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Abstract

Clinical impressions suggest a different sexual profile between individuals with and without Autism Spectrum Disorder (ASD). Little is presently known about the demographics of sexual orientation in ASD. Sexual Orientation was surveyed using the Sell Scale of Sexual Orientation in an international online sample of individuals with ASD (N = 309, M = 90, F= 219), aged (M = 32.30 years, SD = 11.93) and this was compared to sexual orientation of typically-developing individuals (N = 310, M = 84, F= 226), aged (M = 29.82 years, SD = 11.85). Findings suggested that sexual orientation was contingent on diagnosis (N = 570, χ2(9) =104.05, P < 0.001, φ = 0.43). In the group with ASD, 69.7% of the sample reported being non-heterosexual, while in the TD group, 30.3% reported being non-heterosexual. The group with ASD reported higher rates of homosexuality, bisexuality and asexuality, but lower rates of heterosexuality. The results support the impression that non-heterosexuality is more prevalent in the autistic population. Increased non-heterosexuality in ASD has important clinical implications to target unique concerns of this population, and suggests a need for specialized sex education programs for autistic populations for increased support and awareness. Autism Res 2018, 11: 133-141. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Lay summary: Research suggests that individuals with Autism Spectrum Disorder (ASD) report increased homosexuality, bisexuality, and asexuality, but decreased heterosexuality. It is important to increase awareness about increased non-heterosexuality in ASD among autistic populations, medical professionals and care-takers, so as to provide specialized care, if needed and increase support and inclusion for non-heterosexual autistic individuals.

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... The limitations of proxy report were the lack of data captured regarding subjective experiences, private behaviour, self-reported sexual orientation or desire for intimacy. After recognising and addressing these methodological flaws, it is now acknowledged within the literature and clinical community that most autistic people are interested in sexuality and romantic relationships, especially those without cognitive impairment [13][14][15][16][17]. A greater use of self-report and multiple informants now is used within research to capture subjective experiences and obtain richer data [18][19][20]. ...
... Key trends within the literature on autistic people and sexuality and gender include greater levels of non-heterosexual attraction [15], a purported link between autistic traits and gender diversity/dysphoria [30], vulnerability to both sexual coercion-particularly amongst autistic women [31]-and to inappropriate sexual behaviour perpetrated by autistic people at times [32]. These trends are further outlined in the subsequent sections focusing on recent studies and utilising biopsychosocial theories as relevant to contextualise this evidence. ...
... In terms of sexual orientation, the overwhelming consensus of recent research suggests that autistic people demonstrate greater levels of non-heterosexual attraction compared with normative data [14,15,18,36,37]. Higher autistic traits in a Swedish population-based sample (n = 47,356) were found to be associated with increased likelihood of self-reported bisexuality or nonnormative sexual orientation [38], and higher scores on self-report measures of broader autism phenotype traits were associated with more same-sex attraction in a sample from the USA [39]. ...
Article
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Purpose of Review The goal of this paper is to provide an update on recent findings relating to sexuality and gender in autism. The following questions were posed in the review of recent literature: What are the key emerging trends in sexuality and gender within autism, and how might these issues have clinical significance? Recent Findings After many years of misinformation, it is now recognised that most autistic people are interested in romance and sexuality. There is growing awareness of reduced heterosexuality and increased diversity and dysphoria in gender identity in autistic people, and initial clinical guidelines for the potential co-occurrence of autism and gender dysphoria are emerging. There is a heightened risk of inappropriate sexual behaviours and victimisation in autism, and autistic women appear to be more vulnerable in having unwanted sexual experiences than autistic males and typically developing females. Summary Sexuality and gender are importance topics for most autistic people. Experience and expression of sexuality and gender may differ in the autistic population compared with typically developing people, which underlies the importance of identifying, understanding and supporting the development and maintenance of intimate relationships in autistic people. We suggest a biopsychosocial and developmental framework be used to tailor individual support for sexuality and gender-related issues for autistic youth.
... 18 There is a considerable body of research citing a higher prevalence of nonheterosexual orientations in ASD than in the general population. 2,12,29,[60][61][62] Initial observations of this increased prevalence were drawn from caregivers reports of low functioning males, where up to 40% of residents reported nonheterosexual orientations. 12,13 More recently, self-report studies assessing aspects of sexuality have Sexuality and Gender Issues observed similar patterns, where adolescents and adults with ASD reported lower levels of heterosexual interests, behaviors, and orientation (30.3%-50.6%) ...
... 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. ...
... 22,81 This may therefore account for increased fluidity around sexual preferences observed in ASD. 45,62 Although further exploration into the mechanisms driving gender and sexual diversity within ASD is required, current models propose a multivariate account, where an interaction of all possible influences, rather than a single factor, provides a more accurate explanation for these findings. 81 ...
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.
... 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. ...
... Demisexuality represents a sexual orientation in which sexual attraction emerges only when the person establishes a strong bond and emotional connection with someone. These aspects of the asexual community emerged in several studies conducted on the ASD sample (Barnett & Maticka-Tyndale, 2015;Bush, 2020;George & Stokes, 2018a;Kock et al., 2019;Hillier et al., 2019;Sala et al., 2020aSala et al., , 2020b, in which participants reported identities relating to relationship styles or romantic preferences (i.e., Content courtesy of Springer Nature, terms of use apply. Rights reserved. ...
... 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. One of the hypotheses proposed to explain the high prevalence of sexual and gender diversity in the ASD population is the extreme male brain theory (Baron-Cohen, 2002), which emphasizes the role of prenatal exposure to testosterone in the etiology of autism. ...
Article
Full-text available
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.
... Recent research in several, relatively small samples has established significant differences between autistic and nonautistic individuals in the areas of sexual activity and sexual orientation, which may vary based on sex. Autistic individuals, and particularly autistic females, are more likely to report greater sexuality diversity, including less sexual desire/libido (Bejerot & Erikson, 2014;Bush, 2019;Bush et al., 2020;Pecora et al., 2019), higher rates of asexuality (Bush, 2019;Bush et al., 2020;George & Stokes, 2018a), higher rates of hypersexual behavior/ fantasies (Schöttle et al., 2017), lower rates of heterosexuality (Dewinter et al., 2017;George & Stokes, 2018a;Pecora, Hancock, et al., 2020), and higher rates of nonheterosexuality (including homosexuality and bisexuality specifically) (Bejerot & Erikson, 2014;Dewinter et al., 2017;George & Stokes, 2018a;Pecora, Hancock, et al., 2020). One very large study (n = 47,000+ individuals) found that individuals with self-reported high autistic traits were 1.73 times (95% CI: 1.01-2.90) ...
... Recent research in several, relatively small samples has established significant differences between autistic and nonautistic individuals in the areas of sexual activity and sexual orientation, which may vary based on sex. Autistic individuals, and particularly autistic females, are more likely to report greater sexuality diversity, including less sexual desire/libido (Bejerot & Erikson, 2014;Bush, 2019;Bush et al., 2020;Pecora et al., 2019), higher rates of asexuality (Bush, 2019;Bush et al., 2020;George & Stokes, 2018a), higher rates of hypersexual behavior/ fantasies (Schöttle et al., 2017), lower rates of heterosexuality (Dewinter et al., 2017;George & Stokes, 2018a;Pecora, Hancock, et al., 2020), and higher rates of nonheterosexuality (including homosexuality and bisexuality specifically) (Bejerot & Erikson, 2014;Dewinter et al., 2017;George & Stokes, 2018a;Pecora, Hancock, et al., 2020). One very large study (n = 47,000+ individuals) found that individuals with self-reported high autistic traits were 1.73 times (95% CI: 1.01-2.90) ...
