Article

Sexuality in a community based sample of adults with autism spectrum disorder. Research in Autism Spectrum Disorders, 6, 313-318

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Abstract

Few studies have examined the sexual attitudes and behaviours of individuals with high functioning autism spectrum disorders (ASDs) living in community settings. A total of 82 (55 female and 17 male) adults with autism were contrasted with 282 members of the general population on their responses to an online survey of sexual knowledge and experiences. Findings revealed that individuals with ASD display an interest in sex and engage in sexual behaviours and showed no significant differences in breadth and strength of sexual behaviours and comprehension of sexual language when contrasted with non-ASD participants. However, despite these similarities, a higher rate of asexuality was found among individuals with ASD. In addition, the results of the current study indicated that females with ASD show a significantly lower degree of heterosexuality when compared to males with ASD. The results also suggested a higher degree of homosexuality among females with ASD although this effect did not reach significance.

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... Some studies on ASD have shown higher rates of non-heterosexuality as compared to N-ASD peers [8,16,35,67,68]. Gilmour and coworkers observed that individuals with ASD have higher rates of asexuality, bisexuality, and homosexuality, as well as lower rates of heterosexuality than N-ASD controls [69]. An interesting finding was that females with ASD had less heterosexual orientation than males. ...
... Some authors have found that many ASD individuals self-identify as asexual, possibly caused by deficits in social interaction and communication [30,[70][71][72][73]. A recent review of the literature pointed out that asexuality and autism have similar aspects, such as the conception of the romantic dimensions, sexual attraction, and sexual orientation, as well as non-partner-oriented sexual desire [69]. Despite various findings, Ronis et al. suggest that researchers should be cautious about attributing higher asexuality rates among individuals with ASD than the general population by accurately assessing sexual identity [74]. ...
... Gilmour, Schalom, Smith [69] Observational study ...
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ASD consists of a set of permanent neurodevelopmental conditions, which are studded with social and communication differences, limited interests, and repetitive behaviors. Individuals with ASD have difficulty reading eye gestures and expressions, and may also have stereotyped or repetitive language, excessive adherence to routines, fixed interests, and rigid thinking. However, sexuality in adolescents and young adults with ASD is still a poorly studied and neglected issue. This review aims to evaluate sexual function and behavior in individuals with ASD to foster a greater understanding of this important, although often overlooked, issue. This review was conducted by searching peer-reviewed articles published between 01 June 2000 and 31 May 2022 using the following databases: PubMed, Embase, Cochrane Database, and Web of Science. A comprehensive search was conducted using the terms: "Autism" OR "ASD" AND "Sexuality" OR "Romantic relation" OR "sexual behavior" AND/OR "sexual awareness". After an accurate revision of 214 full manuscripts, 11 articles satisfied the inclusion/exclusion criteria. This review found that, although individuals with ASD may have sexual functioning, their sexuality is characterized by higher prevalence rates of gender dysphoria and inappropriate sexual behavior. Furthermore, sexual awareness is reduced in this patient population, and the prevalence of other variants of sexual orientation (i.e., homosexuality, asexuality, bisexuality, etc.) is higher in adolescents with ASD than in non-autistic peers. Sexual health and education should be included in the care path of patients with ASD in order to improve their quality of life and avoid/reduce inappropriate and risky behaviors.
... Levels of sexual interest and desire also show sex differences. Many autistic individuals report an interest in sexuality Byers, Nichols, Voyer, & Reilly, 2013), with some noting comparable levels of sexual interest and desire as individuals without autism (Gilmour et al., 2012). But for women, interest in sex and sexuality, and desire to engage in sexual behaviors is lower than autistic male counterparts (Pecora et al., 2016), yet levels of sexual interest (Pecora et al., 2019) are similar to women without autism, mirroring female sexual desire in the broader population (Petersen & Hyde, 2010). ...
... In this, autistic women display higher rates of diversity in sexual orientation than men (Dewinter et al., 2017;Gilmour et al., 2012). For example, among autistic women, non-heterosexual attraction (19%) and non-heterosexual orientations (≥43.7%; ...
... Autistic women are less likely to report exclusive heterosexual attraction or identify as heterosexual than non-autistic counterparts (Bush, 2016;George & Stokes, 2018a). Higher levels of asexuality are also reported among autistic women (13-36%, Bush, 2018;Bush et al., 2020;Ingudomnukul et al., 2007) than among non-autistic women (0-11%, Bush, 2018 ;Ingudomnukul et al., 2007), and comparable levels of asexuality have been observed between autistic men and women (Gilmour et al., 2012). ...
... Levels of sexual interest and desire also show sex differences. Many autistic individuals report an interest in sexuality Byers, Nichols, Voyer, & Reilly, 2013), with some noting comparable levels of sexual interest and desire as individuals without autism (Gilmour et al., 2012). But for women, interest in sex and sexuality, and desire to engage in sexual behaviors is lower than autistic male counterparts (Pecora et al., 2016), yet levels of sexual interest (Pecora et al., 2019) are similar to women without autism, mirroring female sexual desire in the broader population (Petersen & Hyde, 2010). ...
... In this, autistic women display higher rates of diversity in sexual orientation than men (Dewinter et al., 2017;Gilmour et al., 2012). For example, among autistic women, non-heterosexual attraction (19%) and non-heterosexual orientations (≥43.7%; ...
... Autistic women are less likely to report exclusive heterosexual attraction or identify as heterosexual than non-autistic counterparts (Bush, 2016;George & Stokes, 2018a). Higher levels of asexuality are also reported among autistic women (13-36%, Bush, 2018;Bush et al., 2020;Ingudomnukul et al., 2007) than among non-autistic women (0-11%, Bush, 2018 ;Ingudomnukul et al., 2007), and comparable levels of asexuality have been observed between autistic men and women (Gilmour et al., 2012). ...
... Although there have been few studies of sexuality in people with ASD, there are some results to suggest a significant presence of asexuality in the ASD population (Barnett, 2017;Barnett & Maticka-Tyndale, 2015;Bejerot & Eriksson, 2014;Bush, 2019;Bush et al., 2020;Dewinter et al., 2017;George & Stokes, 2018a;Gilmour et al., 2012;Hartmann et al., 2019;Hillier et al., 2019;Ingudomnukul et al., 2007;Lewis et al., 2020;Marriage, Wolverton, & Marriage, 2009;May et al., 2017;Pecora et al., 2016;Sala et al., 2020aSala et al., , 2020b. Furthermore, the evidence concerning disinterest or lack of sexual attraction in people with ASD is often unclear (Byers et al., 2013a(Byers et al., , 2013bFernandes, et al., 2016;Hellemans et al., 2007Hellemans et al., , 2010May et al., 2017;Rudolph et al., 2018;Schöttle et al., 2017;Strunz et al., 2017), probably due to a lack of knowledge of asexuality or to the use of inadequate assessment tools. ...
... with ASD living in a community setting was also found by Gilmour et al., (2012). Barnett, (2017) described his sample of adults with ASD as characterized by substantial gender and sexual variation, including six participants who identify as asexual. ...
... Gender diversity is a rather common characteristic of both the asexual community (Antonsen et al., 2020;de Oliveira et al., 2020;Gazzola & Morrison, 2012) and the ASD population (Gilmour et al., 2012;Lehmann, Rosato, McKenna, & Leavey, 2020;Pecora et al., 2020;Pecora et al., 2016;Sala et al., 2019;Sala et al., 2020aSala et al., , 2020b. The literature suggests that individuals with ASD show higher rates of non-heterosexuality and gender nonconformity than typically developing (henceforth TD) peers (Beyers et al., 2013;Davidson & Tamas, 2016;George & Stokes, 2017, 2018aHancock et al., 2017;Pecora et al., 2016Pecora et al., , 2020Sala et al., 2020aSala et al., , 2020b. ...
Article
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Asexuality is a lack of sexual attraction to any gender. There is some evidence to suggest that many self-identified asexuals have a formal diagnosis of autism spectrum disorder which is characterized by deficits in social interaction and communication, as well as by restricted and repetitive interests and behaviors. Additionally, the literature shows that asexuality and lack of sexual attraction or low sexual interest is overrepresented in people with autism spectrum disorder compared with neurotypical samples. Nevertheless, no studies have been conducted to investigate the relationship between autism and asexuality in depth. We conducted a systematic review of the literature to examine whether asexuality and autism spectrum disorder are connected. We conclude that asexuality and autism share various aspects, such as a possible role of prenatal factors, reference to romantic dimensions of sexual attraction and sexual orientation, and non-partner-oriented sexual desire, but future research should explore and clarify this link.
... Sexual orientation (e.g., non-heterosexuality) and sexual identity (non-cisgender) are more varied or less rigid, on average, in persons with ASD compared with TD individuals [see (26,27) for reviews]. Rates of same-sex behaviors, homosexual orientation or non-exclusive sexual interests are consistently higher in adults with ASD compared with the general population (14,34,38,(46)(47)(48)(49)(50)(51)(52)(53)(54)(55). In adolescents with ASD, results are mixed. ...
... Still, adolescents with ASD seem to be more inclined to same-sex sexual interactions than their TD peers (23). These mixed results might reflect different proportions of girls included across studies as the effect is more pronounced among women than among men with ASD (46,48,49,51). Different levels of functioning might also be associated with different level of sexual orientation fluidity [with lower levels of functioning being associated with higher odds of non-heterosexual orientation; (52)]. ...
... Self-reports of adults with ASD also indicate higher rates of asexuality (51,66) and lower levels of sexual drive (46) or sexual desire (67), on average, compared with the general population. Women with ASD report less sexual interest, on average, than men with ASD (30). ...
Article
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Although most persons with an Autism Spectrum Disorder (ASD) wish to have romantic and/or sexual relationships, little is known about self-report sexuality of adolescents/young adults with ASD. In this exploratory study, 172 male and female adolescents/young adults (68 with ASD and 104 without ASD) completed an online version of the Sexual Behavior Scale-Third edition. Although many more similarities than differences were observed between the groups for views and desires about romantic relationships (e.g., wishing to have a girlfriend/boyfriend), fewer participants with ASD (mostly boys) had experience with a variety of sexual/dyadic behaviors, and approximately half of girls with ASD reported negative sexual experiences. Significantly higher rates of participants with ASD felt their knowledge about sexuality was limited and found it difficult to understand sexual education compared with typically developing (TD) participants. Significantly lower rates of participants with ASD reported that they identify to their assigned gender compared with TD participants. Multiple regressions revealed that being older at first diagnosis and possessing better knowledge about sexuality were significant predictors of both positive and negative sexual experience. This study explores strengths and challenges related with the sexual health of adolescents/young adults with ASD and implications for clinical and educational practice are discussed.
... Individuals with ASD are more likely to identify as sexual minorities. Surveys of adults with and without ASD found that both women and men with ASD reported higher levels of same-sex attraction and orientation, as well as asexuality, than individuals with TD (Bejerot & Eriksson, 2014;DeWinter et al., 2017;Gilmour et al., 2012). A meta-analysis including studies of individuals with ASD labeled as "highfunctioning" found between 15 and 35% of these individuals reported a sexual minority identity (Pecora et al., 2016). ...
... However, the authors cautioned that this is only one possible pathway between ASD and sexual minority orientation (George & Stokes, 2018a). Other authors hypothesized that individuals with ASD may be around suitable people of the same-sex more often than those of the opposite-sex, and have less awareness of social norms (Bejerot & Eriksson, 2014;Gilmour et al., 2012). Meeting individuals of the opposite sex requires a certain level of social ability, which some individuals with ASD may lack (George & Stokes, 2018b). ...
... Meeting individuals of the opposite sex requires a certain level of social ability, which some individuals with ASD may lack (George & Stokes, 2018b). The study by Gilmour and colleagues found that sexual interests and behaviors were highly correlated in participants with ASD, suggesting that the increased prevalence of sexual minority orientation in ASD is not simply a result of fewer romantic opportunities with the opposite sex (Gilmour et al., 2012). ...
