This interview was originally published on audible.co.uk.
Cognitive neuroscientist Gina Rippon has spent much of her career dedicated to debunking the myth of a male versus female brain. Now, in , she has turned that same line of questioning towards autism spectrum disorder. Gina discusses why autism has largely been considered a “male condition,” leaving behind countless women and girls who go undiagnosed—or who were never evaluated in the first place. Below, Gina shares some of the most surprising findings in her research, and how we can best advocate for the next generation.
In your book , you debunk the myth of a male versus female brain. How does Off the Spectrum and your work with autism converge or diverge with those findings?
That is a great question! Both books tackle the issue of "gender gaps," the causes of world-wide differences between females and males in personality, performance, achievements and power. But also, in the case of autism, the statistics that show that many more males than females are diagnosed with autism (the ratio has been as high as 15:1 but is currently quoted at 4:1). Why are there these female/male differences? Can we just "blame the brain"?
Gender and Our Brains looked at brain-based explanations for gender equality gaps—the under-representation of women in science, for example. How true is the centuries-old assertion that there are two types of brains, female and male, which are inextricably linked to the biological sex of their owners and invariably determine how we think and feel, and therefore what we can do with our lives? A review of decades of psychological and brain-imaging research concluded that this notion was a myth that needed busting.
What about autism? Could it be that, in the rarer reaches of human behavioural differences, biological sex does indeed exert a determining influence in this particular brain-based way of interacting with the world? How could I square the circle of claiming there were no sex differences in the brain (which, actually, I didn’t) with the fact that there were clear sex differences in the prevalence of autism, a genetically determined, brain-based disorder, much more common in males than females? These sex differences in autism were so clear that researchers have been hunting for a "female protective effect" (in a rare example of claiming something positive for female biology) or have proposed that autism arose from the possession of an “extreme male brain.”
And that was the origin of Off the Spectrum. Did the world of autism brain research actually show genuine sex-based differences, which could explain why there was this male prevalence? My initial deep dive to check this out immediately revealed a problem. The notion that autism is a male problem has been so deeply embedded that the sex-difference research I was hoping to comment on was virtually non-existent! And a deeper dive revealed that this male bias was also influencing who was even assessed as autistic in the first place, with a powerful male filter determining how they were assessed. So, both books challenge sex and gender myths in different ways: that brains can be "sexed," and that autism is a male problem. They both reveal that unchallenged beliefs can distort the scientific research process and that this can "leak out" into public consciousness and prop up misleading stereotypes. I’m assuming you mean the gender gap in scientific research into autism. (Although I could rant lengthily about the under-representation of women in science and scientific research!) A core problem is the biased recognition and assessment of autistic females. Boys are 10 times more likely to be referred for an autism assessment than girls, and twice as likely to be diagnosed as autistic than girls. And a high percentage of autistic females are not diagnosed until well into adulthood. For research, this means that there is a very limited number of diagnosed females to be included in research studies. So the so-called "gold standard" autism assessment schedules need to be amended to more accurately recognise autism in females, for example by using gendered norms, but also by incorporating previously unrecognised aspects of autism which are more characteristic of females.
