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How Autism Affects Sex & Intimacy

Published: January 26, 2023 Updated: March 27, 2023
Published: 01/26/2023 Updated: 03/27/2023
Daniel C. Marston, PhD, ABPP
Written by:

Daniel Marston

PHD, ABPP
Headshot of Naveed Saleh, MD, MS
Reviewed by:

Naveed Saleh

MD, MS
  • How Does Autism Affect Sex?Autism & Sex
  • Can Autism Affect a Person’s Sexuality or Gender Identity?Autism, Sexuality, & Gender Identity
  • How to Help an Autistic Person Recognize Their Sexual FeelingsRecognizing Sexual Feelings
  • The Importance of Sex Education for Autistic IndividualsImportance of Sex Education
  • How to Have Great Sex With AutismHaving Great Sex With Autism
  • Final ThoughtsConclusion
  • Additional ResourcesResources
  • Autism & Sex InfographicsInfographics
Daniel C. Marston, PhD, ABPP
Written by:

Daniel Marston

PHD, ABPP
Headshot of Naveed Saleh, MD, MS
Reviewed by:

Naveed Saleh

MD, MS

Sex can be a particularly challenging and complex topic for autistic individuals. Many struggle with sex because it involves handling personal sensory experiences, as well as complicated relational and communication elements. Figuring out how to deal with sexual feelings, approach sex in a relationship, and bring sexual pleasure to a partner may all be differently addressed for autistic people than for others.

A therapist can help you become more comfortable with approaching sex. BetterHelp has over 20,000 licensed therapists who provide convenient and affordable online therapy. BetterHelp starts at $60 per week. Complete a brief questionnaire and get matched with the right therapist for you.

Choosing Therapy partners with leading mental health companies and is compensated for referrals by BetterHelp

Visit BetterHelp

How Does Autism Affect Sex?

For the most part, autistic individuals are as interested in sex as anyone else. Autism does not drastically impact sexual interest, but can affect one’s expression of it considerably. Sex relates to areas of a person’s life that are experienced much differently by neurodiverse individuals than neurotypical people. For example, autistic people handle physical sensations, relationship issues, and effective communication in unique ways. They may be more sensitive and even embarrassed about sex-related topics. Additionally, there is some evidence that asexuality (i.e. lack of sexual interest) may exist at a higher rate for autistic folks, but this remains to be elucidated.

Autism may lead to sex or intimacy-related challenges, such as:

Hypersensitivity

Sex involves physical touch which can be a challenge for some autistic folks. Many are very sensitive to tactile experiences and respond more strongly than others to even minor stimulation. One theory suggests that this is due to a reduced level of the neurotransmitter GABA that is commonly seen with autism.1

Being more sensitive to physical touch can lead to problems associated with sex. Touch sensitivity experienced by autistic individuals may be associated with higher rates of painful sex and premature ejaculation problems in men.2

For autistic adults to have successful intimate relationships, it can be helpful to find ways of moderating touch sensitivities. This is particularly important when one of the partners is autistic and the other is not. Relaxation exercises and practice with mutual masturbation are two approaches that can help an autistic person become comfortable with sex-related touch.

Hypersexuality

Hypersexuality refers to when an individual is particularly focused on sex and thinks about it more often than others. If one partner expects sex more than the other, this can cause problems in a relationship. It may also cause conflict if the hypersexual person seeks relief from sources that do not involve their partner, such as porn or an extra-relational affair.

For some autistic individuals, difficulties with social skills and hypersensitivity to physical sensations can make them more prone to hypersexuality.3
In certain cases, they may express these sexual feelings in socially inappropriate ways. This may result in individuals adopting abnormal—or even dangerous—sexual behaviors that break societal norms as they struggle to find ways of fulfilling their needs.

Communication

Autistic individuals may have problems communicating sexual needs which can cause issues in intimate relationships. They may seek to satisfy these needs on their own, rather than communicate them with their partner. In turn, this can result in hurt feelings.4

In some cases, lapses in communication regarding sex can turn into sexual coercion. This occurs when one individual stresses a need for sex so strongly and inappropriately that it becomes increasingly difficult and uncomfortable for the other person to turn them down. Recognizing when expressing interest in sex becomes demanding may also be challenging for autistic partners. This being because factors that determine what is and is not appropriate greatly depends on the other person’s social cues.

Seeing as this form of coercion is common in teenagers—for example, wanting to be liked by someone leads to doing whatever is necessary to please this person—it is essential that parents of autistic teens learn effective ways to teach their child about healthy sexual behaviors.5

Educational Barriers

Autistic individuals may struggle to stay focused for extended periods and may get mentally lost if multiple topics are presented in rapid succession. This is likely due to issues with processing information when the individual is focused on something else. Autism can make it harder for a person to focus on a topic that they are otherwise uninterested in or uncomfortable with.

