Changing gender norms as cause of the IDEA of "autism"?

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Mona Pereth
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17 Oct 2020, 9:06 am

I just now came across a fascinating article, Did Gender Norms "Cause" the Autism Epidemic? by Robert Chapman, on a blog called Intersectional Neurodiversity.

The author points out that "autism" has no single biological essence:

Quote:
when we review the scientific literature as a whole, things begin to seem a lot more complicated in regards to the purported biological essence of the condition as such. In fact, what the research findings have shown is that over a thousand genes, alongside a huge range of environmental factors – ranging from one’s proximity to busy roads to the age of the mother during pregnancy – seem to increase the chance of tending towards the separate cognitive and behavioural traits associated with the condition. But, crucially, the condition as a whole has no single cause, or even a range of combined causes. Similarly too, there is no neurological essence of the condition: despite systematically misleading reporting by enthusiastic science journalists, the differences seem be unique in each case, and studies reporting to find some neurological unity are rarely replicated.


The article then goes on to explore the question of how the concept of "autism" emerged in the first place:

Quote:
In fact, we should really be more interested in the social causes of our categorisation of autism (including those which have since caused that category to broaden and change), rather than the biological underpinnings of the traits we associate with autism in any given single case. For, once we accept that autism has no unified physical essence, this seems to be to be the most valid way of taking about what “caused” autism to come into being as a distinct human kind, and then to expand into a broad “spectrum” – or, indeed, “epidemic”.


Below are his thoughts on that question. He argues that many of the traits now labeled "autistic" are traits that (in most parts of the West, outside of Nazi Germany and Austria) were considered socially acceptable, even valued, in men and boys during the first half of the 20th century, but then became socially unacceptable and pathologized in men and boys in the 1980's or so, due to the changing nature of the economy.

I think he has some very valid points:

Quote:
Bearing the relationship between social norms and psychiatric medicalisation in mind, we might, then, similarly ask which norms led to autism, when disentangled from intellectual disability, being categorised as a distinct kind of human, in need of medical attention, in the first place. In other words, to locate the “cause” of autism arising as a distinct human kind, we need to ask not what its biological underpinnings are, but rather which social norms changed, and in what way, for those we now labelled as being “mildly” autistic or as having “Asperger’s syndrome” beginning to emerge as problematic – something that first happened briefly in Austria in the 1930s, and then again Britain, before the rest of the West, in the 1980s.

Turn, first, to 1930s Austria, where Dr Hans Asperger and colleagues began noticing a newly distinctive kind of person. Notably, it had long been the case for a long time that those autistic persons with more notable disabilities, for example profound intellectual disability, emerged as being problematic – it was just that they were thought of as, say, “feeble-minded” or “schizophrenic” rather than “autistic”. But around this time, and for the first time in history, various boys (they were always boys, back then) began being sent to clinics in the German-speaking world who we might now class as having “Asperger’s syndrome” or “high-functioning autism”.

When considering the social causes of the emergence of autism in 1930s Vienna, it is initially significant that it coincided with the rise of Hitler, the Nazi Party, and the German the occupation of Austria. On the one hand, as I have written about previously, the Nazi Party subscribed to a Social-Darwinist ideology that drove them to categorise and attempt to eliminate what they considered abnormal behaviours. This goes part way to explaining why divergent persons were increasingly pathologised. However, this alone doesn’t explain why those specific behaviours we now call autistic ended up being deemed abnormal, and only in boys, whilst other “male” behaviours – gambling, womanising, or lying – were not then seen as problematic.

As it turns, out, though, this may be explained by gender norms in Nazi Germany, which were intertwined with the drive to sterilise and exterminate the cognitively disabled. On the one hand, in Nazi ideology, the key role of men was to contribute to the state, and the key role of women was to reproduce. Thus, for those who were profoundly cognitively disabled, neither men nor women would be seen as fit to fulfil their gender roles, meaning they were exterminated. In turn, though, at a more subtle yet equally pervasive level, Nazi ideology also promoted a hyper-masculinity, whereby manliness was specifically associated with heroic group activities. The ideal traits associated with the “new man” were thus to develop a “soldier mentality”, join brotherly male dominated organisations such as the SS, and fight together in battles. Aside from this, there was also a huge patriarchal pressure for men to marry “hereditary fit” Aryan women, reproduce, and instil Nazi values into their children. Without exhibiting all these traits, males would not be considered “real” men, and would have fallen outside the realms of normality.

