Sexuality and Autism: A Critical Review of Selected Literature Using a Social-Relational Model of Disability

Abstract

This article provides a summary of selected research conducted on the sexuality, as well as sexual knowledge and behaviors of individuals with autism over the past 20 years. The discussion section reviews the research according to the following recurrent themes: the importance of sexuality in the lives of individuals with autism, the discourse of problematic sexuality, and the difficulty in translating knowledge into practice. Using Reindal's (2008) pragmatic social-relational model of disability, this article provides an analysis of the research and offers suggestions for future inquiries in this area.

KEYWORDS:

• Autism
• disability
• inclusion
• sexuality

Notes

1. Unless otherwise noted, I shall be using the term “autism” as inclusively meaning “autism spectrum disorder,” “Asperger syndrome,” and “pervasive developmental disorder—not otherwise specified.” I will not be using the acronyms ASD, AS, or PDD-NOS because of my belief that using acronyms as labels inevitably encourages the abstraction of both the individual and the impairment (how often has one heard “He/she is OCD” or “He/she is ADHD” to refer to an individual with an obsessive compulsive disorder (OCD) or attention deficit hyperactivity disorder (ADHD). In these all-too-common examples, the impairments no longer provide information about the individual but rather define the individual (the individual no longer “has” but rather “is” an impairment). This presents the dangerous possibility of creating a slippery-slope where people are no longer seen as such, and where dehumanizing statements can be made on their behalf.

2. The term “intellectual disability” is used here according to the definition set out in Schalock, Borthwick-Duffy, Bradley, Buntinx, Coulter, Ellis, et al. (2010).

3. I have opted to use the term “sexuality” rather than “sex” because the latter term has come to be associated with a narrower definition of education on the subject of sexuality. Sexuality education encompasses more than learning about anatomy, physiology, reproduction, and sexually transmitted infections, as is often assumed when using the term “sex education.” “Sexuality education” addresses more aspects of sexuality, such as sexual health, sexual behavior, society and culture, and so forth (SIECUS, 2004). The addition of the term “socio” is to emphasize the social aspects of sexuality, components such as personal skills and healthy relationships. (SIECUS, 2004). These topics are essential for students with autism, as they often have deficits in the areas communication and social skills. If not explicitly stated, these components are at risk of being left out of the curriculum employed with students who have autism.

4. This time period was chosen for two reasons. Until relatively recently, distinctions were not made between categories of intellectual and developmental disabilities, including autism. As a result, very little research has been conducted specifically on the sexuality and/or socio-sexuality education of individuals with autism specifically. Since there are particularities to sexuality and socio-sexuality education specific to autism, more general research studies that did not specify ‘autism’ were excluded. Likewise, it was not until 1987 that a definition of ‘autistic disorder’ similar to the one used today was added to the Diagnostic and Statistical Manual of Mental Disorders (DSM III-Revised). Prior to 1987, autism was categorized as “Infantile Autism” (DSM III, 1980) and “Schizophrenia: Childhood Type” (DSM I, 1952; DSM II, 1968) (APA, 1952, 1968, 1980, 1987; Grinker, 2007).