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On 16 April 2025, Robert F. Kennedy Jr. delivered a highly publicised address claiming that autism rates have reached epidemic levels. Referencing the CDC’s latest Autism and Developmental Disabilities Monitoring (ADDM) Network survey, Kennedy reported that one in every 31 children is now diagnosed with autism, with boys disproportionately affected. He suggested that environmental toxins are to blame and accused the media and scientific institutions of “epidemic denial.”

He referenced historical data, including a 1970 Wisconsin study by Dr Darold Treffert, to argue that autism was once rare but is now “catastrophic.” In his words, children affected by autism today are “damaged” by environmental exposures. He warned that autistic children “will never pay taxes,” “write a poem,” or “go on a date.”

At Curious Femme, we believe in the power of context, care, and evidence. So let’s dig deeper.

A History Often Forgotten: Autism is not new. In 1943, psychiatrist Leo Kanner described “early infantile autism” based on 11 children with specific behavioural traits. Around the same time, Hans Asperger made similar observations in Austria. But in the decades that followed, autism was frequently misdiagnosed as childhood schizophrenia. The dominant theory at the time blamed mothers labelled “refrigerator parents” for being too cold and unaffectionate (Evans, 2017).

This false narrative caused deep harm. The term “refrigerator mother” was coined in the 1950s by psychoanalyst Bruno Bettelheim, who promoted the idea that autism resulted from emotionally distant, cold, and unaffectionate mothers. According to this theory, the child withdrew into themselves because of a perceived emotional rejection. This concept, entirely lacking in empirical evidence, placed enormous blame and guilt on mothers, many of whom were already struggling to understand and support their children.

Families were torn apart by this stigma. Mothers were often viewed with suspicion by healthcare professionals and even by their own relatives. Fathers, influenced by prevailing societal attitudes, were sometimes encouraged to remove their children from maternal care. As a result, many autistic children were institutionalised, locked away in psychiatric hospitals where they were deprived of education, familial bonds, and adequate care. The long-term emotional and psychological consequences for both children and parents were profound (Evans, 2017; National Autism Centre, 2023). Only the most visibly affected were ever diagnosed. Milder forms of autism were overlooked entirely.

Dr Treffert’s 1970 study in Wisconsin, often cited as a baseline by Kennedy, identified 280 autistic children in a population of 900,000, a rate of 4.5 in 10,000. But this data is rooted in a historical period when autism was narrowly defined, grossly under-recognised, and socially stigmatised. Children were not “missed” due to lack of carelessness, but due to flawed societal frameworks.

Kennedy also referenced a 1987 study conducted in North Dakota, which he described as exhaustive and peer-reviewed. The study, authored by Burd, Fisher, and Kerbeshian and published in the Journal of the American Academy of Child & Adolescent Psychiatry, aimed to determine the prevalence of pervasive developmental disorders (PDD) in the state. By reviewing all available records and conducting in-person assessments across a population of 180,000 children under 18, the researchers reported a prevalence rate of 3.3 per 10,000 (Burd et al., 1987). Kennedy used this figure to argue that today’s higher prevalence cannot be attributed solely to improved recognition. However, it is important to note that diagnostic standards in 1987 were also much narrower and less inclusive than those used today, making direct comparison to current figures problematic.

For instance:

• Rutter et al. (1978) examined the stability and change in behavioural disorders over time, providing early insight into diagnostic consistency:
• Gilberg et al. (1993) investigated school-age children in Sweden, reporting low autism prevalence using the then-current criteria:
• A 2009 study by Hertz-Picciotto and Delwiche explored environmental and diagnostic factors associated with increased autism prevalence in California:
• Baxter et al. (2014) provided a systematic review and meta-analysis of global autism prevalence, highlighting major methodological differences in how autism has been recorded across countries and decades:

These studies illustrate the evolving definitions, tools, and recognition of autism across contexts and eras, and caution against making simplistic comparisons without addressing these critical shifts.A prevalence study of pervasive developmental disorders in North Dakota. Journal of the American Academy of Child & Adolescent Psychiatry, 26(5), 700–703. https://www.sciencedirect.com/science/article/abs/pii/S0890856709650243

Diagnostic Shifts, Not Epidemics. Since the 1980s, researchers such as Dr Lorna Wing have led a transformative shift in how autism is understood. Wing, a British psychiatrist and mother to an autistic daughter, challenged the narrow definitions of autism prevalent in the mid-20th century. Drawing on her clinical observations and the neglected work of Hans Asperger, she introduced the concept of the “autistic spectrum.” Wing argued that autism presents in a wide range of forms, from individuals with high support needs to those who are highly verbal and intellectually able but struggle with social communication and sensory processing (Wing, 1981).