This, more than anything else, may account for why those boys who were previously considered “normal” were suddenly showing up everywhere as problematic. Given that those we now label as having “Asperger’s syndrome” are more in line with what we now think of as “geek” culture – solitary, lacking social attunement, and interested in mechanistic or philosophical pursuits – they would have fallen well outside the Nazi ideal of the “new man”. That is to say, they would neither have seemed particularly good at marrying, due to their purported problems in socialising, or falling in with this “solider mentality”, since they tend to be isolated, original thinkers, unlikely to be swept up in crowd madness. In short, as Dr Asperger noted in 1944, his autistic patients tended to ‘follow only their own wishes, interests and spontaneous impulses, without considering restrictions or prescriptions imposed from outside’ – traits which would have made them highly problematic from the inside viewpoint of the Nazi drive towards homogenous, hyper-masculine group mentality.

If this suggestion seems unreasonable, consider how long it took for Asperger’s syndrome to end up being deemed an issue in the UK and the rest of the West. Whilst it was deemed problematic in the German-speaking world, briefly, in the 1930s and 1940s, it didn’t systematically appear as an issue in the rest of the West until the 1980s. Although biologised approaches to autism cannot easily account for this huge gap, one clear social explanation regards how, during the first half of the 20th Century, gender norms in the liberal West were very different from those in Nazi Germany. In fact, the modernist male ideal in the rest of the West was much more in line with those traits we now associated with Asperger’s: being rational, clear, fixed in focus, and lacking empathetic attunement were celebrated in the modernist masculine ideal.

Consider, as Patrick McDonagh has argued, how many heroes and anti-heroes produced by modernist writers (ranging from Beckett to Kafka) can retrospectively be seen to exhibit remarkable similarities to those bodies now labelled as having Asperger’s syndrome. One example is Albert Camus’ “outsider” Meursault, who has been described as a ‘striking depiction of a high-functioning autistic’. This is not just in light of his intense sensory overload under the blazing Algerian sun, but also, as Camus himself described him, his being ‘an outsider to the society in which he lives, wandering on the fringe, on the outskirts of life, solitary, and sensual’. In stark contrast to the hyper-masculinity of Nazi-Germany, these traits were, wrongly or rightly, positively fetishized in men throughout the first half of the 20th Century in much of the modernist West, meaning that they would not have been deemed pathological and in need of medicalisation.

Whilst these traits were celebrated in the modernist era, they increasingly began to show up as problems in the Britain during the 1980s – meaning that something had changed in British social normativity. Interestingly, according to critical psychiatrist Sam Timimi and colleagues, this largely happened in light of the rise of the neo-liberal market system, and in particular the services economy. In particular, this economic shift began to alter the notion of the ideal male: rather than being fixed in focus and obsessive, men increasingly now had to forever shift into new roles and to constantly sell one’s “self” in order to fit in. Members of the workforce, in other words, now had to become increasingly agile, flexed, narcissistic, and hyper-social in order to succeed and be valued – and this economic drive became reflected in social normativity at all levels of society.

Thus, whereas modernist conceptions of masculinity tended to celebrate autistic traits, neoliberal economic ideology began to alter idealised conceptions of masculinity in such a way that takes them to be pathological. Boys who fell outside these norms began showing up at clinics, and suddenly a renewed interest in Hans Asperger’s previously overlooked publications from the 1940s, led by British psychiatrist Lorna Wing, emerged in order to account for this. By the mid-1990s, Asperger syndrome had been added to all the major diagnostic manuals, the “spectrum” had radically broadened, and diagnoses of the condition had skyrocketed.

