Is Aspergers just gender blending + slow development?

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Hear me out for a second here.

There seems to be mounting scientific evidence that Asperger's diagnoses are very strongly correlated with gender issues,
either physical, mental or both. (See "The extreme male brain revisited: gender coherence in adults with autism spectrum disorder" http://www.ncbi.nlm.nih.gov/pubmed/22500012 and related papers, including the follow up studies that examine the neurological aspects via MRI brain scan comparisons between males and females with and without an ASD diagnosis.).
Basically females with Asperger's often seem fairly shifted to the male side both physically and neurologically, and males with Asperger's are often shifted to the female, physically and also somewhat neurologically (the evidence there is currently somewhat less conclusive). I believe that people such as Simon Baron-Cohen are in fact now taking this angle on board, but I suspect it will be a while before they do an 'about face' and come to new conclusions, (or write a new set of books to replace the 'Extreme male brain'/'Essential difference'/'Empathising/systematising' hypothesis etc.)

You only have to read the other posts on this forum for ample anecdotal evidence that a lot of us can be very confused about gender issues as a whole, either identifying as trans* or genderqueer, or not really understanding the whole concept of gender or feeling that it applies to us very much.

This aspect of gender blending seems to be an overall societal trend in Western countries. The once stark differences between males and female body shapes and behavioural traits seem to be gradually mixing into one another more and more with each successive generation The rise in new fashion trends (androgyny/metrosexuality), of more variant gender identities (bigender, agender, genderqueer, trans*) and variant sexualities, and even a (perhaps somewhat suppressed) increasing prevalence of intersex conditions appearing at birth, seems to be a result of this process. (Also the increasing liberalisation general societal attitudes to these variations may also be a result of the same process operating on our overall behaviour/attitudes)

The ultimate cause of this process may be down to environmental pollutants created by industrialisation (see: 'Our Stolen Future'), the introduction of the contraceptive pill perhaps changing behaviour or disrupting hormonal cycles in the womb during gestation, changes to our diets to include a higher fat content which can increase estrogen in our bodies, or just changes in sexual selection choices (see: Neoteny.org), or some combination of the above factors combined in a more complex feedback cycle, but whatever the cause the effects over the last 30 years seem to at this stage be undeniable across large swathes of society as a whole.

Now of course 'Aspergers' itself has never been that well defined, (or even existent in English speaking nations much before the 1990s, or indeed post DSM 5), and has always been based on a distinct behavioural profile, rather than any aspect of actual biology or neurology. Much money has been spent over the last couple of decades looking for specific genetic markers or environmental causes (the whole vaccine debacle etc.), with limited definitive conclusions being reached, but perhaps the real situation actually 'simpler' but more wide ranging, and coming from a different angle.

Now since my teenage years I've always considered myself rather MTF leaning, but have never taken any action to change my appearance, or really identify as such. Until recently I always assumed that when Transexuals were given hormone treatments it was solely for the purpose of reshaping their bodies into the desired gender appearance.
However having taking on board the scientific and anecdotal sides of the correlation between ASD and Trans* issues from here, and having also read several forums and blogs about the subjective experience of gender dysphoria and the difference that hormone replacement therapy can actually make to someone mentally and emotionally as well as physically, it seemed like a lot of people on both sides were essentially describing the same subjective experiences and issues, they just seemed to be identifying them with very different causes.

So having essentially nothing to lose I decided to do a little experiment on myself. I got hold of some herbal estrogen substitute and started on a low dose. Almost immediately the depression that had plagued me for the last 18 month began to vanish, and I started to feel a lot less anxious in general. As things have gone on it almost seems like a lot of the parts of my brain that weren't functioning correctly have now started to 'light up'. The subjective experience has been very strange and intense at times, so it's probably inadvisable to follow in my footsteps without a fairly firm grip on reality, but it does seem like once my hormonal balance had shifted a bit a lot of the 'problems' I had that are typically associated with 'Aspergers' have begun to solve themselves bit by bit.