Her work laid the foundation for broader, more inclusive diagnostic criteria, culminating in the development of Autism Spectrum Disorder (ASD) as a formal category in the Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM is the standard classification system used by clinicians and researchers in the United States and internationally to diagnose mental health and developmental conditions. The fifth edition (DSM-5), published in 2013, replaced previously distinct diagnoses such as “Asperger’s Syndrome” and “Pervasive Developmental Disorder-Not Otherwise Specified” with a single, unified diagnosis of ASD. This change reflected the understanding that these conditions were not separate disorders but variations along a continuous spectrum (American Psychiatric Association, 2013).

The autistic spectrum encompasses a diverse group of individuals who may differ significantly in communication styles, cognitive abilities, behaviours, and sensory experiences. Recognising this diversity is essential to providing appropriate support and fostering greater inclusion in society.

Meanwhile, diagnostic substitution has also played a role. Children once mislabelled with intellectual disabilities or emotional disorders are now correctly identified as autistic (King & Bearman, 2009). Autism is no longer invisible; our systems are simply becoming better at recognising it.

One area where awareness is still catching up is with women and girls. Historically, diagnostic criteria were developed based on male presentations of autism, overlooking the ways autistic traits can manifest differently in females. Autistic girls often exhibit more subtle signs, such as internalised anxiety, perfectionism, and a strong desire to fit in socially. Many engage in masking or camouflaging behaviours- consciously mimicking peers, rehearsing social scripts, and suppressing stimming, to blend into neurotypical environments.

This ability to ‘mask’ has led to widespread misdiagnosis or non-diagnosis. Girls have been wrongly labelled with personality disorders, eating disorders, anxiety, or depression without clinicians recognising underlying autistic traits. The psychological toll of long-term masking is profound. It often results in burnout, identity confusion, and mental health crises, particularly during adolescence or adulthood.

In recent years, growing awareness has led more women to seek diagnoses later in life. However, accessing appropriate assessments remains challenging. In the UK, thousands of adult women are currently on NHS waiting lists of up to three years for an autism diagnosis (Gould & Ashton-Smith, 2011). These delays can hinder access to vital support, accommodations, and validation. Better training for clinicians, inclusive diagnostic tools, and gender-informed approaches are essential to address these longstanding disparities.

Notably, Kennedy cited a long-established 4:1 male-to-female ratio in autism diagnoses, confirmed in the 1970 Wisconsin study he referenced. At that time, only about 60 children were diagnosed with autism in the entire state. Today, that figure is closer to 20,000. However, the enduring 4:1 ratio also reflects historical and ongoing underdiagnosis in females. Research now shows that autistic girls are likely to be diagnosed later, or not at all, due to outdated gender assumptions embedded in diagnostic systems and clinical training.

What the Science Really Says Kennedy claimed that “genes do not cause epidemics,” suggesting instead that environmental toxins are to blame. But the scientific consensus is that autism is the result of complex interactions between genetic susceptibility and environmental factors, not toxins alone (Sandin et al., 2014).

At King’s College London, pioneering research through the AIMS-2-TRIALS project is transforming autism science. This global initiative seeks to personalise support, identify biological markers, and deepen our understanding of autistic diversity. No single toxin, gene, or experience explains autism. That’s what makes it human.

Stigma Disguised as Concern Perhaps the most worrying thing is the language Kennedy used. One particularly disturbing quote from his speech illustrates this clearly: “I’m 71 years old with full-blown autism-headbanging, non-verbal, non-toilet trained, stimming, toe-walking-these other stereotypical features. Where are these people walking around the mall? You can’t find them. They’re not in homes. There are no homes for them. There are no institutions for them. Why aren’t we seeing them on the street?”

Statements like this reinforce outdated stereotypes of autism as wholly defined by its most visible challenges. They ignore the complexity and range of autistic experience, erase the contributions of non-speaking autistic adults, and imply that visibility equates to validity. Moreover, the suggestion that autistic people are hidden or absent because they are not seen in public is both misleading and ableist.

Such rhetoric does not uplift autistic individuals; it isolates them. At Curious Femme, we say this plainly: autistic people are not broken. They are not failed versions of neurotypical people. They are whole, valid, and worthy of dignity.

