Episode 9: Autism & Sexuality
This is the transcript of the episode. To listen to the episode please click on your preferred podcast button.
No AI is used at any point in this podcast.
This podcast explores recently published research on a number of different neurodivergent types. This season I am talking about autism, and in this episode I will go over some recent research on autism and sexuality. Unless otherwise specified, the research I have done for this and all episodes do not include those with intellectual challenges in conjunction with autism characteristics. While I will describe autistic characteristics in this episode, I also recognise that every autistic person will experience autism differently, and these are not specific to every person who identifies as autistic.
Suicide comes up in the research here, so if you don’t want to hear about that right now, please wait until the next episode comes out, and mind yourself in the best way that suits you. Some support services will be listed in the show notes.
Terminology
In this and the next episode I will talk about recent research on autism and sexuality, and then autism and gender. As some literature appears to conflate both these words, gender and sexuality, I feel it’s important to elaborate on their meanings. Sexuality is the identity a person holds regarding sexual practices, what they find to be sexual, who, and in what capacity. Widely known sexual identities include homosexuality, bisexuality, and heterosexuality, but there are many others that reflect the huge variety of human sexuality, such as pansexual, gynesexual, asexual, queer, fluid, and others. This is not a comprehensive list. Gender is just as varied, including the widely accepted binary of masculine and feminine, as well as Transgender, gender neutral, non-binary, genderqueer, no gender at all, a combination of identities, and more. For some, identifying their gender or sexuality is vitally important to their sense of self, and for others not claiming their exact identity in this regard works for them. The purpose of outlining the confusion some researchers appear to express between sexuality and gender is to highlight a possible identity injustice to their participants, that by not taking time to understand unique differences their results will become inaccurate at best. Sex and sexuality are not the same; sex is a biological designation, likely to be male or female, designated by the doctor at birth, but may also be intersex where genitals, chromosomes, or reproductive organs differ so that they cannot be easily categorised into the binary of male/female. Sex as a descriptor then can be just as varied as sexuality and gender. Those who believe someone’s gender must directly relate to their assigned sex at birth are called Gender Critical, and would not, for example, accept as legitimate a person’s gender identity assigned as one of the two normative sexes who then affirmed themselves as anything else in adulthood. For example, a person designated by doctors as male at birth, who then identifies as female or non-binary later on. In autism research, perpetuating a conflation between gender and sexuality in the minority experiences of participants does not explore the nuance of human expression and how it relates to autism. As far as possible, I will identify when this occurs in research in order to not perpetuate misleading concepts. Gender, sex, and sexuality are of course related, but they are distinct and should be treated as such. A conflation between gender and sexuality is more often found in research published over a decade or so ago, and recent research has made more of an effort to make the distinction between them, however we very often find disclaimers at the end of articles that state more research is needed in these areas to understand the impact they have on autistic people.
Romantic partners
In 2021 in the U.K., the Autism Strategy was refreshed and expanded to include children, young people and adults. The document tells us that ‘over the next 5 years, we want to create a society that truly understands and includes autistic people in all aspects of life’ (Huysamen, Kourti and Hatton, 2023). It doesn’t mention anything about supporting autistic people with their romantic lives, an area that is challenging for reasons I’ll go into in this section. As for many groups of people, the pandemic exacerbated challenges many autistic people already faced, such as loneliness, social isolation and anxiety, where autistic people were seven times more likely that the general public to be chronically lonely during June and July 2020. The term ‘intimate relationships’ has been used in diverse ways to denote various kinds of interpersonal relationships which involve emotional and/or physical intimacy and closeness. In the paper from Huysamen, Kourti and Hatton (2023), they investigated how autistic people’s sexual and romantic interpersonal relationships and practices were represented in government health and social care publications. Aspects of people’s intimate lives may include, but are not limited to, any of the following: meeting romantic or sexual partners, going on dates, forming relationships and bonds, expressing one’s sexual identity, experiencing romantic love, engaging in preferred sexual practices, having sex, experiencing sexual pleasure, belonging to sexual communities, and starting one’s own family. Intimate relationships are an aspect of most adults’ lives. Healthy intimate relationships can mitigate loneliness, act as a protective factor against the risk of suicide, and are proven to improve mental health outcomes and people’s overall sense of well-being. For autistic communities in research, intimate relationships are not often discussed, in part because in literature about disabled communities the subject of sex is controversial. Disabled and neurodivergent groups can be stigmatised as asexual or highly sexualised depending on context, but this is not a realistic perspective and is damaging to groups who are labelled by those with paternalistic attitudes according to their physical, mental, and developmental health. As the paper from Huysamen, Kourti and Hatton (2023) discusses government publications, they looked at how intimate lives can be linked to the concept of sexual citizenship. They discuss how Richardson in his paper ‘Constructing sexual citizenship: Theorizing