After having kind of swung back and forth for a bit I now seem to have a fairly stable 'layer of social context' overlaying my previous world view. I now seem to be 'getting' body language, and fashion, and certain colours seem to pop out at me and grab my attention. I think that I'm understanding other people better and expressing myself more. I feel much more in touch with my own emotions and am better able to identify what my body actually needs in terms of nutrition etc, and for the most part I'm just generally a lot happier and more comfortable in my own skin.

I'm not sure how much further I'm going to go, as I am starting to also have physical changes and I don't want it to get too obvious, but so far the experience has been very positive. I'm not saying I'm 'cured', I'm sure there are so many experiences I have missed out on growing up that I'll probably never have the social skills of an NT, but I believe I may now be having a lot of the same perceptions and emotions, and some of their behavioural patterns are starting to make a lot more sense to me.

The reason I included the 'slow development' in the title relates back to what I read on Neoteny.org and possibly elsewhere. The higher the estrogen level in the womb, the slower the maturation process of the resulting child. Certainly a lot of us seem to always look quite young for our age, and many remain fairly androgynous looking for much of our early life. If this slow physical development is also applied to the brain, we may well have increased neuroplasticity over a much longer period than most NTs, which may possibly explain our often prodigious memory capacity and perhaps picture thinking or possible savant like splinter skills.

At any rate it seemed that at the age of just over 30 I have unfortunately somewhat reached a plateau intellectually, and my 'body clock' seemed to be getting rather insistent that something dramatic needed to change in my life, so perhaps I have now matured sufficiently that my 'missing' social/emotional side could begin fire up and take it's rightful place, it just needed a bit of a 'boost' to kick it into action. I have also been taking rather large amounts of omega 3 fish oils and various other supplements over the last few years, so they may have had some impact.

So the question is, for any of you others that have actually taken HRT to transition, in either direction. Did you feel that it lessened or increased your symptoms of ASD, or did it have no effect whatsoever?
What mental/social/perceptual changes did you encounter during the process and how did you integrate them with your existing personality/behaviour?
What age did you transition, and have you noticed any further changes occurring as you have matured?

If we are indeed more gender blended, and often start out life in a fairly androgynous state, it seems that it could also explain the much fabled 'lack of pretend play' and 'repetitive nonfunctional behaviours' that have come to define our condition.
Having not many of the normal intrinsic male/female behavioural patterns activated when we are young we may tend not to want to play with dolls or cars or create and play out imaginary social scenarios, but instead latch onto other 'random' features in our environment and begin the process of 'modelling' our sensory environment through repetitively recreating the same patterns of stimuli with minor variations until we come to a greater understanding of what is going on around us.
That kind of thing is all rather speculative, but it kind of seems to fit both the neurological evidence and our general behavioural patterns as we develop.

There are more links I could provide to various sources and papers if required, but this is getting rather long already.
Let's see if this post picks up any interesting replies before I go too much further.
As a working hypothesis it appears to be worthy of further scrutiny at any rate.

That makes a lot of sense to me. This article describes me well. Thank you for sharing the article and putting it out there.

To answer your questions

I don't think it had any effect as to lessening or increasing my ASD. I do know that with being on HRT, I have changed in how I act with my ASD symptoms. When I meltdown, I don't get angry and my frustration isn't explosive, but I do cry and panic more. The ASD is still there, and I present the symptoms, but I just do it in a different manner.



Mentally, I'm no longer horny all the time which was rediculously annoying and I'm so thankful for it to be gone. My sexual attraction is starting to swing the other way which is interesting. On the social scene, it's the same as it's always been. I've got AS and I suck at social stuff by default so it's still hit or miss, still stressful, and still a rocky road to do anything. Last Saturday I got stuck at a party for three hours after I wanted to leave because I just couldn't face anyone to say good bye. I finally found a way to sneak out with only one person knowing.



