The Autistic Journalist

Using words to explain the mind

Posts Tagged ‘testosterone

Gay, Lesbian, Bisexual, Transautistic?

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Photo illustration by Alexander Ho

In another story I read in May and stored in my bookmarks, the Journal of Autism and Developmental Disorders published a study led by Simon Baron-Cohen (the cousin of actor Sacha Baron-Cohen) found that female-to-male transgender people have more autistic traits than heterosexual men or women, and also more than male-to-female transgender people. The news magazine Time picked up the story, and is the featured link in this post.

In fact, female-to-male transgender people outscored all but those with Asperger’s diagnoses on the Autism Spectrum Quotient, a scale developed by Baron-Cohen himself.

The study may fit with a theory Baron-Cohen has on people with autism exhibiting an “extreme male” brain, whose style of thinking favors “systemizing,” focusing on predictable patterns found in area like mathematics and mechanical devices (including the devices I’m using to write this post). This contrasts with “empathizing,” or understanding the emotions of others.

The difference is notable because Baron-Cohen and his colleagues recently discovered that giving testosterone to women decreased their ability to empathize, especially with women whose bodies were exposed to higher levels of testosterone in utero. However, because transmen in the study had already changed gender, the study could not reveal if autistic traits were a result of increased hormones or if they led the desire to change gender in the first place. What Baron-Cohen did say is understanding these kinds of connections can lead to better care for people with both conditions.

I must admit I know very few transgender people, having met one at a social justice retreat I attended four years ago in college, so I cannot speak personally on this subject. Maia Szalavitz was in charge of writing the story, mostly summarizing what was found in the study, but included some quotes from Baron-Cohen and a co-author who identifies as a transwoman. This isn’t your “usual” study reporting a rise in autism rates or even an indiscriminate cause; gender identity itself isn’t understood well with most of the population comfortable in their original bodies, not necessarily thinking about emotional challenges endured by those who don’t subscribe to their original gender. We’ve heard of tomboys, but there is a difference between “playing with the boys” and considering a transition to one.

Szalavitz doesn’t stray too far off the typical route journalists take when reporting studies, as finding sources willing to speak about the story would be rare given the subject matter. However, a curiosity exists on how other transmen would respond to the study. Baron-Cohen is among the most respected autism researchers, although Americans are more likely to recognize his thespian cousin (both Baron-Cohens are British). Simon’s theories haven’t been heavily debunked, nor has he been involved in controversy over his research methods, so studies he authors carry noticeable weight for journalists. Even if other transmen had never heard of Simon Baron-Cohen, getting a few quotes would be beneficial regardless of their opinion. Those who agree with his findings would presents reporters a story to help relate the material to readers, and those who disagree would highlight the complicated area of gender identity.

Now, this doesn’t mean females on the autism spectrum will automatically wish to become males. Even women exposed to more testosterone aren’t confined to a linear path of transforming to men. Szavalitz simply reveals another element with much exploration to be done through the reporting of Simon Baron-Cohen’s study. Future coverage is difficult to predict with the social stigma faced by the GLBT community combined with the mystery of the autism spectrum, other than a reinforcement of the non-linear nature of gender identity and mental disability.

Quest for autism’s “holy grail” engulfed by maze of treatments

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Dr. Mark Geier. Photo by Jed Kirschbaum, The Baltimore Sun

As Andrew Wakefield continues to press forward with the vaccine link controversy (which is now being compared to other political debates where opponents repeatedly deny what almost all research suggests), the battle to address the autism spectrum in children found another metaphorical maze in Maryland. In a story originally published by The Baltimore Sun and syndicated by Los Angeles Times, a Maryland doctor sought to regain his medical license after suspension by the Maryland Board of Physicians. The doctor, Mark Geier, uses an alternative form of autism treatment with no scientific backing, injecting patients with Lupron, a drug approved to treat prostate cancer in men and endometriosis in women.

Geier believes testosterone is elevated in autistic children (and a study I discussed in my blitzkrieg of posts last month concurs with his opinion) and worsens the vaccine-related mercury toxicity they believe is causing autism in children, which is why he uses Lupron, as the drug suppresses testosterone production. However, the Maryland Board of Physicians reported that Geier placed children at risk with improper diagnoses and misrepresenting his credentials.

Geier’s branch is small in the story’s “tree.” Frank D. Roylance and Meredith Cohn, the writers who penned this story, summarize a point previously covered in mainstream press coverage but quantify what is known inside the autism community: the slow pace of identifying causes and effective treatments for autism lead to a proliferation of unproven treatments that grow wildly in popularity (the gluten and casein-free diet is one example). 38,000 families participating in a database at the Kennedy Krieger Institute in Baltimore have reported 381 different treatments. Families use five treatments simultaneously on average, spending around $500 per treatment. Do the math, and that’s $2,500 a month and $30,000 annually. Compounding the problem, a source from Kennedy Krieger’s Interactive Autism Network says only 10 percent of autistic children are enrolled at IAN or other research studies.

