Uta Frith, women, autism, and what Dr Stock, Helen Lewis etc think...

[Missproportionate]

Helen Lewis and Kathleen Stock have both commented on this article on X, both slightly ambiguously, as if they aren't sure what to think.

Wondered what anyone on here thinks about this? I am also ambiguous, but full disclosure: I have been diagnosed with autism at the age of 50, I haven't told very many people because I see a lot of identifying as 'neurospicy' online, and it seems to be connected to the whole 'I'm not normal, oh no I'm special' idea that I think has parallels with the queer community. I don't want to be on that bandwagon, I just want to make sense of myself.

I was diagnosed through a long process with several professionals, and a 3 hour interview with me, and a 3 hour interview with my mum about me as a child. I fitted in all the separate areas of criteria. I doubt people I work with or interact with superficially would guess ( but they may find me irritating or insensitive or interrupting - I find it hard to tell).

But it worries me a bit that women who are autistic might be seen as 'not real' and lumped in with the trans community in some way. But then how does that
then work? because as has been observed many times, girls who present with gender dysphoria are very often diagnosed/undiagnosed autistic. I think we should be leaning into attending to the autism in girls, and how an autistic girl might find being trans attractive as a way to 'solve' their feelings of not belonging. If we start to question the genuineness of their autism, we risk failing those girls even more. Don't we?

I don't know what to think.

Uta Frith interview in TLS

This is not true. The diagnostic criteria for autism has not changed. I am sick of reading people say this. The only change has been that Asperger’s syndrome is not a diagnosis any more and is diagnosed as autism instead.

@TempestTost Who is this you-tuber please?

People don’t just go to the GP and get handed a diagnosis.

There are a lot of autistic people in the world and there always were. When I think back to my school life in the 80s, it’s crazy to me how many people were likely undiagnosed ASD. And now, as adults we all have autistic kids. It’s genetic.

Ive been through diagnostic processes for me and 3 of my children. If there is any doubt, a diagnosis is not made. My youngest is 6 and her diagnosis in 2025 involved 6 professionals and about 7 hours of assessment.

This article lists all the changes to the Autism diagnostic criteria introduced by DSM-5 in 2013:

DSM-5 and autism: Frequently asked questions
Autism Speaks (undated)

https://www.autismspeaks.org/dsm-5-and-autism-frequently-asked-questions

At the time it was anticipated that those changes might reduce rather than increase the number of people diagnosed with autism.

Why Combine Autism and Asperger’s?
Childmind - Last reviewed or updated on October 30, 2023.

"When the DSM-5 was released in 2013, Asperger’s and PDD-NOS were eliminated as separate conditions that children could be diagnosed with. The criteria for an autism diagnosis also changed.

The new criteria collapsed what were three separate categories of behaviors into two: persistent deficits in social communication and social interaction, and restricted, repetitive patterns of behavior. They also reduce the number of symptoms within each category while increasing the number required for diagnosis, effectively limiting the “menu” and, to critics, making the diagnosis more restrictive.

Others argue that any fall off in diagnosis should be very modest, or perhaps diagnoses might even increase under the DSM-5 criteria. Many experts have said the revisions are not at all intended to kick people off the spectrum, but rather fine-tune the diagnosis so it is more useful and representative of data gathered over the past 20 years."

https://childmind.org/article/why-combine-autism-and-aspergers/

There were also earlier changes that broadened the diagnostic criteria. So it really depends on what starting point people are referring to when they say that the diagnosis has broadened. This article is mostly but not entirely about the merging of Asperger's into autism and includes info about genetics that you might be interested in:

Is the Definition of Autism Too Broad?
Psychology Today - 2018

"Someone like me would not have been diagnosed with autism at all under the rules of DSM III. A few years later, with the arrival of DSM IV, I was diagnosed with Asperger’s (now a descriptor for autism) and later under DSM5, I was re-diagnosed on the autism spectrum."

https://www.psychologytoday.com/us/blog/my-life-aspergers/201806/is-the-definition-autism-too-broad

From the same article:

"Genetic studies have identified many variations that are implicated in autism. Some are stable and heritable, supporting the neurodiversity paradigm; while others are one-off mutations that suggest pathology.

