Dimensions of Sexuality Among Young Women, With and Without Autism, With Predominantly Sexual Minority Identities

Bush, Hillary H.

doi:10.1007/s11195-018-9532-1

Cited by 20 publications

(22 citation statements)

References 22 publications

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“…We report on mental health symptomatology and subjective quality of life (QoL) in autistic adults with and without a sexual minority identity. Consistent with previous studies reporting a high prevalence of sexual minority identities in autistic samples, 19,21,[23][24][25]51 a large proportion of autistic adults in the current study identified as a sexual minority (43.4%). This is in comparison with ~4% of the general population in the US who report a sexual minority identity 52,53 .…”

Section: Discussionsupporting

confidence: 91%

Comparison of mental health and subjective quality of life in sexual minority versus heterosexual autistic adults

McQuaid¹,

Gendy²,

Lee³

et al. 2021

Preprint

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Background: Although disparities in mental health and subjective quality of life have been reported for autistic adults, reasons for these disparities are poorly understood. A potential factor in these disparities is exposure to social stressors related to minority status (i.e., minority stress), including stigma and discrimination. Autistic individuals are more likely than non-autistic individuals to possess other minority identities, including sexual minority identities. However, to date, few studies have examined whether sexual minority autistic adults experience diminished mental health relative to heterosexual autistic adults, and no research has examined subjective quality of life for sexual minority compared to heterosexual autistic adults.Methods: Participants were 679 autistic adults aged 18.5 to 83.3 years recruited through Simons Powering Autism Research Knowledge Research Match. Participants completed surveys online, including measures of anxious and depressive symptomatology, perceived stress, and subjective quality of life. Participants reported their sexual orientation and other socio-demographic variables. Results: A large proportion of autistic adults reported a sexual minority identity (43.4%). Sexual minority autistic adults showed poorer mental health and lower subjective quality of life relative to heterosexual autistic adults. Diminished quality of life in the sexual minority group appears to be driven by the strength of the effects for gay and pansexual compared to heterosexual autistic adults. Conclusion: Understanding factors that may be related to poorer mental health and decreased subjective quality of life in autistic adults is critical and has been identified as a research priority among autistic stakeholders. The findings reported here underscore the need to examine mental health and subjective quality of life disparities among autistic individuals within a societal context, taking into consideration the potential of intersecting minority identities and increased social stressors, as these hold the potential to increase risks for poorer outcome.

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Section: Discussionsupporting

confidence: 91%

Comparison of mental health and subjective quality of life in sexual minority versus heterosexual autistic adults

McQuaid¹,

Gendy²,

Lee³

et al. 2021

Preprint

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“…Autistic females report greater sexual diversity than autistic males (George & Stokes, 2018a)—except for homosexuality (for which there were no significant differences). They are more likely to report ever having engaged in sexual activity compared to autistic males (Bush, 2019). Our study provides the first evidence that autistic females (mean: 18.02; SD: 4.00) who report ever engaging in sexual activity may begin initial sexual contact at a younger age than autistic males who report ever engaging in sexual activity (mean: 19.44; SD: 5.06) using unadjusted (FDR p value: <0.001) and adjusted models (FDR p value: <0.001).…”

Section: Resultsmentioning

confidence: 99%

“…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) as likely to identify as bisexual and 3.05 times (95% CI: 2.56–3.63) as likely to identify with a sexuality that could not be described as hetero‐, homo‐, nor bisexual (Rudolph et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

The sexual health, orientation, and activity of autistic adolescents and adults

2021

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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.

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“…Women with ASD may face unique challenges in their adolescence and during the transition to adulthood, such as decrypting dating situations (e.g., judging subtle social cues in dating situations such as flirting, aggression, or coercion) and adopting assertive behaviors in intimate relationships ( 34 ). Compared with non-autistic women, autistic women have less sexual interest, but had more experiences and received more unwanted sexual advances ( 24 , 35 , 36 ). They report lower sexual well-being and have an increased risk of sexual abuse ( 24 , 34 , 37 ).…”

Section: Resultsmentioning

confidence: 99%

Toward a Gender-Sensitive Approach of Psychiatric Rehabilitation in Autism Spectrum Disorder (ASD): A Systematic Review of Women Needs in the Domains of Romantic Relationships and Reproductive Health

Dubreucq

2021

Front. Psychiatry

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Later age of diagnosis, better expressive behaviors, increased use of camouflage strategies but also increased psychiatric symptoms, more unmet needs, and a general lower quality of life are characteristics often associated with female gender in autism spectrum disorder (ASD). Psychiatric rehabilitation has shown small to moderate effectiveness in improving patients' outcomes in ASD. Few gender differences have been found in the response to psychiatric rehabilitation. This might be related to the predominance of males in research samples, but also to the lack of programs directly addressing women's unmet needs. The objectives of the present paper were: (i) to review the needs for care of autistic women in romantic relationships and reproductive health; (ii) to review the existing psychosocial treatments in these domains; and (iii) to evaluate the strengths and limitations of the current body of evidence to guide future research. A systematic electronic database search (PubMed and PsycINFO), following PRISMA guidelines, was conducted on autistic women's needs for care relating to psychiatric rehabilitation in romantic relationships and reproductive health. Out of 27 articles, 22 reported on romantic relationships and 16 used a quantitative design. Most studies were cross-sectional (n = 21) and conducted in North America or Europe. Eight studies reported on interventions addressing romantic relationships; no published study reported on interventions on reproductive health or parenting. Most interventions did not include gender-sensitive content (i.e., gender variance and gender-related social norms, roles, and expectations). Autistic women and autistic gender-diverse individuals may face unique challenges in the domains of romantic relationships and reproductive health (high levels of stigma, high risk of sexual abuse, increased psychiatric symptoms, and more unmet needs). We discussed the potential implications for improving women's access to psychiatric and psychosocial treatment, for designing gender-sensitive recovery-oriented interventions, and for future research.

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Dimensions of Sexuality Among Young Women, With and Without Autism, With Predominantly Sexual Minority Identities

Cited by 20 publications

References 22 publications

Comparison of mental health and subjective quality of life in sexual minority versus heterosexual autistic adults

Comparison of mental health and subjective quality of life in sexual minority versus heterosexual autistic adults

The sexual health, orientation, and activity of autistic adolescents and adults

Toward a Gender-Sensitive Approach of Psychiatric Rehabilitation in Autism Spectrum Disorder (ASD): A Systematic Review of Women Needs in the Domains of Romantic Relationships and Reproductive Health

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