Article
Full-text available
Individuals with Autism Spectrum Disorder (ASD) and the Broad Autism Phenotype (BAP) are more likely than individuals with typical development (TD) to report a sexual minority orientation (e.g., Bejerot and Eriksson, PLoS ONE 9:1–9, 2014; DeWinter et al., Journal of Autism and Developmental Disorders 47:2927–2934, 2017; Qualls et al., Journal of Autism and Developmental Disorders 48:3974–3983, 2018). This study operationalized and tested the fit of an existing model of sexual orientation to examine which factors are associated with increased sexual minority orientation (Worthington et al., The Counseling Psychologist 30:496–531, 2002) in individuals with TD, BAP, and ASD. The model was found to have adequate fit, χ2 (130) = 374.04, p < 0.001; RMSEA = 0.07; CFI = 0.95; SRMR = 0.08. Heterosexism was found to be the only predictor of sexual minority orientation and a significant predictor in the BAP and ASD groups, with increased daily heterosexist experiences predicting greater sexual minority orientation in these groups.
... 11 Similarly, no differences in the breadth and strength of sexual behaviors have been observed between high-functioning individuals with ASD and non-ASD comparisons. 22 Thus, the current state of research suggests that although sexual experiences can be impaired for individuals with ASD across all levels of functioning, 17,18 some high-functioning individuals share similar levels of experience to TD peers. Although still in need of further exploration, differences in findings may be caused by the heterogeneous nature of the condition; the assessment of participants across variable levels of functioning; and the reliance on parental reports, which underestimate levels of sexual behavior. ...
... Sexual orientation is a multidimensional construct comprising the domains of sexual identity, sexual interests, sexual attraction, and sexual contact. 9,22 Each domain is distinct from one another. Each influences an individual's underlying sexual preference toward others. ...
... than non-ASD control subjects (69.7%-90.4%). 2,22,[60][61][62] Higher rates of same-sex and bisexual interests and attraction were also observed in these studies, in addition to greater feelings of asexuality than TD groups. ...
Article
This article reviews relevant literature on sexuality in individuals with autism spectrum disorder (ASD). Findings reveal a growing awareness of desire for sexual and intimate relationships in individuals with ASD. However, core impairments of ASD lead to difficulties establishing requisite knowledge and skills necessary to attain a healthy sexuality and facilitate relationships. Consequently, individuals with ASD present with increased risk of engaging in inappropriate sexual behaviors and sexual victimization than their typically developing peers. The literature asserts the need to implement effective sexual education programs to assist in development of healthy sexual identity and relationships that meet each individual's needs.
... Emerging research suggests great diversity within asexuality, and many people participating in asexual communities use language (e.g., "gray ace") to reflect this variability. For reasons not yet fully understood, people with Autism Spectrum Disorder (ASD) appear to be more likely than those without ASD to be asexual (e.g., George and Stokes 2018;Gilmour et al. 2012;Ingudomnukul et al. 2007). Sexuality studies within the ASD community also suggest greater sexual diversity more generally, including lower percentages of individuals identifying as heterosexual (Dewinter et al. 2017;Pecora et al. 2016). ...
... Further, previous studies have identified sexuality-related differences between men and women with ASD. For instance, women with ASD are more likely to be sexual minorities than men with ASD, including asexual (Gilmour et al. 2012). However, asexuality within the ASD community is only beginning to be explored. ...
... Among participants who did not report an asexual spectrum identity, the most frequently reported sexual orientations included bisexual (15% of total sample), pansexual or polysexual (14%), queer (10%), and gay or lesbian (6%). Few participants identified exclusively as heterosexual (8%); while this rate was unexpectedly low in the present sample, high rates of sexual minority identity have been observed in other studies among young people with ASD (e.g., George and Stokes 2018;Gilmour et al. 2012). ...
Article
Existing research suggests that people with Autism Spectrum Disorder (ASD) are more likely than those without ASD to self-identify as asexual, or as being on the asexual spectrum. This study contributes to the literature by exploring aspects of sexuality and well-being in a large, community-based sample of young women (18–30 years old) with ASD (N = 247) and comparing the experiences of those with asexual spectrum identities and those with other sexual orientations (e.g., gay, bisexual, heterosexual). In the present sample, asexual participants reported less sexual desire and fewer sexual behaviors than those with other sexual orientations, but greater sexual satisfaction. Being on the asexual spectrum also was associated with lower generalized anxiety symptoms. Clinical and research implications are discussed.
... Participant demographics are reported in Table 1. It should be noted that there was a high degree of non-heterosexuality in the sample, which according to numerous other studies is to be expected in an autistic population (George & Stokes, 2018;Gilmour et al., 2012Gilmour et al., , 2012). Item creation and refinement. ...
... Participant demographics are reported in Table 1. It should be noted that there was a high degree of non-heterosexuality in the sample, which according to numerous other studies is to be expected in an autistic population (George & Stokes, 2018;Gilmour et al., 2012Gilmour et al., , 2012). Item creation and refinement. ...
... Participant demographics for the autistic sample are reported in Table 9. It should be noted that there was a high degree of non-heterosexuality in the sample, which according to the previous study, and numerous other studies is to be expected in an autistic population (George & Stokes, 2018;Gilmour et al., 2012Gilmour et al., , 2012. ...
Thesis
This thesis aimed to investigate the role of minority stress (MS) and autistic community connectedness (ACC) on mental health (MH) and wellbeing in the autistic community. Multiple methods were used, across four studies. Study one consisted of a qualitative study using grounded theory tools to create a measure of ACC, as none existed. The findings indicated that ACC compromises of three sub-domains – belongingness, social, and political connectedness. Stigma and identity both informed the level of ACC experienced by participants. In study two, a measure of ACC was created and validated in a new sample of autistic individuals (N = 133) using confirmatory factor analysis to test factor-structure and for item purification. Results indicated factorial, convergent and discriminant validity, for a 10-item scale. Studies three and four consisted of a cross-sectional and longitudinal survey where 195 autistic and 181 non-autistic people completed questionnaires at baseline and 99 autistic participants completed measures nine months later at follow-up. Resilience resources, ACC, MH and wellbeing, and MS were measured both times. Study three showed that the differences in MH, wellbeing, and resilience resources between the autistic and non-autistic sample persisted beyond demographics and general stress. Higher MS predicted lower MH and wellbeing, while ACC moderated the relationship between MS and MH, ameliorating the effects of MS. The longitudinal study (study four) showed that higher MS scores at baseline were associated with worse MH and wellbeing nine-months later, while higher ACC was associated with better MH and wellbeing. The results suggest a model of ACC and MS whereby autistic people may experience differing levels of ACC depending on experiences of stigma and autistic identity. This ACC in turn moderates the impact of MS on MH.These findings and implications of the research are further integrated into autism, MS, MH, and community literature.
... 11 Similarly, no differences in the breadth and strength of sexual behaviors have been observed between high-functioning individuals with ASD and non-ASD comparisons. 22 Thus, the current state of research suggests that although sexual experiences can be impaired for individuals with ASD across all levels of functioning, 17,18 some high-functioning individuals share similar levels of experience to TD peers. Although still in need of further exploration, differences in findings may be caused by the heterogeneous nature of the condition; the assessment of participants across variable levels of functioning; and the reliance on parental reports, which underestimate levels of sexual behavior. ...
... Sexual orientation is a multidimensional construct comprising the domains of sexual identity, sexual interests, sexual attraction, and sexual contact. 9,22 Each domain is distinct from one another. Each influences an individual's underlying sexual preference toward others. ...
... than non-ASD control subjects (69.7%-90.4%). 2,22,[60][61][62] Higher rates of same-sex and bisexual interests and attraction were also observed in these studies, in addition to greater feelings of asexuality than TD groups. ...
Article
This article reviews relevant literature on sexuality in individuals with autism spectrum disorder (ASD). Findings reveal a growing awareness of desire for sexual and intimate relationships in individuals with ASD. However, core impairments of ASD lead to difficulties establishing requisite knowledge and skills necessary to attain a healthy sexuality and facilitate relationships. Consequently, individuals with ASD present with increased risk of engaging in inappropriate sexual behaviors and sexual victimization than their typically developing peers. The literature asserts the need to implement effective sexual education programs to assist in development of healthy sexual identity and relationships that meet each individual's needs.
... Comparable percentages of boys in both groups reported having engaged in a variety of sexual experiences, including partnered and solo sexual encounters. Thus, individuals on the autism spectrum report a normal interest and desire for sexuality, [31,32] and similar age of debut for sexual thoughts and behaviors [33], lending support to the notion that adolescents and adults on and off the spectrum have similar sex education needs. ...
... Difficulty with social thinking, potential sensory sensitivities, as well as reduced knowledge or inaccurate information, combined with a demonstrated interest in sexual interactions [31,32], appear to put many people on the spectrum, who may be more naïve in the context of romantic social interactions, at risk for poor sexual health [53]. Worse yet, this combination of low knowledge, reduced benefit and access to sexual education, and enduring interest may increase their likelihood for victimization, a fear which has been substantiated by research. ...
... Similar to the experiences of neurotypically developing adults, there are a wide variety of preferences about sexuality and sexual behavior among adults with autism. However, there is a growing literature that documents the prevalence of romantic and sexual feelings for the same gender appears to be higher among adults on the autism spectrum than in the general population [32,39,[55][56][57]. Sexual and gender identities are also more fluid for adults on the autism spectrum [58,59]. ...
Article
Full-text available
Adults on the autism spectrum report comparable levels of desire for sex and sexual satisfaction as adults who are not on the spectrum. However, there has been little empirical focus on the need for sexual and relationship-oriented education for youth on the spectrum as they transition to adulthood. In this review, we use the Information–Motivation–Behavioral Skills Model of sexual health behavior change as a lens through which to understand the experiences of adults on the autism spectrum. We present those insights infused with emerging data and best practices in the field. Overall, it appears clear from the extant literature that providers need to recognize the specific characteristics of autism when developing sexual education curricula. Specifically, the social communication and sensory profile of people on the autism spectrum appears to interact with access to information, motivation to engage in healthy sexual activities, and the development of skills needed to engage in healthy sexual behavior. Finally, the voice of adults on the spectrum is essential to guide the emerging understanding of healthy sexuality.
... Prior literature has shown that autistic adults report sexual desire and satisfaction at a level that does not differ from non-autistic peers, although some differences have emerged by gender, sexual orientation, and for dyadic versus solitary sexual desire (Bush, 2018;Turner et al., 2019). Autistic individuals may engage in comparable rates of sexual behaviors (Fourie et al., 2017;Gilmour et al., 2012); 96% expressed an interest in sexuality (Hellemans et al., 2007), and 47% reported living with a spouse or romantic partner (Gotham et al., 2015a). Although autistic adults may desire sexual and romantic relationships, several studies have found that autistic adults are less likely to be in a relationship (Bush, 2018;Dewinter et al., 2017;Hellemans et al., 2010;Mogavero & Hsu, 2020a), have fewer opportunities to date (Hancock et al., 2020), and have less dating experience (Mogavero & Hsu, 2020a) than their non-autistic peers. ...
... Across surveys, autistic adults universally rated sexual health education as a gap in their healthcare (Burke et al., 2019), despite literature suggesting that autistic adults may be receiving the same formal sex education in school settings as their non-autistic peers (Hellmans et al., 2010). Findings suggest that autistic adults have comparable knowledge to their peers regarding basic biology (Gilmour et al., 2012) but lower overall knowledge of sexual behaviors, intimate relationships, sexual identity (Dekker et al., 2017;Konstantareas & Lunsky, 1997;Mogavero & Hsu, 2020b), perceived sexual health knowledge (Brown-Lavoie et al., 2014), and awareness of one's sexuality and its impact on others (Bush, 2018;Hannah & Stagg, 2016). Collectively, these findings suggest that existing sex education for autistic individuals may provide some benefit but is insufficient for teaching more complex topics, such as the sociocultural norms involved in interacting with a romantic partner, including how to communicate interest through flirting or what expectations may be on a date. ...
