Content note: Discussion of sexual assault
Psychologist Marcia Eckerd is concerned that, while we know that the majority of autistic people experience abuse and sexual assault during their lifetimes, autistic women are particularly vulnerable, and we need more research in this area. (We also need similar research on victims who are also trans, AFAB, nonbinary, non-speaking, intellectually disabled, and/or POC.)
Two years ago, I wrote an article about diagnosing autism in women, and since that time it has become my specialty. While there are many challenges that these women face, I want to specifically focus on the fact that most of them have been victims of sexual assault. These experiences range from unwanted touch or requests for sex/sexting to actual rape. Too many of the women have been raped. I wanted to look further into the sexual victimization of autistic women—how often it occurs, why, and maybe, how to help prevent it.
This is what I discovered: There has not been much research done into the sexual victimization of autistic adults. It’s been estimated that as many as half to 78% of autistic adults are victimized. There are few studies on this topic, and those that exist mostly refer to “adults” and don’t separate genders.
There’s even less research into the victimization of women, which isn’t surprising since women are so woefully underdiagnosed. What this means is that the numbers that do exist leave out many women who would be diagnosed autistic if they were evaluated. In the few studies in which genders are differentiated, the studies use only genders assigned at birth. I was unable to find studies dealing with gender nonconforming autistic adults or trans autistic women. Only one study mentioned both heterosexual and lesbian women with autism were at high risk for sexual victimization.
There is more research on abuse of children, although it’s usually general trauma and abuse, not focused on sexuality. A Swedish study of twins stood out for differentiating genders and neurodiversity. The researchers found that by age 18 neurodiverse females are more likely to have experienced sexual victimization—a threefold increased risk for autistic females and a twofold increased risk for females with ADHD—compared to the general population.
There’s a marked difference between what I hear from autistic women and the research that’s been done. Studies of autistic young women vary in findings. One study reported less victimization of female autistic college students than allistic female students, but very high rates of victimization for both (61.5% and 83.2%). Another study found autistic young women reported unwanted sexual advances more often than allistic young women, 51% compared to 32%. Studies focus on college women already identified as autistic and who had disclosed their diagnoses; as we know, many young women don’t share this information or aren’t diagnosed until later, and I didn’t find studies that looked at women older than college age. That’s leaving out a lot of women.
I also wondered how researchers are getting these figures, and I found that most studies relied on online self-rating forms for women to self-report abuse. The fact that studies rely on self-report checklists is important, because many of the women I interviewed said they didn’t realize that they were being abused until later, they weren’t aware that certain behaviors would be considered victimization or abuse. One comment also suggested that low rates of reporting abuse might reflect the discomfort autistic women feel at disclosing deeply personal sexual experiences to interviewers.
Why are autistic women victimized?
Assuming these studies probably underreport how often autistic women are victimized, I thought about why this happens. Autistic girls are largely unprepared to navigate the world of sex and relationships. One contributing factor is that their sexuality is frequently ignored. Research found that parents and teachers underestimate the interest that autistic adolescents have in forming relationships. Parents also worry about bringing up sexuality, thinking it will create interest that wasn’t there before. Research shows that autistic teens have the same amount of interest in romantic relationships as their allistic peers. Because of social differences autistic teens are less frequently part of friend groups and therefore they’re unlikely to find partners in known groups of peers. They might not personally know potential partners and aren’t privy to their reputations. They can be more vulnerable because they very much want relationships, are isolated, and generally sexually naïve.
Research shows that autistic adolescents have less sexual education than their allistic (non-autistic) peers. Sometimes they’re pulled from the regular sex ed classes in school, perhaps because they are in special education. When they do participate in these classes, many say they’re confused by the parts of the curriculum about feelings and relationships. The women I’ve met often talk about masking by learning social behavior from watching TV, movies, and social media. They are around but don’t belong to groups of women of their age, so they don’t learn informal information about personal safety and identifying unsafe partners. Getting information about sexual relationships from movies or TV is troubling because the behavior they see is likely to be unrealistic and possibly exaggerated. When they tried to emulate what they saw, they found themselves in trouble.
Who is getting abused?
Research suggests that autistic women who are diagnosed later in life, who have more sexual knowledge and who are perceived as better in their social and communication abilities have more sexual satisfaction. However, these same factors put them at greater risk for sexual victimization. They may be more engaged socially, so therefore more exposed to the potential for victimization.
These women are masking to fit in, but they still describe being confused by social cues, and are unfamiliar with social rules of these situations. They wouldn’t necessarily have the skills to know what to do if a partner behaves provocatively. The women I met all expressed having failed to pick up on nonverbal cues that were red flags. They described themselves as overly trusting and often gullible.
Some women may have more sexual knowledge, but this knowledge tends to be more about puberty, physiology, and early teaching about boundaries, and less about their own sexuality, relationships, and handling difficult situations and conflict. They didn’t have the social tools to get out of situations, such as excusing oneself to go to the bathroom or the classic excuse of claiming to feel ill.
Autistic girls are often taught they are supposed to conform to female gender expectations, to be “people pleasers.” More so than boys, they’re told to smile, look friendly, and do what they’re told. Many of the women I talked to said they weren’t aware that they were allowed to say “no.” They felt that if a person was interested in them sexually, they were supposed to agree. I even talked with one woman who thought if someone asked her to get married, she had to say yes. It took three husbands for her to figure out that she had to enjoy the relationship before she got married.
