Sexuality Communication with Young People on the Autism Spectrum

Research has highlighted that adolescents and adults with high-functioning ASD have just as much capacity for sexual behaviour as those with no diagnosis of ASD. Despite this, individuals with ASD still can experience prejudicial stereotypes that they are asexual, hyper-or hypo sexual, child-like and dependent, and/or uninterested in sex. Moreover, some hold the view that their sexuality is problematic and needs to be managed. There are some features of ASD which have perpetuated stereotypes regarding the sexuality in individuals with ASD. Some of these features include an aversion to being touched by others and the view that because they are ‘unemotional’ they would not have any interest in sexual relationships. Due to their social impairments and sexual ‘anomalies’, young people with ASD who are entering into adulthood may face significant difficulties and challenges in being able to develop and maintain social and romantic relationships.

Research has highlighted that there is currently a lack of support and services (in schools, etc) to help autistic adolescents and adults with ASD develop the necessary skills which will help them understand the social nuances of dating, intimacy and relationships. Additionally, individuals with ASD have been found to be much less likely to be able to obtain sexual health information from their friends or peer groups, media, school and parents. Specifically, many adolescents with ASD do not have connections with extensive peer groups where usually informal discussions about sex take place. As well as individuals with ASD being found to be less likely to receive sex and sexuality education, if they do receive education in sex and social relationships, it may not always be tailored to their specific needs. Research suggests that individuals with ASD are less likely to gain knowledge about sex from their parents or teachers and also indicates that individuals with ASD may often access the media and pornography in order to gain information about sex and relationships. This route to acquiring information that they cannot obtain elsewhere may, in some instances, lead to unintentional online offending.

An increasing number of studies are finding that individuals with ASD had less adaptive sexual knowledge and behaviours, reported less social behaviour (e.g., meeting up with friends), less education about sex and sexuality and less sexual experience compared to typically developing individuals. Studies have also found that while parents of adolescents with ASD believe that their children have an interest in sexual and romantic relationships, they do not know how to instigate conversations with their child with ASD regarding such topics. Another study found that few parents of children with ASD could quickly imagine the likelihood of their child ever having a romantic relationship. This is problematic. Parents may be reluctant to engage sexuality-related discussion if they have the expectation that their child will never have a sexual relationship and/or if the parents have the expectation that their child will not need or benefit from sexuality and relationship education.

It has recently been emphasised that caregivers, educators, and healthcare providers need to be empowered to have clear and direct conversations with both adolescents and young adults with ASD regarding relationships and sexual health. Sex education (tailored for individuals with ASD) should include the following components/topics:

• direct instruction on relationship and sexual health
• prevention of abuse and misconduct
• self-advocacy to support partner’s understanding of sensory, communication, or other personal needs
• social standards for sexual behaviour
• social conventions relating to flirting and dating
• social skills development (e.g., empathy, perspective-taking)
• how to decide when is the right time to engage in sexual intimacy with a partner

In sum, wherever possible, visual supports or skills-based teaching techniques should be used. Such education would also reduce the likelihood of some individuals with ASD later engaging in sexual offending behaviour. For instance, it is suggested that, due to the little or no experience of being in an intimate relationship, some individuals with ASD may find it challenging to express their sexuality within the ‘context of an appropriate relationship’. This may result in offending behaviour as a result of the individual’s sexual frustration.

About our blogger

Dr Clare Allely is a Reader in Forensic Psychology at the University of Salford in Manchester, England and is an affiliate member of the Gillberg Neuropsychiatry Centre at Gothenburg University, Sweden. Read more.