Some genetic markers for autism are associated almost exclusively with very severe disability. Most are not; they can be present in a person whose IQ and other traits may be anywhere on the curve at all.

Other biomarker studies have identified differences in brain connectivity or brain plasticity between autistic and allistic people. Some of those studies show promise in separating autistic and allistic populations, but most cannot resolve where an individual might fall on either of the spectrums.

Interestingly, most biomarker research seems to classify people as autistic in line with the current, expanded, definition of the autism spectrum. That supports the idea that this broader spectrum is the more correct definition."

IMHO this point made in the same article is very pertinent to which diagnostic labels tend to be preferred at any particular time!

"Diagnostic labels tend to follow the money. If there is more funding for intellectual disability more people will be diagnosed with ID."

Others attribute the increase in autism diagnoses to a broader diagnosis plus better screening. This article describes the situation in the USA.

Is There an Autism Epidemic?
Johns Hopkins University - 2025

"There has been a nearly 300% increase over the past 20 years, but if you look at any two-year period across the sites that are monitoring the number of children identified with autism, it’s somewhere between a 10%–20% increase every two years.

There are two main reasons for the increase. The first is the broadened definition of Autism Spectrum Disorder, which means that more people are meeting this definition now than previously.

Second, there have been many widely successful public health programs that increased screening at wellness visits for children ages 18–24 months to look for signs of autism. Parents, caregivers, and community members are also more aware of the symptoms, and autism is being more accepted in the community. People are not as afraid to seek help and know where to go when they have concerns."

"There have been a few studies over the past two years that have looked at a specific subgroup of individuals on the spectrum who frequently need 24-hour-a-day support and care from a caregiver, often have very limited verbal communication skills, or have intellectual disability that co-occurs with autism.

The data has shown that rates of autism for that subgroup have increased minimally, if at all, over the past nearly 10 years.

Rates have increased the most for individuals who are not in that subgroup, who may have more subtle phenotypes and fewer significant co-occurring conditions. We think this is most likely due to our ability to identify these subtle traits and symptoms better."

https://publichealth.jhu.edu/2025/is-there-an-autism-epidemic

So the picture is not as simple as just Asperger's being incorporated into the Austism/ASD diagnosis nor that changes in diagnostic criteria alone are responsible for more children and adults receiving an ASD diagnosis.

I am long enough in the tooth to have seen changes play out in the UK since before 1980, when DSM-3 introduced "Infantile Autism".

How autism became autism: The radical transformation of a central concept of child development in Britain
The History of Human Sciences - 2013

Abstract

"This article argues that the meaning of the word ‘autism’ experienced a radical shift in the early 1960s in Britain which was contemporaneous with a growth in epidemiological and statistical studies in child psychiatry. The first part of the article explores how ‘autism’ was used as a category to describe hallucinations and unconscious fantasy life in infants through the work of significant child psychologists and psychoanalysts such as Jean Piaget, Lauretta Bender, Leo Kanner and Elwyn James Anthony. Theories of autism were then associated both with schizophrenia in adults and with psychoanalytic styles of reasoning. The closure of institutions for ‘mental defectives’ and the growth in speech therapy services in the 1960s and 1970s encouraged new models for understanding autism in infants and children. The second half of the article explores how researchers such as Victor Lotter and Michael Rutter used the category of autism to reconceptualize psychological development in infants and children via epidemiological studies. These historical changes have influenced the form and function of later research into autism and related conditions."

A couple of key points, bearing in mind that this article was published in 2013, so is covering increased diagnosis in the UK before DSM-3:

"There has been a phenomenal increase in diagnoses of autism (in Britain) since the 1960s . . . diagnostic rates of autism did not increase as much in France, where there was no great release of ‘retarded’ children from confinement in the 1960s and where children with developmental problems continue to receive institutional residential care up to the present day."