... Recent research in several, relatively small samples has established significant differences between autistic and nonautistic individuals in the areas of sexual activity and sexual orientation, which may vary based on sex. Autistic individuals, and particularly autistic females, are more likely to report greater sexuality diversity, including less sexual desire/libido (Bejerot & Erikson, 2014;Bush, 2019;Bush et al., 2020;Pecora et al., 2019), higher rates of asexuality (Bush, 2019;Bush et al., 2020;George & Stokes, 2018a), higher rates of hypersexual behavior/ fantasies (Schöttle et al., 2017), lower rates of heterosexuality (Dewinter et al., 2017;George & Stokes, 2018a;Pecora, Hancock, et al., 2020), and higher rates of nonheterosexuality (including homosexuality and bisexuality specifically) (Bejerot & Erikson, 2014;Dewinter et al., 2017;George & Stokes, 2018a;Pecora, Hancock, et al., 2020). One very large study (n = 47,000+ individuals) found that individuals with self-reported high autistic traits were 1.73 times (95% CI: 1.01-2.90) ...
Article
Full-text available
Small studies suggest significant differences between autistic and nonautistic individuals regarding sexual orientation and behavior. We administered an anonymized, online survey to n = 2386 adults (n = 1183 autistic) aged 16–90 years to describe sexual activity, risk of sexually transmitted infections (STIs), and sexual orientation. Autistic individuals are less likely to report sexually activity or heterosexuality compared to nonautistic individuals, but more likely to self-report asexuality or an ‘other’ sexuality. Overall, autistic, and nonautistic groups did not differ in age of sexual activity onset or contraction of STIs. When evaluating sex differences, autistic males are uniquely more likely to be bisexual (compared to nonautistic males); conversely, autistic females are uniquely more likely to be homosexual (compared to nonautistic females). Thus, both autistic males and females may express a wider range of sexual orientations in different sex-specific patterns than general population peers. When comparing autistic males and females directly, females are more likely to have diverse sexual orientations (except for homosexuality) and engage in sexual activity, are less likely to identify as heterosexual, and have a lower mean age at which they first begin engaging in sexual activity. This is the largest study of sexual orientation of autistic adults. Sexual education and sexual health screenings of all children, adolescents, and adults (including autistic individuals) must remain priorities; healthcare professionals should use language that affirms a diversity of sexual orientations and supports autistic individuals who may have increased risks (affecting mental health, physical health, and healthcare quality) due to stress and discrimination from this intersectionality.
... 18 There is a considerable body of research citing a higher prevalence of nonheterosexual orientations in ASD than in the general population. 2,12,29,[60][61][62] Initial observations of this increased prevalence were drawn from caregivers reports of low functioning males, where up to 40% of residents reported nonheterosexual orientations. 12,13 More recently, self-report studies assessing aspects of sexuality have Sexuality and Gender Issues observed similar patterns, where adolescents and adults with ASD reported lower levels of heterosexual interests, behaviors, and orientation (30.3%-50.6%) ...
... 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. ...
... 22,81 This may therefore account for increased fluidity around sexual preferences observed in ASD. 45,62 Although further exploration into the mechanisms driving gender and sexual diversity within ASD is required, current models propose a multivariate account, where an interaction of all possible influences, rather than a single factor, provides a more accurate explanation for these findings. 81 ...
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.
... 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. ...
... Participant demographics are reported in Table 28. 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.
... 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). ...
... However, asexuality within the ASD community is only beginning to be explored. As George and Stokes (2018) summarized, researchers have posed theories about possible factors (e.g., lack of opportunity, sensory issues, social anxiety, hormonal anomalies) that might contribute to increased frequency of asexual identification within the ASD population; a drawback is that many of these theories imply an underlying pathology or deficit, when one may not exist (Brotto and Yule 2017). Continued research into the experiences of asexuality within the ASD population is especially needed to inform best clinical practices (e.g., when and how to ask autistic clients about sexual orientation, and how to affirm someone who identifies as asexual) and sexuality education practices (e.g., how to accurately and respectfully discuss asexuality when developing new curricula). ...
... A main goal of the present study was to better understand characteristics and experiences of asexual young women, and those with nonbinary and more fluid gender identities, with ASD. A secondary goal was to partially replicate the findings of George and Stokes (2018), who in a study on sexual orientation identified a sizeable minority of autistic participants who identified as asexual, who in turn reported fewer sexual behaviors and desires than individuals with ASD and other sexual orientations. Replicating these findings is important for acknowledging that while variability exists within the asexual spectrum, some degree of stability does too (i.e., consistently less desire and fewer behaviors reported by people identifying as asexual), and that young adults with ASD are capable reporters of their own sexualities. ...
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.
... This is especially true in specific sub-groups. Among individuals with Autism Spectrum Disorder (ASD), an estimated 42-69% identify as same-sex attracted or a sexual minority (Byers et al., 2012;George & Stokes, 2018b). Evidence of this relationship has also been found in individuals with the Broad Autism Phenotype (BAP), where an increased number of traits related to ASD, as measured by the Broad Autism Phenotype Questionnaire (BAPQ), was shown to be positively correlated with increased same-sex attraction, behavior, fantasies, and sexual minority identity present in these individuals (Qualls et al., 2018). ...
... Another study found that women with ASD were also more likely to be in a samesex relationship than women with TD, and all participants with ASD reported more same-sex attraction, more varied sexual identities, and more asexuality than individuals with TD (DeWinter et al., 2017). Finally, the most recent study on this topic found the highest percentage of ASD individuals reporting a sexual minority identity-69.7% of an international online sample of 310 adults with ASD, compared to 30.3% of 261 adults with TD (George & Stokes, 2018b). ...
... 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). 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.
... In addition to an increased diversity in both gender identity and sexual orientation, recent insights into the sexuality of autistic individuals have begun to identify a number of challenges and adverse experiences across a range of sexual and relationship-based domains [4,6,14,22]. Some of these include reduced levels of sexual and romantic functioning, marked by lower engagement in sexual behaviours despite an expressed interest in sexuality and relationships [23,24], increased difficulties maintaining relationships [19], and increased risks to sexual victimisation [25] compared to non-autistic peers. ...
... The results of this study contribute to emerging insights of a higher proportion of transgender gender identities among autistic female populations compared to non-autistic populations [2,22] and support proposed relationships between autism and GD [3,5,22]. 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. ...
... The results of this study contribute to emerging insights of a higher proportion of transgender gender identities among autistic female populations compared to non-autistic populations [2,22] and support proposed relationships between autism and GD [3,5,22]. 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. ...
Article
Full-text available
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.
... Incidentally, and perhaps related in part, survey data show that autistic women are also more likely to report variant gender identities and show less identification to their birth-assigned gender, compared to non-autistic women and to autistic men [54,63]. In addition, autistic women are also more likely to identify as bisexual, homosexual, asexual, or other sexual orientations than non-autistic women or autistic men [54,[64][65][66][67]. ...
... It is imperative for future autism and disability research to acknowledge and account for potential sex and gender impacts across areas of study. Furthermore, given the increased prevalence and variation of non-binary gender and non-heterosexual orientation among autistic individuals [54,65,66], increased inclusion of greater sexual and gender diversity is critically needed. ...
Article
Full-text available
Purpose of Review Although awareness of the substantial need for appropriate wellness efforts for adults with autism is growing, females with autism may have been under-identified in the past, and consequently, the research to date is largely based in a male-centric conceptualization of autism. The purpose of this narrative review was to ascertain what is known about wellness efforts for women with autism. Recent Findings Beyond the shared challenges as experienced by autistic men, autistic women may have unique and differing social, physical, and psychological wellness needs; however, there remains limited research to date in many areas of lifespan wellness concerns. Summary We emphasize the need for future autism and disability research to acknowledge and account for potential sex and gender impact across areas of study. Further acknowledgement of sex and gender impact will play an important role in improving clinicians’ capacity to identify autism in girls and women, which is a foundational component of many wellness efforts.
