Sex and the Autism Spectrum
Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that varies in severity. Typically, the core symptoms of ASD revolve around challenges in social communication and interaction. People on the spectrum may find daily human interactions more complex and struggle with day-to-day social behaviors. Sex is one of the most basic social human interactions and does overlap with the Autism Spectrum. ASD is often characterized by the presence of repetitive behaviors and restricted special interests. Some researchers have hypothesized that the restricted interests and repetitive behaviors are commonly seen in ASD may transform into sexualized behaviors in adulthood.
These sexualized behaviors look like many things, though one of the most common being intrusive sexual thoughts coupled with excessive masturbation. It’s said that excessive masturbation is relatively common in males with ASD. This is primarily because there are not a lot of studies investigating the relationship between sexuality and females on the spectrum coupled with the fact that many females are underdiagnosed. In one case study, it was reported that a 17-year-old man with a diagnosis of Asperger’s syndrome (now called high functioning ASD) had intrusive sexual thoughts and urges, and was masturbating 25 to 30 times a day. Another reason for excessive masturbation, other than that of restricted repetitive behaviors in ASD could be the fact that masturbation is the only plausible sexual outlet due to limited social skills. People on the spectrum have the same human emotions and desires as those who are not on the spectrum, making it essential for sex therapists to be educated on how to aid autistic individuals in expressing their sexuality in a consensual fashion.
Research has found that people with ASD do seek out sexual relationships and experience the full range of human sexual activities and behaviors. In some cases, however, the core symptoms of the condition, combined with limited sexual knowledge and experience, can play a role in the development of challenging sexual behaviors, such as hypersexuality, paraphilic disorders, and, in rare cases, even sexual offending. This is why it is critical for sex educators and therapists to understand how sex interplays with the autism spectrum in order to help combat symptoms of hypersexuality and even prevent cases of sexual offending.
The fact of the matter is that sex therapists and clinicians are lacking in the proper education of treating people with ASD when it comes to their sexual desires. In addition, there has been little attention paid to the need for sexual and relationship-oriented education for youth on the spectrum during [the] transitional period between adolescence and adulthood. It’s also noteworthy that adults on the spectrum were less likely to report learning about sexually transmitted diseases, contraceptives, and sexual behaviors from social sources, such as parents, teachers, and peers, as would be expected for non-ASD individuals. This is not only problematic but unjust and unfair. Individuals on the spectrum should be provided with the same sexual education as neurotypical individuals. People with ASD are not being educated on how to express their sexuality or act on sexual urges safely and due to this, they run a high risk of contracting an STI or STD along with unknowingly participating in non-consensual sex acts.
Neurodiverse Couples Therapy
In an article for Autism Spectrum News, Leslie A. Sickels, LCSW, outlines the ways in which sex therapy can be beneficial for neurodiverse couples. She notes that one of the first areas worked on in therapy is often that of communication, specifically communication involving sex or sexual urges. Sickels talks of how the communication deficits present in ASD may be exacerbated when it comes to sex as intimate interactions are often communicated through nonverbal cues such as eye contact, body language, or micromovements. This unspoken language adds a layer of challenge for individuals who struggle with nonverbal communication. Some ways of dealing with such communication issues may include using code words or specific short phrases that can convey emotion, desire, or indicate boundaries or triggers. Code words can be helpful for people with ASD because they have an agreed-upon meaning and thus will be concrete. In turn, this solidified communication can offset nonverbal communication mix-ups by clearly stating needs and wants during intimacy. Furthermore, having clear and direct conversations allows couples to be more explicit about consent and okay during sexual interactions.
Another important area worked on in neurodiverse couples therapy is that of sensory issues. Sickels notes that in neurodiverse couples’ work, it is critical to understand and educate couples on how a partner with ASD may be differently impacted by touching and intimate sensory experiences. Typically, ASD individuals may be hypersensitive to certain sensations and if their partner is neurotypical, challenges can arise when it comes to intimacy. This is because a neurotypical individual typically goes into sex focusing on what feels right for their partner, while a neurodiverse individual may have to focus on what feels suitable for their body before focusing on that of their partner. Through couples therapy, neurodiverse couples are able to discuss these sensory issues and figure out what feels right for both their own and their partner’s bodies. By educating neurodiverse couples on how sensory input is different for individuals with ASD, couples can identify how they each experience sensations and what they need from their partner to feel gratified during sex.
By Alyssa Morterud