"Another reason why diagnoses of autism have risen in Britain and elsewhere is because the closure of institutions for ‘mentally retarded’ children led parents to campaign for better diagnosis and recognition of their children’s problems."

Full article, no pay wall:
https://journals.sagepub.com/doi/10.1177/0952695113484320

This history is also a good read IMHO, highlighting some missteps along the way and current controversies:

The Diagnosis of Autism: From Kanner to DSM-III to DSM-5 and Beyond
Journal of Autism and Developmental Disorders - 2021

https://link.springer.com/article/10.1007/s10803-021-04904-1

I heard a podcast on the BBC, I think it was, talking about a widening of criteria in 2013. This was to include people who used to be borderline but didn’t have any learning difficulties. I’ll see if I can find it.

Just seen that someone has covered the 2013 date much more comprehensively above.

Interesting thread and thanks to those posting full links to interviews.

Trust me, I’ve seem many girls throw chairs about and many extremely introverted boys in my teaching career! In most of these cases, I’d put money on them being ND to a greater degree. Some did end up with a diagnosis, some in my earlier years less so.

Wow I’m going to devour those links- thanks so much @POWNewcastleEastWallsend

My job involves me visiting secondary schools and I can say without any hesitation that the children with gender dysmorphia are overwhelmingly autistic.

yes this is the issue and how I read Uta’s article.

Gina Rippon's recent book, The Lost Girls of Autism, is an interesting read in defence of the idea that there has been significant under-diagnosis of autism (without intellectual impairment) in girls.

The cohorts of children studied historically repeatedly lacked girls, which has meant that the male presentation has been seen as the presentation, and girls excluded who may in fact meet the (shifting) criteria.

She talks about Hans Asperger, who was much more interested in his (male) "Little Geniuses" than their female counterparts - no place for clever autistic girls in a world of Kinder, Küche, Kirche. You can guess what happened to them.

https://www.panmacmillan.com/authors/gina-rippon/the-lost-girls-of-autism/9781035011643

Im glad this article is being discussed under the feminism chat because it wss published in the TES and was really supported by a lot of male educationlists who had the ear of the former government on x (I work in schools) i think we will immediately see this article used a lot by them to push certain behaviour management techniques in school. a bit more resistance to the idea that teen girls have autism and and a bit more 'they are hyper sensitive and anxious' as a direct result of this article

There are lots of points in her article but i think her deadlines around diagnosis are unrealistic in a system where people can only get a diagnosis on the nhs at crisis point.

I dont know if some people would be better supported by a diagnosis that was different to autism or not, its complex. I do actually believe we are looking at more than one thing and calling it autism.

but my concern with this article is that people look at the exact same behaviour in boys and girls and describe it differently. Like bossy v leader. So I am not convinced by her asserting that these girls have something that looks so different to boys it must be different.
Noone notices a girl obsessed by ponies for instance who obsessively lines up her hair ties. The dont see a restricted interest or repetitive behaviour they see cute and future home maker. Whereas a boy who only plays with trains and wants them stored in a certain way raises red flags.

I also think that society has changed to increase the effects of mild (Asperger's type) autism. As social animals we need frequent interactions with others to receive regular feedback that we are conforming socially in a way that ensures our survival.

Modern life can be lived in an isolated way - avoiding speaking in shops, working online, every interaction written. None of this will help someone who finds social interactions difficult as they can avoid practicing those skills.

Humans aren't fixed units that don't change - we respond to our surroundings.

My DD's recent autism diagnosis in her teens has not helped at all in terms of external support. No EHCP, no funding, CAMHS support related only to her suicidality (which predated and prompted the ASD assessment).

Reading everything I can about autism, especially in high masking teenage girls, has helped. I know now, for example, that she has interoception problems and doesn't reliably know if she is hungry or thirsty. I know that she has problems reading her own or other people's emotions. I know that she has problems knowing to speak to people socially. All of this is concrete stuff that I can support her with (by monitoring her food and drink intake; by explaining emotions and situations; by offering her scripts to work with).

