Dealing with sexuality-related issues for students with autism


Katherine Antall

It’s important to realize that for most students with disabilities, even when intellectual functioning does not match the biological age, the biological development itself is on track. For example, a nonverbal 16-year-old who struggles with hygiene still has typical teenage feelings about sexuality. Allowing students their humanity, while redirecting inappropriate behavior and clearing up areas of confusion, was the topic of an webinar, “Autism, Sexual Health, and Today’s Sexual Culture,” by Katherine Antall, human sexuality specialist at Cuyahoga County Board of Developmental Disabilities in Ohio.

Antall began her talk by presenting this chart of typical sexual development:

AgeCommon BehaviorUncommon Behavior
0-5 yearsWill have questions and express knowledge relating to:
- Differences in gender and genitalia
- Hygiene and toileting
- Pregnancy and birth

Will explore genitals

Showing and looking at genitals
Having knowledge of specific sexual acts or explicit sexual language

Engaging in adult-like sexual conduct with another child
6-8 yearsWill have questions and express knowledge relating to
- Physical development, relationships, and sexual behavior
- Menstruation and pregnancy
- Personal values

Experiment with same-age and gender children including games and role-playing

Self-stimulation in private
Adult-like sexual interactions

Having knowledge of specific sexual acts

Behaving sexually in public places or through the use of a phone or technology
9-12 yearsWill have questions and express knowledge relating to
- Sexual materials and information
- Relationships and sexual behavior

Using sexual words and discussing sexual acts and personal values

Increased experimentation with sexual behaviors and romantic relationships

Self-stimulation in private
Regularly occurring adult-like sexual behavior

Behaving sexually in a public place
13-16 yearsWill have questions and express knowledge relating to
- Decision making
- Social relationships and sexual customs
- Personal values and consequences of sexual behavior

Self-stimulation in private

Sexual experimentation between adolescents of the same age

First sexual intercourse will occur for about one-third of teens
Masturbation in public

Sexual interest directed toward much younger children


Combating counterfeit deviance

Because of the disparity between intellectual and biological development, sometimes there is what Antall called “counterfeit deviance”, making the student appear dangerous or predatory, which can be handled through education. It’s important to remain calm and nonjudgmental in these situations because how you respond can affect student attitudes toward themselves for the rest of their lives. For example:

Genital touching. Students may not know that they should not touch their genitals in public. Sometimes this is done for comfort and sometimes for sexual release, but needs to be redirected either way. If it happens, don’t shame the student. Calmly and gently say they can touch their private parts at home in their bedroom with the doors closed. For example, say “I see you need private time, but you can’t do that right now. Let’s do this other activity instead.” Having the student perform heavy work activities such as moving heavy objects can help relieve pent-up energy.

If you have permission to discuss sexuality from the parents or guardian, two helpful resources are the books Things Ellie Likes and Things Tom Likes by Kate E. Reynolds, about sexuality and masturbation for people with autism and related conditions.

Age vs. interest. Some people with ASD (autism spectrum disorder) have very restricted interests which may not align with biological age and which might appear predatory. For example, a 16-year-old who likes Barney might stare at young children playing with Barney. Redirect the student to a different activity.

Time/place confusion. Students may develop romantic relationships with people and act out in inappropriate places such as work. Explain expectations in all environments: home vs. school vs. work.

Boundaries and the helper role. Students know that helpers help, and in confusion may to go them for sexual release, for example by grabbing the teacher’s hand and putting it on their genitals. Or students may want to give and get hugs. Antall says that in all cases, be cool and don’t overreact, but set boundaries from the start by limiting physical contact to fist bumps and high fives instead of hugs or other close contact. This is best done when first meeting the student because it’s hard to discourage hugging once it has started.

Protecting students from abuse

Sadly, people with disabilities are more likely to be sexually abused. To help students protect themselves, do body mapping. Get an outline of a body from Google images and draw circles around body areas, then help the student see where friends are allowed to touch you, where teachers are allowed to touch you, where family is allowed to touch you, etc.

Helping students w/ relationships and modern technology

Students can become isolated and lonely, especially if they have difficulty talking to people. Encouraging students to follow their interests can be a way to help them meet compatible people.

A helpful book about meeting people and having relationships is Autism-Asperger’s and Sexuality: Puberty and Beyond, by Mary Newport and Jerry Newport. The book takes a candid look at aspects of sex and relationships as they apply to people on the autism spectrum: building self-confidence, dating, personal grooming, cleanliness, and explicit advice on how to initiate sex with a partner. Also covered: avoiding pregnancy and STDs, dealing with rejection, how to build a loving relationship that includes sexual intimacy, and more.

Also helpful is this YouTube videos about consent, created by Planned Parenthood:

Equally important is warning students about the risks of connecting through technology, which can be a temporary fix to loneliness but which can be dangerous. For example, sexting is fairly common now among young people and can’t be undone. Explain to students that photos cannot be taken back and that the student’s partner may lose control of the photos. Tell the student not to send anything they wouldn’t want their mom, dad, grandma, or boss to see.

Catfishing, or adopting a fake identity in an online relationship, is also a threat. But it is possible to see whether a profile photo has been copied by doing a reverse image search on Google. On the Google Images search bar, click on the camera icon and choose to search by URL or uploaded image. Here’s a tutorial.

Antall was adamant that viewing pornography, especially on the Internet, is very damaging to forming healthy sexual relationships, because research shows that porn viewing requires the user to see worse and worse images to achieve the same level of arousal, creating unrealistic expectations of a real relationship. Suggest to parents that they set YouTube with Restricted Mode on YouTube and protect their children from porn in other ways as well. See “How to Block Pornography on Internet-Connected Devices.”

Getting additional ideas

For more ideas about helping students with sexuality issues, check out the book Intimate Relationships and Sexual Health: A Curriculum for Teaching Adolescents/adults with High-functioning Autism Spectrum Disorders and Other Social Challenges, by Catherine Davis and Melissa Dubie. Be sure to get parental consent before pursuing instruction.

You can also reach Katherine Antall at and at 216-362-3779.


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