Sex education and sexual health for autistic children

Talking about sex education with autistic children can feel overwhelming, but with the right approach and resources, parents can successfully share important information about puberty, sex, sexuality, and relationships.

Below we explore some of the topics of conversation along with practical advice on how to help manage them. 

Starting the conversation

Begin talking about these subjects early. Since autistic children often require more time to process new information, starting discussions about puberty and sex before these changes begin can help them feel more prepared. Check what your child’s school teaches and when, as this can guide your conversations at home to ensure consistency and clarity.

Adjusting school lessons to home

Schools generally cover sex education at a particular age, but sometimes the pacing may not suit your child’s learning needs. If the lessons move too quickly or assume knowledge your child doesn't have, consider supplementing school learning with discussions at home. This ensures your child gets all the information they need at a pace they can manage.

Consistent, clear communication

Remember to maintain open and clear communication. Encourage your child to ask questions and express their feelings about the topics discussed. Ensure that they understand it's normal to be curious and that you're there to help guide them through any confusion or curiosity they might have about puberty, sex, or relationships.

Understanding sexual health for autistic children and teens

Sexual health is a broad topic that covers everything from personal hygiene to understanding and managing relationships and sexuality. For autistic teenagers who might process information differently or need concrete explanations, it's important to provide clear, straightforward information to help them understand their bodies, engage in safe practices, and navigate their emotional and physical well-being. Let’s explore some of the common sexual health issues 

Private versus public places

An important topic to cover is the difference between private and public spaces and behaviours. Start by identifying what spaces in your home are considered private. Clearly explain that areas like their bedroom or bathroom are private spaces when the door is closed. Activities such as changing clothes or masturbation should only take place in these private areas when they are alone. It’s also important to ensure they understand that these activities should not occur at school, at a friend’s house, or in public places like shopping centres—only at home, where it’s safe and appropriate.

Setting rules for privacy is also important. Establish simple rules like knocking on doors before entering a room to help everyone in the household respect each other’s privacy. Make sure this rule is communicated to everyone who visits your home so that your child understands it’s a common practice.

Discuss who they can talk to about personal or sensitive issues. It’s important for them to know that there are safe people they can trust, such as parents, siblings, a GP, or a school counsellor, with whom they can discuss these topics.

Masturbation

Masturbation is a normal part of growing up and helps individuals understand their bodies.

Start by explaining to your child what masturbation is, why it happens, and what changes they might notice in their body as they grow. It’s important to use clear and simple language so they can understand these concepts.

Emphasise the importance of privacy. Explain to your autistic teen that masturbation, like going to the bathroom, is a private activity. It should only be done in a private place, such as their bedroom or bathroom, with the door locked. To reinforce this, you can use visual cues like simple signs that say "Private" on the bedroom or bathroom doors. These signs can serve as helpful reminders about where private activities should occur.

Menstruation

Menstruation can be a source of anxiety but can be managed with simple and practical advice:

  • Explain: Tell your daughter what menstruation is, why it happens and what changes they can expect to their body. 
  • Product use: Show your daughter how to use sanitary products. Keep explanations simple and the steps clear. Consider sensory sensitivities and store things in accessible places. 
  • Tracking: Use a calendar or a digital app to help track the menstrual cycle, making the process predictable and less overwhelming.
  • Routine hygiene: Establish a simple hygiene routine for menstruation, like changing products regularly and washing hands before and after.
Encouraging a realistic body image

Help autistic teens develop a healthy perception of their bodies by focusing on functionality and normalising diversity:

  • Diverse representations: Use materials that show a wide range of body types and discuss how bodies can differ greatly, stressing that all variations are normal.
  • Media: Teach them how media images can be altered, helping them understand that these are not realistic standards to compare themselves to.
Hygiene and personal care

As children enter puberty, their hygiene requirements change and parents need to help them prepare and adapt.

  • Structured hygiene routine: Establish new hygiene practices into their daily routines, such as showering daily or using deodorant. Visual schedules can help reinforce these new habits.
  • Clear explanations: Provide clear reasons for each aspect of hygiene, like why we use deodorant (to prevent body odour) and the importance of washing hands (to stop the spread of germs).
  • Break things down: Start with basic tasks and gradually introduce more steps as they become comfortable with their routine.

Sexual feelings and identity

Sexuality encompasses more than just the act of sex. It involves how one feels about their developing body, their feelings of intimacy, attraction, and affection towards others, and their ability to develop and maintain respectful, intimate relationships. For autistic teenagers, just like their non-autistic peers, sexual development is a crucial aspect of their overall health and maturation. However, they might require additional support to navigate the social complexities associated with these developments.

Autistic teenagers experience sexual development similarly to other teenagers but may show varying levels of interest in sex and sexuality. This spectrum of interest is typical and is seen across all teenagers, irrespective of neurotypical or autistic status. They might develop romantic relationships that could be either sexual or non-sexual in nature.

It is important to recognise and respect their sexual orientation and gender identity, which may include heterosexual, homosexual, bisexual, or asexual orientations. Understanding and accepting these aspects of their identity are beneficial not only for their personal development but also for strengthening the parent-child relationship.

Expressing sexual feelings

Some autistic teenagers may find it challenging to understand and manage their sexual feelings. This can be supported by breaking down these feelings into small,  understandable components such as thoughts, physical sensations, and behaviours. For instance, if an autistic teen is attracted to someone, they might frequently think about that person, experience physical sensations like butterflies in the stomach, or try to spend more time around them.

Using tools like social stories or visual supports can help communicate these feelings effectively. Additionally, it's important to guide autistic teenagers in expressing their feelings appropriately to avoid misunderstandings or inappropriate behaviours that could lead to risky situations or unhealthy relationships.

Social interactions and consent

Practising social interactions can be a helpful way for autistic teenagers to navigate the complexities of dating and relationships. Role-playing scenarios such as initiating a conversation, asking someone out, or responding to acceptance or rejection can be immensely helpful. Setting clear rules about respectful dating practices, such as how often to ask someone out and respecting their response, is crucial.

Understanding and respecting sexual consent is vital for guiding autistic teenagers. It's important to explain cues that might indicate a person’s interest in advancing physically and to ensure mutual consent before progressing. This approach can help in developing healthy, respectful, and safe relationships.

Addressing sensory sensitivities

Some autistic teenagers may experience sensory sensitivities that make them uncomfortable with physical intimacy, such as hugging or kissing. It is crucial for them to understand that they should only engage in physical affection if they feel comfortable doing so, and they should not feel pressured to conform to societal expectations of intimacy.

Safety and appropriate behaviour online and offline

It is important to ensure safety in both physical and digital environments. Parents can use resources like social stories to teach their children how to recognise and handle situations where someone might behave inappropriately towards them and how to seek help. Online safety is equally important. You can find resources and advice on how to stay safe online. 

Seeking professional help

Accessing professional support from psychologists, counsellors, or specialists in sexuality (sexologists) can provide tailored guidance through the nuances of gender identity and sexuality. Organisations like Planet Puberty and SECCA have excellent resources and professionals who can provide this support.