Pioneer of ‘extreme male brain’ theory of autism now says phrase unhelpful

The scientist who pioneered the “extreme male brain” theory of autism has said he regrets characterising the condition in this way because the phrase lends itself to misunderstandings.Prof Simon Baron-Cohen’s theory that autistic people tend strongly towards systemising over empathising has been hugely influential in shaping the popular perception of autism over the past two decades. The underlying science had stood the test of time, he said, but he now views the “extreme male brain” label as unhelpful.“Some of those terms were very easily misunderstood and so I do regret that,” he said. “It can lead to simplistic headlines like ‘autistic people lack empathy’, which is not true.“Some of that language, like male brain and female brain, I just don’t think it’s useful today.”Speaking to the Guardian before the announcement of a £26m ($34.5m) gift to Cambridge University from the US philanthropist Lisa Yang, Baron-Cohen said the funding would be used for research guided by the priorities of the autistic community.It is one of the largest ever donations to a UK university for autism research and will be used to create the autism-research" class="entity-link entity-organization" data-entity-id="159179" data-entity-type="organization">K Lisa Yang Centre for autism Research, and a clinical autism centre in a future Cambridge children’s hospital, both of which Baron-Cohen will oversee.The research centre is expected to focus on improving life expectancy and health outcomes for autistic people, earlier diagnosis and practical solutions to improve quality of life. The physical health of autistic people, in particular, is an area that has been overlooked, according to Baron-Cohen.“Although people think of autism as to do with the mind and the brain, what’s been neglected is the fact that autistic people tend to die younger,” he said.Recent findings by his team, which are yet to be peer-reviewed, suggest autistic people are at substantially increased risk of cardiovascular disease. Based on data from 141,672 people, they concluded that autistic women were at 71% higher risk of a heart attack, stroke and other serious cardiac events, even after taking into account known risk factors such as blood pressure, diabetes and obesity.“If you’d asked me 20 years ago to look at autism and cardiovascular disease, it just wouldn’t have been on our radar, but it’s come from the autism community,” Baron-Cohen said.Reasons for the association could include difficulty accessing NHS services, lifestyle or genetic factors. “It suggests if your patient is autistic, you need to be looking for these particular things as well,” he said. “It could have a direct benefit.”The centre is also likely to explore physical health experiences of autistic women, including distress related to childbirth and menstrual issues, which some previous findings indicate may be more common.“That could relate to the sensory hypersensitivity, but it could be directly hormonal as well,” said Baron-Cohen. “The dialogue with the autism community is changing where we shine a light and which are the phenomena, or the problems, that need attention and that were being neglected.”Baron-Cohen has previously sparked controversy in the autism community, dating back to his “extreme male brain” theory, which was criticised for framing autism as an empathy deficit and reinforcing gender stereotypes.In fact, he said, his own research showed that autistic people tend to differ in cognitive empathy (interpreting facial expressions and language) but not affective empathy (the internal response to others’ feelings). “Once they know that someone is upset, it upsets them and they want to do something about it,” he said. “There’s a kind of myth that autistic people lack empathy.”More recently, Baron-Cohen’s team faced a backlash over a plan to sequence the genomes of 10,000 autistic people, which eventually resulted in the project being dropped after a two-year consultation with the autistic community. He said there was now a far greater emphasis on consultation at an early enough stage for research priorities to be shaped, or enriched, by the input of autistic people.“I can’t generalise, but many autistic people think differently, they’re not just being led by fashion or convention, they’re thinking from first principles for themselves and might come up with a very fresh way of looking at something,” he said.The Cambridge donation comes against a backdrop of a continued rise in autism diagnoses. There was a nearly 800% increase in the UK between 1998 and 2018 and, in 2024-2025 the number of cases of children referred to mental health services with possible autism rose by almost 50% in a single year.Some argue that “over-diagnosis” is to blame, but Baron-Cohen dismissed the idea that people would seek a diagnosis in “a casual way”. His team is doing a pilot of whether GPs can diagnose autism as accurately as specialist referral centres, which he said could “cut the waiting lists overnight”.