... Badania nad seksualnością wśród kobiet z autyzmem są nadal rzadkością, komplikowaną różnymi aspektami i oczekiwaniami kulturowymi oraz licznymi tabu narosłymi wokół tego tematu. Niektóre kobiety deklarują homoseksualizm, George i Stokes [10] natomiast odnotowują wyższe wskaźniki homoseksualizmu, biseksualności i aseksualności wśród dorosłych osób z autyzmem. Rynkiewicz [3] oraz Ormond i wsp. ...
... Kobiety z autyzmem są podatne na różnego rodzaju nadużycia i różne formy wykorzystania z powodu swojej społecznej naiwności oraz innych trudności związanych z autyzmem. Są podatne na wykorzystania seksualne i gwałt, dlatego wymagają większego wsparcia terapeutycznego ze strony osób, które pracują z tą populacją pacjentek [10,16]. ...
Article
Full-text available
Girls and women with autism are often undiagnosed, misdiagnosed or receive a diagnosis of autism at later age. This can result in adverse outcomes in their well-being, mental health, education, employment, and independence. The diagnosis of autism spectrum condition/disorder (hereinafter referred to as autism), with its current features linked with descriptions in the major diagnostic classification systems, is based primarily on observations and research on males. The term ‘Autism Spectrum Condition’ (ASC), used in this paper, has been coined by Simon Baron-Cohen and used in the professional literature for a decade to respect these individuals on the autism spectrum who feel that the term ‘disorder’ is stigmatizing, whereas ASC presents both the strengths of these people and difficulties they experience. The research shows that autism in females has unique symptomatology and manifests itself differently, more subtly, especially in high-functioning girls and women, i.e., those with fluent speech, average or above-average intelligence quotient. The research also shows diagnostic stereotypes and lack of required sensitivity to identify autistic females. Additionally they do not reflect the unique presentation of autism in females demonstrated by greater compensatory capacity and an ability to develop sophisticated methods of ‘camouflaging’ and masquerading. Furthermore, autism in females is associated with high comorbidity during adolescence including anxiety disorder, tic disorder, depression, high incidence of suicide, eating disorders, and high rates of other medical problems. Timely diagnosis, however, can reduce the difficulties that females with autism experience over their lifetime, allowing for the assessment of their needs regarding health, education, leisure, social relationships, and employment.
... Autistic people may have difficulties with hiding non-conformative sexualites, don't think that it may be inappropriate to talk about it in certain contexts, 47 or are less likely to supress 'deviant' sexual preferences as a result of social pressure than non-autistic people. 48 Thus, it may appear that autistic people are more likely to express alternative sexual behaviors and identities, 49 whereas here non-conformative sexual identities and behavior are presented as being due not to any essential difference in the way people with or without autism function sexually, but rather that autistic people are less likely to conform to social pressures to 'behave' a certain way sexually. ...
... This call for qualitative research soliciting the views and experiences of autistic people has been made for decades [46,47]. With the increasing interest in studying sexuality generally [48], and a growing understanding that the complexity of human sexuality and gender identity is not currently captured by traditional research methods and categories [40,49,50] perhaps the time is now ripe to carry out this research. Or are we all stuck in the same tension, the 'epistemic hamster-wheel' that is manifested on the forum: is deficit so much a part of meanings of both sexual and neurological difference that we are unable to untangle the validity of our own sexual experience from the stories we have been told about it? ...
Conference Paper
Autism is conceptualised in much scientific literature as being associated with restricted and repetitive interests, characterised by an ‘empathy deficit’, and as negatively impacting social communication. Further, ‘good and healthy’ sexuality is largely considered to be a social endeavour: asexuality and sexualities defined by acts rather than by partner gender – for example kink or BDSM - are broadly pathologised in relevant works. Given the overwhelmingly deficit-driven discourses in relation to both autism and sexual non-conformity, we consider the ways in which the intersection of autism and sexuality is understood and experienced in first-hand autistic accounts of sexuality within a specific context, through analysis of a Swedish online discussion forum in which autistic people discuss sexuality. Following feminist theorist Lynn Hankinson Nelson, we conceptualise this group as constituting an ‘epistemological community’, sharing and leaning on knowledge issue from ‘experts’ and thereby co-creating knowledge about their sexual and intimate lives. We examine some of the tensions this co-production of knowledge causes within this particular online autistic community. Finally, we ponder the extent to which people are free – or not – to narrate themselves and their experiences other than through the lenses that pre-existing theories provide.
... Fortunately, the literature highlights that many Autistic people experience some form of sexuality and desire intimate relationships [16], as do those with intellectual disabilities [17], and the recognition of need for adequate sexuality and relationship education (SRE) for these groups has grown. The literature on sexuality and Autism also highlights additional considerations which may not be currently addressed, such as sensory sensitivity [18], increased incidence of gender dysphoria [19], and increased same-sex attraction [20][21][22]. There are many self-help books and materials available for Autistic people and their families, which discuss topics of sexuality with Autistic adolescents and long-term relationships into adulthood [23,24], however the literature on sexuality education interventions that have been empirically-evaluated remains small. ...
... Despite their limitations in scope and detail, the topics covered are consistent with many recommendations in the literature for SRE regarding Autistic individuals and those with ID [7,25,26]. While it is promising that the content is consistent with the recommendations, there may still be areas pertinent to Autistic individuals' sexuality such as lower rates of heterosexual attraction and higher rates of gender dysphoria than the typically-developing (TD) population, [19,22,74], as well as sensory sensitivities in the context of sexual contact [18] that are currently being overlooked. Although some studies broached sexual orientation and education on gay and lesbian relationships [41,45,58] most studies appeared 1 3 biased towards heterosexuality in their treatment (and measurement) of contraceptive issues and dating skills, and no studies specifically focused on sensory modulation and physical contact. ...
Article
Full-text available
Individuals with neurodevelopmental disorders, including Autism (ASD) and intellectual disability (ID), have a right and need for appropriate sexuality and relationship education (SRE). These individuals often have the same desires as typically-developing people to express their sexuality and form intimate relationships; and may have an increased risk of sexual exploitation and abuse. While there are various materials recommended for teaching SRE to these groups, there is a lack of empirical evaluation of such. A systematic review was carried out on peer-reviewed articles published in English between 1980 and March 2018 to identify what SRE programs have been evaluated empirically, highlighting their content, methods of delivery, efficacy in changing knowledge and behavioural outcomes, and limitations. Thirty-three studies were retained for inclusion which quantitatively evaluated SRE interventions delivered to individuals diagnosed with ID (approximately 63%) and ASD. Most of the studies evaluated stand-alone programs derived from mixed sources within the broader SRE literature. They focused more on biological content (e.g., anatomy, puberty, reproduction) and self-awareness/safety (e.g., boundaries, assertiveness, privacy) than personal sexuality (e.g., sexual orientation, masturbation) and relationships (e.g., dating, emotions, parenting). Most programs improved outcomes, however the overall quality of included studies was poor. Limitations included scant description of theoretical and ethical paradigms within programs and use of non-validated outcome measures. Recommendations for future research and clinical implications are discussed.
... Autistic people may have difficulties with hiding non-conformative sexualites, don't think that it may be inappropriate to talk about it in certain contexts, 47 or are less likely to supress 'deviant' sexual preferences as a result of social pressure than non-autistic people. 48 Thus, it may appear that autistic people are more likely to express alternative sexual behaviors and identities, 49 whereas here non-conformative sexual identities and behavior are presented as being due not to any essential difference in the way people with or without autism function sexually, but rather that autistic people are less likely to conform to social pressures to 'behave' a certain way sexually. ...