sexual rights’ (2000) conceptualises sexual citizenship as a collection of sexual rights: the right to express one’s desired sexual practice, the right to define one’s sexual identity, and the right to have it acknowledged by state institutions. The inclusion of intimate lives in national health and social care publications represents state recognition of autistic people as sexual subjects and sexual citizens, with sexual rights and responsibilities. This recognition resists tropes that construct autistic people as inherently disinterested in and unknowledgeable about sex, or as sexually disordered or deviant, which can be situated within broader discourses that pathologise, infantilise, and desexualise people with disabilities. Huysamen, Kourti and Hatton (2023) identified a shift towards developing more holistic understandings of autistic people’s intimate lives, providing evidence that while some people identify as asexual or aromantic, most autistic people are interested and participate in sexual and/or romantic relationships. However, social norms and cues, and normative sexual and romantic scripts and communication patterns, present difficulties and elicit anxiety for autistic people, that may result in autistic people avoiding initiating intimate and sexual relationships, and can leave them isolated and feeling excluded from participating in intimate relationships. The government documents failed to recognise autism-specific needs, such as those relating to sensory preferences, social anxiety, and communication differences. To improve future health and social care publications and ensure that autistic people’s priorities around their intimate lives are no longer overlooked, the researchers (Huysamen, Kourti and Hatton, 2023) stated that policy-makers must avoid the deficit-based medical discourses and acknowledge the abdication of state responsibility for intimate lives. The Core Capabilities Framework (published by Health Education England, 2019) demonstrates the value of publications that are informed by a social model of disability (although still person-centred), strengths-based approaches that are both driven by autistic people’s aspirations, and that address the social barriers produced by our majority neurotypical society. Any publication about intimate lives must recognise that autistic people are not a homogeneous group, and that sexuality, gender, disability, ethnicity, class, culture, religion, and age are important sites of difference which may shape individuals’ intimate lives and their support needs (Huysamen, Kourti and Hatton, 2023).
Other research from Yew and others (2021) revealed that autistic people may have very satisfying romantic and intimate relationships, even though features of the relationship might vary from those between non-autistic individuals. Furthermore, characteristics of autism that might be perceived as barriers to relationship building by some non-autistic individuals might not be barriers at all to couples where both partners are autistic. Some of the reasons autistic people may find barriers to finding romantic partners include lack of social membership and under-employment, despite many autistic people having a high level of education. For more on the current research into autistic employment, please see episodes 5 and 6. Yew and others (2021) found studies that reported autistic young adults were two to four times less likely than young adults with other disabilities to see friends, and three times less likely to be invited to social activities (where potential partners can be met, and social communication observed and practiced). They identified that personality traits such as honesty and trustworthiness are common in autistic people, and although often come under different labels, are attractive to potential partners in general-population research. An apparent disregard for social small talk and ingratiation could also make autistic individuals appear to be more genuine, conscientious, and intelligent (ibid). These traits are associated with higher academic achievement and professional advancement, both of which are also highly attractive in partner selection (ibid). Physical intimacy, which for many individuals is a key feature of romantic relationships, may provide a challenge for some autistic individuals with either hyper- or hypo-sensitivity issues (ibid). Sex has been shown to promote relationship stability and sexual satisfaction, and is positively associated with relationship satisfaction and negatively associated with relationship dissolution (ibid). Although many autistic individuals express an interest in sex, the sensory sensitivities can have an impact on sexual satisfaction, both for these individuals and their partners (ibid). A sample of autistic adults reported that sensory dysregulation, coupled with communication difficulties with their partners, resulted in an unpleasant or even painful experience of partnered sex, a challenge which some participants addressed using sensory barriers, practicing communication, and negotiating with partners (ibid). Yew and others (2021) uncovered research that found communication issues in fact pose a major barrier to intimacy and relationship satisfaction for autistic individuals and their non-autistic partners. The use of the internet to initiate relationships, or online dating, may assist autistic individuals in overcoming some of the socio-communicative challenges faced when trying to initiate a relationship with non-autistic individuals (ibid). Online dating offers a number of unique features that are potentially beneficial to autistic individuals, including greater access to potential partners and the opportunity to initially communicate in a less socially demanding manner (ibid). However, socio-communicative differences may not be totally addressed with online dating and may also continue to be an issue when transitioning to face-to-face meetings and in longer-term relationships (ibid). Another point of interest from this paper is that couples made up by an autistic with a non-autistic person reported dissatisfaction with the amount of leisure time spent together, with the non-autistic partner reporting higher levels of dissatisfaction. They report that this could be explained by a number of reasons, including differences in interests or hobbies, or that some autistic individuals prefer to spend time alone (ibid).
