The extreme male brain revisited: gender coherence in adults with autism spectrum disorder

  title={The extreme male brain revisited: gender coherence in adults with autism spectrum disorder},
  author={Susanne Bejerot and Jonna Maria Eriksson and Sabina Bonde and Kjell Carlstr{\"o}m and Mats B Humble and Elias Eriksson},
  journal={British Journal of Psychiatry},
  pages={116 - 123}
Background The ‘extreme male brain’ theory suggests that autism spectrum disorder (ASD) is an extreme variant of male intelligence. However, somewhat paradoxically, many individuals with ASD display androgynous physical features regardless of gender. Aims To assess physical measures, supposedly related to androgen influence, in adults with and without ASD. Method Serum hormone levels, anthropometry, the ratio of 2nd to 4th digit length (2D:4D) and psychiatric symptomatology were measured in 50… 
Testing the Extreme Male Brain Theory of Autism Spectrum Disorder in a Familial Design
The findings emphasize the role of familially based elevated pre‐ and postnatal testosterone levels in the liability for ASD, but challenge the use of 2D:4D ratio as a proxy of prenatal testosterone exposure solely.
Sexuality and Gender Role in Autism Spectrum Disorder: A Case Control Study
It is concluded that the extreme male patterns of cognitive functions in the autistic brain do not seem to extend to gender role and sexuality, and a gender-atypical pattern for these types of characteristics is suggested in autism spectrum disorder.
Testing the ‘Extreme Female Brain’ Theory of Psychosis in Adults with Autism Spectrum Disorder with or without Co-Morbid Psychosis
The bias for empathizing over systemizing may be linked to the presence of psychosis in people with ASD, and the link between mania/hypomania and an empathizing bias was greater in women with ASD and psychosis than in men with ASD.
Sex differentiation of brain structures in autism: Findings from a gray matter asymmetry study
  • Zhizhou Deng, Suiping Wang
  • Psychology, Biology
    Autism research : official journal of the International Society for Autism Research
  • 2021
A diagnosis‐by‐sex interaction effect was identified in the planum temporale/Heschl's gyrus that supports the FPE theory in showing greater brain structure changes (masculinization) in females with ASD.
Attenuation of Typical Sex Differences in 800 Adults with Autism vs. 3,900 Controls
Both males and females with autism showed a shift toward the extreme of the “male profile” on these measures and in the distribution of “brain types” (the discrepancy between standardized EQ and SQ-R scores).
The face predicts the brain: An investigation of facial morphology associated with autism
Previous studies have indicated that testosterone may be associated with cognitive masculinisation in individuals with autism. Testosterone also exerts masculinising effects on facial morphology.
Perceived Gender Ratings for High and Low Scorers on the Autism-Spectrum Quotient Consistent with the Extreme Male Brain Account of Autism
Comparing groups of males selected for high or low scores on the Autism-spectrum Quotient as to the rated masculinity of their faces and voices, and comparable groups of females as toThe rated femininity of their face and voices provides partial support for a link between high levels of autistic-like traits and hypermasculinization for males and defeminization for females, consistent with the EMB theory.
Minor Physical Anomalies in Adults with Autism Spectrum Disorder and Healthy Controls
Examining the prevalence and patterns of MPAs in adults with autism spectrum disorder (ASD) and whether MPAs are associated with symptom severity and overall functioning suggested a link between MPAs, autistic traits, and level of functioning.
Understanding the Neuropsychology of Autism Spectrum Disorders in Men
Men in the general population exhibit more autistic traits than women, and among control subjects without autism spectrum disorder (ASD), twice as many men as women had elevated scores on an autism screener, the Autism Spectrum Quotient (AQ).
Sex-different abnormalities in the right second to fourth digit ratio in Japanese individuals with autism spectrum disorders
The present findings suggest that high prenatal testosterone could be a risk factor both for Japanese men and women with ASDs, elucidating one potential etiology of ASDs in women.


Fetal testosterone and autistic traits.
Studies of amniotic testosterone in humans suggest that fetal testosterone (fT) is related to specific (but not all) sexually dimorphic aspects of cognition and behaviour. It has also been suggested
Topical Review: Fetal Testosterone and Sex Differences in Typical Social Development and in Autism
It is argued that prenatal and neonatal testosterone exposures are strong candidates for having a causal role in sexual dimorphism in human behavior, including social development, and as risk factors for conditions characterized by social impairments, particularly autism spectrum conditions.
The Autism-Spectrum Quotient (AQ): Evidence from Asperger Syndrome/High-Functioning Autism, Malesand Females, Scientists and Mathematicians
The Autism-Spectrum Quotient is a valuable instrument for rapidly quantifying where any given individual is situated on the continuum from autism to normality, and its potential for screening for autism spectrum conditions in adults of normal intelligence remains to be fully explored.
Autistic features in girls from a psychiatric sample are strongly associated with a low 2D:4D ratio
A low 2D:4D ratio in girls was highly predictive of the presence of autistic features, suggesting that a low ratio could possibly be used as a diagnostic predictor in clinical practice.
The extreme male brain theory of autism
Autism Spectrum Disorders in Gender Dysphoric Children and Adolescents
Clinicians should be aware of co-occurring ASD and GID and the challenges it generates in clinical management and the risks it poses to patients.
RAADS-14 Screen: validity of a screening tool for autism spectrum disorder in an adult psychiatric population
RAADS-14 Screen is a promising measure in screening for ASD in adult psychiatric outpatients, and three factors consistent with mentalizing deficits, social anxiety, and sensory reactivity relevant for the diagnosis of ASD are identified.
Large Brains in Autism: The Challenge of Pervasive Abnormality
  • M. Herbert
  • Psychology, Biology
    The Neuroscientist : a review journal bringing neurobiology, neurology and psychiatry
  • 2005
A convergence of findings and models suggests that a systems- and chronic disease-based reformulation of function and pathophysiology in autism needs to be considered, and it opens the possibility for new treatment targets.