I started transitioning when I was 28. I have sh***y executive function combined with getting stressed out if I attempt to do more than one major life thing at a time so I'm still transitioning. I've been on HRT for almost 3 years now so there have been some physical changes which have made me modify what I wear in guy mode. I need to move so that's going to eat up the next three months of my life preventing me from doing anything else. I just finished dealing with my cyclothymia diagnosis and getting a psychiatrist for that. Before that was the allergest which took up most of January. Before that was the holidays. Before that was my knee surgery, and before that was my hair transplant surgery, and before that was physical therapy, and before that switching doctors, and before that was more and more things that just consumed me whole but only one thing at a time. I accept this now. I can only do one thing at a time well even if it takes me weeks to get it taken care of. Otherwise it's not good. I think I'll be transitioning for quite some time yet. I know others without ASD who have transitioned quite successfully in less than a year and it's frustrating that I just can't do things as fast as them or multiple things at once.

I've believed that there is some type of gender blending component to AS for quite some time. I'm interested in seeing what will be learned from more research.

Excellent article. It's rather ironic that I (a straight-as-an-arrow, tall, fit male) brought up this exact point to my psychologist. When she asked how I can be sure I have Aspergers, I gave her all the evidence but also added: although it's not a diagnostic criteria, I am confused how Aspergers is viewed as an "extreme male brain" when I felt most comfortable around women growing up and when really young wished I was a girl and was sad to think I couldn't wear dresses, grow my hair long, wear earrings, etc. While I've always known I was male and have always been attracted to females, I did feel almost jealous that women were able to 'express' who they were. I was mercilessly ridiculed in school already and wouldn't DARE mention I felt more 'at home' around girls! I was already teased daily about being gay even though I am not and I wonder if my Aspie nature gave that impression subconsciously. While I'm attracted to soft 'feminine' girls I would be lying if I said I don't have plenty of feminine traits, such as being exceptionally good with children, sensitive, caring and emotional at times. I am FAR more male now but as I child, I was definitely thought of as a wuss and a wimp and as embarrassing as it is to admit publicly, felt more like a girl. I felt like I could not relate to the boys and their obsessions with alcohol and sex.

One thing I have noticed is that while I am extremely rare in my generation (which is why I was bullied and ridiculed so much), it seems like close to 10% of kids I see have ASD traits and probably up to 25% have a personality similar to mine, which is probably why I prefer talking to teenagers and young adults. I would assume it has to do with the rise in 'unnatural' chemicals in the environment, something my Chemistry whiz brother has long suspected. I probably would not be picked on in school if I were a child right now. One final thing I should point out was that EVERYONE, doctors included were convinced I was a girl to the point my name was supposed to be Amy and my parent's had to quickly come up with a boy's name. Co-incidence?

Hi stardraigh
I'm sorry your transition is such a challenge, I don't think I'd very much enjoy being left in limbo for an extended period if I attempted it. Isn't 3 years of HRT long enough to pretty much go as far as you can go body wise, or are you on a very low dose?
I'm not attempting an actual transition at this stage, just tested the waters a bit, but I've been told I could have a very long wait before I could even begin to see someone 'officially' about it. I'm getting some hormone and other checks done soon, the results of which might escalate the process a bit if I'm 'lucky' and they find something 'interesting' going on.

I haven't noticed much improvement 'executive function' wise either yet, I also don't seem to manage to make more than one major lifestyle change at a time, which means planning things like that out over several years.

I'm still doing research into the Executive Function issue, it turns out that there is actually a whole book about it, so some people somewhere must be taking it seriously. http://ukcatalogue.oup.com/product/9780198523499.do,
(I managed to get hold of a second hand copy, so it wasn't nearly as expensive as that thankfully!)
It's written in rather academic terms and my knowledge of neuroanatomy is not really that detailed just yet so it's a bit heavy going at the moment. It seems to be mostly to do with using the prefrontal cortex to help control the 'thread' of concious thought so that it doesn't get 'context switched' so much by different environmental stimuli, though I'm sure there is a lot more to it than that.