Sexual Identities and Autism
Having a minority sexual identity outside of the normative heterosexual one impacts the lives of people who might identify as lesbian, gay, homosexual, queer, and others. In addition to that, if they identify as autistic as well, they have two minority identities to contend with (Hillier et al., 2020). In research from Hillier and others (2020) they report that members of the LGBTQIA+ community frequently experience notable barriers. However, they report that in annual surveys, there is a changing societal view of gay male, lesbian, and bisexual relationships (ibid). People are more positive about non-heterosexual relationships than they were, but violence against LGBTQIA+ people is still prevalent. Studies that show the impact of identifying as LGBTQIA+ by autistic people are scarce and more research is needed in this area. Some initial findings have indicated that autistic people may be more tolerant towards homosexuality than non-autistic (ibid). They reference a study on autistic and non-autistic males, where both groups showed the same amount of same-sex feelings, however, the autistic males exhibited significantly more acceptance towards homosexuality than non-autistic. They also identify other previous work where there was a higher prevalence of homosexual feelings and behaviours among autistic males. In many studies, researchers reference a lack of strong feelings by autistic people over whether themselves, or others, might be identified as non-heterosexual, and also that autistic people appear to be more open to sexual attraction of the same sex. Researchers appear to question whether this is due to the way autistic people tend to disregard social constructs in general and so do not hold much weight over cultural ‘ways of being’ regarding sexual identity. Autistic people appear to gravitate to their sexual preferences without undue pressure over what society or culture dictates are ‘normal’ or acceptable. Of course, once identified, they may find their sexual preferences cause them harm or upset because of the society and/or cultural involvement their circumstances designate. For example, there may be a significant circumstantial difference to being homosexual and autistic in a large city as opposed to living in a small town, or from within religious communities. The study participants in Hillier and others’ (2020) described bias against them as identifying as LGBTQIA+ and disabled as being cumulative, and eroded their credibility as autonomous individuals (ibid). This intersectionality cut across the themes identified and emerged as a significant barrier in many contexts. Importantly, the participants collectively rejected a common notion that autistic people may be confused about their sexual orientation and/or gender identity. Those around them, including their parents, often rejected their non-binary gender identity or minority sexual orientation status, or questioned their ability to really know who they are and what they want (ibid). They reflected that, prior to attending college, they lacked the necessary vocabulary to understand who they were resulting in significant stress and damaged self-esteem. This supports existing research which has identified inadequate sex education, and education based on heteronormative and cisnormative perspectives (ibid). Holding multiple minority identities magnified social challenges and resulted in greater isolation. As participants discussed advantages/challenges stemming from membership in the autism and LGBTQIA+ communities, they described rejection from the LGBTQIA+ community because of traits associated with their autism, and from the autism community because of their sexuality and/or gender identity (ibid).
The World Health Organisation describes sexuality as “a central aspect of being human through-out life (that) encompasses sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy, and reproduction” (WHO, 2006, p.5). It goes on to say that sexual health and well-being are closely related to overall health and well-being of individuals, partners, and families, and to the social and economic development of communities and countries (ibid). Human rights apply to sexual and gender diversity rights, including the right to freedom of thought and expression, equality, non-discrimination, privacy, autonomy, integrity, information, education, and health (ibid). As stated by researchers Dewinter and others (2024), views on autism, sexuality and gender have changed over the years, from ignoring the sexuality of autistic people to focusing on possible “sexual problems,” “inappropriate behaviours,” or assumptions that autistic people are “confused” regarding their experience of sexual orientation or gender diversity; and more recently, a shift toward recognition that sexuality and gender development are part of being human for autistic and non-autistic adolescents and adults alike, and include a wide range of expressions and identities. However, for many autistic people, human, sexual, and gender diversity–related rights have not been realised (ibid).