Article
Full-text available
Autistic adults have similar levels of desire for sexual and romantic relationships as their non-autistic peers. However, autistic adults are less likely to be in relationships and have less dating experience. We compared sexual knowledge, experiences, and pragmatic language ability in a community sample of young adults with (n = 27, mean age = 22.11) and without autism (n = 122, mean age = 19.47). Receipt of sex education and sexual knowledge did not differ between groups. However, autistic adults had significantly fewer partnered experiences and impaired pragmatic language. Within both groups, pragmatic skill predicted accurate sexual knowledge above and beyond general communication abilities. Findings suggest that sex education for autistic adults must address the social communication component of healthy romantic and sexual relationships.
... Despite varied prevalence of asexuality in the general population, some researchers have suggested a link between asexuality and autism spectrum disorder (ASD) (George & Stokes, 2018;Gilmour et al., 2012), which is characterized by impairments in social interaction and communication as well as by limited and stereotyped patterns of behaviors, interests, and activities (American Psychiatric Association, 2013). As outlined below, the link between ASD and asexuality is interesting for both clinical and theoretical reasons. ...
... Another study of 82 mostly female community-dwelling persons with ASD used the Sell Scale of Sexual Orientation (Sell, 1996) to measure sexual orientation as a continuous construct; the mean level of "asexuality" was significantly higher among the ASD group compared to a control group of 282 individuals from the general population who did not have ASD (Gilmour et al., 2012;see George & Stokes, 2018 for similar results). In another study, Bejerot and Eriksson (2014) found that one of 25 males and one of 22 females with ASD (approximately 4%), versus none (0%) of the neurotypical males and females, reported not being sexually attracted to men or women. ...
Article
Full-text available
Researchers have suggested that asexuality, which has been conceptualized traditionally as a persistent lack of sexual attraction to others, may be more common among individuals with autism spectrum disorder than in the neurotypical population. However, no studies to date have considered how these individuals understand and conceptualize their sexual identity. The aim of this study was to provide a more nuanced understanding of asexuality among individuals with high-functioning autism spectrum disorder (HF-ASD) than has been done in the past. Individuals with ASD, 21–72 years old (M = 34.04 years, SD = 10.53), were recruited from online communities that serve adults with ASD and Amazon’s Mechanical Turk to complete an online survey of sexual and gender identity. Overall, 17 (5.1%) participants who met study criteria (N = 332) self-identified as asexual. However, 9 of the 17 people identifying as asexual expressed at least some sexual attraction to others. In addition, based on open-ended responses, some participants linked their asexual identity more with a lack of desire or perceived skill to engage in interpersonal relations than a lack of sexual attraction. Results suggest that researchers should be cautious in attributing higher rates of asexuality among individuals with ASD than in the general population to a narrow explanation and that both researchers and professionals working with individuals with ASD should consider multiple questions or approaches to accurately assess sexual identity.
... Autistic females also present with greater variability in their sexual orientation. This has been evidenced by higher rates of bisexual and lesbian sexual orientations, as well as lower rates of heterosexuality in autistic females when compared to both autistic males [4,6,20], and non-autistic females [21]. Within this study, the term non-heterosexual/homosexual sexual orientation is used to describe identification with lesbian or bisexual sexual orientation. ...
... Study findings also provide further evidence of an increased sexual diversity (i.e. higher incidence of homosexual or bisexual orientation, and lower incidence of heterosexual orientation) in autistic female groups, compared to the general population. This is consistent with existing research [18,[20][21][22]. ...
Article
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Background: There is growing recognition that autistic females present with more diverse gender and sexual identities than their non-autistic counterparts. Likewise, autistic females are also at an increased risk of adverse sexual experiences. As higher rates of sexual victimisation are observed in individuals with diverse sexual identities in the broader population, rates of negative sexual experiences among autistic females remain unclear. This study aimed to investigate the representation of gender and sexual diversity within autistic females and examine their rates of regretted, and unwanted, sexual encounters among females with a transgender gender identity and non-heterosexual sexual orientation. Methods: Two hundred and ninety-five females completed the Sexual Behaviour Scale-III (SBS-III) online. Self-reported gender identity and sexual orientation were compared between 134 autistic (Mage= 26.2 years, SD = 8.7) and 161 non-autistic females (Mage = 22.0 years, SD = 4.6). Differences in the prevalence of negative sexual experiences were compared across diagnosis and each gender identity and sexual orientation label. Results: Autistic females were more likely to identify with a transgender gender identity (p < .05) and non-heterosexual sexual orientation (p < .007) compared to non-autistic females. Autistic homosexual females were more likely to have experienced a range of negative sexual experiences than autistic heterosexual females (OR ≥ 3.29; p < .01) and were more likely to have experienced unwanted sexual experiences than non-autistic females regardless of sexual orientation (OR ≥ 2.38; p < .05). There were no differences in rates of negative sexual experiences between autistic bisexual and both autistic heterosexual and non-autistic bisexual females. Non-autistic bisexual females (OR = 0.24; p = .018) presented with a reduced risk of regretted sexual experiences than non-autistic heterosexual peers. There were no differences in negative sexual experiences across gender identity in the autistic sample. Limitations: The use of fixed format response items may have restricted participants' abilities to provide rich responses pertaining to their sexual identities and nature of negative sexual experiences. The small number of participants who identified as transgender (n = 40) limits the reliability of results pertaining to sexual experiences across gender identity. Moreover, although multiple recruitment methods were used in this study, non-representative may bias estimates of prevalence rates. Thus, the data may not be representative of the broader population. Conclusions: Results indicate that autistic females present with greater diversity in their sexual identities than individuals without autism, with those with a homosexual sexual orientation being at greater risk of experiencing adverse sexual encounters. Findings suggest the importance of increased clinical attention to this diversity and the need to provide support to facilitate the development of a healthy sexual identity and reduce the risks identified in this study.
... A growing interest in the psychosexual functioning of adolescents with autism spectrum disorder (ASD) has led to an increase in research. Adolescents and adults with ASD are shown to have a desire for intimate and sexual relations (Dewinter, Vermeiren, Vanwesenbeeck, Lobbestael, & Van Nieuwenhuizen, 2015;Gilmour, Schalomon, & Smith, 2012;H enault, 2006;Stokes, Newton, & Kaur, 2007) and have similar experiences and behaviors compared to typically developing adolescents (Dewinter et al., 2015). Previous research into the psychosexual functioning of adolescents with ASD reports higher levels of difficulties, such as the portrayal of inappropriate Sexual behaviors (Dekker et al., 2015;Hellemans, Colson, Verbraeken, Vermeiren, & Deboutte, 2007;Sevlever, Roth, & Gillis, 2013;Stokes et al., 2007); fewer appropriate Sexual behaviors (Mehzabin & Stokes, 2011) and less psychosexual knowledge (e.g., Dekker et al., 2017;Ginevra, Nota, & Stokes, 2016;Hellemans et al., 2007;Stokes & Kaur, 2005). ...
... However, in research on the psychosexual functioning of general population (GP) adolescents, generally self-report is used (Schrimshaw, Rosario, Meyer-Bahlburg, & Scharf-Matlick, 2006). In contrast, in research on psychosexual functioning of adolescents with ASD, the parents or caregivers are generally used as informants, and self-report is used limitedly Byers, Nichols, Voyer, & Reilly, 2013;Dewinter et al., 2013;Gilmour et al., 2012;H enault, 2006;Kuo, Orsmond, Cohn, & Coster, 2013;Mehzabin & Stokes, 2011). Parent report has been favored as it is often thought that individuals with ASD have limited insight into their own functioning (Cederlund, Hagberg, & Gillberg, 2010;Urbano, Hartmann, Deutsch, Polychronopoulos, & Dorbin, 2013). ...
Article
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The private nature of psychosexual functioning leads adolescents and their parents to have different perspectives, which highlights studying parent–child informant discrepancies in this domain. We investigated informant discrepancy in psychosexual functioning, using the self‐report and parent report versions of the Teen Transition Inventory (TTI), of adolescents with autism spectrum disorder (ASD; 136 parent–child dyads) compared to adolescents from the general population (GP; 70 parent–child dyads). Significantly larger informant discrepancies exist in ASD dyads than GP dyads in most domains of psychosexual functioning, except for Body image, Sexual behavior, and Confidence in the future. It is important to use and pay attention to both informants, as discrepancies are relevant for both research and clinical practice regarding psychosexual functioning.
... Even though individuals with Autism Spectrum Disorders (ASD) have similar interests and characteristics with their peers who show typical development (TD) for the sexual development period, it is stated that inappropriate sexual behaviors occur or sexual abuse problems may develop in cases where sexual education is not adequately provided and knowledge about sexuality is limited (Gilmour et al., 2012;Stokes and Kaur, 2005). When considered in a broad context, sexual education includes physical health and hygiene, gender awareness, appropriate expression of emotions, privacy, physical intercourse, sexual behaviors, protection from abuse, and understanding and displaying appropriate behaviors in accordance with sexual identity (Sullivan and Ceterino, 2008). ...
Article
Cinsel eğitimin, cinsiyet farkındalığı, duyguların uygun biçimde ifade edilmesi, sağlık, hijyen, cinsel kimliğe uygun cinsel davranışları anlama ve bunlara uygun davranışlar sergileme, mahremiyet ve istismardan korunma gibi geniş bir yelpazede ele alınabilecek davranışları kapsayan bütüncül bir yaklaşımla ele alınması önerilmektedir. Bu bileşenler dikkate alındığında otizm spektrum bozukluğu (OSB) olan bireyler için cinsel gelişim alanı eğitsel anlamda geniş bir kapsamla ele alınması gereken bir alandır. Bu alanyazın inceleme çalışmasında, cinsel gelişim dönemleri, OSB olan bireyler için cinsel eğitimin önemi, OSB’nin karakteristik özelliklerine bağlı olarak ortaya çıkan güçlükler, cinsel eğitim süreçlerinde OSB olan bireylerin özelliklerine uygun biçimde kullanılabilecek müfredat içerikleri, öğretim uygulamaları ve bu konuya ilişkin yayımlanmış araştırma örnekleri ele alınmıştır.
... As a component of sexual relationships between adults, imaginative play is linked to the exploration of desire and pleasure (Paasonen, 2018). Its absence could therefore partly explain the lack of interest in sexual relationships that is sometimes found in autism (Gilmour et al., 2012): without its shared playful aspect, the sexual relationships would be deprived of their pleasurable components, and experienced as insipid or negative. Particularities in imaginative play could also underlie the important variations in sexual identity that are found in autism compared to neurotypicality (George & Stokes, 2018). ...
Article
Objectophilia (also known as objectum-sexuality) involves romantic and sexual attraction to specific objects. Objectophiles often develop deep and enduring emotional, romantic, and sexual relations with specific inanimate (concrete or abstract) objects such as trains, bridges, cars, or words. The determinants of objectophilia are poorly understood. The aim of this paper is to examine the determining factors of objectophilia. We examine four hypotheses about the determinants of objectophilia (pertaining to fetishism, synesthesia, cross-modal mental imagery, and autism) and argue that the most likely determining factors of objectophilia are the social and non-social features of autism. Future studies on the determinants of objectophilia could enhance our understanding and potentially lessen the marginalization experienced by objectophiles.
... As a component of sexual relationships between adults, imaginative play is linked to the exploration of desire and pleasure (Paasonen, 2018). Its absence could therefore partly explain the lack of interest in sexual relationships that is sometimes found in autism (Gilmour et al., 2012): without its shared playful aspect, the sexual relationships would be deprived of their pleasurable components, and experienced as insipid or negative. Particularities in imaginative play could also underlie the important variations in sexual identity that are found in autism compared to neurotypicality (George & Stokes, 2018). ...
Article
Full-text available
Objectophilia (also known as objectum-sexuality) involves romantic and sexual attraction to specific objects. Objectophiles often develop deep and enduring emotional, romantic, and sexual relations with specific inanimate (concrete or abstract) objects such as trains, bridges, cars, or words. The determinants of objectophilia are poorly understood. The aim of this paper is to examine the determining factors of objectophilia. We examine four hypotheses about the determinants of objectophilia (pertaining to fetishism, synesthesia, cross-modal mental imagery, and autism) and argue that the most likely determining factors of objectophilia are the social and non-social features of autism. Future studies on the determinants of objectophilia could enhance our understanding and potentially lessen the marginalization experienced by objectophiles.