In both times and places where Asperger’s syndrome came to be seen as a distinctively problematic condition – first, briefly, in Nazi-occupied territory during the 1930s and 1940s, and then again in neo-liberal Britain, Europe, and the United States, from the late 1980s onward – shifting gender norms help account for why the condition began to show up as problematic, and that too in more and more subtle cases. Gender norms, in other words, can account for the “cause” of autism, and the autism “epidemic”, in the only way that notion makes any sense: not as something physical, but rather as something that came into being, and grew, as a distinct social grouping at some point in history.


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Jiheisho
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17 Oct 2020, 1:29 pm

Thanks for the link. It was interesting, but...

If you can actually show that gender norms in NAZI Germany were actually unique then the hypothesis could be supported. Unfortunately, while NAZI Germany was a unique point in history, it was not unique it its views at that time.

The argument is really circular. It is simply stating the way the issue needs to be defined and then choosing the information to support it. It also misrepresents anything that would contradict it.

Psychology is biology. Those two things cannot be simply separated. To say a social norm is completely unrelated to biology would ignore the science should how biology can unpin that behavior. Baron-Cohen actually shows that in his work (the misrepresentation of Baron-Cohen's work in the post is just an indication of the author's incomplete picture of the state of research).

What really disturbs me is the anti-science position the author takes--if science can't point to a simple cause to autism, then science is wrong. No, there is no social gene. There is not a stimming gene or a sensory sensitivity gene either. Th author is right in that autism is in terms of variation in human behavior, but it is also not random behavior even though it can manifest itself in people differently.

I am saying the idea the author is raising is not valid--there are some good ideas in the piece. But he clearly is advocating for a position, and as such, is rejecting important elements of autism. (I am also not a fan of post-modernism.) Some of us would not need support if society did not impose behavioral norms that make autism a "disability." But simply changing social norms will not eliminate the issues facing autistics.

I agree that we need a conversation on social behavior. I just think this oversimplification of the discussion and the rejection of the complexity of autism will not lead to solutions for the autism community broadly. Ironically, the author seems to be just asserting his social status on the argument



Mona Pereth
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17 Oct 2020, 4:24 pm

Jiheisho wrote:
Thanks for the link. It was interesting, but...

If you can actually show that gender norms in NAZI Germany were actually unique then the hypothesis could be supported. Unfortunately, while NAZI Germany was a unique point in history, it was not unique it its views at that time.

Nazi ideas of masculinity weren't totally unique, but they were certainly carried to a greater extreme in Nazi Germany than in the rest of the West. Robert Chapman pointed out plenty of literary examples showing that the rest of the West, or at least the English-speaking world, was more accepting of a variety of personalities and eccentricities during the early part of the 20th century.

Jiheisho wrote:
The argument is really circular. It is simply stating the way the issue needs to be defined and then choosing the information to support it. It also misrepresents anything that would contradict it.

Psychology is biology. Those two things cannot be simply separated. To say a social norm is completely unrelated to biology would ignore the science should how biology can unpin that behavior.

Social norms vary a lot from one culture to another and from one era to another. While they aren't completely unaffected by biology, they are certainly affected by a lot more than just biology.

Jiheisho wrote:
Baron-Cohen actually shows that in his work (the misrepresentation of Baron-Cohen's work in the post is just an indication of the author's incomplete picture of the state of research).

Since you may understand the details of Baron-Cohen's work better than I or others here, could you please explain the specifics of how Baron-Cohen's work is misrepresented in this article?

Jiheisho wrote:
What really disturbs me is the anti-science position the author takes--if science can't point to a simple cause to autism, then science is wrong.

I didn't see him say that science itself is wrong. However, science does not exist in a vacuum. The questions that science asks, in the first place -- and that are deemed to be worthy of research grants -- are determined to a large degree by social, cultural, and economic factors outside of science itself.

