Simon Baron-Cohen, Alex Tsompanidis, Deepak P. Srivastava, Jonathan Mill, Madeline A. Lancaster, Dwaipayan Adhya, Dwaipayan Adhya, Omar Al-Rubaie, Carrie Allison, Bonnie Auyeung, Rosie Bamford, Simon Baron-Cohen, Richard Bethlehem, Tal Biron-Shental, Graham J. Burton, Tereza Cindrová‐Davies, Joanna Davis, Juan Pablo Del Río, Lucia Dutan-Polit, Dori Floris, Alice Franklin, Lidia V. Gabis, Daniel H. Geschwind, Ramin Ali Marandi Ghoddousi, Jose Gonzalez-Martinez, David M. Greenberg, Yuanjun Gu, Alexander E. P. Heazell, Rosemary Holt, M. E. Hurles, Yumnah T. Khan, Kyriaki Kosidou, Meng-Chuan Lai, Madeline A. Lancaster, Michael V. Lombardo, Hilary C. Martin, Jonathan Mill, Mahmoud Mousa, Roland Nagy, Kathy K. Niakan, Niran Okewole, Adam Pavlinek, Marcin A. Radecki, David H. Rowitch, Laura Sichlinger, Deepak P. Srivastava, Alex Tsompanidis, Florina Uzefovsky, Elizabeth Weir, Xinhe Zhang, Varun Warrier
We first proposed the prenatal sex steroid theory of autism 25 years ago to account for a number of then-unexplained observations around autism, including (1) the more frequent diagnosis of autism in male than in female individuals and (2) apparent 'male-type' shifts in cognitive traits associated with autism, such as empathizing and systemizing. Here we review 25 years of research testing this theory. Early studies found that higher prenatal testosterone levels were associated with slower social, language and empathy development, greater attention to detail, stronger systemizing and more autistic traits. Subsequent studies suggested that both prenatal androgens and oestrogens are associated with autism. New methods in genetics and using stem-cell-derived neural organoids have further indicated the importance of sex steroid hormones for neurodevelopment, as well as atypical patterns in autism. These new findings support and open new lines of research into the prenatal sex steroid theory of autism.