Autism and sexual health

Sexual health is a crucial aspect of overall wellbeing, and it is essential for everyone, including autistic individuals, to have access to accurate information and appropriate resources. 

Understanding contraception, sexually transmitted infections (STIs), pregnancy, and consent can help autistic individuals make informed decisions and lead healthy, fulfilling lives.

Understanding sexual health

Sexual health encompasses physical, emotional, mental, and social wellbeing related to sexuality. It is not merely the absence of disease or dysfunction but involves a positive and respectful approach to sexuality and sexual relationships. For autistic individuals, navigating sexual health can present unique challenges due to differences in communication, sensory processing, and social interactions.

Contraception

Contraception, or birth control, is essential for preventing pregnancy and managing reproductive health. There are various methods available, each with its own benefits and considerations. Autistic individuals need to understand their options and choose a method that best suits their needs and lifestyle, always in consultation with a healthcare professional.

• Barrier methods: Condoms and diaphragms physically block sperm from reaching the egg. Condoms also protect against STIs, making them dual-purpose. It’s important to use them correctly every time sexual activity occurs to ensure effectiveness.
• Hormonal methods: Birth control pills, patches, injections, and implants regulate hormones to prevent ovulation. They are highly effective but need to be taken on a consistent schedule, which might be challenging for some autistic individuals. Reminders or pill organisers can help maintain the routine.
• Intrauterine Devices (IUDs): These are small devices inserted into the uterus to prevent pregnancy and can be hormonal or non-hormonal (copper). IUDs are long-term and low-maintenance but require a medical procedure for insertion and removal. A good option for those who prefer not to worry about daily or monthly contraceptives.
• Emergency contraception: Used after unprotected sex to prevent pregnancy. Options include the morning-after pill and copper IUDs. It should be used as soon as possible after unprotected intercourse to maximise effectiveness.
• Permanent methods: Sterilisation procedures like tubal ligation for women and vasectomy for men are irreversible options intended for individuals who do not want children in the future. These methods should be considered carefully.

Autistic individuals might have specific considerations when choosing contraception. Sensory sensitivities can make certain methods uncomfortable, so it's important to discuss these concerns with a healthcare provider to find a suitable option. Hormonal methods require sticking to a schedule, which can be challenging. Setting reminders and using pill organisers can help maintain consistency. Clear communication with healthcare providers is essential. Bringing a support person to appointments can help with understanding and decision making, ensuring that the chosen method aligns with the individual's needs and lifestyle.

Sexually transmitted infections (STIs)

Sexually transmitted infections (STIs), sometimes called sexually transmitted diseases (STIs), are infections that are spread from one person to another through sexual contact. This includes vaginal, anal, and oral sex. Some common STIs are chlamydia, gonorrhea, syphilis, herpes, and HIV. These infections can cause a range of health problems, so it's important to know how to protect yourself and others.

Autistic people might be more vulnerable to STIs due to various factors, including difficulties with social interactions, which can lead to misunderstandings about consent and boundaries., There might be challenges in accessing or understanding sexual health education. It's important to provide clear, straightforward information and support to help autistic individuals understand and recognise STIs and how to stay safe.

When teaching an autistic person about STIs, it's essential to use clear and simple language. Visual aids, like diagrams or videos, can be very helpful. Break down the information into small, manageable parts and check for understanding frequently. Role-playing scenarios might also be useful for practising safe behaviours and responses in different situations. Be patient and give plenty of opportunities for questions and discussions.

Preventing STIs involves practising safe sexual behaviours. This includes always using condoms during sex to reduce the risk of infection. Regular testing for STIs is also important, especially if you have multiple partners or a new partner. Open and honest communication with your sexual partners about your sexual health and history can help in making informed decisions. Vaccinations, such as the HPV vaccine, can also protect against certain STIs, and you can discuss these options with your healthcare provider. 

Pregnancy

Understanding pregnancy, from conception to childbirth, is essential for those who may want to become parents or need to avoid pregnancy. Autistic individuals should have access to comprehensive information about pregnancy, including prenatal care, childbirth options, and parenting resources.

For autistic women, it's crucial to understand how pregnancy might affect you differently. Sensory sensitivities can make the physical changes and new sensations during pregnancy more challenging. Discussing these potential challenges with your healthcare provider can help you develop strategies to manage them. For example, if certain foods or textures are difficult for you, your provider can help you adjust your diet to ensure you're getting the necessary nutrients in a way that suits your preferences and needs.

On the other hand, if you're looking to avoid pregnancy, understanding your contraceptive options is key. There are various methods available, from barrier methods like condoms to hormonal methods such as birth control pills, patches, or implants. Each method has its benefits and considerations, and choosing one that fits your lifestyle and needs is important. Consulting with a healthcare professional can help you make an informed decision and ensure that you're using the method correctly and consistently.

Clear communication with your healthcare provider is important whether you're planning to become a parent or looking to avoid pregnancy. Bringing a support person to appointments can help ensure you understand the information and make the best decisions for your health. Additionally, understanding your own body and recognising the signs of pregnancy early on can help you take the necessary steps, whether that means beginning prenatal care or seeking out emergency contraception. Read more about women’s health here.

Consent

Understanding and teaching consent is crucial, especially for autistic adults, to ensure healthy and respectful relationships. Consent means agreeing to something willingly and understanding what you are agreeing to. It's a clear, enthusiastic, and ongoing "yes" that can be reversed anytime. Consent isn't just about sex; it applies to any physical touch or personal boundary, like hugging or sharing personal information.

When teaching consent to autistic adults, using clear and simple language is important. Visual aids, role-playing scenarios, and social stories can be very effective. These tools help illustrate what consent looks, sounds, and feels like in different situations. For example, practising how to ask for consent and how to say "no" can build confidence and understanding. It's also essential to explain that everyone has the right to set their own boundaries and to have those boundaries respected by others.

Considerations for autistic adults include recognising sensory sensitivities and communication preferences. Some autistic individuals might find reading social cues difficult or verbalising their feelings challenging. Therefore, incorporating alternative communication methods, such as picture cards or written scripts, can be helpful. Reinforce that consent should always be clearly communicated and checked regularly, as feelings and comfort levels can change.

Encouraging open and honest discussions about consent and boundaries in a safe and supportive environment is important. It helps to create a sense of autonomy and respect. Remind autistic adults that it's okay to say "no" and that their feelings and boundaries are valid. By providing practical strategies and consistent support, we can empower autistic individuals to navigate relationships confidently and respectfully.