Hopefully it'll turn out that there is actually a solution for those kinds of issues as well, that doesn't involve taking powerful stimulant medications for the rest of your life, although frankly I'll give anything a try just to get my life working a little better right now. There are a lot of 'potential' gentler solutions out there already, like EEG neurofeedback training, to teach yourself how to control your concentration. The necessary equipment may now be affordable for home use, however without being able to establish much of a regular routine on my own I don't seem to be able to add extra 'training' things like that to my day without someone else setting up a particular time and place for it to happen and holding me to it. If I tried it it would probably just end up stuffed in a box somewhere unused.

Executive function development/refinement is supposed to be one of the final stages of emotional maturity, which should take place from the late teens to the early twenties. Frankly I still seem to be way behind on most of that stuff even at >30, but hopefully, just maybe I'll get there by the time I'm 50 or so. I just hope it isn't to late to actually 'do something' by that late stage.

It does seem amazing what a difference the hormone thing seems to have made to me though, so maybe I've now 'cracked' at least the depression/anxiety issues for good, and can use my somewhat improved concentration to move onto other more pressing problems. Getting to the point of a general level of happiness itself has been a bit step up for me. I've had some 'good spells' in the past, but they never seem to have lasted more than a few months at a time.

We can't just wait around for the scientists to come up with the answers to these things, we've got lives to lead, and they just seem to want to take baby steps forward while they publish enough papers to last a whole career.

I haven't noticed much of a difference with my ASD issues from HRT, actually. There were a few things, like oddly avoiding physical contact, to liking hugs, but not a whole lot else, really. I still get obsessions a.k.a. special interests, still say socially-awkward statements, and have trouble making friends.

I'm actually more depressed on HRT than I was before HRT, but I wouldn't give it up for anything. I feel more like a woman now due to the estrogen, and with my body not being affected a whole lot by the hormones, I hate my male body that much worse. It's to the point where I cry most days and often wish myself dead, like today.

I don't come to this forum much unless I have nowhere else to go, as is the case for talking about my gender issues. If you see me post here, it pretty much means that I'm crying and distraught, such as right now.

It's a high dose at 8mg a day but I know others who were on higher for short times.





I haven't given up on myself for transitioning. I've got the attitude of - So what if it takes the next 20 years to do this. I'm doing it.




Thanks for the book reference. I'm going to see if I can find an inexpensive copy of it.

I know I'm good at planning ahead. But that's worthless if I didn't exercise the executive function to remember to plan ahead to mitigate the executive function issue. Combined with my cyclothymia, when I'm at the peak of my upcycle and bottom of my downcycle, I tend to not care to plan ahead.




I know exactly what you're describing about routine. It's the same with everything I do that has a choice between doing it by myself or doing it in a specific setting with rules. As an example I can't exercise at home because other things win out.



I've learned a few things about maturity and myself. One is that I always feel immature even if I'm the subject matter expert. If It needs getting done, I have to do it myself. There are some things that despite having a want or need for it now, I'm just not ready for until later in life.



I agree on the hormones. it definitely changed how I view myself both physically and mentally. It has helped with my body-gender issues. I still have other body image problems and mental issues the hormones so far have had no bearing on. I get to work on them now. It's kind of like a filter. The HRT has allowed certain problems to be dealt with and what remains can now be taken in turn.



I concur

but a ton don't

as for me I have always felt female and my gender is pretty steady my reason for HRT was just to stop my hot flashes (although my Dr informs me it will help prevent osteoporosis and keep me younger/healthier)

I've been on hormones for 5 years 9 months now and am still not transitioned because my body is too severely male. I wish I were dead but don't have the courage and/or desperation to kill myself, or maybe don't really want to die.

I haven't had facial feminization surgery (FFS) even though I can afford it, and a big reason why is that if I had FFS and it wasn't enough for me to pass, then I would be truly out of options and that would be enough to take action on killing myself. That fear has stopped me so far.