Roylance and Cohn highlight the low percentage by including three parent perspectives. We hear from Alison Singer, who was featured in Autism Speaks’ Autism Every Day and is co-founder of the Autism Science Foundation. While she tried several alternative treatments for her autistic daughter, she now advocates any new treatment should seek for a scientific study. Other mothers shared their experience with alternative treatments, and ultimately refused some because they lacked scientific evidence.

Despite the small percentage of autistic children enrolled in research studies, data from the IAN project is helping identify widely-used therapies so they can be subjected to scientific testing. Although science is not always accepted (the vaccine controversy still burns despite a mountain of evidence disproving a link), finding treatments proven to work can reduce the likelihood of parents making irrational decisions about their autistic children. Based on Kennedy Krieger’s data, a lot of irrationality exists. With families giving their children an average of five treatments for autism simultaneously, even if those treatments mitigate the symptoms of autism spectrum disorder, there’s no way to decipher which treatment actually works. With the money and time invested in so many treatments without scientific backing, little discussion is needed to explain why researching treatments should be a priority.

As the Kennedy Krieger source states, telling parents not to pursue any interventions without scientific support is impractical. Instead, the goal is encouraging families to avoid rash decisions that lead to children receiving a multitude of treatments. Emotional responses are road blocks to such a strategy, and Roylance and Cohn use their sources to explain why logic is sometimes discarded: vulnerability is high when parents first learn of an autism diagnosis. Since most parents will instinctively fight for their child’s success, and many lack an understanding of autism when they first hear of the disability, their susceptibility to doctors claiming to have a solution increases.

Geier’s treatment and recent suspension were subjects of recent stories, as two links appear as related articles to the investigative story filed by Roylance and Cohn. Using people like Geier as a springboard to a deeper story is a commonly-used tactic when resources and news editors allow reporters to execute the strategy. Treatments for autism are ripe subjects for story exploration because supposed techniques have exponentially increased. Most individual treatments without scientific evidence aren’t usually covered in mainstream news. Even if a treatment allegedly works on an autistic child, that technique can only represent a theory, not fact. The lack of scientific proof in alternative interventions can leave reporters in a precarious position with an autism community eager for awareness. However, Geier’s recent coverage opened the door to this realm of the autism spectrum while allowing Roylance and Cohn to filter the story and not create an impression of advocating alternative therapies themselves. Thanks to their reporting, we learn why Geier and other doctors can gain popular support: many parents of autistic children are rarely at the forefront of finding answers. Explaining why few parents involve their children in research studies is difficult, outside of simple impatience, but the low percentage of children in research studies should not be attributed to laziness.

Roylance and Cohn don’t suffer from laziness either. Readers unfamiliar with Geier are briefed on why he’s in the news, and they use parental perspectives to validate the analysis presented by Kennedy Krieger sources on the proliferation of autism treatments. Readers on top of autism coverage also gain a new perspective from the parental point of view. While emotional volatility is almost a guarantee for parents who learn of their child’s autism diagnosis for the first time, that mental state is transferred to research, regardless of what choice is made with alternative treatments. Roylance and Cohn could also open another door by highlighting the lack of involvement of autistic children in research of treatments. They didn’t specifically list how to enroll in research studies, but other reporters could piggyback on that subplot.

Blame my absence on testosterone

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I’m sure plenty of you are wondering what happened to this site’s activity. To summarize, my schedule was eaten up by a swarm of Minnesota state tournament coverage, but I’ve now returned from my hiatus to continue informing you of autism’s role in the news. I appreciate the visits you’ve made in my three months away from The Autistic Journalist, which passed 10,000 hits during my pause. To thank you, I’ll pull out an article I had saved to discuss with you.

Two months ago, MSNBC reported a study suggesting testosterone could be a culprit in the higher prevalence of autism in males. A similar story was picked up by a CBS TV affiliate in Green Bay, but that story has since been removed. The study found testosterone lowers the ability for cells to express a particular gene known as RORA. That gene, when activated, can protect neurons from the effects of stress and inflammation, and both are elevated in autistic people. Conversely, estrogen raises RORA levels, which may protect females against autism even if RORA levels were otherwise low. An alternate theory is genes in the X chromosome, suggesting females have a “backup copy” since they carry two X chromosomes while males have one X and one Y chromosome. Despite the theory’s plausibility, no X chromosome genes have been associated with autism.

This doesn’t mean your boys will develop autism upon reaching puberty, when testosterone increases can be noticed. The story gives us a potential clue to autism’s cause, but genes and testosterone levels are simply a game of chance when cells are developing. The explanations provided in the story make sense, but more research will be needed to make an accurate conclusion to this hypothesis.

While the story doesn’t say much, people have been wondering why boys are more likely to receive an autism diagnosis than girls, and any step that brings an answer closer to a question may help ease the mind of concerned individuals.

Written by TheSportsBrain

April 12, 2011 at 11:39 pm