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No BS, Just Science?

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AUTISM: Gender confused or gender unbiased?

80% of females with ASD feels ... female ... 92% of males with ASD feels ... male ..., but only…

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80% of females with ASD feels … female … 92% of males with ASD feels … male …, but only 0.9% of males with ASD feels female, and 0.9% of females with ASD feels male … so what’s is going on here!? Let’s do a deep dive into the latest research on Gender Identity, Sexual Orientation, and Romantic Relationships in Adolescents and Adults with Autism.

TOPIC: Sexual Orientation, Gender Identity, and Romantic Relationships in Adolescents and Adults with Autism Spectrum Disorder …

Introduction


Experience with solo and partnered sexuality and with romantic relationships is common for the majority of adolescents and adults with autism spectrum disorder without an intellectual disability (Dewinter et el., 2017).

Evidence for the view of sexuality as a normative part of adolescent development and adult functioning in ASD is relatively recent, and contrasts with earlier views that a majority of adolescents and adults with ASD is asexual, or that sexuality is a problematic issue for them (Dewinter et el., 2017).

Still, existing research suggests differences relating to sexual development in some people with ASD compared to typically developing (TD) people (Dewinter et el., 2017).

In the current study, we focus on sexual orientation, gender identity and relationship status in adolescents and adults with ASD compared to peers in the general population (Dewinter et el., 2017).

First, findings relating to sexual orientation (feeling attraction to someone of the same sex, the other sex or both sexes) in adolescents and adults with ASD varied. Some studies found similar proportions of same sex attraction or experience (5–10%) among participants with ASD and TD peers, while other studies reported higher levels of non-heterosexual feelings and experiences in ASD compared to the general population. In the US population 17.4% of girls and women, and 6.2% of boys and men (age 18–44) reported same-sex experiences at some point during their lifetime. In this study 7.9% of men and 19% of women felt also or only attracted to someone of the same sex, and 7.7% of women and 4.9% men identified as other than heterosexual or straight. Prevalence data on sexual orientation in large groups of people with ASD are still lacking.

Second, a relationship between ASD and gender dysphoria (GD) was suggested. Gender refers to the behaviours and attitudes that, in a specific time and culture, are considered typical to males or females. While the number of people with GD is comparatively small, the prevalence of ASD characteristics in people referred to gender clinics is relatively high. Unfortunately, the findings regarding ASD and gender dysphoria are based on diverse samples (e.g. adolescents and adults with GD vs. participants with ASD) and not consistent across studies. Different explanations were raised for this greater variation in sexual orientation and gender identity in people with ASD. Biological theories point to the influence of higher levels of antenatal testosterone exposure and to the assumption that GD and ASD share common genetic patterns. Psychosocial explanations include the effects of social experiences, the opportunity to meet people of the other sex, the role of sensory preferences, stereotyped interests and limited flexibility, and feeling less hampered by societal prejudices to come out. Empirical support for these mechanisms is mostly lacking. Yet, findings in the general population suggest that sexual minorities face several additional challenges (e.g. coming out) and risks (e.g. exclusion, abuse, violence) in their sexual development and well-being compared to their peers. Little is known yet about the well-being and development of LGBT (i.e. Lesbian, Gay, Bisexual, Transgender) people with ASD. Adolescents and adults with ASD and LGBT-feelings might face a double coming out: they might experience a sense of difference from the general population not only relating to their ASD-characteristics, but also pertaining to their gender identity, sexual orientation, or doubts about them. Better insight in sexual orientation and identity in adolescents and adults with ASD can lead to an increased awareness in sexuality education and support (Dewinter et el., 2017).

Third, research in samples of adults with ASD without cognitive impairments showed that 17% to 73% of people with ASD had a romantic relationship or were living with a partner. Being single was not negatively perceived by a third of the singles in the study of Strunz et al. (2017) and participants reported a variety of reasons why they did not feel up to being in a relationship (e.g. contact with a partner is exhausting). Singles with ASD can also experience sexuality in a positive way. However, some people with ASD without relationship experience compared to those with relationship experience showed poorer sexual functioning, e.g. less arousability, more anxiety or less desire . Still, results on relationship experience vary strongly and there is not yet a clear view of how this is experienced by adolescents and adults with ASD. Most of the existing research is based on relatively small samples (the largest recent studies included n=141 (Byers et al. 2012) and n=229 (Strunz et al. 2017) participants with ASD) and case studies. Only the most recent studies are based on self-report. Recruitment of volunteers for sexuality related research might also have biased these results: volunteers in sexuality research were found to be more sexually experienced, to have a more positive affect towards sexuality and to be more interested in sexual novelty compared to controls in a non-sexual study (Dewinter et el., 2017).