... This call for qualitative research soliciting the views and experiences of autistic people has been made for decades [46,47]. With the increasing interest in studying sexuality generally [48], and a growing understanding that the complexity of human sexuality and gender identity is not currently captured by traditional research methods and categories [40,49,50] perhaps the time is now ripe to carry out this research. Or are we all stuck in the same tension, the 'epistemic hamster-wheel' that is manifested on the forum: is deficit so much a part of meanings of both sexual and neurological difference that we are unable to untangle the validity of our own sexual experience from the stories we have been told about it? ...
Article
Full-text available
Autism is conceptualized in much scientific literature as being associated with restricted and repetitive interests, characterized by an ‘empathy deficit’, and negatively impacting social communication. Meanwhile, ‘good and healthy’ sexuality is largely considered to be a social endeavor: asexuality and sexualities defined by acts rather than by partner gender—for example kink or BDSM—are broadly pathologized. Perhaps, therefore, first-hand autistic experiences of sexuality challenge existing assumptions about ‘good and healthy’ sexualities within couplehood. As a theoretical starting point to explore this potential, we revisit Gayle Rubin’s notion of ‘sex within the charmed circle’ to ask whether autistic sexuality can ever truly ‘fit’ within this (neurotypically defined) virtuous sexual arena. We further consider the ways in which the intersection of autism and sexuality is understood and experienced in first-hand autistic accounts of sexuality within a specific context, through analysis of a Swedish online discussion forum in which autistic people discuss sexuality. In doing so we seek both to better understand autistic sexual experience, and to track and deconstruct potentially restrictive assumptions of (non-autistic) couple sexuality more generally. We also consider ways in which assumptions of deficit concerning both non-normative sexualities and autism may have a deleterious effect on autistic people and on research more broadly, limiting theoretical and conceptual understandings of autism and autistic ways of (sexual) being by a default comparison to sexual and neurological norms.
... Concealing autistic traits ("camouflaging") is more common in autistic females and has been reported to account for 3.5% of the variance in suicidal behaviour (Cassidy et al., 2018). A relatively high portion of autistic females report non-binary gender preference or minority sexual orientation (George & Stokes, 2018b). Incongruence between sex and gender can have subsequent impacts on mental health and well-being (George & Stokes, 2018a). ...
... Given that differences in gender identity and sexual orientation are relatively common within the autistic population (George & Stokes, 2018a, 2018b, supports are needed for autistic youth in relation to their sexual identity and development (Vanbergeijk et al., 2008). ...
Chapter
Full-text available
People who are diagnosed with Autism Spectrum Disorder (ASD) are at increased risk of suicidal behaviour compared to the general population; recent population-based studies demonstrate a three- to sevenfold increased risk of premature death by suicide. This chapter provides an overview of: (a) the current literature regarding risk and prevalence of suicide behaviour in autism; (b) the role of intellectual disability/intellectual developmental disorder in suicide in autism; (c) correlates, risk and protective factors; (d) dimensional constructs of suicide, including autistic traits; (e) current approaches to suicide assessment, including potential modifications; and (f) suicide prevention and service access. We consider these topics by drawing on state-of-the-art research, the perspective of lived experience, and consideration of the potential impacts of major events such as the coronavirus (COVID-19) pandemic.
... 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. ...
... We also advocate for a sensitive and comprehensive psychosexual evaluation among persons with HF-ASD to determine the range, intensity, and frequency associated with their sexual attractions, behaviors, and romantic attractions. In addition, because some individuals with ASD experience sensory dysregulations (Barnett & Maticka-Tyndale, 2015;George & Stokes, 2018), it is important to determine whether individuals with HF-ASD experience sensory-related asexuality and whether they are distressed. In their qualitative study with individuals with HF-ASD, Barnett and Maticka-Tyndale (2015) found that many of their participants reported that some of the sensations they experienced during sexual activity were unpleasant (i.e., experienced hypersensitivity) or that they were not consciously aware of physical sensations including arousal during sexual activity (i.e., experienced hyposensitivity). ...
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.
... These results indicate a much higher percentage of samesex attraction in individuals with ASD than is found in TD individuals (2.3% of Americans; Ward et al. 2014). A recent study by George and Stokes (2018) provides an even higher estimate. They found that 69.7% of an international online sample of adults with ASD reported being non-heterosexual compared to 30.3% of the sample of TD adults. ...
Article
Full-text available
Individuals with higher levels of the broad autism phenotype (BAP) have some symptoms of autism spectrum disorder (ASD). Like individuals with ASD, people with higher-BAP may have fewer sexual experiences and may experience more same-sex attraction. This study measured BAP traits, sexual experiences, and sexual orientation in typically developing (TD) individuals to see if patterns of sexual behavior and sexual orientation in higher-BAP resemble those in ASD. Although BAP characteristics did not predict sexual experiences, one BAP measure significantly predicted sexual orientation, β = 0.22, t = 2.72, p = .007, controlling for demographic variables (R2 change = .04, F = 7.41, p = .007), showing individuals with higher-BAP also reported increased same-sex attraction. This finding supports the hypothesis that individuals with higher-BAP resemble ASD individuals in being more likely than TD individuals to experience same-sex attraction.
... In the case of children and adolescents that have been diagnosed as having Autism the expression of the sexuality may face barriers which can be very challenging (Ballan & Freyer, 2017;George & Stokes, 2018. (Graff et al.,2018. ...
... Children diagnosed with ASD have documented seven times the "gender variance" of their non-ASD peers (Janssen, Huang, & Duncan, 2016). Almost 70% of persons self-reporting ASD aligned with sexual orientation labels that are not exclusively heterosexual versus 30% of neurotypical respondents (George & Stokes, 2018). ...
Article
Autism diagnoses continue to increase, and students who have autism spectrum disorder (ASD) are attending college in greater numbers. Many choose community colleges to start their postsecondary careers, so these institutions have a unique opportunity to provide necessary social support. When developing social support initiatives, it is important to consider the diversity of the spectrum, not just in terms of ASD features, but also cultural factors. Autism is diagnosed more in males than females, is linked to gender nonconformity, and is variably diagnosed across racial groups. This article uses intersectionality as a theoretical framework to identify needs and make suggestions about how to best support students on the spectrum.
... The awareness of one's gender usually emerges around 18 months to 3 years of age. However, sometimes an individual's natal sex is not the same as their gender (George and Stokes 2017a). In DSM-5, the term "gender dysphoria" (GD) is used and van Schalkwyk et al. (2015) points out the difference in terminology from the DSM-IV, where the diagnosis previously was named "gender identity disorder," which gave the impression that being transgender was a form of mental illness. ...
Chapter
The term Gender Dysphoria (GD) is defined as a mismatch between the phenotypic sex of an individual and that person’s perception of their biological gender (American Psychiatric Association 2013), and was previously defined as Gender Identity Disorder (American Psychiatric Association 2000; World Health Organization 1992). GD hereby used to describe Gender Identity Disorder (GID), and Gender Dysphoria (GD) is increasingly reported in ASD research.
... M o r e o v e r , t h e c u r r e n t l i t e r a t u r e s h o w s neurodevelopmental disorders including ADHD, mood disorders, anxiety disorders, and emotional and behavioral problems in adolescents with GD (5,9). Recent studies show that symptoms of ASD (one of the neurodevelopmental disorders), are seen more than expected in children and adolescents with GD (26), and autistic individuals are more diverse in the gender identity spectrum (27). Our results support the previous literature stating that the mental disorders accompanying GD are ADHD (47.1%), major depression (52.9%) and common anxiety disorder (35.3%). ...
... Walsh, Krabbendam, Dewinter, and Begeer (2018) similarly found that trans and non-binary identities were elevated in autistic adults with autistic natal females reporting such identities more frequently than autistic natal males. With respect to sexual orientation, R. George and Stokes (2018) found that autistic adults reported higher rates of homosexuality, bisexuality, and asexuality, and lower rates of heterosexuality than TD adults. In particular, autistic females report more variance in their sexual attraction compared to non-autistic females. ...
