Absence of sex differences in mental rotation performance in autism spectrum disorder.
Adult men and women with autism perform the same on mental-rotation tests, so sex-based expectations will mislead you.
01Research in Context
What this study did
Stevens et al. (2018) asked if men and women with autism differ on mental-rotation tasks. They tested adults with high-functioning autism and a neurotypical group. Everyone completed the same paper-folding test while the team recorded speed and accuracy.
What they found
Men and women with autism scored the same. Their average accuracy and speed were nearly identical. The neurotypical group also showed no sex gap, so the classic male advantage in mental rotation did not appear in either population.
How this fits with other research
Bassett-Gunter et al. (2017) found the same null result in a large community sample: males and females with ASD looked alike on IQ, age at diagnosis, and symptom severity. Together these studies weaken the idea that autism is an extreme male brain.
Mandy et al. (2012) seems to disagree. They showed girls with ASD have milder repetitive behaviors than boys. The difference is real, but it lives in social behavior, not in visual-spatial skill, so the papers talk about different domains.
Szakal et al. (2026) meta-analysis of 34 studies adds nuance. Autistic females show bigger drops in empathizing than autistic males, yet their systemizing scores are similar. Mental rotation is a systemizing task, so the null finding in S et al. fits the meta-analysis picture.
Why it matters
Stop expecting autistic women to score lower on visual-spatial tasks. When you assess adaptive skills or plan vocational supports, use the same benchmarks for all adults with ASD. If a female client struggles with mental rotation, look beyond sex and check for visual or motor issues instead.
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02At a glance
03Original abstract
Mental rotation is one of the most investigated cognitive functions showing consistent sex differences. The 'Extreme Male Brain' hypothesis attributes the cognitive profile of individuals with autism spectrum disorder to an extreme version of the male cognitive profile. Previous investigations focused almost exclusively on males with autism spectrum disorder with only limited implications for affected females. This study is the first testing a sample of 12 female adults with high-functioning autism spectrum disorder compared to 14 males with autism spectrum disorder, 12 typically developing females and 14 typically developing males employing a computerised version of the mental rotation test. Reaction time and accuracy served as dependent variables. Their linear relationship with degree of rotation allows separation of rotational aspects of the task, indicated by slopes of the psychometric function, and non-rotational aspects, indicated by intercepts of the psychometric function. While the typical and expected sex difference for rotational task aspects was corroborated in typically developing individuals, no comparable sex difference was found in autism spectrum disorder individuals. Autism spectrum disorder and typically developing individuals did not differ in mental rotation performance. This finding does not support the extreme male brain hypothesis of autism.
Autism : the international journal of research and practice, 2018 · doi:10.1177/1362361317714991