Scientist regrets using ‘extreme male brain’ phrase for autism

A scientist famous for his theory about the ‘extreme male brain’ in autism now says he regrets using this phrase. Professor Simon Baron-Cohen believes the term was easily misunderstood and can lead to wrong ideas about autistic people.

For about 20 years, Professor Baron-Cohen’s idea that autistic people tend to focus more on systems and less on emotions has been very influential. He still believes the science behind his theory is strong. However, he now feels that calling it the ‘extreme male brain’ was not a helpful way to describe it.

He admitted that some of the language he used was easily misunderstood, leading to simple headlines like ‘autistic people lack empathy,’ which he states is not true. He also feels that terms like ‘male brain’ and ‘female brain’ are not useful today.

Professor Baron-Cohen spoke to The Guardian before a large donation of £26m was announced for Cambridge University from American philanthropist Lisa Yang. He explained that this money will support research chosen by the autistic community. This donation is one of the biggest ever given to a UK university for autism research and will help create new centres for research and clinical care.

The new research centres are expected to focus on improving the lives of autistic people, including helping them live longer and healthier lives, diagnosing autism earlier, and finding practical ways to improve their quality of life. Professor Baron-Cohen highlighted that the physical health of autistic people has often been ignored, even though autism is often thought of as being only about the mind.

His team’s recent research, which is still awaiting official review, suggests that autistic people have a significantly higher risk of heart problems. The study looked at data from over 141,000 people and found that autistic women had a 71% higher chance of experiencing heart attacks, strokes, and other serious heart issues, even when other risk factors like high blood pressure, diabetes, and weight were considered.

Professor Baron-Cohen explained that difficulties in accessing healthcare, lifestyle choices, or genetic factors might explain these health differences. He believes doctors should be more aware of these risks when treating autistic patients, as this awareness could have a direct positive impact on their health.

The centre will also investigate the physical health experiences of autistic women, such as issues related to childbirth and monthly cycles, which some studies suggest might be more common. He mentioned that these issues could be linked to sensory sensitivities or hormonal factors. He noted that the conversation about autism is changing, with a greater focus on understanding and addressing the problems that have been overlooked.

Professor Baron-Cohen has faced criticism in the past regarding his ‘extreme male brain’ theory, which some felt suggested autism was about a lack of empathy and supported gender stereotypes. However, he clarified that his own research indicates that while autistic people might differ in understanding emotions from facial expressions or words (cognitive empathy), they do not lack the ability to feel for others (affective empathy). He stated it is a myth that autistic people lack empathy, explaining that when they see someone upset, they often feel upset too and want to help.

More recently, his team faced disagreement over plans to study the genes of 10,000 autistic people. This project was later cancelled after a two-year consultation with the autistic community. Professor Baron-Cohen now emphasizes the importance of consulting with autistic people early in the research process so their priorities can shape the research direction.

He suggested that many autistic individuals think differently from others; they don't just follow trends but think through issues themselves, often bringing fresh perspectives. The donation to Cambridge comes at a time when autism diagnoses continue to increase. In the UK, there was a large rise in diagnoses between 1998 and 2018, and the number of children referred for mental health support with possible autism rose significantly in the past year.

While some believe this rise is due to ‘over-diagnosis,’ Professor Baron-Cohen dismissed the idea that people would seek a diagnosis lightly. His team is currently testing if GPs could diagnose autism as accurately as specialists, a change that he believes could significantly reduce waiting times for diagnosis.