Article
Full-text available
Youth with autism spectrum disorder can face social-communication challenges related to sexuality, dating, and friendships. The purpose of this study was to assess the feasibility, acceptability, and preliminary efficacy of the Supporting Teens with Autism on Relationships program. In total, 84 youth with autism spectrum disorder aged 9 to 18 and their parents participated in this study; two groups received the Supporting Teens with Autism on Relationships program (interventionist-led parent group vs parent self-guided), while an attentional control group received a substance abuse prevention program that included instruction in problem-solving and social skills. Feasibility and acceptability of the Supporting Teens with Autism on Relationships program was high overall. The Supporting Teens with Autism on Relationships program was effective in increasing parent and youth knowledge of sexuality, while the attentional control was not. There was preliminary support for improvement in parenting efficacy related to discussing sexuality with their children. Gains were seen among completers regardless of whether the parent received support from a facilitator. Implications and future directions are discussed.
... The Extreme Male Brain theory has been criticised for stereotyping behaviour as either exclusively male or female (13), and research into gender identity and ASD has often excluded nonbinary individuals. Research suggests that there are higher occurrences of homosexuality, bisexuality and asexuality in ASD samples (14), gender-nonconformity is higher in individuals with ASD (15) and especially so in women (16). At present, little is known about individuals who self-identify as nonbinary. ...
Article
Background: Autism spectrum traits are increasingly being reported in individuals who identify as transgender, and the presence of such traits have implications for clinical support. To-date little is known about autism traits in individuals who identify as nonbinary. Aims: To empirically contribute to current research by examining autistic traits in a self-identifying transgender and nonbinary gender group. Method: One hundred and seventy-seven participants responded to a survey consisting of the Autism Spectrum Quotient (AQ), the Empathy Quotient (EQ), the Systematising Quotient (SQ) and the Reading the Mind in the Eyes Task (RME). Comparisons were made between cisgender, transgender and nonbinary groups. Results: Individuals with autism spectrum disorder (ASD) or meeting the AQ cut-off score for ASD were over-represented in both the transgender and nonbinary groups. The key variables differentiating the transgender and nonbinary groups from the cisgender group were systematising and empathy. Levels of autistic traits and cases of ASD were higher in individuals assigned female at birth than those assigned male at birth. Conclusions: A proportion of individuals seeking help and advice about gender identity will also present autistic traits and in some cases undiagnosed autism. Lower levels of empathy, diminished theory of mind ability and literalness may impede the delivery of effective support. Clinicians treating transgender and nonbinary individuals, should also consider whether clients, especially those assigned female at birth, have an undiagnosed ASD.
... An additional factor that has contributed to the uncertainties that surround the sexuality of autistic females is the absence of any literature that has investigated female samples via quantitative means. To date, current understandings of the sexuality of autistic females have been drawn from a small number of clinical anecdotes and qualitative case reports (Attwood 2009;Cridland et al. 2014;George andStokes 2016, 2018;Haracopos and Pederson 1992;Nichols 2009;Pecora et al. 2016). Although limited in scope and number, the findings have been consistent. ...
Article
Full-text available
Current understandings of the sexuality of autistic females have been predominantly drawn from qualitative studies. This study aimed to quantitatively examine the sexual functioning of autistic females (N = 135), by comparing these to the sexual interest, behaviours, and experiences to 96 autistic males and 161 typically developing females. Autistic females reported less sexual interest, yet more experiences than autistic males. More autistic females also reported engaging in sexual behaviours that were later regretted, unwanted, or receiving unwanted sexual advances. Differences between autistic and typically developing females were significant. Results indicate that due to a mismatch between less sexual interest, yet increased sexual behaviours, autistic women are at greater risk of negative sexual experiences including victimisation and abuse than autistic men.
... This means that these children may receive less support and understanding from service providers, which may compound stigma (and other sources of oppression) related to race. Finally, there is emerging evidence that autistic individuals are more likely to identify as LGBT than non-autistic individuals (George and Stokes 2018;van der Miesen et al. 2018), although there is very little research to guide school professionals on how best to support students who are both autistic and LGBT. Because of these issues, it is important to explore whether there are differences in perceptions of high school experiences according to gender, race, and LGBT status. ...
Article
Full-text available
We used an online survey to gather perspectives of autistic youth (n = 248) on the impacts of autism, school professionals, family members, and peers on their high school experiences; what each stakeholder group could have done better; and what future high school professionals and autistic youth should know. Two-thirds of participants viewed autism as negatively impacting their school experience, and this was more prevalent in women. The majority viewed impacts of school professionals, family, and peers as positive. Women were more likely to view school professional contributions as positive than men, and LGBT youth were more likely to view school professional and peer contributions as negative than non-LGBT youth. Suggestions for stakeholders included providing more help, care, and quality time.
... However, due to the small number of participants who endorsed a non-binary gender identity we were unable to conduct analyses in this subsample. Autistic adults generally report higher levels of transgender, non-binary, and gender-fluid identities than the general population [56,61]. It is important to explore the impact of camouflaging on mental health in this group, who are already at a greater risk of mental health problems compared to cisgender individuals [62,63]. ...
Article
Full-text available
Background There is inconsistent evidence for a clear pattern of association between ‘camouflaging’ (strategies used to mask and/or compensate for autism characteristics during social interactions) and mental health. Methods This study explored the relationship between self-reported camouflaging and generalised anxiety, depression, and social anxiety in a large sample of autistic adults and, for the first time, explored the moderating effect of gender, in an online survey. Results Overall, camouflaging was associated with greater symptoms of generalised anxiety, depression, and social anxiety, although only to a small extent beyond the contribution of autistic traits and age. Camouflaging more strongly predicted generalised and social anxiety than depression. No interaction between camouflaging and gender was found. Limitations These results cannot be generalised to autistic people with intellectual disability, or autistic children and young people. The sample did not include sufficient numbers of non-binary people to run separate analyses; therefore, it is possible that camouflaging impacts mental health differently in this population. Conclusions The findings suggest that camouflaging is a risk factor for mental health problems in autistic adults without intellectual disability, regardless of gender. We also identified levels of camouflaging at which risk of mental health problems is highest, suggesting clinicians should be particularly aware of mental health problems in those who score at or above these levels.
... In the case of children and adolescents that have been diagnosed as having Autism the expression of the sexuality may face barriers which can be very challenging (Ballan & Freyer, 2017;George & Stokes, 2018. (Graff et al.,2018. ...
Chapter
Full-text available
Autism spectrum disorder (ASD) involves difficulties in communication, relationships, and social interactions. Social deficits, in conjunction with sensory issues, can provoke several difficulties regarding the capacity of a child to be engaged in a relationship. The present study is a case report that outlines the implementation of a sex educational program, aiming at increasing participant awareness and the ability to improve/establish relationships. Findings also revealed the need for early intervention on issues regarding sex education and the involvement of the family of children with ASD.
... These limitations may have contributed to an under-estimation of autistic people's interest in sexuality and relationships by ignoring subjective self-report, and focusing on observable displays of heterosexual behaviour. Self-report instruments have become more common in recent research, and greater levels of non-heterosexual attraction (e.g., Byers et al. 2013;Dewinter et al. 2017;George and Stokes 2018a;May et al. 2017;Strunz et al. 2017), and gender dysphoria/variation (e.g., De Vries et al. 2010;Glidden et al. 2016;George and Stokes 2018b) have been suggested among autistic populations than would be expected based on normative data. ...