She is definitely one of the expanded cohort that Frith is concerned about and she is definitely highly sensitive - but high sensitivity really doesn't capture everything that is happening for her. She is hyposensitive in terms of pain, hunger, thirst.

I don't have a view on whether ASD should be a spectrum or a number of separate conditions. I am desperate for support for my child and have no idea what would help her get an education (she's out of school). But I agree with OP that there is a risk of throwing out the baby with the bathwater, if we put too much of the expansion in diagnosis down to social contagion.

This is such an interesting thread - many thanks to contributors.

I can see why Kathleen Stock is getting pushback. She comes across as a bit smug. She doesn't seem to appreciate that her four year-old boy getting angry at having to brush his teeth is not the same as a ten year-old boy getting angry at having to brush his teeth and so on. She describes her experience from a position of always having physical power over her boy, but has failed to think how different it would be to experience the same behaviour with a child who is bigger and stronger than her. She comes across as one of those perfect mums you meet at baby groups, whose baby sleeps beautifully through the night and cannot understand why other mums are struggling. That lack of empathy in her is surprising and saddening.

That said, I do think she's onto something in her description of PDA, and it's interesting to think about how that fits in with the Uta Frith interview. I'm looking forward to reading more about Uta Frith's opinions and to POWNewcastle's links.

My personal 2p on PDA: one of my sons has ADHD and autism. His initial diagnosis was PDD-NOS under DSM-4; then DSM-5 came out and a thoughtful clinician re-assessed him and he ended up with ADHD and autism. A couple of painful years later, someone else suggested PDA. By that point, I was so tired of clinicians that it remained a suggestion. On the one hand, I can see why Stock says what she does about PDA - on the face of it, it does sound pretty made-up. But on the other, I can see in my son (now a young adult at uni) a bizarre urge to avoid demands.

This where my pet theory is that, for him anyway, the trans thing comes in - having been roundly schooled in it. Frightened about growing up into a Man and having to do Manly Grown Up Things? Think Andrew Tate is a loser and worried about being that sort of Man? Fear not! Leave all that behind and become a woman! So as much as a Peter Pan thing, it's about trying to avoid the inevitable demands of adulthood. As I say, that's my pet theory for why my son has fallen into the trans rabbit hole at uni. I don't know if that resonates with anyone else?

This is what makes me think that people might - reasonably - be cross at Kathleen Stock. My other children are completely normal, for want of a better word. If she'd walked half a mile in my shoes, trying to raise this difficult violent son who then got fed balderdash at school, she might be a little more sympathetic.

Absolutely this

I usually point out on threads that our systems that we have created for ourselves, from work, to school, to play, to household management even, are 'inhman'. Not necessarily inhumane, although sometimes it might be!

But inhuman. Its not related at all to our needs or how we function as a species. Its like when you put animals in the wrong environment and they turn aggressive or start rocking or grimacing inappropriately. This is what we are doing to ourselves and yet when we observe this in our children or ourselves we'll say its a genetic, fixed disorder.

I think for some it definitely is, for others its not.

Im suspicious of the late diagnosed women for example, around the age of menopause. As someone going through this now I think that having to cope with an inhuman work environment, social environment causes effects that are then put down to ND rather than acknowledging what is actually happening to women, its another way of minimising the effecgts of the menopause in my view. Not for all, but for many I would suspect

I also agree with a PP, I say on every thread about this about the diagnostic changes that have occured and will continue to occur over time. And about perhaps it being an umbrella term, much like schizophrenia is, its not a distinct disorder in itself but a mixture of issues under one umbrella.

Much like there is a lot of focus on how women with ND were misdiagnosed with BPD and actually they are ND, it wouldnt surprise me if later down the line its found they're misdiagnosed with ND and its something else.

I agree that some of the late ND diagnosis in women is potentially environmental factors (mixed with the perimenopause messing with us). I'd probably now meet the diagnostic criteria for ADHD right now, but is it actually ADHD, or just lifelong scattiness exacerbated by hormonal change and extreme stress linked to unsustainable responsibilities? Probably the latter, but I am tempted to seek a diagnosis if it would get me some helpful drugs? Yes. Different for autism though, where there are no helpful drugs.

