ASD Teens and Sexual Issues

The two most important issues to address with ASD (high functioning autistic) teens are sexual safety and social issues related to sexuality. It comes down to education directed to personal and sexual safety - starting with closing and locking the bathroom door, knowing who can and can't help with menstrual care, and understanding the difference between good touching and bad touching.

Very few programs exist to teach young people with ASD about sex and sexuality, and because ASD teens are often unaware of social cues and peer expectations, clear, direct education is often critical. For example, they need to know they should lock the bathroom stall, and they need to learn how to do it. Sometimes moms and dads think it's safer if they take their youngster into the bathroom with them, but the challenge with that is that the person most likely to cause abuse is someone the kid knows, not someone he/she doesn't know. And if you don't teach your son/daughter to close and lock the door in a public bathroom, he/she's too open to abuse.

Beyond day-to-day hygiene and the issues of bathroom and locker room safety, it's important to address the social aspects of sexuality. Unlike most youngsters, teens with autism are unlikely to learn about sexual norms from peers or even from teachers. So it's up to moms and dads to pick up the slack. Some things that almost anyone on the autism spectrum can learn about include:
  • bathroom and locker room independence
  • circles of comfort (who may touch you or ask you to undress)
  • good touch/bad touch
  • reporting of past events such an inappropriate touch

For parents of these special needs teens, however, there's a second level of difficulty: teaching even the most basic social aspects of sexuality. Even masturbation has a social component. ASD teens need to know when and where it's okay to touch themselves, and they need to understand the absolute need for privacy.

For kids on the spectrum going to middle school, if we're not pre-teaching, they'll get a skewed vision of human sexuality. Right now, there's no curriculum that truly addresses these issues in a functional way, and there's little research on the topic. You're also teaching values and social competence.

How can parents begin to think about this issue?
  • Be concrete (talk about the penis or vagina, not the birds and bees).
  • Be consistent and repetitive about sexual safety.
  • Be sure to address the social dimension of sexuality.
  • Find someone of the same gender to teach the basics of safety and hygiene.
  • Redirect inappropriate behaviors. For example, if a child is likely to masturbate in class or in public, give him something to carry or hold, etc.
  • Strongly reinforce for all appropriate behavior.
  • Think ahead - be proactive ("pre-teach").

The change from child to adult is an especially dangerous time for ASD adolescents in our society. From their earliest years, kids watch television shows and movies that insist that "sex appeal" is a personal quality that people need to develop to the fullest. ASD adolescents are at risk -- not only from AIDS and STDs -- but from this sort of mass-market encouragement.

Sexual content is regularly marketed to younger kids, pre-teens, and teens and this affects young people's sexual activity and beliefs about sex. According to the fact sheet, Marketing Sex to Children, from the Campaign for a Commercial-Free Childhood, kids are bombarded with sexual content and messages:
  • 42% of the songs on the top CDs contain sexual content -- 19% included direct descriptions of sexual intercourse.
  • Before moms and dads raised an outcry, Abercrombie and Fitch marketed a line of thong underpants decorated with sexually provocative phrases such as "Wink Wink" and "Eye Candy" to 10-year-olds.
  • Girls who watched more than 14 hours of rap music videos per week were more likely to have multiple sex partners and to be diagnosed with a sexually transmitted disease.
  • 83% of the episodes of the top 20 shows among teen viewers contained some sexual content, including 20% with sexual intercourse.
  • On average, music videos contain 93 sexual situations per hour, including eleven "hard core" scenes depicting behaviors such as intercourse and oral sex.

TV, movies, and music are not the only influences -- the Internet provides adolescents with seemingly unlimited access to information on sex as well as a steady supply of people willing to talk about sex with them. Adolescents may feel safe because they can remain anonymous while looking for information on sex. Sexual predators know this and manipulate young people into online relationships and, later, set up a time and place to meet.

Autistic adolescents don't need a sexual predator to introduce them to online pornography. It comes to them through porn spam on their e-mail or by inadvertently clicking on a link to a porn site. Through pornography, young people get a twisted view of what constitutes normal relationships. In fact, pornography is directly related to sexual abuse, rape, and sexual violence.

