Online Publication of Undergraduate Studies 2019, Volume 10, Issue 1
Sexuality and Autism Spectrum Disorders
Sexual Experiences in the Autism Spectrum Disorder Community Brianda Hickey
Autism spectrum disorder (ASD) is a neurodevelopmental condition involving persistent challenges in social communication, as well as restricted, repetitive patterns of behavior (American Psychiatric Association, 2013). As ASD is a spectrum, individuals diagnosed may experience a wide range of symptoms, and are characterized as “requiring support,” “requiring substantial support,” or “requiring very substantial support,” based on the severity of symptoms (American Psychiatric Association, 2013). Since individuals with ASD often have difficulty with interpersonal skills and communication, they are regularly mischaracterized as having a lowered libido, a disinterest in intimate relationships, or being incapable of forming romantic relationships (Byers, Nichols, & Voyer, 2013; Rosqvist, 2014). Yet, research has shown that individuals with ASD develop the same levels of sexual interest as their typically developing (TD) peers (i.e., those without developmental disabilities; Dewinter, Vermeiren, Vanwesenbeeck, & Van Nieuwenhuizen, 2016; May, Pang, Williams, 2017; Pecora, Mesibov, & Stokes, 2016). Nevertheless, the experience of sexuality (i.e., sexual identity, courting, and sexual interactions) greatly differs for a person with ASD (Barnett & Maticka-Tyndale, 2015; Pecora et al., 2016). These discrepancies in experience are informed in part by the symptoms associated with their ASD diagnosis, the high prevalence of non-heterosexual identities within this community, as well as the sex education that individuals with ASD receive (Gilmour, Schalomon, & Smith, 2012; Holmes et al., 2014; Rosqvist, 2014). Understanding how individuals with ASD engage in sexual interactions and the factors influencing their sexual engagement is important, since research indicates that participating in intimate relationships is a strong predictor for developing feelings of independence and empowerment, as well as social skills, for individuals with ASD in particular (Byers, Nichols, & Voyer, 2013; Pearlman-Avnion, Cohen, & Eldan, 2017). Given the broad spectrum of ASD, this review focused primarily on individuals with ASD who “require support” (i.e., those needing minimal assistance with social interactions and daily behaviors; Barnett & Maticka-Tyndale, 2015; Mintah & Parlow, 2018). Thus, this review focused primarily on individuals with autism who “require support”, and sought to answer the research question: How do individuals with autism spectrum disorder experience sexuality? Sexual Experiences Individuals with ASD often cite social cues, sensory
dysregulation, and restricted, repetitive behaviors as significantly affecting their sexual experiences (Aston, 2012; Byers et al., 2013; Rosqvist, 2014). These factors not only influence the interactions involved in a sexual experience, but can vary depending on the preferences and challenges of the specific individual, since even within the ASD community, individuals experience a range of different symptoms at varying degrees (Barnett & MatickaTyndale, 2015; Hannah & Stagg, 2016; Rosqvist, 2014). Social communication, a key component of ASD, may complicate the interactions involved with flirting, which is one of the key components in expressing sexual interest (Barnett & MatickaTyndale, 2015). Flirting is a social process rife with nonverbal and purposefully indirect (e.g., euphemism- or innuendo-based) methods of communication, and it requires the understanding of both verbal and non-verbal social cues, such as pitch, tone, and facial expression (Moore, 1985; Wade & Feldman, 2016). As such, difficulty ascertaining these social cues can result in an increased misunderstanding of the nature of flirtatious advances (Barnett & Maticka-Tyndale, 2015; Mintah & Parlow, 2018). Individuals with ASD have reported misinterpreting flirtatious interactions as strictly friendly, as well as misperceiving nonverbal social cues of disinterest as flirtatious (Barnett & Maticka-Tyndale, 2015; Mintah & Parlow, 2018). Consequently, individuals with autism may also have difficulty recognizing subtle cues that indicate if a person is taking advantage of them, as well as whether or not the person has ill intentions (Rosqvist, 2014). Research further indicates that an impairment in interpreting non-verbal cues in ASD may also hinder some individuals’ ability to communicate or interpret feelings, intentions, and agreements in sexual interactions (Holmes et al., 2014). This impairment, in turn, may lead to situations where individuals with ASD are unable to communicate or revoke consent, which may place them at risk for sexual abuse (Hannah & Stagg, 2016). In addition to a decreased ability to interpret nonverbal social cues, individuals with ASD often have difficulty with sensory dysregulation (i.e., an increased or decreased sensitivity to outside stimuli) when engaging in sexual activity (Rogers & Ozonoff, 2005; Rosqvist, 2014). For some individuals, this can lead to extreme pain, while for others it may present itself as an absence of sensation (Aston, 2012; Barnett & Maticka-Tyndale, 2015). Both of these experiences can consequently prevent a person with autism from engaging in or enjoying sexual acts either with or without a partner (Aston, 2012; Barnett & Maticka-Tyndale, 2015). Literature Review | 9