Jiheisho wrote:
No, there is no social gene. There is not a stimming gene or a sensory sensitivity gene either. Th author is right in that autism is in terms of variation in human behavior, but it is also not random behavior even though it can manifest itself in people differently.

I am saying the idea the author is raising is not valid--there are some good ideas in the piece. But he clearly is advocating for a position, and as such, is rejecting important elements of autism.

What important elements of autism do you see him rejecting?

Jiheisho wrote:
(I am also not a fan of post-modernism.)

I don't completely accept post-modernism, but I think it's rooted in some valid ideas.

Jiheisho wrote:
Some of us would not need support if society did not impose behavioral norms that make autism a "disability." But simply changing social norms will not eliminate the issues facing autistics.

It wouldn't completely eliminate them, but would go a long way toward making many autistic people's issues easier to deal with.

Most of the remaining issues would affect a much smaller number of people. As Robert Chapman himself points out, the more severely disabled autistic people were always seen as disabled even before the rise of the concept of "autism"; they were just seen as "feeble-minded" rather than as "autistic."

Jiheisho wrote:
I agree that we need a conversation on social behavior. I just think this oversimplification of the discussion and the rejection of the complexity of autism will not lead to solutions for the autism community broadly. Ironically, the author seems to be just asserting his social status on the argument

How is he rejecting the complexity of autism? Much of his argument hinges on pointing out the heterogeneity of autism.


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Jiheisho
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17 Oct 2020, 5:14 pm

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17 Oct 2020, 5:26 pm

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17 Oct 2020, 5:29 pm

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17 Oct 2020, 5:37 pm

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17 Oct 2020, 5:53 pm

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Mona Pereth
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17 Oct 2020, 8:16 pm

Jiheisho wrote:
Did he point out Franco and Mussolini? Did he point out the persecution of homosexuality in the UK?

Yes he did mention the persecution of homosexuality (throughout the West including the English-speaking world). Indeed, one of the author's major points (which I didn't feature in my quote) was that the reason why homosexuality was considered a "disorder" by psychiatrists (until the gay rights movement got big enough) was because it was persecuted in society at large. He argues that the psychiatric concept of "autism" arose for a similar (though less longstanding) reason: that various traits previously regarded as harmless eccentricities came to be regarded as very detrimental, especially in men, and that this change in social attitudes spurred the classification of these traits as a mental disorder.

Jiheisho wrote:
Did he point out the NAZI sympathy in the West?

No, but sympathy for the Nazis per se was never a mainstream view in the West (although some specific Nazi beliefs were indeed mainstream in the West).

Jiheisho wrote:
Did he point out that eugenics was also embraced in the West? The forced sterilization of disabled women in the US was supported in the early 1900s and the Supreme Court ruling in Buck v. Bell in 1927 created a huge increase in this practice.

He didn't mention it, but, as far as I am aware, it's not evidence against Chapman's hypothesis, because, as far as I am aware, the traits American eugenicists sought to weed out did not include what are now regarded as the defining traits of autism. If I'm not mistaken, they mainly sought to weed out low IQ (eugenics being one of the purposes for which the IQ test was invented) and physically debilitating hereditary diseases.

Also, as far as I am aware, non-Nazi eugenicists did not aim to kill the people they deemed to be dysgenic, but only to sterilize them. Which is not to say that forced sterilization was okay, but it was not as extreme as the Nazi eugenics program. I would hazard a guess that the killing of disabled children under the Nazi regime may have been what spurred Dr. Asperger to define -- and defend -- a category of boys who were unable to fit in with Nazi social norms but who weren't disabled enough to warrant killing them either, because they could do valuable jobs such as code-breaking. Toward that end he might have been spurred, also, by his memory of the earlier, more liberal Viennese social norms you mentioned:

Jiheisho wrote:
Yes, I can also find the opposite. Vienna in the early 20th century was a very liberal place, but Vienna is also an exception.

Vienna was no longer "very liberal" when the Nazis took over. Perhaps such a drastic cultural change might explain a lot?