Article
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Although autistic people have difficulties with social-emotional reciprocity, most still desire intimate romantic relationships. This study sought to identify enablers and barriers to emotional and physical intimacy for Autistic (n = 31) and non-autistic (n = 26) individuals. All participants completed an online survey including demographic information, the Autism Spectrum Quotient and questions on intimacy which were subject to thematic analysis. Enablers of intimacy for both groups included communication, sharing and similarity, respect and safety for self and other, and working on the relationship. Barriers for both groups included intra- and interpersonal conflicts; autistic people specifically highlighted uncertainty about relationships and communication. These findings suggest autistic and non-autistic people have similar notions of intimacy, yet have different challenges in experiencing it.
... Een verhoogde prikkelgevoeligheid kan het aangaan van seksueel contact sterk hinderen, met name wanneer er al sprake is van chronische overbelasting. Wellicht ervaart een deel van de vrouwen met ass problemen in het seksuele contact door hun prikkelgevoeligheid en mogelijk zorgt dit bij sommigen voor een aseksueel bestaan (Aston, 2012;George & Stokes, 2018). In dat geval is het overigens de vraag of daadwerkelijk sprake is van aseksualiteit, of van het (tijdelijk) uit de weg gaan van seksualiteit om overprikkeling te voorkomen. ...
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.'
... 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
Full-text available
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.
... 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). George and Stokes (2018) explored sexual orientation, gender identity, and autism and suggested that gender dysphoric traits may mediate sexual orientation. They postulated that many autistics experience gender identity formation differently than non-autistics and are more likely to question their gender identity and explore opposite gender roles. ...
Article
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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.
... Though why people develop different sexual orientations has been intensively investigated, the reason still remains unclear. Several biological factors (gene, hormone) may make contributions (Reinisch, Mortensen, & Sanders, 2017;Sanders et al., 2015;Yu et al., 2015), while various other traits, for example, childhood gender nonconfirmity (as mentioned above), ASD (George & Stokes, 2017), height , and handedness (Ellis, Skorska, & Bogaert, 2017) are found to be associated with sexual orientation. A survey by Nardi and Sherrod (1994) also found that gender differences diminished when it came to gay men and lesbians in some aspects of friendship. ...
Article
Full-text available
The current research aimed to investigate gender-related preferences of youths with different sexual orientations and examine the effects of gender role and sexual attraction. In Study 1, participants from China recalled the gender composition of their friends at different times, and data from 216 of them aged 17-24 were analyzed. Growth curve models showed that more than half of the friends of heterosexual individuals were same-gender ones and they had an increasingly larger ratio of cross-gender best friends through adolescence, while gay men and lesbians had an increasingly larger ratio of same-gender friends and more than half of them had same-gender best friends. Gay men had a larger ratio of cross-gender friends in primary school than heterosexual men, while lesbians had a larger ratio of same-gender friends at university than heterosexual women. In Study 2, participants from China ranked their preferences for a set of character profiles and reported their gender role, and data from 141 of them aged 16-24 were analyzed. Gay men and lesbians preferred same-gender persons over cross-gender ones. Gender role of the participant had an independent effect on preferences to a character with a given gender role. Findings indicated that sexual orientation has a strong impact on the gender composition of youths’ friendships, and more attention should be paid to sexual minorities in this field of research.
... The value of an intersectional approach, that takes account of multiple intersecting identities and the advantages/disadvantages that these entail [53], is prominent in autism research for two key reasons. First, we know that autistic people are more likely than the general population to identify as non-heterosexual, and outside the gender binary [54,55]. Second, we know that black and minority-ethnic autistic people face specific combinations of discrimination as a result of their race and diagnostic status [56][57][58] and yet are under-represented in research [59]. ...
Article
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Purpose of Review Inclusive research practice is both a moral obligation and a practical imperative. Here we review its relevance to the study of neurodevelopmental diversity in particular, briefly describing a range of inclusive research models and justifying their use. The review itself is inclusively co-authored with three autistic collaborators and community leaders who all have extensive experience of research involvement. Recent Findings Drawing on theoretical arguments and specific exemplar projects, we describe six key considerations in the delivery of inclusive research. These are the following: taking the first steps towards inclusive practice; setting expectations; community-specific inclusion measures; inclusion and intersectionality; the role of empowerment; and knowledge exchange for inclusion. Together, these sections provide an illustrated guide to the principles and process of inclusive research. Summary Inclusive research practice is both beneficial to and a requirement of excellence in neurodevelopmental research. We call for greater engagement in this participatory research agenda from grant-awarding bodies to facilitate not just inclusive but also emancipatory research.
... The conclusions drawn from the existing research therefore have limited applicability to nonheterosexual individuals. Considering the greater proportion of autistic individuals identifying as LGBT+ (Dewinter et al., 2017;George & Stokes, 2018a, 2018bStrang et al., 2014), this is an important limitation and highlights the need to include nonheterosexual individuals and couples in studies of romantic functioning in autistic individuals. The ages of participants across all included studies also ranged from 13 to 77 years old. ...
Article
Autistic individuals report similar levels of interest in romantic relationships to their nonautistic peers but experience greater challenges with the initiation and maintenance of these relationships. This systematic review synthesizes the factors that contribute to romantic relationship initiation and maintenance among autistic individuals to inform relationship support programs. Both successes (e.g., ability to initiate relationships and maintain a satisfying relationship) and challenges (e.g., relationship dissatisfaction) were investigated. Out of 1403 potentially relevant articles, 11 articles comprising 13 studies met the inclusion criteria (investigated factor[s] of romantic relationship success of challenges, involved participants with a formal autism diagnosis and/or their partners, presented quantitative results in relationship factors, and was available in an English-language version). Social and communication challenges were studied to the greatest extent and were associated with difficulties in both relationship initiation and satisfaction. Several factors relating to the partner of the autistic individual were associated with successful relationships, including reciprocal liking, partner support, and the ability to meet the autistic partner's needs. Conclusions are limited by the small number of studies but provide initial indications that social and communicative factors, as well as the role of nonautistic partners, are important to the success of romantic relationships for autistic individuals. In keeping in line with the community's preference for identity-first language (i.e., “autistic individual” rather than “individual with autism”), this language has been used throughout this review.
Article
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Objectum-sexuality (OS) is a sexual orientation which has received little attention in the academic literature. Individuals who identify as OS experience emotional, romantic and/or sexual feelings towards inanimate objects (e.g. a bridge, a statue). We tested 34 OS individuals and 88 controls, and provide the first empirical evidence that OS is linked to two separate neurodevelopmental traits - autism and synaesthesia. We show that OS individuals possess significantly higher rates of diagnosed autism and significantly stronger autistic traits compared to controls, as well as a significantly higher prevalence of synaesthesia, and significant synaesthetic traits inherent in the nature of their attractions. Our results suggest that OS may encapsulate autism and synaesthesia within its phenomenology. Our data speak to debates concerning the biological underpinnings of sexuality, to models of autism and synaesthesia, and to psychological and philosophical models of romantic love.
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The abstract for this document is available on CSA Illumina.To view the Abstract, click the Abstract button above the document title.
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The nature and frequency of men's and women's sexual fantasies were investigated by surveying 307 students (182 females, 125 males) at a California state university or junior college via a paper‐and‐pencil questionnaire. The questionnnaire was inspired by modern evolutionary theory and was designed to investigate sex differences in sexual fantasies. Substantial sex differences were found in the salience of visual images, touching, context, personalization, emotion, partner variety, partner response, fantasizer response, and inward versus outward focus. These data, the scientific literature on sexual fantasy, the historically‐stable contrasts between male‐oriented pornography and female‐oriented romance novels, the ethnographic record of human sexuality, and the ineluctable implications of an evolutionary perspective on our species, taken together, imply the existence of profound sex differences in sexual psychologies.