I'm very interested in how the school environment has changed such that it is so much more difficult for autistic or "autistic" girls - and indeed, looking at rates of absence, this whole generation. I really don't understand enough of what goes on at school.

My DD appeared to be thriving academically and socially until she suddenly tried to end her life. First thing the crisis team suggested was autism and my tiny mind was blown. Everything I read about autism explains why school would be hard - but I don't understand why it's so much harder now than a generation ago

I am very keen to read this.

She recently did a really good podcast with a gp, who interestingly was also late diagnosed.

Rachel Rooney had some good points on Twitter around this; it’s a very complex discussion but one that need to be had. And I feel lies in the question - what does a diagnosis mean/ lead to? That’s the biggest problem for me. (Often nothing. Hence piling onto SM looking for answers. And identity stuff follows.)

My DD got an adult diagnosis of what is best termed high functioning autism. The patterns were there from early childhood but when I first mentioned it to her in her thirties she was highly resistant. It took five years after that to seek an assessment and the process was revelatory to her. After a while she identified a feature best corresponding to PDA, essentially a major component of her endless self-sabotage. It’s almost the flip side of her associated OCD traits. On the one hand, there are things she knows she should do (includes eating, sleeping and talking to people) but cannot bring herself to do. On the other, there are things she knows she shouldn’t do or has no need to do but feels she must do, like writing down the indoor and outdoor temperature every morning, constantly rearranging furniture and having to immediately wash any item of clothing that falls on the floor. She has actually done pretty well, considering, but life has been quite exhausting for her, and she’s only recently settled doing something she enjoys.

Everything I read about autism explains why school would be hard - but I don't understand why it's so much harder now than a generation ago

Schools are brutal environments now for everyone in them. The endless pressure on children and their teachers has ramped up exponentially. The constant focus on “mental health” induces anxiety in itself. Learning is a series of endless PowerPoints, teaching is always towards passing exams, messages are mixed and conflicting - children are expected to be both independent thinkers yet conformist in almost every way - and staff are expendable.
It was bad enough thirteen years ago when I retired, but reports from my friends who are still practising tell me how much worse it’s become.

Kathleen Stock has written another piece about this: https://unherd.com/2026/03/the-feminisation-of-autism/

A lot of what Im about to say would be quite muddled but I think there are layers of things. I think at the same time as infantilising children, we also adult them to think about adult concepts like risk, safety etc, in a way that we didnt before

I think for girls social media is horrendous, even if they're not on it themselves or only in a limited way, the social norms around them will be guided by this. When I was growin up, the women on screen were proper adult women and that wasnt what I identified with, why would I. The women in pop were largely 'girls next door' or the girls in the upper years type role models.

Today, we have a plethora of highly highly sexualised 'role models', not one pop star taht I can think of (and Im out of the loop!) isnt like that, how can I identify as that as a scared little 11 year old or so?
The 'influencers', all have a set way of being and looking and the expectations and rigidity of 'group think' for young people, given to them by adults is quite strong I think.

Then there is school itself, much shorter days than I remember, so more condensed, poor food environment, cant use the loo properly, either a perception or reality of sexual assault at every turn by the boys in the school, much much more focus on going to university, its expected, its the 'only' pathway. Expectation of staying in school until much later, the light at the end of the tunnel is far away now.

And I hate to be that person but screens, sleep, noise, all contributing I think to high levels of anxiety, agitation etc.

Oh you've summarised much better than me!!

Agree, a lot of current school trends which are ultimately driven by outcome tracking and ofsted, are actually not great for a wide range of pupils.

I definitely wouldn’t have coped if I’d gone through some of the systems being used today.

Even things like somehow going through school without ever needing to wear uniform.

There’s been a severe lack of critical thought around the way some schools have approached things; the main aim being churning out a load of perfect peters.

None of this is a black and white binary conversation; many things need to be considered.