Just as sexual preferences are learned behavior, most or all sexual deviations are also learned behaviors, with pornography having the power of conditioning into sexual deviancy. Pornography can be addictive, with the individual becoming desensitized to 'soft' porn and moving on to dangerous images of bondage, rape, sadomasochism, torture, group sex and violence.

At the very least, addiction to pornography destroys relationships by dehumanizing the individual and reducing the capacity to love. At worst, some addicts begin to act out their fantasies by victimizing others, including kids and animals.

ASD adolescents also have their own cultural beliefs about what is normal sexual behavior. Although most teenage girls believe that sex equals love, other adolescents -- especially boys -- believe that sex is not the ultimate expression of the ultimate commitment, but a casual activity and minimize risks or serious consequences. That is, of course, what they see on TV. The infrequent portrayals of sexual risks on TV, such as disease and pregnancy, trivialize the importance of sexual responsibility.

Other misconceptions include:
  • a girl can't get pregnant if it's her first time
  • a girl can't get pregnant if she's menstruating
  • all adolescents are having sex
  • having sex makes you an adult
  • something is wrong with an older teen (17-19) who is not having sex
  • you are a virgin as long as you don't have sexual intercourse -- oral sex doesn't count

Clearly, moms and dads are in a tough spot. But there are some key ideas that help make sense of things.

These adolescents should learn the facts about human reproduction, contraception, and sexually transmitted diseases. Of the over 60 million people who have been infected with HIV in the past 20 years, about half became infected between the ages of 15 and 24. According to the U.S. Centers for Disease Control and Prevention (CDC), about 25% of sexually active adolescents get a sexually transmitted disease (STD) every year, and 80% of infected adolescents don’t even know they have an STD, passing the diseases along to unsuspecting partners. 

Your child needs to know that adolescents who are sexually active and do not consistently use contraceptives will usually become pregnant and have to face potentially life-altering decisions about resolving their pregnancy through abortion, adoption, or parenthood.

Health classes and sex education programs in the schools typically present information about the risks of sexually transmitted diseases, pregnancy risk, and contraception. However, evidence shows that traditional sex education, as it has been offered in the United States, increases sexual knowledge, but has little or no effect on whether or not adolescents engage in sex or use contraception.

Moms and dads, too, need to know important information, such as the younger the age of first sexual intercourse, the more likely that the experience was coercive, and that forced sexual intercourse is related to long-lasting negative effects.

The following is all related to later onset of sexual intercourse:
  • Attending church frequently
  • Good school grades
  • Having better educated moms and dads
  • Parental supervision
  • Sexually abstinent friends
  • Supportive family relationships

The challenge for any person is to make sense of facts in ways that are meaningful in life -- in ways that help them think and make wise choices. Schoolroom lessons leave much to be desired in this regard.

Commitments and values differ so widely in society that schools cannot be very thorough or consistent in their treatment of moral issues. According to a growing body of research, moms and dads and religious beliefs are a potent one-two combination when it comes to influencing a teen’s decisions about whether or not to have sex.

Moms and dads can best help their ASD adolescents from becoming sexually active by:
  • letting adolescents know that they are expected to abstain from sex until marriage
  • maintaining a warm and loving relationship with their kids

Moms and dads who are involved in their kid's lives, and who confidently transmit their religious and moral values to their kids, have the greatest success in preventing risky and immoral behavior.

For this reason, it is more important for teenagers to see real-life examples of people who understand and deal responsibly with their sexual natures.

Morals are not abstractions. Morals have to do with real-life commitments to people and things that have value. Moms and dads and other influential adults (at school, at church, and in the community) need to show adolescents the difference between devotion and infatuation and help them make the distinction in their own hearts.

ASD adolescents need to understand that satisfying sexual relationships -- like other relationships -- require careful thought and wise action.

Resources for parents of children and teens on the autism spectrum:

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