All of the women I spoke with were literal and truthful and didn’t recognize manipulation. They accepted bullying or coercive behavior because they thought, or they were told, that this was what happens in relationships. The women described being gaslit, told that discomfort was their own fault, or that they had agreed to sex by getting into a compromised situation. Many of the women I met have alexithymia, an inability to recognize feelings. This a significant liability if one is in a situation where it’s important to rely on “gut feelings” and instinct—these women weren’t aware of their own level of
discomfort until it was too late. Most women I talked with describe “shutting down” when
Several women described using alcohol or drugs to lower their social anxiety and inhibition so they could go to parties or bars and get “picked up.” They didn’t realize that sexual promiscuity wasn’t the same as having a romantic partner and were confused when their sexual partner dismissed them. When drunk or stoned, they were less likely to make good judgments about the situations they were getting into.
What can be done?
If autistic women don’t have the knowledge to prepare them to navigate sexual relationships, they need reliable sources of information. While some teens and young adults may be uncomfortable talking to parents about sex, it’s critical that they have some trusted adult with whom they can have frank discussions about everything sexual.
The next few examples come from my clients who are boys, but they give an idea of the specificity of questions autistic teens ask. I had an autistic young man in college ask me how to French kiss. I must confess that nothing in my professional training prepared me for giving concrete and detailed instructions for French kissing. An autistic pre-teen heard his classmates use sexual language considered vulgar. His peers were typical 13-year-olds trying to be cool. When they were angry at a girl, they called her a slang term referring to a vagina. My client had no idea what this meant, but when he was upset at a teacher, he called her that name. The teacher was horrified, and it took a while to sort out that my patient had no idea of what he had said. He came into his next session wanting me to go through every slang sexual word that could possibly be insulting.
My point in these examples is that despite our misgivings, adults need to overcome our anxiety and squeamishness and give autistic adolescents the information they want to know. Specifically, we need to give autistic girls and young women the detailed information they might be missing – behavioral signals that a partner might be inappropriate or sexually aroused, what kinds of invitations might be unsafe, what kind of sexual behavior might be appropriate in what situation, how to give and withdraw consent, and especially, pre-scripted strategies for getting out of situations that are getting out of hand.
They need to know that no matter what preceded a situation, they still have the right to say no, and that any discomfort is something they are entitled to act upon.
We can’t suddenly start talking about sex with 15-year-olds who are teenagers and don’t want to listen. Sexuality affects our children’s lives from the beginning. Names, the colors of bedrooms and the choice of toys are often determined by gender expectations. Girls who are most comfortable with clarity and certainty can have trouble at puberty with their changing bodies, handling new challenges in self-care both at home and at school. Physically developing girls can experience sexually oriented bullying. They also observe changes in the behaviors and relationships among their peers as young as pre-teens. Autistic girls often feel like failures for experiencing social isolation or rejection and may seek any way of getting a “friend,” even one who mistreats them.
Luckily, there are resources for sexual education. If sexuality is an open and acceptable subject with young children, it’s easier to keep the door open for discussions as they mature. Amaze Parents has a series of YouTube videos on talking to younger children about sexuality, bodies, consent, relationships, and other subjects. (amaze.org #moreinfolessweird ). Kids Health has a good video on girls and puberty called Am I Normal (Girls and Puberty).
The Organization for Autism Research (OAR) has an excellent online resource, Sex Education Guide for Self Advocates (OAR Sex Ed Guide), which covers early issues but also healthy relationships, dating 101, sexual orientation and gender identity, and more. There’s information that can be shared with a younger child, but it’s designed to be read by older children, teenagers, and young adults, and it can be a platform for discussion.
It’s important that adults ask questions to know what a teen knows—it’s the only way to identify misinformation from online sources. Adults need to validate questions—all questions are good and open for discussion. Adults need to be truthful, concrete, and logical—not just what and how, but why.
One can’t always expect a positive response. A 14-year old young woman asked me what her sexual identity was. After I explained the varieties of gender identity and the importance of lived experience, she looked at me, crossed her arms and said, “Well, that wasn’t useful.” She wanted an answer.
Books that can be helpful:
- Sonya Renee Taylor: Celebrate Your Body: The Ultimate Puberty Book for Girls
- Dr. Lisa Klein and Dr. Carrie Leff: Celebrate Your Body 2
- Sarah Atwood: Making Sense of Sex: A Forthright Guide to Puberty, Sex and Relationships for People with Asperger’s Syndrome
- Liane Holliday Willey: Safety Skills for Asperger Women
- Dr. Susy Ridout: Neurodiversity, Autism, and Recovery from Sexual Violence
If we have encouraged open dialogues with appropriate trusted adults all along, it will be less problematic to encourage autistic young women to seek out guidance concerning relationships, whether with a friend of the family, relative, sibling, therapist, or another trusted adult. We need to normalize that many of us have a challenging path to learning about sexuality and safety, and that this is an appropriate and necessary subject on which to seek guidance.
There is an overwhelming need for ongoing support. Supervised online groups for teens and young adults exist, such as those on AANE.org, although they might not focus on sexuality and concerns about abuse specifically. Teens will often turn to Reddit for discussions with peers, which may or may not get them factual answers. There is little to no support for adults.
Women have navigated the world of developing sexuality alone. This is true for men as well, but it is women who most often are the targets of abuse. There is no support system available to these women that I know. If such support exists, it needs to be more widely publicized. There needs to be more research, more education, and more support if anything is going to change.