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This study examined the sexual functioning of single adults (61 men, 68 women) with high functioning autism and Asperger syndrome living in the community with and without prior relationship experience. Participants completed an on-line questionnaire assessing autism symptoms, psychological functioning, and various aspects of sexual functioning. In general participants reported positive sexual functioning. Participants without prior relationship experience were significantly younger and more likely to be male and identify as heterosexual. They reported significantly higher sexual anxiety, lower sexual arousability, lower dyadic desire, and fewer positive sexual cognitions. The men reported better sexual function than did the women in a number of areas. These results counter negative societal perceptions about the sexuality of high functioning individuals on the autism spectrum.
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This study explored factors (gender, age, relationship status, symptomatology) associated with the sexual well-being of 141 (56 men and 85 women) adults with high-functioning autism and Asperger syndrome (HFA/AS) living in the community. Participants completed an online survey consisting of a measure of autistic symptoms as well as measures of dyadic and solitary sexual well-being. Canonical correlation analyses showed that participants who were currently in a romantic relationship reported more frequent dyadic affectionate and genital activity and greater sexual assertiveness and sexual satisfaction, pointing to the importance of context in an active sex life. After controlling for the first variate, men and individuals with less autism symptomatology, particularly in the social and communication domains, generally reported significantly greater dyadic sexual well-being, including greater sexual satisfaction, assertiveness, arousability, and desire and lower sexual anxiety and fewer sexual problems. Men also reported better solitary sexual well-being, including more sexual thoughts, more sexual desire, and more frequent solitary sexual activity; however, they had lower sexual knowledge. These results highlight the importance for research and sexuality education with individuals with HFA/AS to conceptualize sexual well-being as a multidimensional construct consisting of both dyadic and solitary aspects.
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Group home caregivers of 20 institutionalized, male adolescents and young adults with Autistic Disorder (AD) and Borderline/Mild Mental Retardation (MR) and of 19 institutionalized, male adolescents and young adults with Borderline/Mild MR, without AD were interviewed with the Interview Sexuality Autism-Revised (ISA-R). Overall the individuals with AD were not significantly less sexually active than the individuals with MR. Masturbation was common in both groups. Individuals with MR had significantly more experience with relationships. No difference was found in the presence of inappropriate behavior. No difference was found in sexual orientation. Some deviant sexual behaviors (stereotyped sexual interests; sensory fascinations with a sexual connotation; paraphilia) were present in the group with AD, but not in the group with MR. A difference seemed to exist in the nature of sexual problems in the individuals with AD and MR, problems in individuals with AD being more related to an obsessive quality of the sexual behavior. KeywordsAutism-Sexuality-Mild mental retardation-Borderline mental retardation-Belgium
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This study examined the effects of mentor–protégé similarity (sex and attitudinal) and relationship duration on the quantity of mentoring (psychosocial and career) received. Survey data collected from 97 National Collegiate Athletic Association Division I women’s basketball head coaches in the USA indicated both types of similarity were associated with the receipt of more psychosocial and career mentoring as assistant coaches. Those who had White male mentors also reported receiving more career mentoring than those with sex dissimilar mentors. Finally, the effects of sex similarity were significantly weaker in longer than in shorter mentoring relationships.
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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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People act more prosocially when they know they are watched by others, an everyday observation borne out by studies from behavioral economics, social psychology, and cognitive neuroscience. This effect is thought to be mediated by the incentive to improve one's social reputation, a specific and possibly uniquely human motivation that depends on our ability to represent what other people think of us. Here we tested the hypothesis that social reputation effects are selectively impaired in autism, a developmental disorder characterized in part by impairments in reciprocal social interactions but whose underlying cognitive causes remain elusive. When asked to make real charitable donations in the presence or absence of an observer, matched healthy controls donated significantly more in the observer's presence than absence, replicating prior work. By contrast, people with high-functioning autism were not influenced by the presence of an observer at all in this task. However, both groups performed significantly better on a continuous performance task in the presence of an observer, suggesting intact general social facilitation in autism. The results argue that people with autism lack the ability to take into consideration what others think of them and provide further support for specialized neural systems mediating the effects of social reputation.
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There is a discrepancy between self-reported sexual identity and sexual behavior. The magnitude of this discrepancy is unclear, as is its variation across race/ethnicity and gender. The goal of the study was to assess the range of discrepancy in self-reported sexual identity and sexual behavior in men and women of four racial/ethnic groups. Self-reported data on sexual identity (homosexual, bisexual, heterosexual) and sexual behavior in the past 3 months were collected from 1494 African American, Hispanic, Asian, and white men and women in public congregation places in Houston, Texas. Data indicated that concordance rates between self-reported sexual identity and sexual behavior varied widely across racial/ethnic groups, with the highest rates of concordance in Asian males and females and the lowest in African American females and white males. The largest discordant category was in those self-described heterosexuals who reported partners of both genders. Breakdown of data to exclude those who reported sex trade work or illegal sources of income improved the concordance rates for African American and Hispanic subsamples. Data indicate the importance of designing and targeting HIV risk interventions and clinical screening, based on behavior and not reported sexual identity.
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Few studies have compared sexual behaviours among adolescents with high-functioning autism (HFA) and typical populations, and indicated whether specialized education is required. We hypothesized that adolescents with HFA would (1) display poorer social behaviours; (2) engage in fewer behaviours related to privacy and have poorer knowledge regarding privacy issues; (3) have less sex education; and (4) display more inappropriate sexual behaviours; and that (5) parental concerns would be greater for the HFA sample. Parents of typical adolescents (n = 50) and adolescents with HFA (n = 23) were surveyed with a Sexual Behaviour Scale (SBS) developed by the authors, with domains corresponding to the hypotheses. The HFA and typical groups were found to be significantly different on all five domains. However, following covariation with age and level of social behaviour, it was found that only parental concerns about their child distinguished between typical adolescents and those with HFA. Specialized sex education programmes with a social interaction emphasis should be considered for this group. <br /
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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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The study was undertaken to evaluate the nature of sensory dysfunction in persons with autism. The cross-sectional study examined auditory, visual, oral, and touch sensory processing, as measured by the Sensory Profile, in 104 persons with a diagnosis of autism, 3-56 years of age, gender-and age-matched to community controls. Persons with autism had abnormal auditory, visual, touch, and oral sensory processing that was significantly different from controls. This finding was also apparent when the high and low thresholds of these modalities were examined separately. At later ages for the group with autism, lower levels of abnormal sensory processing were found, except for low threshold touch, which did not improve significantly. There was a significant interaction in low threshold auditory and low threshold visual, suggesting that the two groups change differently over time on these variables. These results suggest that sensory abnormalities in autism are global in nature (involving several modalities) but have the potential to improve with age.
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We examine the nature and predictors of social and romantic functioning in adolescents and adults with ASD. Parental reports were obtained for 25 ASD adolescents and adults (13-36 years), and 38 typical adolescents and adults (13-30 years). The ASD group relied less upon peers and friends for social (OR = 52.16, p < .01) and romantic learning (OR = 38.25, p < .01). Individuals with ASD were more likely to engage in inappropriate courting behaviours (chi2 df = 19 = 3168.74, p < .001) and were more likely to focus their attention upon celebrities, strangers, colleagues, and ex-partners (chi2 df = 5 =2335.40, p < .001), and to pursue their target longer than controls (t = -2.23, df = 18.79, p < .05). These results show that the diagnosis of ASD is pertinent when individuals are prosecuted under stalking legislation in various jurisdictions.
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The purpose of this study is to investigate differences in sensory processing among age-matched children between ages 3 and 6 years with autism spectrum disorders (ASD) and those who are typically developing. Reported sensory processing abilities of 281 children with ASD were compared to age-matched peers who were typically developing, using the Short Sensory Profile (SSP). Ninety-five percent of the sample of children with ASD demonstrated some degree of sensory processing dysfunction on the SSP Total Score, with the greatest differences reported on the Underresponsive/ Seeks Sensation, Auditory Filtering, and Tactile Sensitivity sections. The ASD group also performed significantly differently (p < .001) on 92% of the items, total score, and all sections of the SSP. These findings, considered with similar published studies, begin to confirm the prevalence and types of sensory processing impairments in autism. Further research is needed to more clearly define patterns of sensory processing in people with ASD.