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17 Oct 2020, 8:33 pm

Mona, I want to thank you for for the link. The Chapman piece was thought provoking.

My presentation of autism is that I will dissect things. It is just my thing--take no notice of it, it is just me thinking out loud, a habit I need to break.

Please keep posting interesting things you find.



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17 Oct 2020, 8:43 pm

Jiheisho wrote:
Mona Pereth wrote:
I didn't see him say that science itself is wrong. However, science does not exist in a vacuum. The questions that science asks, in the first place -- and that are deemed to be worthy of research grants -- are determined to a large degree by social, cultural, and economic factors outside of science itself.


In one sentence, after taking a few paragraphs attacking the science, he completely dismisses science:

Quote:
The question, in other words, is driven by a fundamental unsupported assumption: that autism is a natural category, like “gold” or “mammal”, rather than social category, like “black” or “female”.


This is a common anti-science argument, simply cast doubt on the science. This is how the tobacco and oil industries took on science. That strange thing is that science does not take away from the validity of his argument, but he did try to dismiss science.

Unlike the tobacco and oil industries, he does not dismiss any well-established actual findings of science. He just disputes some of the terminology (e.g. "extreme male brain") and some of the questions/goals being pursued by the relevant scientists (and their funders). The terminology issues are a semantic questions, not a scientific questions per se. And the questions/goals to be pursued by science are determined by the available funding sources, which are certainly influenced by larger social trends, not just by pure scientific curiosity. I don't see this as an attack on science per se.

EDIT: It is true that some actual attacks on science bring up the above kinds of issues too. Perhaps that's why Chapman's piece came across to you as anti-science?


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Dvdz
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17 Oct 2020, 8:48 pm

It's quite easy to refute this because approximately 20-30% of autism cases can be attributed to a monogenic cause.

Various twin studies also show that there is a significant genetic effect.



So his hypothesis for autism as a social construct is already wrong.



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17 Oct 2020, 8:49 pm

The very fact the article calls autism an "epidemic" has just made me die a million deaths. :skull:

Every time I come to WP I see either some new form of autismophobic stupidity or American politics. I should just give up on everything and leave. :(



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17 Oct 2020, 9:24 pm

lostonearth35 wrote:
The very fact the article calls autism an "epidemic" has just made me die a million deaths. :skull:

If you actually read the article, it should be clear that he means an "epidemic" of autism diagnoses, not an epidemic of "autism" per se. I think the title was meant to be ironic.


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17 Oct 2020, 9:53 pm

Dvdz wrote:
It's quite easy to refute this because approximately 20-30% of autism cases can be attributed to a monogenic cause.

Actually, a variety of different monogenic causes, and that still leaves 70-80%, i.e. the vast majority of "autistic" people, without a monogenic cause.

Dvdz wrote:


It has been a while since the last time I watched that video, but, if I remember correctly, Dr. Chung herself talks about the huge variety of different "autisms," acknowledging that "autism" is far from being one single condition.

Her acknowledgement of the heterogeneity of autism -- heterogeneity in both its manifestations and its causes -- is consistent with Chapman's contention that autism is not a "natural category."

Dvdz wrote:
So his hypothesis for autism as a social construct is already wrong.

I think you misunderstand what is meant by calling autism a "social construct." He's not claiming that autistic traits don't have biological underpinnings. Rather, he's saying that the category "autism" is a social construct.

Given how heterogeneous "autism" is, the fact that we all ended up getting lumped together under that one particular label is indeed an accident of social history, and it's worth examining how and why that came about.


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17 Oct 2020, 10:45 pm

His definition of "natural" and "social" categories is already problematic.

"Natural": gold, mammal
"Social": black, female

What? Why? What's the difference?

For the distinction, he references his own opinion (https://medium.com/the-establishment/autism-isnt-just-a-medical-diagnosis-it-s-a-political-identity-178137688bd5), which doesn't have any references. And even after reading that, I still don't know what exactly a "social" category is.

I'm sorry but I just can't take his kind of "science" seriously, where he references his own opinion as fact.