google Scholar
- World Health Organization. 2009. Women and health: Today's evidence tomorrow’s agenda. WHO. http://www.who.int/gender/documents/9789241563857/en/index.html. Accessed September 23, 2011.
- Zahn-Waxler, C. 2006. The origins and development psychopathology in females and males. In Developmental psychopathology—vol. 1: Theory and method, ed. D. Cicchetti and D.J. Cohen, 76–138. Hoboken: Wiley.Google Scholar