... The term High-Functioning Autism (HFA) is used for people with ASD without an intellectual disability who often have an estimated IQ of 70 or higher [5]. New research revealed this group's unique sexual profile and sexual functioning with a similar level of interest in sex as healthy individuals [6,7]. In societies, cultures, and religions, the concept of inappropriate sexual behavior is different. ...
Article
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Sexual behavior is influenced by social and communication deficits in autism spectrum disorder (ASD) and is a serious challenge for parents who lack effective strategies for providing sexual education to their children with ASD. The purpose of this study was to explore Iranian parents' experiences of psychological distress in dealing with the sexual behaviors of their children with ASD. This qualitative study was designed following the conventional content analysis approach. Semi-structured and in-depth interviews were conducted with 27 parents of children with ASD aged 8–34 years. All interviews were audio-recorded and transcribed verbatim. The data were collected through purposeful sampling and continued until data saturation. The worries theme was extracted from data interpretation using qualitative content analysis, and this theme entailed four subthemes: 1) sexual vulnerability, 2) unintended social consequences, 3) psychological suffering, and 4) confusion about the future of a child's sex life. This study emphasized the importance of paying attention to parents' concerns about the sexual behaviors of children with ASD. Parents' psychological distress is a major obstacle to proper coping with sexual behaviors, and using coping strategies may help reduce psychological distress in parents of children with ASD. Therefore, it is necessary to design, implement, and evaluate culture-appropriate educational programs to address parents' concerns regarding the sexual health of a child with autism.
... The sample was also skewed toward female autistic adults without intellectual disability and those who held postsecondary qualifications, and therefore results may not be representative of the wider autism population. Self-selection in online surveys can lead to a female gender bias (Guo et al., 2017;Sax et al., 2003), as also has been noted in other online autism research (Cage et al., 2018;Gilmour et al., 2012). Additionally, the difficulties and barriers of recruiting people with intellectual disability and low educational and occupational status to participate in research has been the topic of many other papers (Ellard-Gray et al., 2015;Lennox et al., 2005;Patel et al., 2003;Russell et al., 2019). ...
Article
Autistic adults experience a high number of job changes, reduced working hours, minimal workplace supports, and overrepresentation in entry-level and low paid positions. This study adds to the existing evidence base to guide clinical decisions and interventions for this population. This study utilized baseline data collected between 2015 and 2017 from the Autism CRC's Australian Longitudinal Study of Autism in Adulthood. The aim was to describe the employment profiles and explore factors related to employment for Australian autistic adults aged 25 and older (N = 149). Comparisons between participants and the Australian workforce were made using Australian Bureau of Statistics (ABS) data. Two logistic regression models were conducted to explore the association between underemployment and underutilisation with personal and environmental factors. In comparison to the Australian workforce, autistic adults were more likely to work part-time, work reduced hours and be employed at skill levels lower than their qualifications warranted. Logistic regressions reported that more autistic traits, more social supports and having workplace adjustments implemented were significantly associated with a higher odds of autistic adults being appropriately employed and/or utilized in the workforce. Results suggest that interventions implementing appropriate workplace adjustments, a supportive workplace environment, and adequate social supports may improve employment outcomes for autistic adults. All employees may benefit from workplace resources targeted toward fostering an inclusive workplace environment. Lay summary This study aimed to describe the employment profiles and explore factors related to employment for Australian autistic adults. We compared this with the Australian workforce using data from the Australian Bureau of Statistics. Autistic adults with more autistic traits and more social and workplace supports were more likely to be employed and have jobs that were better suited to them. Autistic adults might have better employment outcomes if they have the appropriate workplace adjustments, a supportive workplace and adequate social supports.
... Sexual attraction and activity are part of normal adolescent development (Tolman & McClelland, 2011). Most people on the autism spectrum experience sexual attraction (Gilmour et al., 2012;May et al., 2017) and many are sexually active, including adolescents (Byers et al., 2013a(Byers et al., , 2013bByers et al., 2013aByers et al., , 2013bHellemans et al., 2007;Holmes & Himle, 2014;Mehzabin & Stokes, 2011;Ousley & Mesibov, 1991;Strunz et al., 2017). Up to 70% of autistic adolescent boys have engaged in partnered sexual behavior (Dewinter et al., 2015(Dewinter et al., , 2016, and one study found that autistic adolescent girls and neurotypical controls had comparable sexual activity (May et al., 2017). ...
Article
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Background This systematic review investigated the state of intervention science on programs that promote healthy intimate relationship skills and sexual health for autistic youth (i.e., healthy intimacy).Methods Using PRISMA guidelines, we reviewed randomized controlled trials (RCTs) published in 2010 or later that enrolled ≥ 1 autistic adolescent participant.ResultsOf 1934 articles returned, three met inclusion criteria: Supporting Teens with Autism on Relationships, Tackling Teenage Training, and Peers Engaged in Effective Relationships-Decision-Making. All increased content knowledge and one improved social/ behavioral functioning.Conclusion We identified three RCT-supported interventions for autistic youth that teach healthy intimacy skills. Comparative effectiveness research on these programs would benefit the field.
... Some studies find similar proportions of same-sex attraction or experience among autistic participants and non-autistic peers, which is typically around 5-10% [47], whereas other studies report higher levels of non-heterosexual feelings and experiences in autistic adolescents and adults [48]. More autistic women compared to autistic men identify as bi-sexual, endorsing sexual attraction to both sameand opposite-sex partners [49]. ...
Article
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For those growing up on the autism spectrum, adolescence is associated with unique challenges. This narrative review explores three core psychological elements for clinicians to consider when treating adolescents on the autism spectrum: self-awareness, gender identity, and sexuality. Developmental tasks of adolescence include adaptation to a maturing mind and body, increased expectations for independence, and the ability to establish satisfying interpersonal relationships. What are welcome opportunities for non-autistic peers can become nearly insurmountable hurdles for autistic teens, which, in turn, could lead to crisis, particularly if skills needed for success in managing these tasks have not yet been acquired.
... Non-social sources, such as the internet, may be used to gain this knowledge. Those with ASD are just as likely as neurotypical individuals to display sexual interest or engage in sexual behavior (Gilmour et al., 2012). However, they do not have the same sexual outlets throughout development, which may delay social and sexual development (Attwood et al., 2014). ...
Article
Purpose Autism-specific characteristics have been associated with internet criminal activities. Internet and non-internet offenders differ on a series of demographic, psychological and offending variables. However, the clinical and criminal presentation of individuals with autism spectrum disorder (ASD) in forensic secure care settings has been underexplored. This paper aims to explore the profiles of internet offenders with ASD admitted to a secure psychiatric unit. Design/methodology/approach This study provides the results of a service evaluation of individuals with ASD. The demographic, clinical and criminal characteristics of a small sample of internet offenders with ASD admitted to secure care are described and discussed. Findings Internet offenders present in secure care with high rates of comorbid disorders, histories of violence and traumatic experiences, mood disorders and difficulties with relationships. Of the 24 internet offenders discussed, 18 of them committed an offence of a sexual nature involving children. Originality/value This paper highlights the potential risks for individuals with ASD in using the internet and the possible difficulties associated with detecting this because of rapid advancements in technology.
... Studies show that most autistic people experience sexual feelings and have satisfying sexual relationships, although some may not want or have partners. [4][5][6][7][8][9][10][11][12][13][14] However, there is limited research on how autistic traits affect sexual and intimate experiences and ways to support autistic people to achieve satisfaction in their sexual and romantic relationships. ...
... Additionally, providers may face a number of challenges commonly associated with SRH education for adolescents and adults with intellectual and developmental disabilities. First, individuals with intellectual and developmental disabilities are more likely to identify as a sexual or gender minority (Bejerot & Eriksson, 2014;George & Stokes, 2018a, 2018bGilmour et al., 2012). Evidence supports the need for inclusive sexual health information for all youth, but especially for youth who identify as a sexual or gender minority (Bedard et al., 2010;Gougeon, 2009;Hodges & Parkes, 2005;Stauffer-Kruse, 2007;Wilson et al., 2018). ...
Article
Background: Individuals with intellectual and developmental disabilities demonstrate disparities in sexual and reproductive health (SRH) compared to individuals without disabilities (e.g., lack of sexual education and knowledge, increased rates of abuse, unplanned pregnancies and sexually transmitted infections). Therefore, the purpose of this study was to identify topics healthcare providers address and perceived barriers and supports to SRH education. Methods: We conducted semi-structured interviews with healthcare providers (N = 12). Results: Providers address relationships, safety, protection and appropriate sexual behaviours with clients with intellectual and developmental disabilities. Parent education and client-centred care were identified as supports, while the patient's level of understanding, the provider's lack of knowledge or access to resources and to appropriate referrals were identified as barriers to SRH education. Conclusion: Future studies are needed to link providers to resources they can use to provide comprehensive, accessible SRH education for clients with intellectual and developmental disabilities.
... A large percentage of these women are in their reproductive years (i.e. 15-44 years of age) with desires for sexual relationships similar to their non-autistic peers (Dewinter et al., 2017;Gilmour et al., 2012). Nearly half of all pregnancies are unplanned (Sedgh et al., 2014), and health before pregnancy has been shown to influence risks for adverse reproductive, maternal, and neonatal outcomes (World Health Organization, 2012). ...
Article
Lay abstract: While an increasing number of girls and women are being identified with autism, we know little about reproductive-aged autistic women's health. This study used administrative data from Ontario, Canada, to compare the health of reproductive-aged autistic women with non-autistic women. Overall, reproductive-aged autistic women had poorer health compared with non-autistic women, including increased rates of material deprivation, chronic medical conditions, psychiatric conditions, history of assault, and use of potentially teratogenic medications (i.e. drugs that can be harmful to the development of an embryo or fetus). These findings suggest that there is a need for health interventions tailored to the needs of reproductive-aged autistic women.
... Large survey studies in Sweden (Rudolph et al. 2018) and the Netherlands (Dewinter et al. 2017) have reported that as many as 18-44% of autistics identified as sexual minorities compared to 10-13% of neurotypicals in those countries. Other studies have reported similar findings (Fernandes et al. 2016;Gilmour et al. 2012;Strunz et al. 2017) with few exceptions (Dewinter et al. 2015). Demographic data from studies of autistics unrelated to sexuality are also telling, as some have reported occurrence of sexual minority status ranging from 37 to 70% (Hall et al. 2020;Lewis 2017). ...
Article
Full-text available
Autistics are more likely than neurotypicals to be gay, lesbian, bisexual, asexual, and other sexual orientations. Autistics and sexual minorities represent populations at high risk for depression, anxiety, and suicidality. Little is known about the experiences of individuals living at this intersection. In this phenomenology, 67 individuals who identified as autistic sexual minorities participated in online interviews to describe the meaning of their experiences. Six themes emerged, including: self-acceptance is a journey; autistic traits complicate self-identification of sexual orientation; social and sensory stressors affect sexual expression; feeling misunderstood and isolated; challenges finding mutually satisfying relationships; and difficulty recognizing and communicating sexual needs. Autistic sexual minorities experience a “double minority” status that complicates identity formation and increases vulnerability in sexual relationships.
... Physical changes and sexual interests are emerging at the same rate among individuals with ASD as well as their typically developing peers [6][7][8][9][10][11], thus, the sexual health discussion regarding the adolescent population on the spectrum must be addressed. Nevertheless, understanding the sexuality of people with ASD is often overlooked or considered taboo by the general public. ...
