ReviewPLoS biology2011
Why are autism spectrum conditions more prevalent in males?
Review in PLoS biology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 327 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
327 citing papers in PubMed, 7 syntheses or guidelines pooled it, 754 citations in OpenAlex.
- Does the Extreme Male Brain Hypothesis of Autism Apply More to Females Than Males? A Systematic and Meta-Analytic Approach.Autism research : official journal of the International Society for Autism Research · 2026Pooled it
- I tweet, therefore I am: a systematic review on social media use and disorders of the social brain.BMC psychiatry · 2025Pooled it
- Genomic insights and advanced machine learning: characterizing autism spectrum disorder biomarkers and genetic interactions.Metabolic brain disease · 2024Pooled it
- Steroid hormone pathways, vitamin D and autism: a systematic review.Journal of neural transmission (Vienna, Austria : 1996) · 2023Pooled it
- Sex and age differences in "theory of mind" across 57 countries using the English version of the "Reading the Mind in the Eyes" Test.Proceedings of the National Academy of Sciences of the United States of America · 2023Pooled it
- Brain-based sex differences in autism spectrum disorder across the lifespan: A systematic review of structural MRI, fMRI, and DTI findings.NeuroImage. Clinical · 2021Pooled it
- Meta-Analysis of Cognitive Performance in Neurodevelopmental Disorders during Adulthood: Comparisons between Autism Spectrum Disorder and Schizophrenia on the Wechsler Adult Intelligence Scales.Frontiers in psychiatry · 2020Pooled it
- Effects of oxytocin administration on salivary sex hormone levels in autistic and neurotypical women.Molecular autism · 2020Trial
- Does testosterone impair men's cognitive empathy? Evidence from two large-scale randomized controlled trials.Proceedings. Biological sciences · 2019Trial
- Sex differences in early sensorimotor processing for speech discrimination.Scientific reports · 2019Trial
- Intranasal oxytocin enhances intrinsic corticostriatal functional connectivity in women.Translational psychiatry · 2017Trial
- Article
- Autism and Dementia: A Summative Report from the 2nd International Summit on Intellectual Disabilities and Dementia.Journal of autism and developmental disorders · 2026Review
- Inflammatory Cytokines as Biologic Signatures of the Effect of Dietary Supplementation With Omega Fatty Acids on Autism-Related Behaviors and Features Among Young Children: A Randomized Controlled Trial.Journal of autism and developmental disorders · 2026Article
- Sterol pathway disruption in pregnancy: a link to autism.Molecular psychiatry · 2026Article
- Sex Differences in Psychopathology and Neurocognition in Community Youth With Autism Spectrum Disorder.Autism research : official journal of the International Society for Autism Research · 2026Article
- Autism associatedbioRxiv : the preprint server for biology · 2026Article
- Global and regional insights: unravelling the epidemiological factors and burden of autism spectrum disorders with a focus on China from 1990 to 2021.BMJ paediatrics open · 2026Article
- MeCP2 Governs maternal hyperandrogenism-induced cortical defects and behavioral alterations via noncanonical AR-dependent regulation of Mef2c.Nature communications · 2026Article
- Mapping brain growth and sex differences across prenatal to postnatal development.Scientific reports · 2026Article
267 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
Abstract
Autism Spectrum Conditions (ASC) are much more common in males, a bias that may offer clues to the etiology of this condition. Although the cause of this bias remains a mystery, we argue that it occurs because ASC is an extreme manifestation of the male brain. The extreme male brain (EMB) theory, first proposed in 1997, is an extension of the Empathizing-Systemizing (E-S) theory of typical sex differences that proposes that females on average have a stronger drive to empathize while males on average have a stronger drive to systemize. In this first major update since 2005, we describe some of the evidence relating to the EMB theory of ASC and consider how typical sex differences in brain structure may be relevant to ASC. One possible biological mechanism to account for the male bias is the effect of fetal testosterone (fT). We also consider alternative biological theories, the X and Y chromosome theories, and the reduced autosomal penetrance theory. None of these theories has yet been fully confirmed or refuted, though the weight of evidence in favor of the fT theory is growing from converging sources (longitudinal amniocentesis studies from pregnancy to age 10 years old, current hormone studies, and genetic association studies of SNPs in the sex steroid pathways). Ultimately, as these theories are not mutually exclusive and ASC is multi-factorial, they may help explain the male prevalence of ASC.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.