In the current study, a large group of adolescents and adults with ASD reported on their sexual orientation, gender identity and relationship status (Dewinter et el., 2017).

The findings on attraction and relationship status could be compared to those of peers in the general population (Dewinter et el., 2017).

The results of this study can add to a nuanced and more realistic view on sexuality and relationships of people with ASD and offer input for sexuality education and support (Dewinter et el., 2017).

THE FACTS

SEXUAL ORIENTATION

Sexual orientation was more varied in ASD compared to controls in both men and women (Dewinter et el., 2017).

(Dewinter et el., 2017).
(Dewinter et el., 2017)
(Dewinter et el., 2017)

ASSIGNED GENDER and ORIENTATION

This study shows that most people with and without ASD identify in line with their assigned gender at birth, feel attraction to someone of the other sex and have been in a heterosexual romantic relationship (Dewinter et el., 2017).

ATTRACTION

However, adolescents and adults with ASD reported non-heterosexual attraction more often than their peers in the general population (Dewinter et el., 2017).

In addition, a notable number of the men and women with ASD in this study indicated sexual attraction to neither men or women, possibly reflecting feelings of doubt, limited awareness of sexual orientation, or possibly the absence of sexual attraction (Dewinter et el., 2017).

RELATIONSHIPS

About half of the participants with ASD in this study were in a relationship (in most cases a satisfying one), and most people with ASD who were in a relationship lived with their partner (Dewinter et el., 2017).

The majority was in a relationship with an opposite-sex partner (Dewinter et el., 2017).

In line with earlier findings, the people with ASD in a relationship were slightly older than the singles (Dewinter et el., 2017).

No differences between men and women appeared concerning relationship experience, in contrast to earlier findings (Dewinter et el., 2017).

One in ten men (1/10, 10%) and a third (1/3, 33%) of the women with ASD reported having a partner with (or suspected of having) ASD, which was related to higher relationship satisfaction (Dewinter et el., 2017).

BIAS

Possible bias related to differences in response style between autistic participants compared to those in the general population group cannot be excluded, e.g. autistic participants being less influenced by societal views or stereotypes on attraction and gender, or people who do not recognise themselves in the response categories (Dewinter et el., 2017).

Some of these (unstudied) mechanisms might result in a more diverse picture of the autistic participants compared to the general population (Dewinter et el., 2017).

RATIO and PHENOTYPE

The participants declared that they have been diagnosed with ASD, which is also reflected in the high AQ scores (Dewinter et el., 2017).

The overrepresentation of women in the group with ASD is remarkable and differed from the generally found M:F ratio of 4:1 (M: 75%, F: 25%), but is in line with general higher response rates of females compared to males in participating in research (Dewinter et el., 2017).

FINDINGS

These findings have implications for clinical and educational practice (Dewinter et el., 2017).

First, this study demonstrates that a large percentage of adolescents and adults with ASD have romantic experience and feelings. However, a larger group of people with ASD compared to typical peers remains single and longs for a relationship. Attention to their experience and needs is advised (Dewinter et el., 2017).

Second, more adolescents and adults, especially women, report same-sex attraction and identify not completely or exclusively to their birth-assigned gender. This small group of men and women with ASD might face additional challenges (e.g. coming out) and risks (e.g. exclusion). Caregivers and professionals should be aware of and open towards these feelings and actively offer support when needed. In sexuality education and communication with adolescents with ASD, relationship skills, sexual diversity, and sexual identity development should be given appropriate attention (Dewinter et el., 2017).

REFERENCES

Dewinter, J., De Graaf, H., & Begeer, S. (2017). Sexual Orientation, Gender Identity, and Romantic Relationships in Adolescents and Adults with Autism Spectrum Disorder. Journal of autism and developmental disorders, 47(9), 2927–2934. https://doi.org/10.1007/s10803-017-3199-9

Full-Text Version of this study

https://link.springer.com/content/pdf/10.1007/s10803-017-3199-9.pdf

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