Autism Gender Gap

Long before autism existed as a clinical syndrome, it summarized a state of being that placed gender at the heart of selfhood. When Swiss psychiatrist Eugen Bleuler first used the term “autism” in 1911, he described a state of insulation from reality so complete that it locked out other human beings while locking its victims into unreachable interior worlds. Such extreme isolation was profoundly debilitating, but observers have always appreciated that milder variations were both normal and linked to masculinity. Manly ideals, including self-reliance and independence, were often expressed as social disconnection and emotional distance, for example. Because difficulty relating to others was the quintessential sign of autism, it is hardly surprising that autism diagnoses have been far more common among boys and men than girls and women. That may also explain why fathers have written more autism memoirs than narratives about other forms of physical or developmental disability.

Leonard Nimoy famously played Spock in “Star Trek,” only one of many popular fictional male characters who combined extreme rationality with emotional illiteracy.

One recent theory is that autism may be a too-highly concentrated version of masculinity. British researcher Simon Baron-Cohen proposed this in his 2003 book, The Essential Difference: Men, Women, and the Extreme Male Brain. We are all familiar with the cultural stereotypes that tie autism to male gender. From Dustin Hoffman’s character in Rain Man (1988) to Star Trek’s Dr. Spock and The Big Bang Theory’s” Sheldon Cooper, autistic archetypes are invariably male.

Representations of  Asperger Syndrome have been overwhelmingly so. Asperger’s, which appeared in the DSM-IV in 1994, was named after Hans Asperger, a Viennese pediatrician whose 1944 article describing autism wasn’t widely known in the English-speaking world until the early 1980s. Boys were the only subjects of Asperger’s case study and the syndrome was widely interpreted as “high-functioning” autism.

Asperger’s cemented popular associations between technical and scientific skill, on the one hand, and social and emotional cluelessness, on the other. Mark Zuckerburg, the founder of Facebook, was rumored to have Asperger’s, along with others in Silicon Valley, ground zero of “the geek syndrome.” Of the eleven children included in Leo Kanner’s iconic 1943 article about autism, eight were boys and three were girls. The CDC estimates that boys are five times more likely to be diagnosed with autism than their female counterparts. Few obstacles remain to asserting that there definitely are male and female brains, or that nerdiness has neurological underpinnings.

The move from masculinizing autism to feminizing its opposite mirrored and reinforced gender stereotypes. Boys were considered good at abstract cognitive operations that made them brilliant at math but blind to the mental states and emotional experiences of others. Girls, in contrast, were empathizers at ease in relationships. Their brains were wired to detect interpersonal subtleties, so they devoted considerable time to thinking about what other people were thinking. In the language of autism research, girls naturally possessed “theory of mind.” According to this theory, the pull that many girls and women felt toward emotional intelligence, relational connection, and caring labor was just as natural as boys’ tendency toward social awkwardness.

Because the autistic condition has systematically excluded girls and women, girls and women who experience it are difficult to detect, a fact that leads, in circular fashion, to skepticism that female experiences can ever be autistic. Evidence for this can be found in the many autism studies that have not included female subjects, taking as a given that autism was more or less synonymous with masculinity.

This makes it interesting that a woman, Temple Grandin, is the most famous autistic individual alive in the United States, and perhaps in the world. Rather than stemming the flood of stories that implicate male gender in autism, Grandin’s powerful persona has cancelled out her gender. Her technical skills in engineering, tall stature, fondness for no-nonsense western apparel, and indifference to romance lend her a distinctly androgynous, even masculine sensibility. When a girl or woman has autism, in other words, it may be easier to suspect her gender than recast autism as a feminine possibility. In fact, conventionally feminine traits are widely understood to be antithetical to autism. Just think about how parents respond to princess preoccupations or ballerina fantasies, or how they manage some girls’ insistence on having the color pink everywhere. These represent restricted interests and obsessions with sameness and can be as compulsive and rigid as memorizing train schedules or performing mathematical calculations. Yet we tend to categorize them as harmless aspects of femininity, even when they become enduring traits of personality.

Gender has been key factor in autism’s history. It shaped the earliest definitions of the syndrome, influenced its diagnostic criteria, and fixated researchers and ordinary people alike on an exclusive alliance between autism and masculinity. Gender helped to set the boundaries around autism, telling us what it was and who could experience it.

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