Sex education carries with it a need to focus on a variety of topics that can be uncomfortable. This can pose problems for autistic folks, along with the fact that sex education centers around social behaviors and situations involving intimacy. Therefore, it is important for autistic people to be provided with sex education geared specifically towards them and that it is taught by individuals familiar with neurodiversity.6

Sexual Victimization

Autistic folks may be more vulnerable to sexual victimization than neurotypical individuals.7 This includes being coerced or tricked into having sex with someone who may appear to care about them. As a result of challenges related to understanding social cues, autistic people may be more susceptible to sexual abuse.

Additionally, recognizing that people may have different intentions then they put forth can be particularly difficult for autistic folks. It is not that autism makes people naïve. Rather, autistic individuals tend to take things at face value. Thus, an autistic person may not initially suspect that someone who “loves” them does not actually mean what they say.

Understanding Public Vs. Private Behaviors

Social behaviors can be quite complex. Nowhere else is this more evident than when making a determination between what can and cannot be shared publicly. Autism is believed to cause lapses in social comprehension, which can make it particularly challenging for neurodiverse individuals to make the distinction between private and socially appropriate thoughts. Sexual behaviors and feelings are a perfect representation of this.

Generally, sexual feelings are not expressed publicly without some form of associated negative response or connotation. Even the most minor type of sexual behavior in public can result in many problems. Deciding what sexual behavior is acceptable around others is a complex task magnified by the intensity and subjectivity of sexual feelings. An autistic individual may overstep certain societal boundaries due difficulties understanding social cues or constructs regarding sex.

Can Autism Affect a Person’s Sexuality or Gender Identity?

Some research suggests that autistic individuals collectively experience a wider variety of sexual orientations than neurotypical people.8 Why this is the case is not clear, but it may stem from the definiteness associated with identifying as a certain gender or sexual orientation.  Autistic people have a strong preference for clarity; naming orientation can be a way of gaining this regarding sexuality. Whereas some neurotypical individuals may view this as labeling and something to be avoided (if they prefer to remain sexually fluid), autistic people can see naming their sexuality as both validating and comfortable.

How to Help an Autistic Person Recognize Their Sexual Feelings

Learning how to communicate effectively can be difficult for autistic individuals. Because of this, having a loved one be the first to breach the subject of sex can “make or break” how well an individual learns healthy sexual behavior.

Below are some tips for helping an autistic loved one understand their sexuality:

Educate Them About Sex

Offer your autistic loved one sex education in concrete and direct ways. Allow frequent breaks for questions and make it clear that no questions are off the table. Help them feel comfortable and create a safe place for discussion about any topic related to sex and intimacy.

Autism is not associated with different sexual feelings, but it does impact how a person interprets or expresses these. Sex education is beneficial as it addresses topics such as how to use touch effectively during intimacy, appropriately share sexual thoughts, and communicate honestly with intimate partners.9

Encourage Flexible Thinking About Sex

Sex in general can be a tough topic for autistic folks, as sexual feelings are not always easy to define and express. Encourage an autistic loved one to think more flexibly and fluidly about sexuality. Let them know that sex is not always straight-forward and simple, and that this is OK.(F10)

Remain Non-Judgmental

There is evidence suggesting that rates of gender dysphoria are higher among neurodiverse individuals than neurotypical individuals.11
Be sure to establish with your loved one that they can always come to you with questions or thoughts related to their sexuality. Autistic and neurotypical people alike need a judgment-free environment to share their feelings. Providing positive statements and encouragement after discussing uncomfortable topics is especially beneficial.

Work Out Concrete Plans

One of the more problematic aspects of sexuality is how complex and confusing it can be. It is not always possible to be concrete when discussing intimacy. However, whenever this is possible, it should be emphasized. Offer solid and concrete ways to handle sexual feelings with an autistic individual. Be sure to express that creating and maintaining healthy sexual boundaries is important.12

The Importance of Sex Education for Autistic Individuals

Sex education is important for everyone. However, addressing healthy sexual behaviors for autistic individuals is often overlooked. Many sex educators do not fully understand autism and may therefore struggle with effectively communicating the topic to autistic people.

When providing sex education to autistic individuals, being specific and concrete about  everything involved is essential. Establishing what information and feelings need to remain private is one factor, as well as determining how inappropriate sexual urges can be approached or lessened. For autistic folks, do not allow discomfort with sexual material to stand in the way of receiving a useful and valuable education.