I've met plenty of Asperger's / ASD guys who don't seem to have any of the gender issues as mentioned above, but do have the usual ASD issues. Contrast this with me, someone with ASD issues as well, but who is also suicidally gender dysphoric. I don't really know what the difference between us and the "cisgender ASD" people is.

My thought on the gender component of AS is not necessarily sexual. For instance - all of the AS men I know tend to have a female energy about them, they identify as male and want to be with a woman but find it difficult to take on a 'normal' male role/behavior/energy in a relationship. But, they can and do find women that love them just as they are.
It makes sense that female hormones might quiet the male part of their brain and ease the struggle with their 'female' nature, but not their sexuality, as such. It's all very complicated. difficult and painful.

Well the other papers that get into the more neurological aspects of the 'problem' are

Autism Attenuates Sex Differences in Brain Structure: A Combined Voxel-Based Morphometry and Diffusion Tensor Imaging Study
and
Biological sex affects the neurobiology of autism
which both show that our brains tend to show gender incongruities with our bodies.

Perhaps what's really going on is an unexpected hormonal cycle produced by the mother effects the developing foetus, leaving one part of the body 'programmed' differently to another part, either more masculine or more feminine or more androgynous. So you could also have a weakly masculine body and an extremely masculine brain, or vice versa. Or a feminine body with a male type brain.

This page shows the various 'events' that occur during gestation, as you see neural characteristics are laid down at a different stage of development to the sexual characteristics.

Personally my body is pretty androgynous, though quite large, sort of like Varys from Game Of Thrones, but with slightly more hair!
The concious part of my mind seems to be typically male or at least androgynous, but the subconscious part seems very female in beliefs, behaviour and expectations.
(I find it's quite hard to tell what the subconscious is doing most of the time, but I try to pick up clues here and there from my major drives and emotional responses to things. It definitely feels like I 'want' to be doing a lot more female things than I am currently doing, but I don't seem to get the opportunity to get out of the basic work/sleep cycle and explore that side of me very much)

Last edited by youwho on 27 Feb 2014, 1:24 pm, edited 1 time in total.

The description of being consciously male and sub- consciously female would describe most AS men in my opinion, that's a good way to put it and it applies to me more than I will admit to anyone and I am completely straight - just for a point of reference.

Well I've been 'nominally' straight but sexually inactive for a long time, however on detailed self-examination I've come to the conclusion that I don't actually seem to have any kind of male sex drive or any essentially masculine long term behavioural patterns or desires. If I were to pursue a straight relationship it would only be through desperately trying to fake being something I am fundamentally not and don't really want to be, so what would be the point? I mean I suppose I could try to find a more masculine/dominant woman who would want to 'wear the trousers' so to speak, but really that seem like a fake as well, especially if I don't really ever think about having sex that way around.

There's far too much of me that seems to actually want to 'be' the female in any potential relationship, that it seems it wouldn't really feel right any other way, either sexually or emotionally. So far as I can tell from my basic motor instincts, I'm pretty much wired up to be the receptive partner, and I'd much rather welcome people through the front door than the back, were I to have the necessary construction work done to make the front door accessible. If you get my drift.
Obviously I know it's a very long and difficult path to get to that stage, with no guarantee of your achieving your goal,
but I think I'm now getting to the stage where I need to make my decision before it's too late.

For the moment I am just kind of Trans-Questioning, while enjoying the nice mental and slight physical changes that my experiments with the hormones have brought me. What it's done to me certainly feels a lot more right than wrong at the moment, though there have been some emotional ups and downs along the way.

I'm very relived to see someone write this. I always wondered what the heck was wrong with me growing up and almost felt I would feel more normal if I wasn't straight! That is a perfect way to describe me and before I came to WP, I didn't think there was anyone else like me in the world! How else can you explain being a hot headed extremely tall guy with a huge ego who has a low sex drive, very feminine skin and hair (seriously, my hair is finer than most women's!), cries at the drop at a hat and prefers to spend time caring for children and would love to be a stay at home dad?