Article
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The complexities of living with Autism Spectrum Disorder (ASD) can derail an adolescent’s opportunity to engage in healthy sexual relationships. Social connection, a large component of healthy sexual relationships, is often a major obstacle for adolescents diagnosed with ASD. Sexual health goes beyond the physical component and relies on emotional and social skillsets that directly influence appropriate sexual behaviors and connection with others. The concept of appropriate psychosexual norms is quite important and can be adopted by exposing adolescents with ASD to social environments that form healthy interactions with others. The sexual behavior of adolescents with ASD is often observed from a problem-based perspective rather than a strength-based approach. There is a lack of evidence-based sexual education curriculums geared towards the needs of adolescents with ASD which bring closer together the dynamical relationship between sexual socialization and sexual behavior. Therefore, the purpose of this conceptual paper is to describe that dynamic relationship and how inadequate sexual socialization often leads to socially “inappropriate” sexual behaviors of adolescents with ASD. Full text: https://rdcu.be/b54ry
... Este tipo de actividades se dan porque a las personas con TEA les resulta complicado comprender en su totalidad las normas sociales debido a las dificultades que muestran para adaptarse socialmente, y esto genera prestar mayor atención a las limitaciones olvidando sus potencialidades (Dantas et al., 2014;Garrido et al., 2017). Esta situación donde las habilidades sociosexuales se ven afectadas (Gilmour et al., 2012) puede repercutir de manera negativa en el desarrollo de su sexualidad (Gerdel et al., 2017), pudiendo generar sentimientos de soledad o exclusión social (Baixauli et al., 2017). También, se ha comprobado que en la sociedad actual todavía predomina un único modelo social, lo que condiciona el desarrollo sexual de las personas con TEA, ya que estas personas no siguen el mismo modelo y, por consiguiente, mayormente, solo son aceptadas por su círculo familiar y los profesionales que los rodean (Rubin, 1984). ...
... 5) Deseo sexual: Los padres tienden a infraestimar los deseos sexuales de sus hijos 3 y análisis realizados con información de padres 11,12 concluyeron que existía una disminución del deseo sexual en las personas con TEA. Cuando se les pregunta a ellos 6,12,13 , muchos refieren fantasías y deseos sexuales de contenido erótico, aunque el grado de satisfacción sexual es menor del que les gustaría. Una minoría de ellos parecen presentar poco deseo sexual. ...
Article
Full-text available
Autistic spectrum disorders (ASD) are neurodevelopmental disorders that affect social communication and present repetitive, stereotyped and inflexible behaviour. A third of the people with a diagnosis of ASD also have intellectual disability associated and two thirds present an intellectual capacity within the average range. The nuclear autistic and others associated symptoms can affect the affective and sexual development. This article exposes which are the problems people with ASD present in the affective and sexual development, the most frequently described and brief guides for evaluation and support for an adequate affective-sexual development in people with ASD.
... Similarly, parents of youth with autism have reported that when they initiated FSC and did most of the talking, youth seemed less likely to internalize or apply the information (Ballan 2012). That people with autism could develop interest in adulthood (Gilmour et al. 2012;Ingudomnukul et al. 2007;May et al. 2017) or could be interested but less likely to initiate conversation (Koegel et al. 2014) means that critical opportunities for FSC could be missed. Additionally, youth who appear less interested or comfortable talking about sexuality will benefit from FSC focused on physical and emotional development, bodily autonomy and consent, identifying and communicating needs and desires, and avoiding potentially dangerous people and situations. ...
Article
Full-text available
Families are a critical context for healthy sexuality development. This study characterized family sexuality communication for autistic adults (age 18–30) without intellectual disability (n = 117) versus a neurotypical comparison group (n = 319). Parent-reported number of sexuality topics covered did not significantly differ by gender or autism/comparison group. Parents of autistic adults who covered few or no topics (31%) reported higher religiosity, lower comfort and self-efficacy, and were less likely to say that the adult expressed attraction or desire for relationships. Parents of autistic adults were more likely than comparison parents to perceive their young person as being uninterested or not ready to learn about sexuality topics. These results suggest that families of autistic people require support to convey sexuality-related knowledge and values.
... The X-linked homolog of NLGN4Y, NLGN4X, is very similar in structure to NLGN4Y, and an immune reaction raised against NLGN4Y may also stimulate a cross-reaction against fetal NLGN4X in some later gestations. There is evidence that mutations in NLGN4X and NLGN4Y are linked to autism spectrum conditions (Jamain et al., 2003;Ross et al., 2015) and such conditions may be elevated in asexual people (e.g., Gilmour et al., 2012). Moreover, there is some evidence that an FBOE occurs in asexual men (Yule et al., 2014). ...
Article
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We review research supporting biological mechanisms in the development of sexual orientation. This research includes studies on neural correlates, prenatal hormones and related physical/behavioral correlates, genetics, and the fraternal birth order effect (FBOE). These studies, taken together, have provided substantial support for biological influences underlying the development of sexual orientation, but questions remain unanswered, including how biological mechanisms may differ in contributing to men's and women's sexual orientation development.
... 2 87 Self-selection in online surveys can lead to a female gender bias, 84 as also has been noted in other online autism research. [88][89][90] Commonly reported as a 4 to 1 male bias, 91 there is suggestion the true autism gender ratio may be closer to 3 to 1 87 or lower 82 as females with autism are at a higher risk of being underdiagnosed. 3 Limiting recruitment to participants age 25 years or older, changing diagnostic practices, 92 in combination with the convenience sampling, has likely led to the large percentage of participants who had received their autism diagnosis in adulthood. ...
Article
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Purpose There is a significant knowledge gap regarding the lives of adults on the autism spectrum. Some literature suggests significant health and mental health inequalities for autistic adults, yet there is a lack of comprehensive longitudinal studies exploring risk factors. Further, most research does not include the perspective of autistic adults in its conduct or design. Here, we describe the baseline characteristics and inclusive research approach of a nationwide longitudinal study. Participants The Autism Cooperative Research Centre for Living with Autism’s Australian Longitudinal Study of Adults with Autism (ALSAA) is a questionnaire-based longitudinal study of autistic adults (25+ years old) with follow-up at 2-year intervals. Autistic advisors were involved in each stage of research apart from data analysis. Three questionnaires were developed: self-report, informant report (ie, proxy report) and carers (ie, carer experiences and characteristics). Findings to date An inclusive research protocol was developed and agreed with autistic advisors. Baseline data were collected from 295 autistic adults (M=41.8 years, SD=12.0) including 42 informant responses, 146 comparison participants and 102 carers. The majority of autistic participants (90%) had been diagnosed in adulthood (M=35.3 years, SD=15.1). When compared with controls, autistic adults scored higher on self-report measures of current depression and anxiety. Participant comments informed ongoing data gathering. Participants commented on questionnaire length, difficulty with literal interpretation of forced response items and expressed gratitude for research in this area. Future plans A large comprehensive dataset relating to autistic adults and their carers has been gathered, creating a good platform for longitudinal follow-up repeat surveys and collaborative research. Several outputs are in development, with focus on health service barriers and usage, caregivers, impact of diagnosis in adulthood, further scale validations, longitudinal analyses of loneliness, suicidal ideation, mental illness risk factors and other areas. Baseline data confirm poorer mental health of autistic adults. The ALSAA demonstrates a working approach to inclusive research.
... Additionally, one study found increased rates of STIs among those receiving special education services when compared to peers without disabilities [10]. Also, individuals with disabilities are as likely, or more likely, to experience gender differences [38] or identify with any sexual orientation [39], which emphasizes the importance of including identity in sexual health education interventions. ...
Article
Full-text available
Individuals with intellectual and developmental disabilities (I/DD) may experience greater risk of sexually transmitted infections, higher rates of sexual abuse, and decreased sexual health knowledge, emphasizing the need for accessible, comprehensive sexual health education. The purpose of this scoping review was to identify the extent and nature of sexual health education interventions among individuals with I/DD ages 15–24 years. Six studies were included in the review. They investigated sexual health interventions for individuals with autism spectrum disorder and mild I/DD, covered a wide range of topics (e.g. puberty, healthy relationships), included multiple learning activities (e.g. illustrations, activity-based learning), and measured behavior and sexual health knowledge outcomes. Future research is needed in this area to assess intervention effectiveness.
... As the relevant literature shows, even if the ASD population shows an interest in sexuality, they often receive less sexual education or at least less education that meets their special needs [40,41]. Nowadays, sexual education programs specifically developed for the ASD population have become more available and appear to be effective in improving knowledge about sexuality in children and adolescents [6]. ...
Article
Full-text available
The transition from adolescence to adulthood may be a challenging period for all young people, yet, for youth with autistic spectrum disorder (ASD) it may present some additional challenges. Developing a more coherent sense of the self, defining one’s values and having a sexual awakening are all important processes for the passage from youth to an adult life. People with ASD have difficulties in the aforementioned areas and also face additional risks for sexual exploitation or even abuse. Those challenges underline the importance of sexual education for individuals with ASD. The aim of this case study is to systematically investigate the effectiveness of a behavior analytic intervention in helping an adolescent with Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) improve in the area of sexual behavior and at the same time minimize his inappropriate behavior. Specifically: (a) to develop a verbal repertoire pertaining to adolescence and sexuality, (b) to improve personal hygiene skills, (c) to develop or improve self-satisfaction related to sexual expression, (d) to decrease inappropriate behavior pertaining to sexuality, and (e) to train the father to undertake a part of the intervention that would be unethical for the researcher to contact—monitor the participant’s masturbation practices. Using a multiple-baseline-across-response-categories experimental design, it was demonstrated that the majority of the aforementioned goals were attained, yet, one goal—the decrease of inappropriate behavior—was only temporarily reached.
... A gender bias towards females was apparent in this sample, which is contrary to the established gender ratio for autistic samples (Halladay et al., 2015). This is a commonly evidenced phenomenon in online research with self-selecting samples (Guo, Kopec, Cibere, Li, & Goldsmith, 2016) and has been true of other online survey studies involving those on the spectrum (Gilmour, Schalomon, & Smith, 2012;Nicolaidis et al., 2013). Studies have inconsistently reported gender differences regarding sensory sensitivities and repetitive behaviours (Antezana et al., 2019;Bitsika, Sharpley, & Mills, 2018), and further research may be useful in understanding their presentation and relationship to anxiety. ...
Article
Anxiety is present in high rates in both children and adults on the autism spectrum. An increasing number of studies have highlighted the potentially important role that intolerance of uncertainty may have in anxiety for those on the spectrum, as well as their interrelationships with sensory sensitivities and repetitive behaviours. In response to a lack of studies involving adults, this study examined self-report survey data regarding intolerance of uncertainty, sensory sensitivities, repetitive behaviours and anxiety in a sample of 176 adults on the autism spectrum (mean age=42). Intolerance of uncertainty and anxiety were both found to be elevated relative to non-autistic adults (N=116) and significant, positive correlations were found between intolerance of uncertainty, anxiety, repetitive behaviours and sensory sensitivities in those on the spectrum. Intolerance of uncertainty was found to be a significant mediator between sensory sensitivities and anxiety, as well as between anxiety and insistence on sameness behaviours. These results were not sensitive to age. Intolerance of uncertainty is an important factor to be considered in the conceptualisation and management of elevated rates of anxiety for adults on the autism spectrum.
... 58 Some studies have found females with ASD report a gay or bisexual orientation more often than males with ASD. [59][60][61] Adolescents and young adults may be exploring their changing bodies, sexual preferences, and gender roles, and as for all people at SWETLIK AND COLLEAGUES this age, these roles emerge against a backdrop of familial and societal expectations that may or may not be concordant with their own projected path regarding sexuality and reproductive health. 62 Having the conversation As with non-ASD patients, a thorough sexual history should be collected via open-ended questions when possible to determine types of sexual activity and partners. ...
Article
Children with autism spectrum disorder (ASD) eventually grow up and need to make the transition from pediatric services to adult. This is a diverse patient population.
