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Researchers have reported a higher incidence of same-sex attractions among individuals with autism spectrum disorder (ASD) but little is known about the sexual and intimate relationships of these individuals. In this study, 5 men in middle adulthood with ASD who acknowledged attractions to other men were interviewed and the interviews were analyzed utilizing Interpretative Phenomenological Analysis. Four themes were identified. First, these men want and have had intimate and sexual relationships, and there is considerable diversity in the types of relationships they have experienced. Second, they have experienced challenges to initiating and maintaining these relationships. Third, they have struggled with integrating their sexual and autism identities. Fourth, they have experienced insufficient support from professionals and their communities. This study contributes to dispelling the myth that individuals with ASD do not desire intimate-partner relationships or are unable to sustain them. Public Significance StatementThis study found that men in middle adulthood who have autism spectrum disorder (ASD) and same-sex attractions can initiate and maintain satisfying and successful relationships with other men. However, these men might experience obstacles to meeting partners and might feel disconnected from other lesbian, gay, bisexual, transgender, queer (LGBTQ) individuals. The study highlights a need for professionals who are trained in both ASD and human sexuality to work with this population.

Congenital lumbar spinal stenosis is an uncommon condition that is often asymptomatic in young adults. Herein, we document the first reported occurrence of acute radicular back pain and associated congenital lumbar spinal stenosis in a healthy 24-year-old woman undergoing an epidural blood patch for treatment of a post-dural puncture headache related to an accidental dural puncture sustained during placement of a labor epidural catheter. The acute pain symptoms were elicited twice with injection of less than 1 mL of fluid into the epidural space during the fluoroscopically assisted epidural blood patch. Subsequent magnetic resonance imaging of the lumbar spine demonstrated shortened pedicle length consistent with severe congenital lumbar spinal stenosis and prominent epidural fat. We speculate that the transient increase in pressure within the epidural compartment following injection of a small amount of fluid could have compressed neural structures resulting in severe radicular pain. The prominent epidural fat could have prevented rapid disbursement of the injected fluid which could have further served to propagate the pressure increase throughout the epidural compartment. The unique radiographic features of congenital spinal stenosis could predispose some patients with this unrecognized condition to develop acute pain upon injection of a small amount of fluid into the epidural compartment. Unrecognized congenital lumbar spinal stenosis is an important addition to the differential diagnosis of acute radicular pain elicited during an epidural blood patch in previously asymptomatic patients. Key words: Epidural blood patch, congenital spinal stenosis, epidural lipomatosis, acute spinal pain

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