Resources For Autism

Autism Newsletter – Free newsletter from Choosing Therapy for those impacted by autism or have a loved one on the autism spectrum. Get encouragement, tips, and latest info sent twice per week. Sign Up


Parent Training For Autism – Forta’s parent training program empowers you to help your child learn and develop through personalized therapy. Provide ABA therapy and help your child diagnosed with autism progress to their next milestone. Visit Forta


Virtual Reality Therapy – Imagine a virtual world that is safe for learners, equipping them with skills and tools they can apply in their everyday lives. Floreo teaches social, behavioral, communication, and life skills for individuals with Autism Spectrum Disorder (ASD). Visit Floreo

Choosing Therapy partners with leading mental health companies and may be compensated for marketing by Forta and Floreo.

How to Have Great Sex With Autism

Sex plays a significant role in many romantic relationships, and difficulties related to intimacy can be a major barrier. Communicating effectively, setting boundaries, and experimenting with a partner are all great ways to reduce anxiety regarding sex for autistic folks.

Below are some tips for navigating healthy sexual relationships with autism:

Have Open & Honest Communication

Sexual feelings are subjective, and it is only with open and honest communication that a romantic partner will know what the other is experiencing. These conversations can be uncomfortable and stressful. If you or your autistic partner are struggling to effectively communicate your needs, try being very specific about what you are thinking and feeling regarding sex. If you are having a fantasy, express it exactly as you see it. Be open and honest.

Additionally, every partner in a relationship needs to be mindful of both their own and the others’ needs. No party involved should be made to feel bad about their sexual preferences.  Addressing what is expected in terms of sex early on can help prevent future rifts in communication. Autistic individuals often struggle with addressing emotional distress, so ensuring that healthy intimacy is clearly and concretely outlined can help avoid relational conflict.

Find Out What You Enjoy

Sex is meant to be enjoyable. Therefore, partners need to discuss with one another what they enjoy during intimacy. Taking steps to ensure that topics such as sexual fantasies and sex positions are openly communicated is important. Partners should feel comfortable with being specific about their desires, even if the discussion gets graphic or dirty. Creating a judgment-free environment for these conversations is essential for autistic individuals.

Distinguishing between sexual fantasy and reality should also be taken into account by some autistic partners. Autistic folk may have issues with abstract, complex constructs as they are more comfortable with concrete ones. For example, fantasizing about something does not necessarily mean you want it to happen. An autistic person may view their fantasies as concrete desires and thus feel they need to be acted on.

Because of this, it is especially beneficial for autistic folk to share these fantasies openly with their partner. If their partner is willing to experiment, then articulating these desires can further expand and strengthen their relationship. Examples of this may include having a threesome or engaging in “cuckolding” (one partner has sex with another person while the other partner watches).

Set Healthy Boundaries

When it comes to sex, setting healthy boundaries in a relationship about consent is crucial. Determining a “safe word” to use if a sexual experience goes too far is necessary for both neurotypical and neurodivergent individuals. Do not be afraid to be specific about what is and is not okay during intimacy.

Because autism can cause difficulties with understanding complex material, it is beneficial to establish a safe word. The use of safe words during sex is a good example of concrete behavior that is easily understood by all parties involved. Some sexual experiences, such as bondage and anal sex, can be exciting. However, they can also be potentially painful or dangerous. When in the midst of sexual excitement, it can be difficult to tell a partner to stop when something oversteps a boundary. Setting a specific word that both partners agree upon ensures safe and healthy sex.

Get Comfortable With Messiness

Let’s be honest, sex can be beautiful and exciting—but it is also often messy. Autistic individuals may have a heightened difficulty with the sensory experiences associated with having fluids (such as semen or arousal fluid) on their bodies than others. In these cases, partners should discuss this with one another. It may take several attempts before an autistic partner becomes comfortable with what is involved. Talking helps, but so do things like having clean bed linens prepared for after sex.

Additionally, having a partner pleasure them orally can be exciting for a person. It can also be one way for a partner to sexually satisfy the other if they don’t want to be satisfied themselves. However, this can pose particular challenges for autistic people with sensory issues related to what oral sex involves. It is important to remember that not everyone is comfortable with oral sex. But, if you are and are interested in exploring it with your partner, allow yourself to make room for the messiness that comes with it and learn from the process along the way.

Practice Safe Sex

Sex can get heated quickly. Making sure to use condoms and practice safe sex is important for everyone. These are topics that need to be discussed before getting into the heat of the moment. Be specific about what you expect from your partner and do not be afraid to get detailed. Try practicing using a condom on yourself or on your own ahead of time. This way, you can see if you have any sensory issues with certain types of textures. Mutual masturbation can also help if you are new to sex. In this way, partners can still pleasure and get more comfortable with each other.

Consider Sex Therapy

Sex therapy is a treatment approach that focuses on helping couples communicate effectively about sex and better meet the sexual needs and desires of their partners. Addressing communication during intimacy and creating a safe environment to do so can be particularly helpful for autistic individuals. Before considering this option, it is helpful to make sure that the therapist has familiarity with autism.