Article
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Introduction: Sexual health might prevent negative health consequences among children with autism spectrum disorders. Aim: The purpose of the present study was to design a questionnaire for health and sexual behavior of children on the autism spectrum (parent form) and to evaluate its validity and reliability. Method: Research method was descriptive, psychometrics type. The statistical population of the present study was all children with autism spectrum disorder in Tehran who were referred to autism education and rehabilitation centers in 2021-2022, of which 420 (114 girls and 306 boys) were selected by convenience sampling method. The research instrument included a researcher-made Questionnaire on the Health and Sexual Behavior of Children on the Autism Spectrum (parent form). The face and content validity of the scale was obtained using the Content Validity Ratio (CVR), the construct validity of it through exploratory factor analysis, to ensure the reliability of the instrument, Crowbach's alpha coefficient and SPSS-26 were used. Results: The results of exploratory factor analysis using independent varimax rotation presented five independent factors of body awareness (self-care), shame (sexual social function), sexual knowledge and health, sexual function and sexual abuse, which together explained 99.56% of the total variance of the variables. Cronbach's alpha coefficient in the reliability of the five factors of the questionnaire was 0.87, 0.90, 0.85, 0.80, 0.84 and 0.92 for the whole questionnaire, respectively. Conclusion: Due to the desirable behavioral characteristics of the Autism Spectrum Health and Sexual Behavior Questionnaire, this tool can be used for research and clinical applications.
Chapter
In the past decade, human asexuality has garnered much attention and emerged as an empirically documented sexual orientation. Asexuality is generally defined as an absence of sexual attraction and approximately 1% of the general population report not feeling sexually attracted anyone. In this chapter, we examine the evolving definition of asexuality and diversification of individuals who identify as asexual. We provide an overview of gender differences and review the extant literature on human asexuality, which has mainly focused on exploring how to best conceptualize asexuality. Various theories have been proposed to classify asexuality as a mental disorder, a sexual dysfunction, or a paraphilia. However, we challenge these speculations and pose that asexuality may best be thought of as a sexual orientation as it is likely a normal variation in the experience of human sexuality. We discuss factors that make the study of asexuality challenging and propose possible solutions for researchers to consider. Future research into asexuality is necessary and might inform our understanding of sexuality in general. Researchers need to examine and understand the biological correlates of asexuality and directly test asexuality as a sexual orientation.KeywordsAsexualitySexual attractionSexual desireSexual orientationRomantic attraction
Article
A common misperception of people with disabilities is that they are unable and/or disinterested in sex; however, research indicates that they express sexual desires and engage in sexual behaviors. Studies about the sexuality of people on the Autism Spectrum (ASD; on the spectrum), however, suggests they receive limited sex education and are more likely than the general population to identify as a sexual minority, making the need for inclusive sex education especially important. This selective review will present the sexual orientation/identity statistics for people on the spectrum, factors proposed that may help explain identity differences and trends, and sex education implications, particularly for those who identify as a sexual minority. Future sex education practice and research recommendations are also provided.
Article
The purpose of this study is to understand the sexual experiences and perspectives of adolescents and young adults (AYA) with intellectual or developmental disabilities, how they are receiving sexual education, and how sexual education can be tailored to their needs. This qualitative study utilized semi-structured focus groups and interviews with eight AYA with intellectual or developmental disabilities from January 14 to May 7, 2019. Data were analyzed using a constant comparative approach. Participants reported a diverse range of sexual experiences and an interest in marriage and parenting in the future. Two themes emerged for how AYA are learning about sexual health information: through formal (school, doctors’ visits, or from caregivers) and informal education (peers, siblings, self-exploration, or Pop Culture). Sexual education can be tailored to this population by addressing educational gaps (pregnancy, contraception, sexually transmitted infections, intimacy, and sexual activity) and by implementing specific participant recommendations (proactive, inclusive education with real-life examples). With a growing emphasis on disability rights to sexual education among individuals with intellectual or developmental disabilities, it is vital to understand AYA’s experiences, perspectives, and current understanding of sexual health information so that we can design a program specifically tailored to meet their unique needs.
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Introduction Autistic adults face a range of unique barriers to accessing their communities via cars and/or public transport. Previous studies report that learning to drive can be difficult, and that using public transport can be filled with anxiety for autistic adults. Indeed, car and public transport access and use are associated with greater quality of life. This study sought to explore these factors for autistic adults, compared to non-autistic adults, using a large national sample. Methods Data are from wave one of the Australian Longitudinal Study of Autism in Adulthood. Descriptive statistics and inferential analyses were used to describe and explore associations between community mobility, quality of life, employment status and educational attainment. Regression models were used to determine if community mobility use and access were predictors of quality of life, employment and education. Results Autistic adults self-reported less accessibility to both public transport and driving to meet their community mobility needs and were less likely to use a car or public transport. Further, autistic adults reported significantly lower self-rated quality of life, were less likely to be employed and were less likely to have completed further education. Notably, although public transport or car access are not predictors of employment and educational outcomes, such access improves quality of life, but in different ways when compared to non-autistic adults. By contrast, public transport use is a predictor of better educational outcomes, and public transport and car use are predictors of both. Conclusions More nuanced attention to autistic people's individual perspectives and their experiences will help better develop ways to more intuitively define and measure both access and use in a meaningful manner. Qualitative studies are needed to explore why access does not always equate to use. The needs of autistic people should be considered by a range of policies impacting community environments, such as urban and public transport design, training of police and transit authorities and emergency response.
Article
This clinical report updates a 2006 report from the American Academy of Pediatrics titled "Sexuality of Children and Adolescents With Developmental Disabilities." The development of a healthy sexuality best occurs through appropriate education, absence of coercion and violence, and developmental acquisition of skills to navigate feelings, desires, relationships, and social pressures. Pediatric health care providers are important resources for anticipatory guidance and education for all children and youth as they understand their changing bodies, feelings, and behaviors. Yet, youth with disabilities and their families report inadequate education and guidance from pediatricians regarding sexual health development. In the decade since the original clinical report was published, there have been many advancements in the understanding and care of children and youth with disabilities, in part because of an increased prevalence and breadth of autism spectrum disorder as well as an increased longevity of individuals with medically complex and severely disabling conditions. During this same time frame, sexual education in US public schools has diminished, and there is emerging evidence that the attitudes and beliefs of all youth (with and without disability) about sex and sexuality are being formed through media rather than formal education or parent and/or health care provider sources. This report aims to provide the pediatric health care provider with resources and tools for clinical practice to address the sexual development of children and youth with disabilities. The report emphasizes strategies to promote competence in achieving a healthy sexuality regardless of physical, cognitive, or socioemotional limitations.
Article
Asexuality has gained importance with the entrance of the present century. However, this phenomenon has been little studied. The investigations carried out to date confirm that the lack of “erotic attraction” towards one sex or the other is defining and imposes itself as the axis of all the asexual behaviors encompassed under the same name. Therefore, the present study focuses on defining precisely the concept of “sexual attraction”, which is different from affection, admiration, the so-called “romantic attraction”, and sexual excitement. On the other hand, there are frequent masturbatory and paraphilic behaviors in asexual people, and it is obvious that these behaviors respond to other factors not dependent on the “erotic attraction”, which leads us to maintain as evidence the existence of three fundamental constituent factors of the core of human sexuality: sexual attraction, excitement, and orgasm. Non-covariable factors, whose presence, joint or isolated, explains the different sexual behaviors of men and women.
Chapter
In this chapter, the five steps used to conduct the scoping review are outlined. It begins by explaining how the research questions were formulated. The purpose of these questions was to support the focus of this scoping review; namely, to uncover the experiences and insights of autistics about their sexual behaviours, relationships, sexuality, and gender identity. The search terms, academic databases consulted, and the inclusion and exclusion criteria are then outlined. The studies included and excluded from this scoping review are then listed, followed by an explanation of the characteristics that were identified in the studies that could address the research questions and the focus of this scoping review.
Chapter
In this chapter, the results of this scoping review are presented. It begins by describing the basic characteristics of the studies collected, such as the study’s publication year or location. It then explains the findings in the literature about the sexual orientation and gender identity of autistic participants. The focus of this chapter then shifts from reviewing the sexuality and gender identify of autistics towards describing their relationship status. It then concludes with a review of the literature about the online sexual activities of autistics.
Article
Bij vrouwen met een autisme­ spectrumstoornis verloopt de ontwikkeling van de seksuele en genderidentiteit vaak anders dan bij andere vrouwen. Wat zijn de gevolgen hiervan en hoe kun je hiermee rekening houden in de spreekkamer? Annelies Spek en collega's geven een overzicht van de beschikbare literatuur en gaan in op implicaties voor de klinische praktijk. 'Uit wetenschappelijk onderzoek komen duidelijke aanwijzingen naar voren dat er bij vrouwen met ass vaker sprake is van gendervariantie.'
Article
Purpose There remains a lack of knowledge surrounding paraphilic or deviant arousal sexual behaviours in individuals with Autism spectrum disorder (ASD) (Kellaher, 2015). The purpose of this paper is to explore the literature for any empirical study, case study or discussion/review paper surrounding individuals with ASD and zoophilia or bestiality. Design/methodology/approach A systematic PRISMA review was conducted. Findings This systematic review highlighted only a small number of papers, which have looked at zoophilia or bestiality in individuals with ASD. Only one article was identified as being relevant in the present review, three further articles included a description of a case involving someone with ASD who engaged in zoophilia or bestiality and another paper, although not the focus of the study, found one person with Asperger’s disorder who had several paraphilias including olfactophilia, podophilia and zoophilia in a sample of 20 institutionalised, male adolescents and young adults with Autistic disorder and borderline/mild mental retardation. All the case studies clearly highlight some of the ASD symptomology that can contribute to engaging in bestiality or zoophilia. Practical implications It is important that individuals with ASD have access to appropriate and timely sex education and that parents are supported by healthcare professionals to engage with their children with ASD in such interactions across the autism spectrum irrespective of the parent’s expectations. Originality/value To the author’s knowledge, this is the first review of ASD in relation to bestiality and zoophilia.
Chapter
The desire for intimate relationship and sexual well-being in closely tied, and characterizes all human-beings. Intimate relationships, and healthy sexual life that come with it, can promote the life the individual, and create a “calling-card” to enter society. Nevertheless, social standards and norms that can help the establishment of romantic and sexually characterized relationships may make them challenging for people on the Autism Spectrum Disorder (ASD). This chapter opens with a description of the importance of sexuality as a central aspect of adult life in general, followed by an exploration of the link between sexuality and aspects of quality of life among people, especially females, with ASD, being a minority within a minority, through contemporary literature review. The differences in ASD symptomology between males and females directs to key issues regarding sexuality among females with ASD including: interest and attraction, behavior, and orientation, and the impacts each of these have on sexuality and sexual functioning in this population. Findings regarding greater diversity in the gender identity and greater flexibility in sexual attraction among people with ASD that is more pronounced among females than males, as well as higher vulnerability and risk of abuse, raise a concern regarding the link between sexuality and victimization among females with ASD. The chapter addresses some relevant recommendations for professional staff and therapists.
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Currently there are no brief, self-administered instruments for measuring the degree to which an adult with normal intelligence has the traits associated with the autistic spectrum. In this paper, we report on a new instrument to assess this: the Autism-Spectrum Quotient (AQ). Individuals score in the range 0–50. Four groups of subjects were assessed: Group 1: 58 adults with Asperger syndrome (AS) or high-functioning autism (HFA); Group 2: 174 randomly selected controls. Group 3: 840 students in Cambridge University; and Group 4: 16 winners of the UK Mathematics Olympiad. The adults with AS/HFA had a mean AQ score of 35.8 (SD = 6.5), significantly higher than Group 2 controls (M = 16.4, SD = 6.3). 80% of the adults with AS/HFA scored 32+, versus 2% of controls. Among the controls, men scored slightly but significantly higher than women. No women scored extremely highly (AQ score 34+) whereas 4% of men did so. Twice as many men (40%) as women (21%) scored at intermediate levels (AQ score 20+). Among the AS/HFA group, male and female scores did not differ significantly. The students in Cambridge University did not differ from the randomly selected control group, but scientists (including mathematicians) scored significantly higher than both humanities and social sciences students, confirming an earlier study that autistic conditions are associated with scientific skills. Within the sciences, mathematicians scored highest. This was replicated in Group 4, the Mathematics Olympiad winners scoring significantly higher than the male Cambridge humanities students. 6% of the student sample scored 327plus; on the AQ. On interview, 11 out of 11 of these met three or more DSM-IV criteria for AS/HFA, and all were studying sciences/mathematics, and 7 of the 11 met threshold on these criteria. Test—retest and interrater reliability of the AQ was good. The AQ is thus a valuable instrument for rapidly quantifying where any given individual is situated on the continuum from autism to normality. Its potential for screening for autism spectrum conditions in adults of normal intelligence remains to be fully explored.