Some autistic individuals report more satisfaction with their relationship if their partner is also autistic (ibid). Contrary to ongoing myths, autism does not increase the risk for sexual offense. In fact, research has shown that autistic people, especially women, are more than four times as likely to experience sexual and physical violence and abuse as non-autistic individuals (ibid). The consequences of victimisation and needs of autistic survivors may be different from those in the general population (ibid). The impact of sexual victimisation on autistic people might be exacerbated by previous negative experiences, social exclusion, and inadequate reactions from others when seeking support (ibid). Ways to support autistic individuals, as outlined by Dewinter and others (2024), include sex education that can help individuals learn to understand their personal preferences, boundaries, and identities, and build skills to develop healthy relationships and recognise harmful ones. In addition to this, autistic adults stressed the need for attention to diverse interests and experiences (e.g. specific sexual interests, asexuality, sensory experiences and preferences, masturbating to regulate stress) which should be covered in Comprehensive Sexuality Education. Awareness about cultural differences should also be factored in (e.g. in some countries sex ed is not yet provided in schools so other avenues may be needed) (ibid). To counter the paternalistic nature of some health organisations, autistic participants recommended that autistic people are included in research projects studying sexuality, gender, and related health, and well-being (ibid). They also suggested that governing bodies should promote and develop research on how to understand and support sexuality, intimate relationships, and gender diversity-related needs in people with intersecting identities—such as autistic people of colour, autistic people with limited verbal communication, and autistic people with intellectual disabilities (ibid).
Homosexuality and Autism
Hogan and Micucci (2020) studied same-sex attraction in five autistic gay men. Previous research suggested that same-sex attraction is more common among autistic people than among the neurotypical population (ibid), and participants in a historical study reported that those with autistic traits were more likely to feel that their sexual orientation could not be described using traditional labels, such as heterosexual, homosexual, or bisexual (ibid). Despite the evidence that nonheterosexual attractions and relationships are relatively more common among autistic people than in the neurotypical population, little is known about the nature of these same-sex relationships or how autistic individuals experience them, and this is what Hogan and Micucci (2020) studied in their paper. There is little research on autistic individuals in middle adulthood and later in life, and the period of middle adulthood poses typical challenges, including a review of one’s life choices, a reassessment of identity, realisation of mortality, and a perceived decline in sexual performance and attractiveness (ibid). Gay and bisexual men in middle adulthood experience additional challenges, including age discrimination within the gay and bisexual communities as well as higher rates of loneliness (ibid). The men in their study (Hogan and Micucci, 2020) wanted and had intimate and sexual relationships, exhibited considerable diversity in the types of relationships experienced, and struggled with integrating their sexual and autistic identities. They experienced a variety of relationships, ranging from casual sexual encounters to stable, long-term marital or marriage-like partnerships (ibid). Therefore, the findings of their study help to dispel the myths that autistic individuals do not desire sexually intimate relationships and that they are not able to initiate or maintain intimate relationships (ibid). Despite successful experiences in intimate relationships, the participants also reported obstacles to finding and maintaining relationships with other men. Challenges communicating with neurotypical individuals and understanding others’ emotional states sometimes posed difficulties for these men in navigating their relationships. Sensory sensitivities posed fewer challenges in one-to-one relationships, but did lead them to avoid places, such as bars and clubs, where they might have an opportunity to make connections (ibid). All participants acknowledged having struggled with isolation and loneliness during their lifetimes. Some of the participants avoided crowded meeting places such as clubs and bars. Others expressed negative attitudes toward the “gay scene” and all but one reported feeling disconnected from their local LGBTQIA+ communities. Although some autistic people prefer to meet people online and online dating is common among gay men, the men in this paper reported that they did not find that meeting men online was helpful (ibid). Only one participant disclosed positive experiences with online dating, but even he stated that he used it only for casual encounters, not for initiating longer-term relationships. The experience of disconnection from their local LGBTQIA+ communities was associated with experiences of perceived discrimination, especially by other gay men. None of the men reported discrimination within the autism community for their sexual minority identity, a finding consistent with other reports of tolerance for homosexuality among autistic individuals (ibid). All of the men disclosed that there were times when they did not feel accepted in their local communities, at their jobs, or by their families, consistent with other reports that autistic individuals feel misunderstood and unaccepted by neurotypical individuals (ibid). One man spoke about the current debate among autistic individuals about the advisability of being “out” as a neurodivergent person, and said that he thought that autism advocates should take their cue from LGBTQIA+ communities because civil, educational, and personal gains had been made because of the gay rights movement (ibid).