Autism is not an epidemic. It is a difference.

At Curious Femme, we say this plainly: autistic people are not broken. They are not failed versions of neurotypical people. They are whole, valid, and worthy of dignity.

Autism is not an epidemic. It is a difference.

Why This Matters Narratives matter. Public figures shape how society sees differences. If we describe autism as a public health crisis, we ignore decades of advocacy, science, and lived experience. We risk fuelling stigma, undermining support, and misdirecting research.

The real challenge is not autism itself; it is our failure to build a world that includes all minds. That includes ending diagnostic delays, improving educational access, and listening, really listening to autistic voices.

Further Reading

• Aza United (2023). How the autism diagnosis has evolved over time.
• Evans, B. (2017). An autism revolution in the history of child development. Queen Mary University of London.
• Gould, J. and Ashton-Smith, J. (2011). ‘Missed diagnosis or misdiagnosis? Girls and women on the autism spectrum’, Good Autism Practice, 12(1).
• King, M. and Bearman, P. (2009). ‘Diagnostic change and the increased prevalence of autism’, International Journal of Epidemiology, 38(5).
• King’s College London (2023). AIMS-2-TRIALS Project.
• National Autism Center (2023). Historical Perspective on Autism.
• Sandin, S. et al. (2014). ‘The familial risk of autism’, JAMA, 311(17).
• Scientific American (2023). The real reason autism rates are rising.
• Silberman, S. (2015). NeuroTribes: The Legacy of Autism and the Future of Neurodiversity.
• The Guardian (2025). ‘RFK Jr. falsely links autism to suicide and LGBTQ identity’.

References
American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 5th ed. Arlington, VA: American Psychiatric Publishing.
Baxter, A.J., Brugha, T.S., Erskine, H.E., Scheurer, R.W., Vos, T. and Scott, J.G. (2014) ‘The epidemiology and global burden of autism spectrum disorders’, Journal of the American Academy of Child & Adolescent Psychiatry, 53(9), pp. 996–1005.
Burd, L., Fisher, W.P. and Kerbeshian, J. (1987) ‘A prevalence study of pervasive developmental disorders in North Dakota’, Journal of the American Academy of Child & Adolescent Psychiatry, 26(5), pp. 700–703. https://www.sciencedirect.com/science/article/abs/pii/S0890856709650243
Evans, B. (2017) An autism revolution in the history of child development. Queen Mary University of London. https://www.qmul.ac.uk/media/news/2017/hss/an-autism-revolution-in-the-history-of-child-development.html
Gilberg, C., Steffenburg, S. and Gillberg, I.C. (1993) ‘Prevalence of autism: A population study of four-year-old children in a Swedish urban area’, Journal of the American Academy of Child & Adolescent Psychiatry, 32(2), pp. 407–412.
Gould, J. and Ashton-Smith, J. (2011) ‘Missed diagnosis or misdiagnosis? Girls and women on the autism spectrum’, Good Autism Practice, 12(1), pp. 34–41.
Hertz-Picciotto, I. and Delwiche, L. (2009) ‘The rise in autism and the role of age at diagnosis’, Pediatric Research, 66, pp. 493–500.
King, M. and Bearman, P. (2009) ‘Diagnostic change and the increased prevalence of autism’, International Journal of Epidemiology, 38(5), pp. 1224–1234.
National Autism Center (2023) Historical Perspective on Autism. https://nationalautismcenter.org/autism/historical-perspective/
Rutter, M., Tizard, J. and Whitmore, K. (1970) ‘Education, Health and Behaviour: Psychological and Medical Study of Childhood Development’, London: Longman. Also discussed in:
Sandin, S., Lichtenstein, P., Kuja-Halkola, R., Larsson, H., Hultman, C.M. and Reichenberg, A. (2014) ‘The familial risk of autism’, JAMA, 311(17), pp. 1770–1777.
Scientific American (2023) The real reason autism rates are rising. https://www.scientificamerican.com/article/the-real-reason-autism-rates-are-rising/
Silberman, S. (2015) NeuroTribes: The Legacy of Autism and the Future of Neurodiversity. New York: Avery.
UC Davis Health (2009) Autism Rise Not Fully Explained by Better Diagnosis or Awareness. https://www.sciencedaily.com/releases/2009/01/090108095429.htm
Wing, L. (1981) ‘Asperger’s syndrome: a clinical account’, Psychological Medicine, 11(1), pp. 115–129.

Thanks for reading Curious Femme. Stay curious, stay kind.