Adults with autism report a broad range of sexuality -- being much more likely to identify as asexual, bisexual or homosexual than people without autism, a new study finds.
In a survey of nearly 2,400 adults, researchers found that those with autism were three to nine times more likely to identify as homosexual, asexual or "other."
Among men, those with autism were over three times more likely to say they were bisexual, while women showed a different pattern: Those with autism were no more likely to identify as bisexual, but were three times as likely to say they were homosexual.
The underlying reasons are unclear. One possibility is that people with autism are less bound by social expectations, and feel more free to express their true identities, said researcher Elizabeth Weir.
The bigger point is that people with autism have diverse sexual preferences and experiences, said Weir, a doctoral candidate at the University of Cambridge in the United Kingdom.
The study is not the first to show that. But it offers more evidence to debunk the old stereotype that people with autism are uninterested in sex, according to Weir.
"We shouldn't be making assumptions," she said. "We need to see this on a person-to-person basis."
The findings also underscore another point: Kids and adults with autism should have access to sex education and sexual health screenings, Weir said.
In reality, though, that's often not the case, noted Eileen Crehan, an assistant professor at Tufts University in Medford, Mass., who was not involved in the research.
"Sadly, studies consistently show that access to sex education is low for autistic students," said Crehan, who studies social functioning in young people with autism.
She said that "outdated beliefs" about autism and sexuality can be one barrier to young people receiving appropriate sex education.
Beyond that, existing school programs do not always reach students with autism, Crehan explained.
In some cases, that may be because they are in special education classes, while sex ed is given only in mainstream classes. In other cases, "sex ed might be offered, but is not tailored to the learning profiles of autistic students," Crehan said.
Then there's the fact highlighted in this study, she said: Many young people with autism do not identify as heterosexual, which is often the sole focus of sex education.
"The significant majority of sex education programs do not discuss anything other than heterosexual relationships between cisgendered people," Crehan said.
Autism is a developmental brain disorder that affects about one in 54 children in the United States, according to the Centers for Disease Control and Prevention.
In general, autism impairs people's ability to communicate and socialize, but the disorder is complex and varies widely among individuals.
Some are profoundly affected -- speaking little, if at all, and getting wrapped up in repetitive, obsessive behaviors. Others have milder difficulties with social skills. Some people have intellectual disabilities, while others have average or above-average IQs.
The current survey involved 1,183 people with autism, aged 16 to 90. Most had no intellectual disabilities, Weir said, since they had to complete an extensive online questionnaire.
Overall, people with autism were less likely to say they were sexually active. For every 10 adults without the disorder who were sexually active, four with autism said the same. People with autism were also almost eight times more likely to describe themselves as asexual.
There's nothing wrong with not having sex, Weir stressed. "I don't think there's a need to put a value judgment on it," she said.
Crehan agreed, but also said that based on past surveys, most people with autism say they want romantic relationships. If people want to be sexually active but are not, she noted, that can take a toll on mental health.
While the survey found differences between adults with and without autism, it also found similarities. Those who were sexually active started having sex around the same age, and were just as likely to have had a sexually transmitted infection.
To Crehan, a take-away for parents is to broach the subject of sexuality sooner rather than later, which can include the help of a health care provider.
Kids may need guidance on everything from how to tell when someone "likes you," to "sexting," to masturbation, according to Crehan. Too often, she noted, sexuality is ignored until a "negative sexual behavior" occurs -- at school, for instance -- and there's a big response.
That may leave kids with a sense of fear or shame, Crehan said.
"If we talk about sex and sexual health early, and in honest and safe ways, we've set a more positive tone for the discussion in the event that something positive or negative comes up in the future," she added.
Weir was scheduled to present the findings at the annual meeting of the International Society for Autism Research, being held online May 3 to 7. Studies presented at meetings are generally considered preliminary until they are published in a peer-reviewed journal.
The Organization for Autism Research has resources on sexuality and sex education.
SOURCES: Elizabeth Weir, doctoral candidate, psychiatry, Autism Research Center, University of Cambridge, United Kingdom; Eileen Crehan, PhD, assistant professor, child study and human development, Tufts University, Medford, Mass.; International Society for Autism Research, presentation, online meeting, May 3-7, 2021