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Empathy involves an understanding of what others are thinking and feeling, and enables us to interact in the social world. According to the Empathizing-Systemizing (E-S) theory, females on average have a stronger drive to empathize than males. This sex difference may in part reflect developmental differences in brain structure and function, which are themselves under the influence of fetal testosterone (fT). Previous studies have found that fT is inversely correlated with social behaviors such as eye contact in infancy, peer relationships in preschoolers, and mentalistic interpretation of animate motion. Male fetuses are exposed to higher levels of testosterone than are female fetuses. The present study investigates empathizing in children, as a function of amniotic measures of fT. One hundred ninety-three mothers of children (100 males, 93 females) aged 6-8 years of age completed children's versions of the Empathy Quotient (EQ-C), and the children themselves were tested on "Reading the Mind in the Eyes" Task (Eyes-C). All mothers had had amniocentesis during the 2nd trimester of pregnancy. There was a significant negative correlation between fT and scores on both measures. While empathy may be influenced by post-natal experience, these results suggest that pre-natal biology also plays an important role, mediated by androgen effects in the brain. These results also have implications for the causes of disabilities involving empathy, such as autism spectrum conditions, and may explain the increased rate of such conditions among males.
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Interviewed 21 high-functioning adults with autism and 20 mildly to moderately mentally retarded adults without autism about sexuality and dating. Sexual knowledge and interest were assessed by a sexuality vocabulary checklist and a multiple-choice questionnaire. Group differences were found in experience, with more sexual experiences among the mentally retarded adults, but not in knowledge or interest. In both groups IQ was positively correlated with knowledge scores and males had significantly greater interest in sexuality than females. Implications of sex and group differences are discussed.
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Systemizing is the drive to analyse systems or construct systems. A recent model of psychological sex differences suggests that this is a major dimension in which the sexes differ, with males being more drawn to systemize than females. Currently, there are no self-report measures to assess this important dimension. A second major dimension of sex differences is empathizing (the drive to identify mental states and respond to these with an appropriate emotion). Previous studies find females score higher on empathy measures. We report a new self-report questionnaire, the Systemizing Quotient (SQ), for use with adults of normal intelligence. It contains 40 systemizing items and 20 control items. On each systemizing item, a person can score 2, 1 or 0, so the SQ has a maximum score of 80 and a minimum of zero. In Study 1, we measured the SQ of n = 278 adults (114 males, 164 females) from a general population, to test for predicted sex differences (male superiority) in systemizing. All subjects were also given the Empathy Quotient (EQ) to test if previous reports of female superiority would be replicated. In Study 2 we employed the SQ and the EQ with n = 47 adults (33 males, 14 females) with Asperger syndrome (AS) or high-functioning autism (HFA), who are predicted to be either normal or superior at systemizing, but impaired at empathizing. Their scores were compared with n = 47 matched adults from the general population in Study 1. In Study 1, as predicted, normal adult males scored significantly higher than females on the SQ and significantly lower on the EQ. In Study 2, again as predicted, adults with AS/HFA scored significantly higher on the SQ than matched controls, and significantly lower on the EQ than matched controls. The SQ reveals both a sex difference in systemizing in the general population and an unusually strong drive to systemize in AS/HFA. These results are discussed in relation to two linked theories: the 'empathizing-systemizing' (E-S) theory of sex differences and the extreme male brain (EMB) theory of autism.
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Empathy is an essential part of normal social functioning, yet there are precious few instruments for measuring individual differences in this domain. In this article we review psychological theories of empathy and its measurement. Previous instruments that purport to measure this have not always focused purely on empathy. We report a new self-report questionnaire, the Empathy Quotient (EQ), for use with adults of normal intelligence. It contains 40 empathy items and 20 filler/control items. On each empathy item a person can score 2, 1, or 0, so the EQ has a maximum score of 80 and a minimum of zero. In Study 1 we employed the EQ with n = 90 adults (65 males, 25 females) with Asperger Syndrome (AS) or high-functioning autism (HFA), who are reported clinically to have difficulties in empathy. The adults with AS/HFA scored significantly lower on the EQ than n = 90 (65 males, 25 females) age-matched controls. Of the adults with AS/HFA, 81% scored equal to or fewer than 30 points out of 80, compared with only 12% of controls. In Study 2 we carried out a study of n = 197 adults from a general population, to test for previously reported sex differences (female superiority) in empathy. This confirmed that women scored significantly higher than men. The EQ reveals both a sex difference in empathy in the general population and an empathy deficit in AS/HFA.
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I used data from a national probability sample (N > 18,000) of British residents to investigate asexuality, defined as having no sexual attraction to a partner of either sex. Approximately 1% (n = 195) of the sample indicated they were asexual. A number of factors were related to asexuality, including gender (i.e., more women than men), short stature, low education, low socioeconomic status, and poor health. Asexual women also had a later onset of menarche relative to sexual women. The results suggest that a number of pathways, both biological and psychosocial, contribute to the development of asexuality.
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I present a case study of a latency-age boy referred for assessment of a nonverbal learning disability/disorder (NLD) who also had features of Asperger's syndrome (AS). I review NLD terminology, presumed brain-behavior relationship, neuropsychological profile, and diagnosis/classification issues. I discuss the challenge of differentiating NLD from AS in relation to the client's pattern of visual-spatial, communication, social-emotional, and behavioral NLD correlates. I integrate neuropsychological and personality assessment data with interviews, observations, prior testing, and input from teacher and therapist in formulating a diagnostic impression. I discuss Rorschach (Exner, 2003) and neuropsychological consultations in relation to subtle language and interpersonal features of the client's communication style. I provide parent feedback at 18 and 24 months posttesting. I discuss implications relative to a model of school neuropsychological assessment that includes the Rorschach test.
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Group home caregivers of 24 institutionalized, male, high-functioning adolescents and young adults with Autism Spectrum Disorder, were interviewed with the Interview Sexuality Autism. Most subjects were reported to express sexual interest and to display some kind of sexual behavior. Knowledge of socio-sexual skills existed, but practical use was moderate. Masturbation was common. Many subjects were seeking physical contact with others. Half of the sample had experienced a relationship, while three were reported to have had sexual intercourse. The number of bisexual orientations appeared high. Ritual-sexual use of objects and sensory fascination with a sexual connotation were sometimes present. A paraphilia was present in two subjects. About one third of the group needed intervention regarding sexual development or behavior.
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It has been suggested that both adult sexual orientation and the 2nd to 4th finger length ratio (2D:4D) are influenced by prenatal testosterone levels. Bearing this in mind, 2D:4D has been tested as a proxy measure of the putative prenatal testosterone impact on adult human homosexuality, but the results are inconsistent. To date, most studies in this field of research comprise categorical group comparison of heterosexuals and homosexuals with respect to their 2D:4D. The purpose of our study was to evaluate 2D:4D and the dimensional perspective of sexual orientation in addition to categorical results. We examined a community-based sample of 409 subjects and calculated correlations of 2D:4D and sexual orientation as a continuum ranging from homosexual to heterosexual. We found a significant negative correlation of 2D:4D with homosexual orientation (fantasy, attraction, activity and general score) in women, but not in men. Our results indicate that with higher prenatal testosterone levels in women, the likelihood of homosexual orientation might increase. We hypothesize a continuous neurohormonal sexual differentiation of the brain, most notably for women, that overrides categories and results in varying dimensions of sexual orientation. This hypothesis contrasts with the predominant suggestion of fixed organizational effects of androgens in the brain and a categorical sexual orientation.
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It has been hypothesised that autism is an extreme version of the male brain, caused by high levels of prenatal testosterone (Baron-Cohen 1999). To test this proposal, associations were assessed between three visuo-spatial tasks and prenatal testosterone, indexed in second-to-fourth digit length ratios (2D:4D). The study included children with Autism Spectrum Disorder, ASD (N = 28), and chronological as well as mental age matched typically-developing children (N = 31). While the group with ASD outperformed the control group at Mental Rotation and Figure-Disembedding, these group differences were not related to differences in prenatal testosterone level. Previous findings of an association between Targeting and 2D:4D were replicated in typically-developing children and children with ASD. The implications of these results for the extreme male brain (EMB) theory of autism are discussed.
Article
Empathy is an essential part of normal social functioning, yet there are precious few instruments for measuring individual differences in this domain. In this article we review psychological theories of empathy and its measurement. Previous instruments that purport to measure this have not always focused purely on empathy. We report a new self-report questionnaire, the Empathy Quotient (EQ), for use with adults of normal intelligence. It contains 40 empathy items and 20 filler/control items. On each empathy item a person can score 2, 1, or 0, so the EQ has a maximum score of 80 and a minimum of zero. In Study 1 we employed the EQ with n = 90 adults (65 males, 25 females) with Asperger Syndrome (AS) or high-functioning autism (HFA), who are reported clinically to have difficulties in empathy. The adults with AS/HFA scored significantly lower on the EQ than n = 90 (65 males, 25 females) age-matched controls. Of the adults with AS/HFA, 81% scored equal to or fewer than 30 points out of 80, compared with only 12% of controls. In Study 2 we carried out a study of n = 197 adults from a general population, to test for previously reported sex differences (female superiority) in empathy. This confirmed that women scored significantly higher than men. The EQ reveals both a sex difference in empathy in the general population and an empathy deficit in AS/HFA.
Article
Does everyone mean the same thing when they talk about having sex, losing their virginity, or who they would consider to be a sexual partner? The researchers were interested in (a) determining if students differ in their definitions of these terms; (b) examining the relationship between students' own sexual experience and their labelling of behaviours comprising these terms; and (c) determining whether such factors as orgasm, dating status, the sex of the partner, and the sex of the participant influence their definitions. One hundred fifty-five undergraduate students completed five questionnaires, three of which asked them to indicate whether they would consider a list of hypothetical behaviours as involving having sex, sexual partner, and a loss of virginity, and one of which asked them to indicate whether they had engaged in a list of parallel sexual behaviours with a member of the opposite or same sex. Students reported a broader definition of sexual partner than of having sex and a broader definition of having sex than of virginity loss. Students' definitions were more likely to include scenarios involving a longer dating status, an opposite-sex partner, and the presence of orgasm. Females reported a broader definition of having sex than males and no relationship was found between students' sexual experience and their sexual definitions.
Article
This article provides a brief overview of the significant findings and theories focusing on how an individual develops his or her sexual orientation, with special emphasis on male homosexuality as a reflection of the literature as a whole. Research is considered from the following perspectives: prenatal development, brain morphology and function, behavioral genetics, environmental factors, studies of childhood and adolescence, and stability/plasticity of sexual orientation. Sociopolitical implications of this area of research are briefly discussed.
Article
Measurement and definition of sexual orientations have increasingly become a central focus in both research design and public policy debates. This paper reviews major methods, and their theoretical underpinnings, for the definition and measurement of sexual orientations, highlighting their limitations and pitfalls, both practical and conceptual. The increasing politicization of this area is discussed and cautioned against. Recommendations, both general and geared toward measurement concerns with adolescent populations, are made. A specific measurement strategy, which can be utilized at a number of different levels, is detailed.
Article
The second-to-fourth digit ratio (2D:4D) is sexually differentiated and is a likely biomarker for the organisational (permanent) effects of prenatal testosterone on the human brain. Recent research has highlighted a possible role of prenatal testosterone levels in both the etiology of autism-spectrum disorders and in sex and individual differences in cognitive styles of the normal mind (Baron-Cohen’s Extreme Male Brain Theory of Autism and Empathising/Systemising Theory). Importantly, autistic children present lower (hypermasculinised) 2D:4D than healthy controls. Based on these accounts, we investigated the relation of 2D:4D with Baron-Cohen’s measures of empathising (“Reading the Mind in the Eyes” test, RMET; Empathy Quotient, EQ), systemising (Systemising Quotient, SQ), and autistic-like traits (Autism-Spectrum Quotient, AQ) in the general population (N = 423 Austrian adults). Whereas sex differences into the expected direction and of expected size were obtained for all variables and internal scale consistencies tallied to retrievable reference values, 2D:4D was unrelated to RMET, EQ, SQ, and AQ scores. Candidate explanations for this lack of correlation might be possible developmental timing differences in the expression of 2D:4D and empathising/systemising, qualitative (as opposed to quantitative) functional differences between the normal and the autistic mind, or the suboptimal psychometric properties of the measures.
