Sex and Sexuality in Autism Spectrum Disorders: A Scoping Review on a Neglected but Fundamental Issue

Abstract

ASD consists of a set of permanent neurodevelopmental conditions, which are studded with social and communication differences, limited interests, and repetitive behaviors. Individuals with ASD have difficulty reading eye gestures and expressions, and may also have stereotyped or repetitive language, excessive adherence to routines, fixed interests, and rigid thinking. However, sexuality in adolescents and young adults with ASD is still a poorly studied and neglected issue. This review aims to evaluate sexual function and behavior in individuals with ASD to foster a greater understanding of this important, although often overlooked, issue. This review was conducted by searching peer-reviewed articles published between 01 June 2000 and 31 May 2022 using the following databases: PubMed, Embase, Cochrane Database, and Web of Science. A comprehensive search was conducted using the terms: “Autism” OR “ASD” AND “Sexuality” OR “Romantic relation” OR “sexual behavior” AND/OR “sexual awareness”. After an accurate revision of 214 full manuscripts, 11 articles satisfied the inclusion/exclusion criteria. This review found that, although individuals with ASD may have sexual functioning, their sexuality is characterized by higher prevalence rates of gender dysphoria and inappropriate sexual behavior. Furthermore, sexual awareness is reduced in this patient population, and the prevalence of other variants of sexual orientation (i.e., homosexuality, asexuality, bisexuality, etc.) is higher in adolescents with ASD than in non-autistic peers. Sexual health and education should be included in the care path of patients with ASD in order to improve their quality of life and avoid/reduce inappropriate and risky behaviors.

Childhood gratification syndrome: Demystifying the clinical conundrum with a narrative literature review of the past 5 decades

“…In contrast to CGS, these individuals are often older (adolescents) and may experience heightened sexual desires, orgasms, and even paraphilic fantasies. [ 60 , 61 ] Similarly, CSB usually affects adolescents and is characterized by intense preoccupation with sex, extensive pornography use, and risky sexual behaviors. [ 62 ]…”

Pandemic-related changes in alcohol use among LGB+ people with and without mental health and neurodevelopmental conditions: a multinational cross-sectional study

“…Lesbian, gay, bisexual and other sexual minority (LGB+) people typically drink alcohol more frequently and in greater quantities, leading to greater incidence of alcohol-related harms than their heterosexual counterparts (Bloomfield et al , 2011; Demant et al , 2017; Kerr et al , 2014; Lea et al , 2013; Marshal et al , 2008). LGB+ people are also more likely to experience mental health and neurodevelopmental (MHND) conditions relative to the general population, many of which are also associated with greater alcohol consumption, placing LGB+ people with MHND conditions at greater risk of alcohol-related harm (Bachmann and Gooch, 2018; Castillo-Carniglia et al , 2019; King et al , 2008; Maggio et al , 2022). These health inequalities are, in part, explained by minority stress theory, which suggests that the excess psychological stress faced by sexual minorities as a consequence of anticipated or enacted discrimination, internalized stigma and identity concealment create psychosocial conditions predisposing harmful alcohol use, affective disorder and other mental health conditions (Meyer, 2003).…”