The sexual health, orientation, and activity of autistic adolescents and adults.
Autistic adults are more likely to identify as LGBTQA+ or asexual, so ask about orientation with every client.
01Research in Context
What this study did
Kuenzel et al. (2021) sent an online survey to autistic adults. They asked about sexual orientation, activity, and health.
The team compared answers to what we know about non-autistic adults. They looked for patterns by sex and age.
What they found
Autistic adults said they had less sex and fewer straight relationships. More called themselves asexual, gay, bi, or queer.
Men and women showed different patterns, but both groups started sex at the same age and caught STIs just as often.
How this fits with other research
Tissot (2009) showed how one school taught sexuality to autistic teens with learning disabilities. The new survey widens the lens to adults without ID.
Griffith et al. (2012) found transmen score high on autistic traits. Elizabeth’s team flips the view: autistic adults report more LGBTQA+ identities.
Song et al. (2023) proved autistic adults will answer daily phone surveys. Elizabeth used the same remote method once, showing the tool works for sensitive topics too.
Why it matters
Expect more LGBTQA+ clients on your caseload. Ask every autistic teen or adult, “How do you identify?” without assuming straight. Add questions about asexuality and safe sex to your intake. A calm, open tone lets clients share needs you might otherwise miss.
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02At a glance
03Original abstract
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. LAY SUMMARY: This is the largest study on the sexual activity, orientation, and health of autistic adults. This study reaffirms that the majority of autistic adults are interested in sexual relationships and engage in sexual activity. Sexual education and sexual health screenings must remain a priority for all individuals, including those with autism; healthcare professionals should be aware that autistic patients may be more likely to identify as Lesbian, Gay, Bisexual, Trans, Queer, Asexual, and other identities not listed here (LGBTQA+) which may put them at greater risk of mental and physical health difficulties due to discrimination.
Autism research : official journal of the International Society for Autism Research, 2021 · doi:10.1002/aur.2604