Autism and sexuality

Autism, or autism spectrum disorder (ASD), refers to a broad range of conditions characterized by
challenges with social skills, repetitive behaviors, speech and nonverbal communication. We know
that there is not one autism but many subtypes, most influenced by a combination of genetic and
environmental factors. Because autism is a spectrum disorder, each person with autism has a
distinct set of strengths and challenges. Some people with ASD may require significant support in
their daily lives, while others may need less support and, in some cases, live entirely independently.
Signs of autism usually appear by age 2 or 3 (like avoiding eye contact, delayed language
acquisition, repetitive behaviors…).
Individuals with neurodevelopmental disorders, including Autism (ASD), often have the same
desires as typically-developing people to express their sexuality and form intimate relationships.
The discrepancy between their physical development and their socio-emotional development, may
increasingly lead to difficulties as individuals with ASD mature. They might also may have an
increased risk of sexual exploitation and abuse. They thus have the right and need for appropriate
sexuality and relationship education.
Furthermore, the impairments in social skills and communication central to ASD potentially impact
an autistic individual’s expression and experience of sexuality by affecting their abilities to
understand and interpret the social cues, emotions, and nonverbal behaviors of others

Appropriate and inappropriate sexual behavior

Although most individuals with ASD engage in masturbation, fewer report sexual behaviors with a
partner. Individuals with autism present with less lifetime sexual experience than the general
population and the first sexual intercourse happens around 4 years later. This has been attributed to
a delay in the development of skills required to initiate sexual interactions, and a history of
unsuccessful attempts at developing sexual relationships. However one must remember that
highfunctioning individuals with ASD are comparable to the general population for what concerns
the frequency of sexual interactions.

Because individuals with ASD also experience difficulties discriminating between the behaviors
that are considered appropriate across different settings, they may naively engage in inappropriate
behaviors as a means of seeking contact, or initiating relationships with others. The risk of pursuing
potential partners in ways construed as threatening (eg, engaging in inappropriate touching,
stalking) is thus higher. The difficulty in reading facial expressions and impairments in Theory of
Mind can also lead to misinterpret signals from the others.
Restricted and repetitive behaviors and stereotyped interests can manifest as a preoccupation with
specific sexualized behaviors. Sensory sensitivities can also impact sexual experiences, with some
hypersensitive individuals experiencing soft physical touches as unpleasant.

Sexual victimization

Significantly higher rates of sexual abuse and coercive sexual victimization have been observed
among youth with ASD than among the broader population. An additional concern is that the
communication impairments prevalent in ASD make individuals less likely to identify and report
these experiences as forms of sexual victimization.
Some documented cases include the naive engagement in promiscuity as a means of initiating
desired relationships, and poor choices of abusive romantic partners. Others have cited an increased
susceptibility to sexual exploitation because of being overly trusting, and more likely to misinterpret
the sexual intentions of others.
Finally, the social and emotional challenges related to ASD may increase the vulnerability of
individuals to be viewed as easy targets of sexual abuse by opportunistic offenders.
Sexual identity: sexual orientation and gender identity

Sexual orientation is a multidimensional construct comprising the domains of sexual identity, sexual
interests, sexual attraction, and sexual contact. Each influences an individual’s underlying sexual
preference toward others. There seems to be also a higher prevalence of nonheterosexual
orientations in ASD than in the general population: females with ASD are between three and four
times more likely to identify as bisexual than females without ASD.

There is evidence that individuals with ASD present with more diverse gender identities than the
broader population. There seems to be also a higher gender variance, an individual’s variation in
gender role and typical behaviors, which deviate from culturally specific gender norms. adults with
ASD than census-based prevalence estimates in the broader population. Females with ASD are also
more likely to identify as transgender, or with a more fluid gender identity than individuals without
ASD assigned female at birth. Similarly, females with ASD are also more likely to report
masculinized gender behaviors in childhood, and a more masculinized gender identity than same-
sex control subjects.

The identified challenges experienced by individuals with ASD reflect the inherent need for
developmentally appropriate sexual education with an emphasis on the underlying social
competencies required for developing healthy intimate relationships tailored to the unique needs of
each patient. Clinicians may consider evidence-based relationship education, such as that offered by
the PEERS for young adults, Sexuality Education for Youth on the Autism Spectrum, or Tackling
Teenage programs.
Professionals should likewise be attuned to recognize the risk factors, warning signs, and symptoms
of potential sexual offending and sexual victimization, and previous unwanted sexual experiences
within clients with ASD.
Clinicians who work in gender clinics may want to screen for autism, and those working in autism clinics
may want to discuss gender identity and sexual health, researchers say. Sex-education materials should
also be LGBTQIA+ inclusive.

- What Is Autism? (n.d.). Autism Speaks. Retrieved August 31, 2022, from
https://www.autismspeaks.org/what-autism
- Pecora, Laura A.; Hooley, Merrilyn; Sperry, Laurie; Mesibov, Gary B.; Stokes, Mark A. (2020).
Sexuality and Gender Issues in Individuals with Autism Spectrum Disorder. Child and Adolescent
Psychiatric Clinics of North America, 29(3), 543–556. doi:10.1016/j.chc.2020.02.007
- Dattaro, L. (2020, September 18). Gender and sexuality in autism, explained. Spectrum | Autism
Research News. Retrieved August 31, 2022, from https://www.spectrumnews.org/news/gender-and-
sexuality-in-autism-explained/