Final Thoughts

Sex is an important part of lasting romantic relationships. Having autism does not necessarily entrail more intimacy challenges, but it can present different and unique ones. Dealing with the emotional complexities, communication needs, and sensory processing aspects associated with sex can be particularly daunting for autistic individuals. Taking time to approach these issues in healthy ways, even if it’s uncomfortable, is worth the effort for a healthy relationship.

Additional Resources

Education is just the first step on our path to improved mental health and emotional wellness. To help our readers take the next step in their journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy may be compensated for marketing by the companies mentioned below.

Autism Newsletter – Free newsletter from Choosing Therapy for those impacted by autism or have a loved one on the autism spectrum. Get encouragement, tips, and latest info sent twice per week. Sign Up

Parent Training For Autism – Forta’s parent training program empowers you to help your child learn and develop through personalized therapy. Provide ABA therapy and help your child diagnosed with autism progress to their next milestone. Visit Forta

Virtual Reality Therapy – Imagine a virtual world that is safe for learners, equipping them with skills and tools they can apply in their everyday lives. Floreo teaches social, behavioral, communication, and life skills for individuals with Autism Spectrum Disorder (ASD). Visit Floreo

Choosing Therapy partners with leading mental health companies and is compensated for marketing by Forta and Floreo.

For Further Reading

  • Gender and sexuality in autism, explained
  • Gender and Sexuality Resources
  • Sex Education and Autism
  • The Autism Spectrum Guide to Sexuality and Relationships: Understand Yourself and Make Choices that are Right for You

Autism & Sex Infographics

How Does Autism Affect Sex?   How to Help an Autistic Person Recognize Their Sexual Feelings   How to Have Great Sex With Autism

12 sources

Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

  • Sapey‐Triomphe, et al. (2019). Tactile hypersensitivity and GABA concentration in the sensorimotor cortex of adults with autism. Autism Research, 12(4), 562-575.

  • Martin-Tuite, P., & Shindel, A. W. (2020). Management options for premature ejaculation and delayed ejaculation in men. Sexual medicine reviews, 8(3), 473-485.

  • Schöttle, D., et al. (2022). Sexuality in autism: hypersexual and paraphilic behavior in women and men with high-functioning autism spectrum disorder. Dialogues in Clinical Neuroscience, 19(4), 381-393.

  • Solomon, D., Pantalone, D. W., & Faja, S. (2019). Autism and adult sex education: A literature review using the information–motivation–behavioral skills framework. Sexuality and Disability, 37(3), 339-351.

  • Pugliese, C. E., et al. (2020). Feasibility and preliminary efficacy of a parent-mediated sexual education curriculum for youth with autism spectrum disorders. Autism, 24(1), 64-79.

  • Sala, G., et al. (2019). Autism and Intellectual Disability: A Systematic Review of Sexuality and Relationship Education. Sex Disabil 37, 353–382. https://doi.org/10.1007/s11195-019-09577-4

  • Sala, G., et al. (2020). As diverse as the spectrum itself: Trends in sexuality, gender and autism. Current Developmental Disorders Reports, 7(2), 59-68.

  • Maggio, M. G., et al. (2022). Sex and Sexuality in Autism Spectrum Disorders: A Scoping Review on a Neglected but Fundamental Issue. Brain Sciences, 12(11), 1427-1441

  • Calabrò, R.S., et al. (2022). Sexual Coach in High-Functioning Autism: A Growing Need. Brain Sciences, 12(8):964. https://doi.org/10.3390/brainsci12080964

  • Cooper, K., et al. (2022). Healthcare clinician perspectives on the intersection of autism and gender dysphoria. Autism, 13623613221080315.

  • Thrower, E., et al. (2020). Prevalence of autism spectrum disorder and attention-deficit hyperactivity disorder amongst individuals with gender dysphoria: a systematic review. Journal of autism and developmental disorders, 50(3), 695-706.

  • Chun, J., et al. (2022). The interplay of supports and barriers during the transition to adulthood for youth on the autism spectrum. Disability and Rehabilitation, 1-11.

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Daniel C. Marston, PhD, ABPP
Written by:

Daniel Marston

PHD, ABPP
Headshot of Naveed Saleh, MD, MS
Reviewed by:

Naveed Saleh

MD, MS
  • How Does Autism Affect Sex?Autism & Sex
  • Can Autism Affect a Person’s Sexuality or Gender Identity?Autism, Sexuality, & Gender Identity
  • How to Help an Autistic Person Recognize Their Sexual FeelingsRecognizing Sexual Feelings
  • The Importance of Sex Education for Autistic IndividualsImportance of Sex Education
  • How to Have Great Sex With AutismHaving Great Sex With Autism
  • Final ThoughtsConclusion
  • Additional ResourcesResources
  • Autism & Sex InfographicsInfographics
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