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Clinical impressions indicate that there is an overrepresentation of gender-dysphoria within the autism spectrum disorder. However, little is presently known about the demographics of gender-identity issues in autism spectrum disorder. Based upon what little is known, we hypothesized that there would be an increased prevalence of gender-dysphoria among those with autism spectrum disorder compared to a typically developing population. We surveyed gender-dysphoria with the Gender-Identity/Gender-Dysphoria Questionnaire among 90 males and 219 females with autism spectrum disorder and compared these rates to those of 103 males and 158 females without autism spectrum disorder. When compared to typically developing individuals, autistic individuals reported a higher number of gender-dysphoric traits. Rates of gender-dysphoria in the group with autism spectrum disorder were significantly higher than reported in the wider population. Mediation analysis found that the relationship between autistic traits and sexual orientation was mediated by gender-dysphoric traits. Results suggest that autism spectrum disorder presents a unique experience to the formation and consolidation of gender identity, and for some autistic individuals, their sexual orientation relates to their gender experience. It is important that clinicians working with autism spectrum disorder are aware of the gender-diversity in this population so that the necessary support for healthy socio-sexual functioning and mental well-being is provided.
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We demonstrate that widely used measures of antigay sentiment and the size of the lesbian, gay, bisexual, and transgender (LGBT) population are misestimated, likely substantially. In a series of online experiments using a large and diverse but nonrepresentative sample, we compare estimates from the standard methodology of asking sensitive questions to measures from a “veiled” methodology that precludes inference about an individual but provides population estimates. The veiled method increased self-reports of antigay sentiment, particularly in the workplace: respondents were 67% more likely to disapprove of an openly gay manager when asked with a veil, and 71% more likely to say it should be legal to discriminate in hiring on the basis of sexual orientation. The veiled methodology also produces larger estimates of the fraction of the population that identifies as LGBT or has had a sexual experience with a member of the same sex. Self-reports of nonheterosexual identity rose by 65%, and same-sex sexual experiences by 59%. We conduct a “placebo test” and show that for nonsensitive placebo items, the veiled methodology produces e ects that are small in magnitude and not significantly di erent from zero in seven out of eight items. Taken together, the results suggest antigay discrimination might be a more significant issue than formerly considered, as the nonheterosexual population and antigay workplace-related sentiment are both larger than previously measured.
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Many people treat the terms “sex” and “gender” as though they were synonymous. Biological sex comprises physical attributes such as external genitalia and internal reproductive structures such as gonads, sex chromosomes, and sex hormones. Gender, on the other hand, can be a little less straightforward and is not inherently or exclusively associated to one’s physical anatomy. Gender is a product of the complex interrelationship between an individual’s biological sex and one’s gender identity, which is an internal sense of self as male, female, both, or neither.
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This paper provides a brief overview of research, knowledge and practice regarding Asperger's syndrome, an autistic spectrum disorder that has only recently been acknowledged by clinicians. The paper reviews our knowledge of the degree and nature of the impairments of social understanding of such individuals, especially their problems with making and keeping friends, perception of social and emotional cues, understanding and management of emotions, and ability to recognise the thoughts and feelings of others. Difficulties with communication and conversation skills are explained, as well as the person's tendency to develop areas of expertise and special interests. People with Asperger's syndrome have an unusual profile of cognitive abilities; some have signs of movement disturbance and some are extraordinarily perceptive of sensory experiences. The prevalence and aetiology of Asperger's syndrome are discussed briefly.
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Background: Persons reporting sexual identity that is discordant with their sexual behavior may engage in riskier sexual behaviors than those with concordant identity and behavior. The former group could play an important role in the spread of sexually transmitted diseases. Objective: To describe discordance between self-described sexual identity and behavior among men who have sex with men and associations between identity-behavior and risk behaviors. Design: Cross-sectional, random digit-dialed telephone survey of health status and risk behaviors. Setting: New York City. Participants: Population-based sample of 4193 men. Measurements: Concurrent measures of sexual identity and sexual behaviors, including number and sex of sex partners, condom use during last sexual encounter, and recent testing for HIV infection. Sex partner information was ascertained in a separate section from sexual identity; all participants were asked about the number of male sex partners and then were asked about the number of female sex partners in the past year. Results: Of New York City men reporting a sexual identity, 12% reported sex with other men. Men who had sex with men exclusively but self-identified as heterosexual were more likely than their gay-identified counterparts to belong to minority racial or ethnic groups, be foreign-born, have lower education and income levels, and be married. These men were more likely than gay-identified men who have sex with men to report having only 1 sexual partner in the previous year. However, they were less likely to have been tested for HIV infection during that time (adjusted prevalence ratio, 0.6 [95% Cl, 0.4 to 0.9]) and less likely to have used condoms during their last sexual encounter (adjusted prevalence ratio, 0.5 [Cl, 0.3 to 1.0]). Limitations: The survey did not sample groups that cannot be reached by using residential telephone services. Conclusions: Many New York City men who have sex with men do not identify as gay. Medical providers cannot rely on patients' self-reported identities to appropriately assess risk for HIV infection and sexually transmitted diseases; they must inquire about behavior. Public health prevention messages should target risky sexual activities rather than a person's sexual identity.
Article
Executive Summary Increasing numbers of population-based surveys in the United States and across the world include questions that allow for an estimate of the size of the lesbian, gay, bisexual, and transgender (LGBT) population. This research brief discusses challenges associated with collecting better information about the LGBT community and reviews eleven recent US and international surveys that ask sexual orientation or gender identity questions. The brief concludes with estimates of the size of the LGBT population in the United States. Key findings from the research brief are as follows:  An estimated 3.5% of adults in the United States identify as lesbian, gay, or bisexual and an estimated 0.3% of adults are transgender.  This implies that there are approximately 9 million LGBT Americans, a figure roughly equivalent to the population of New Jersey.  Among adults who identify as LGB, bisexuals comprise a slight majority (1.8% compared to 1.7% who identify as lesbian or gay).  Women are substantially more likely than men to identify as bisexual. Bisexuals comprise more than half of the lesbian and bisexual population among women in eight of the nine surveys considered in the brief. Conversely, gay men comprise substantially more than half of gay and bisexual men in seven of the nine surveys.  Estimates of those who report any lifetime same-sex sexual behavior and any same-sex sexual attraction are substantially higher than estimates of those who identify as LGB. An estimated 19 million Americans (8.2%) report that they have engaged in same-sex sexual behavior and nearly 25.6 million Americans (11%) acknowledge at least some same-sex sexual attraction.  Understanding the size of the LGBT population is a critical first step to informing a host of public policy and research topics. The surveys highlighted in this report demonstrate the viability of sexual orientation and gender identity questions on large national population-based surveys. Adding these questions to more national, state, and local data sources is critical to developing research that enables a better understanding of the understudied LGBT community.
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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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This chapter addresses the impact of technology on human sexual behavior by examining how the Internet may affect interpersonal communication and allow freer access to all manner of sexual pursuits. The psychology of Internet sexuality is explored based on the clinical and theoretical positions of experts, along with empirical evidence gathered to date in this rapidly developing area of human sexuality. Implications for mental health professionals are discussed, including preventive, ameliorative, and facilitative interventions as well as ethical and research considerations. Finally, thoughts about how the Internet may impact sexuality in the future are also offered. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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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.
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Appropriate education in sexuality is critical to the development of a person's positive self-esteem. The development of a healthy self-image may overcome potential feelings of depression and loneliness for the person with autism. This paper addresses the need for and challenges to providing sexuality education to individuals with autism. It summarizes teaching methods and approaches which have proven to be successful with this population.