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The extreme male brain revisited: gender coherence in adults with autism spectrum disorder
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.ORCID iD: 0000-0002-3587-6075
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Northern Stockholm Psychiatry, St Göran Hospital, Stockholm, Sweden.
Department of Woman and Child Health, Division of Obstetrics and Gynaecology, Karolinska Institutet, Stockholm, Sweden.
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2012 (English)In: British Journal of Psychiatry, ISSN 0007-1250, E-ISSN 1472-1465, Vol. 201, 116-123 p.Article in journal (Refereed) Published
Abstract [en]

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 adults with high-functioning ASD and age- and gender-matched neurotypical controls. Photographs of face and body, as well as voice recordings, were obtained and assessed with respect to gender coherence, blindly and independently, by eight assessors.

Results: Women with ASD had higher total and bioactive testosterone levels, less feminine facial features and a larger head circumference than female controls. Men in the ASD group were assessed as having less masculine body characteristics and voice quality, and displayed higher (i.e. less masculine) 2D:4D ratios, but similar testosterone levels to controls. Androgynous facial features correlated strongly and positively with autistic traits measured with the Autism-Spectrum Quotient in the total sample. In males and females with ASD dehydroepiandrosterone sulfate did not decrease with age, in contrast to the control group.

Conclusions: Women with ASD had elevated testosterone levels and several masculinised characteristics compared with controls, whereas men with ASD displayed several feminised characteristics. Our findings suggest that ASD, rather than being characterised by masculinisation in both genders, may constitute a gender defiant disorder.

Place, publisher, year, edition, pages
London, United Kingdom: Royal College of Psychiatrists , 2012. Vol. 201, 116-123 p.
National Category
Medical and Health Sciences Psychiatry
Identifiers
URN: urn:nbn:se:oru:diva-50142DOI: 10.1192/bjp.bp.111.097899ISI: 000307423800010PubMedID: 22500012Scopus ID: 2-s2.0-84862222896OAI: oai:DiVA.org:oru-50142DiVA: diva2:925928
Available from: 2016-05-03 Created: 2016-05-03 Last updated: 2017-10-17Bibliographically approved

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