Relationships and Sexual Health for adults with autism
Autism-specific research on Sexual Health and Relationships is limited but the evidence available to date indicates that adults with ASD are more likely to be unmarried and isolated, and experience difficulties with social relationships, mental health issues and a poor quality of life. Only 15% of people with ASD report having had a sexual or romantic relationship and only 25% have at least one close friend (Howlin and Moss 2012).
Scotland-wide research on people with learning disabilities, which includes some adults with ASD, produced similar findings. Three quarters of people interviewed were not in relationships and reported significant barriers to achieving this (Scottish Government 2000, SCLD 2006).
Scotland’s Learning Disability Strategy, ‘The Keys To Life’ highlights Sexual Health and Relationships as a key area for improvement;
‘’Having meaningful relationships is a priority for people with learning disabilities. They may be more prone to abuse and are more likely to be denied the opportunity to conduct their own lives as any adult would take for granted, including the ability to form and conduct relationships. But having the chance to make and sustain friendships and relationships is something that improves their wellbeing and quality of life. Many people with learning disabilities want that chance to have a romantic, sexual and long-term relationship.’’
Most of us perceive Relationships, Love and Intimacy as an important and fundamental part of our own life. Yet we often accept or expect that someone with autism -or any other additional support need- would not need to experience relationships and intimacy.
Whilst it should be acknowledged that some young people and adults with ASD may choose not to have a relationship, we need to create opportunities for those who do. We should also remember that a person may not want a relationship now, but may do so in the future. Young people and adults should also know that they can define their relationship as they wish. Sex will be a choice for some couples, others may not be able to consent, or may simply choose to have a less physically intimate relationship.
Parents, carers and professionals have an important role to play in bringing about change and breaking down barriers. Under the National Care standard 16, carers and services have a duty of care with regards to Relationships ; “Staff recognise that your sexuality and sexual needs and preferences are important to you. They accept and support your right to have intimate relationships that you have consented to in the privacy of your home and if it is legal to do so.”
Here are some useful tips on putting Sexual Health and Relationships on the agenda for the people you care for;
• Even if the person has had Relationships & Sexual Health Education at school, they will need to recap (or completely re-learn) this information as adults. You can borrow resources (books, DVD’s etc) from your NHS Resource library. LINK
• Teachers can access a range of resources to provide a structure curriculum for teaching human sexuality and relationships to young adults and adolescents with high-functioning ASD. See Intimate Relationships and Sexual Health: A curriculum for Teaching Adolescents/Adults with High-Functioning Autism Spectrum Disorders and Other Social Challenges from Catherine Davies and Melissa Dubie, 2012. A valuable resource is Sexuality and Relationship Education for Children and Adolescents With Autism Spectrum Disorders.
• Talk about their knowledge and understanding and allow them to ask questions. People who have received no Sexual Health & Relationships Education are more likely to rely on Pornography for their information, which creates an unrealistic view of Sex, Relationships, Boyfriends and Girlfriends.
• Forth Valley has a number of Social Groups. It is important for people with ASD to experience Friendship and learn social skills before they move in to a Relationship:
o Match4Me is a dating service run by ENABLE in Forth Valley that helps people with a learning disability to find a partner. It also helps to prepare people for Relationships by offering Educational sessions in dating skills including; holding a conversation, boundaries, appropriate behaviour, the Law and consent, real life v fantasy (dangers of pornography), choosing a suitable partner, respect and responsibility, abuse, intimacy and sex, contraception and where to get help. The directory of services can be accessed here.
o Central Sexual Health (NHS Forth Valley) have clinics for adults and young people and provide advice on relationships, contraception and condoms, testing for sexually transmitted infections, treatment for sexual problems (e.g erectile dysfunction) and psychosexual and/or couple counselling. Link
o There are LGBT social and support groups for young people and adults who may be Lesbian, Gay, Bisexual or Transgender. Link
o You can contact your Adult Learning Disability Team who can help assess a persons understanding of Relationships and Capacity to Consent Link
References
Curtice, L (2006). How is it Going? A Survey of what Matters Most to People with Learning Disabilities in Scotland Today, Scotland: Scottish Consortium for Learning Disability and ENABLE Scotland, available here
Howlin, P and Moss, P. (2012) Adults with Autism Spectrum Disorders. The Canadian Journal of Psychiatry 57, 5 , 275-283 quoted in Hartman, D (2014) Sexuality and Relationship Education for Children and Adolescents with Autism Spectrum Disorders, Jessica Kingsley Publishers, London
The Scottish Government (2000) The Same As You? A review of services for people with learning disabilities
The Scottish Government (2000) The Keys To Life. Improving quality of life for people with learning disabilities