Microsocial Contexts
According to Qualls and others (2022), microsocial contexts refer to the social interactions to which a person is exposed on a day-to-day basis. A review of the minority sexual orientation literature showed that studies examining the effect of family on sexual minority orientation were most common, leading Qualls and others (2022) to examine the impact of family on autistic people in a sexual minority group. One of the most important factors of family in relation to developing a sexual minority orientation is the degree to which family members expressed views on sexual minority individuals affects the development of sexual minority orientation. In their review, Qualls and others (2022) found that having sexual minority parents increased the likelihood for the young adult child to have considered or to have had a same-sex relationship and to have more friends that identify as sexual minorities, but not necessarily to identify as a sexual minority themselves. Individuals who identify as sexual minorities are less likely to identify as religious than the general United States population, especially in the case of female sexual minorities, particularly bisexual women (ibid). These researchers also found in their review that attendance at a non-identity-affirming church was associated with significantly higher internalised homophobia compared to that of individuals who attended an affirming church or who never attended church. Also, sexual minority individuals tended to be less religious, which Qualls and others (2022) hypothesised could be due to a causal relationship between religious affiliation and internalised homophobia. Systematic homonegativity, prejudice, and stigma can be simplified into the term “heterosexism” (ibid). Heterosexism is defined as “a cultural ideology embodied in institutional practices that work to the disadvantage of sexual minority groups even in the absence of individual prejudice or discrimination” (Blumenfeld, 1992). Sexual prejudice and violence has the consequence of forcing heteronormativity on people who might otherwise identify as sexual minorities (Qualls and others, 2022). For autistic people then, who may be masking or camouflaging already to ‘fit in’, feeling an additional obligation to hide their sexuality from others may become untenable to their lives, and could contribute to well established findings of feelings of isolation and depression.
Support
There are support groups for people who identify as autistic and nonheterosexual or gender non-conforming. Here in Ireland there exists the incredible organisation, BelongTo, who support nonheterosexual youth, as well as the website LBGT.ie who provide advice and support for adults and youth. The National Autistic Society in the UK also support LGBTQIA+ people through their online branch, and in the U.S., Twainbow provide support for those living under a ‘double rainbow’, a term synonymous with being autistic and nonheterosexual or non-cisgender. Links to these organisations are in the show notes.
During Neurodiversity Celebration Week 2024, a webinar was held that discusses the intersections of autism and LBGTQIA+. A link to the webinar is in the show notes, and there are many videos from this, and previous years, on a variety of interesting topics. Neurodiversity Celebration Week or Month is a global awareness-raising concept for neurodivergence in all walks of life, and was founded by Siena Castellon in 2018.
Show Notes
Special thanks to the Ballyfermot Library Creative Studio.
Samaritans Ireland and UK – 116 123
Papyrus (people under 35) – 0800 068 4141
Autistica suicide help page - https://www.autistica.org.uk/what-is-autism/signs-and-symptoms/suicide-and-autism
BelongTo Ireland: https://www.belongto.org/
LGBT.IE Ireland: https://lgbt.ie/
National Autistic Society (LBGTQ Branch): https://www.autism.org.uk/what-we-do/branches/lgbtq-online-branch
Twainbow (US): https://www.twainbow.org/
Webinar – ‘Neurodivergent & LGBTQIA+: The ‘double-rainbow’ intersection’: https://www.youtube.com/watch?v=Jny3KPoxXIc&ab_channel=NeurodiversityWeek
References
Blumenfeld, W. (1992). Homophobia: How we all pay the price. Beacon Press.
Dewinter, J. et al. (2024) 'Short report: Recommendations for education, clinical practice, research, and policy on promoting well-being in autistic youth and adults through a positive focus on sexuality and gender diversity', Autism : the international journal of research and practice, 28(3), pp. 770-779.
Hillier, A. et al. (2020) 'LGBTQ + and autism spectrum disorder: Experiences and challenges', International journal of transgender health, 21(1), pp. 98-110.
Hogan, M. S. and Micucci, J. A. (2020) 'Same-Sex Relationships of Men With Autism Spectrum Disorder in Middle Adulthood: An Interpretative Phenomenological Study', Psychology of sexual orientation and gender diversity, 7(2), pp. 176-185.
Huysamen, M., Kourti, M. and Hatton, C. (2023) 'A critical overview of how English health and social care publications represent autistic adults’ intimate lives', Critical social policy, 43(4), pp. 626-653.
Qualls, L. R. et al. (2022) 'Testing a Model of Sexual Minority Orientation in Individuals with Typical Development, the Broad Autism Phenotype, and Autism Spectrum Disorder', Journal of autism and developmental disorders, 52(4), pp. 1678-1692
World Health Organization. (2006). Defining sexual health: Report of a technical consultation on sexual health 28–31 January 2002, Geneva.
Yew, R. Y. et al. (2021) 'A systematic review of romantic relationship initiation and maintenance factors in autism', Personal relationships, 28(4), pp. 777-802.