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To survey the adult functioning of patients with Autism Spectrum Disorder (ASD), and to compare the outcomes for those diagnosed in childhood with those diagnosed as adults. Using a chart review, we evaluated the adult outcomes for 45 individuals diagnosed with ASD prior to age 18, and compared this with the functioning of 35 patients whose ASD was identified after 18 years. Concurrent mental illnesses were noted for both groups. Adult outcome was poorest for those with the combination of ASD and Intellectual Disability (ID). The sub- group of individuals with Autism identified in adulthood whose functioning was assessed after 25 years of age had achieved more in the areas of education and independent living. All three groups had a high frequency of psychiatric co-morbidity. While co-morbid ID and ASD generally imply a poor outcome, for children and youth with ASD and normal range IQ, adult functioning is more variable and difficult to predict. Because of delays in ongoing social development, some of these individuals may attain educational, independent living and relationship goals, but reach them a decade or more later than typical for the general population.
Article
Autistic features such as deficits in social interactions and communication have been associated with a low 2D:4D ratio in normal children.This study assessed this association in a large sample of children with a variety of psychiatric disorders (n = 35 girls and n = 147 boys). Autistic features were assessed with a highly valid and reliable measure (Autism Diagnostic Observation Schedule-Generic). Correlations between the 2D:4D ratio and autistic features were computed separately for boys and girls. Some small negative correlations (r = -0.17 and r = -0.19) were found in the right hand for boys; however, particularly in girls, large negative correlations (r = -0.51 to r = -0.64) were found in the left hand. A low 2D:4D ratio in girls was highly predictive of the presence of autistic features. Thus, a low ratio could possibly be used as a diagnostic predictor in clinical practice.
Article
Out of 865 homosexual males who were registered by venerologists in 6 districts of the GDR highly significantly more homosexuals were born during the stressful war and early postwar period of the Second World War, i.e. between 1941 and 1947 (with a maximum of relative frequency in 1944-1945), than in the years before or after this critical period. This finding suggests that stressful prenatal (or perinatal) events may represent an aetiogenetic factor for homosexuality in human males.
Article
Researchers determining the prevalence of homosexuality in nationally representative samples have focused upon determining the prevalence of homosexual behavior, ignoring those individuals whose sexual attraction to the same sex had not resulted in sexual behavior. We examine the use of sexual attraction as well as sexual behavior to estimate the prevalence of homosexuality in the United States, the United Kingdom, and France using the Project HOPE International Survey of AIDS-Risk Behaviors. We find that 8.7, 7.9, and 8.5% of males and 11.1, 8.6, and 11.7% of females in the United States, the United Kingdom, and France, respectively, report some homosexual attraction but no homosexual behavior since age 15. Further, considering homosexual behavior and homosexual attraction as different but overlapping dimensions of homosexuality, we find 20.8, 16.3, and 18.5% of males, and 17.8, 18.6, and 18.5% of females in the United States, the United Kingdom, and France report either homosexual behavior or homosexual attraction since age 15. Examination of homosexual behavior separately finds that 6.2, 4.5, and 10.7% of males and 3.6, 2.1, and 3.3% of females in the United States, the United Kingdom, and France, respectively, report having had sexual contact with someone of the same sex in the previous 5 years. Our findings highlight the importance of using more than just homosexual behavior to examine the prevalence of homosexuality.
Article
Measurement and definition of sexual orientations have increasingly become a central focus in both research design and public policy debates. This paper reviews major methods, and their theoretical underpinnings, for the definition and measurement of sexual orientation, highlighting their limitations and pitfalls, both practical and conceptual. The increasing politicization of this area is discussed and cautioned against. Recommendations, both general and geared toward measurement concerns with adolescent populations, are made. A specific measurement strategy, which can be utilized at a number of different levels, is detailed.
Article
A survey of the sexual behavior of 89 adults with autism living in group homes in North Carolina found that the majority of individuals were engaging in some form of sexual behavior. Masturbation was the most common sexual behavior. However, person-oriented sexual behaviors with obvious signs of arousal were also present in one third of the sample. The relationship between sexual behavior and demographic variables and other types of behaviors is explored. Information regarding group home sexuality policies and procedures are described.
Article
Thirty-one individuals, 15 with autistic disorder and 16 with developmental delay, male and female, were asked to select from a series of drawings depicting sexually relevant activities and to define them. In addition they were asked to describe their sexual experiences, attitudes, and interests, using a semistructured interview format. Ability to select through pointing out sexually relevant body parts or activities was not different by level of functioning, group, or gender. There were differences in providing a sociosexual label, however, with better performance for those with developmental delay and for the higher functioning. No differences were evident for sexual experiences, likely because of the considerable variability across subjects and types of activity, with some individuals reporting very many and others very few. As to attitudes, individuals with autistic disorder endorsed more sexual activities than those with developmental delay. Higher knowledge of sexuality terms and activities was inversely related to their endorsement. Literalness and perseveration were evident in the responses of some, primarily those with autistic disorder. Results are discussed for their relevance to the reliability and validity of information on sexual awareness among the developmentally disabled. Suggestions for future research are offered.
Article
It has been suggested that autism may arise as the result of exposure to high concentrations of prenatal testosterone. There is evidence that the ratio of the lengths of the 2nd and 4th digit (2D:4D) may be negatively correlated with prenatal testosterone. We measured 2D:4D in 95 families recruited via the National Autistic Society, UK. The sample comprised a total 72 children with autism (62 males, 10 females; age range 2 to 14 years), including 23 children (20 males, three females) with Asperger syndrome (AS), 34 siblings, 88 fathers, 88 mothers and sex- and age-matched control participants. We found that the 2D:4D ratios of children with autism, their siblings, fathers and mothers were lower than population normative values. Children with AS, who share the social and communicative symptoms of autism but have normal or even high IQ, had higher 2D:4D ratios than children with autism but lower ratios than population normative values. There were positive associations between 2D:4D ratios of children with autism and the ratios of their relatives. Children with autism had lower than expected 2D:4D ratios and children with AS higher ratios than expected in relation to their fathers' 2D:4D ratio. It was concluded that 2D:4D ratio may be a possible marker for autism which could implicate prenatal testosterone in its aetiology.
Article
The key mental domains in which sex differences have traditionally been studied are verbal and spatial abilities. In this article I suggest that two neglected dimensions for understanding human sex differences are 'empathising' and 'systemising'. The male brain is a defined psychometrically as those individuals in whom systemising is significantly better than empathising, and the female brain is defined as the opposite cognitive profile. Using these definitions, autism can be considered as an extreme of the normal male profile. There is increasing psychological evidence for the extreme male brain theory of autism.
Article
The ratio of 2nd to 4th digit length (2D:4D) is sexually dimorphic (mean 2D:4D is lower in males than females) and is thought to be fixed early in development. 2D:4D has been reported to be related to fetal growth, hand preference, autism, Asperger's syndrome, sperm counts, family size, age at myocardial infarction in men and breast cancer in women. There is indirect evidence that 2D:4D is established in utero and is negatively related to prenatal testosterone and positively with prenatal estradiol. However, there are no studies which show direct relationships between fetal testosterone (FT), fetal estradiol (FE) and 2D:4D. To investigate the relationships between 2D:4D ratios and FT and FE from amniotic fluid. Cohort study. 33 children. Radioimmunoassays of FT and FE obtained from routine amniocentesis; 2D:4D ratios calculated from 2nd and 4th digit length of the right and left hands at age 2 years. A significant negative association between right 2D:4D ratio and FT/FE ratio, which was independent of sex. These preliminary findings lend support to an association between low 2D:4D and high levels of FT relative to FE, and high 2D:4D with low FT relative to FE.
Article
Sex-differences exist in some areas of human social behaviour. In animals, foetal testosterone (fT) plays a central role in organising the brain and in later social behaviour. fT has also been implicated in language development, eye-contact, and spatial ability in humans. Fifty-eight children (35 male and 23 female), whose fT was analysed in amniotic fluid, were followed up at age 4. Their mothers completed the Children's Communication Checklist, a questionnaire assessing language, quality of social relationships and restricted interests. fT was negatively correlated to quality of social relationships, taking sex-differences into account. fT was also positively correlated with restricted interests in boys. These findings implicate fT in both social development and attentional focus. They may also have implications for understanding the sex ratio in autism.
Article
Study familial and pre- and perinatal factors in Asperger Syndrome (AS). One hundred boys with AS had their records reviewed. "Pathogenetic subgroups" were defined according to presence of medical syndromes/chromosomal abnormalities, indices of familiality, and pre- and perinatal risk factors predisposing to brain damage. No major index of pathogenetic factors was found in 13%, a syndrome/chromosomal abnormality in 8%, pre- or perinatal risk 13%, combined pre- or perinatal risk and family history in 11%, and family history only in 55%. About 50% of all boys with AS have a paternal family history of autism spectrum disorder. Pre- and perinatal risks appear to be important in about 25% of cases.
Article
Empathizing and systemizing have recently been put forward as two important individual-difference dimensions, whose different mean levels in men and women are argued to account for many psychological sex differences. This paper presents a series of studies designed to investigate the reliability and validity of the empathizing and systemizing quotients (EQ & SQ), to relate them to existing personality constructs, and to replicate reported sex and sexual orientation-related differences. Correlations with interests and social behaviour suggest the two measures are valid. However, empathizing appears essentially equivalent to agreeableness in the five-factor model of personality. Systemizing cannot be reduced to established personality dimensions, though it is moderately correlated with conscientiousness and openness. Men have higher levels of systemizing than women, and non-heterosexual women higher than heterosexuals. However, no differences were found between heterosexual and non-heterosexual men. Although systemizing and empathizing account for a number of observed sex differences, there are others they do not explain.
Article
Studies of amniotic testosterone in humans suggest that fetal testosterone (fT) is related to specific (but not all) sexually dimorphic aspects of cognition and behaviour. It has also been suggested that autism may be an extreme manifestation of some male-typical traits, both in terms of cognition and neuroanatomy. In this paper, we examine the possibility of a link between autistic traits and fT levels measured in amniotic fluid during routine amniocentesis. Two instruments measuring number of autistic traits (the Childhood Autism Spectrum Test (CAST) and the Child Autism Spectrum Quotient (AQ-Child)) were completed by these women about their children (N=235), ages 6-10 years. Intelligence Quotient (IQ) was measured in a subset of these children (N=74). fT levels were positively associated with higher scores on the CAST and AQ-Child. This relationship was seen within sex as well as when the sexes were combined, suggesting this is an effect of fT rather than of sex per se. No relationships were found between overall IQ and the predictor variables, or between IQ and CAST or AQ-Child. These findings are consistent with the hypothesis that prenatal androgen exposure is related to children exhibiting more autistic traits. These results need to be followed up in a much larger sample to test if clinical cases of ASC have elevated fT.
Sexuality and autism: A national survey in Denmark
  • D Haracopos
  • L Pedersen
Haracopos, D., & Pedersen, L. (2004). Sexuality and autism: A national survey in Denmark. Bagsvaerd, Denmark: Centre for Autisme.
Diagnostic and statistical manual of mental disorders
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: American Psychiatric Association.
Fetal testosterone and autistic traits
  • B Auyeung
  • S Baron-Cohen
  • E Ashwin
  • R Knicmeyer
  • K Taylor
  • G Hackett
Auyeung, B., Baron-Cohen, S., Ashwin, E., Knicmeyer, R., Taylor, K., & Hackett, G. (2009). Fetal testosterone and autistic traits. British Journal of Psychology, 100, 1-22.