Last updated Oct 26 2024 | by Iain Dolan, autistic psychologist

Being autistic can affect sexual intimacy. While many factors unrelated to autism can influence sexual experiences—such as trauma, illness, religious beliefs, or relationship challenges—autistic traits can add unique layers to sex that are worth exploring.

As an autistic psychologist, I have the privilege of engaging in deeply personal conversations with hundreds of autistic adults each year. Discussions about autism’s relation to sexual intimacy and shame arise naturally with many of my clients—if you've had similar experiences, you're not alone.

While I offer some suggestions, this article focuses on a validating and compassionate exploration of autism and sexuality for adults, drawing from clinical expertise, lived experience, and current research. These topics can be sensitive, and understanding them can aid in growth and healing. I invite you to engage with this information at your own comfort level, knowing that awareness itself can be beneficial.

Note: Sex is a sensitive and personal subject, and I’ve done my best to approach it thoughtfully. If anything here feels inaccurate or offensive, please let me know so I can learn from your perspective and consider updating the article accordingly.

Sexual Shame

Shame can make it challenging to discuss sex and can even prevent us from being honest with ourselves about our desires, needs, or boundaries. It’s a common experience, and because shame thrives in secrecy, it’s worth addressing openly.

In this section, I pull from an excellent article on sexual shame in therapy that my friend Emily W (a psychologist) wrote for me on my website for therapist development:

Shame makes us feel like we are inherently “bad.”

Sexual shame can cause us to feel that wanting sex and participating in sexual activities, in all their lovely and unique forms, is “bad.” It’s the internalization of negative appraisals about sexual activities.

Sex is diverse and variable for every person. These factors include, but are not limited to:

• Who it’s with (ourselves, one person, or multiple people)

• How much

• How desire shows up

• What objects/aides are included in sex (toys, lubricant, medication, contraception, etc.)

• Sexual fantasies

• What is pleasurable/not pleasurable

Any and all of these factors can have shame attached to them.

Even with this top-down knowledge, many people still operate with an unconscious bias that sex is something that needs to be hidden. A person might be unknowingly playing politics with themselves to construct a narrative of self in which they present an “acceptable” sexual self (e.g., compulsory heterosexuality, vanilla sex, secret masturbation, hidden pornography use, etc.). These can be manifestations of sexual shame.

Even if your childhood caregivers and broader community were sex-positive, many of us still live in a world dominated by sex-negative ideology and messaging. As a result, people often have internalized and adopted at least one negative opinion related to sex—which can make it much harder to discuss. “Shame loses power when it is spoken” ~Brene Brown.

Autism and Sex

Autistic people can experience a wide range of sexual experience, just like anyone else. Many, but not all, autistic people are interested in and enjoy romantic connection and sexual intimacy at times. Some autistic people may encounter unique challenges or differences in their sexual experiences related to their autism, while others may not. These differences can vary significantly from person to person.

Below, I explore various ways autism can influence sexual experience, though it's important to remember that these aren't universal experiences. Each person's journey is valid and unique. And while I won't focus on it here, it's crucial to note that all sexual experiences should be consensual and feel safe for everyone involved.

Sex-ed and Autism

When we access reliable information about our bodies and experiences, we can deepen self-awareness, which can nurture self-acceptance and diminish shame. As shame fades, we create space for more genuine pleasure and authentic sexual expression.

Sexual education seems like a very simple part of the solution, but societal factors—such as cultural taboos, shame, stigma, and religious beliefs—often interfere with the effectiveness of sex education. This can lead to incomplete or inadequate education, failing to address crucial topics like consent, sexual orientation, gender identity, healthy relationships, and communication skills. High-quality sex education is important to any person’s ability to understand their body and healthy, full sexual experience.

This 2021 research suggested that autistic people were more likely to feel that “their knowledge about sexuality was limited and found it difficult to understand sexual education compared with” non-autistic peers. This study highlighted that while many autistic adolescents and autistic young adults desire romantic and sexual relationships, they can experience some challenges compared to non-autistic peers. Here, autistic individuals reported lower levels of sexual knowledge, experience, and ease in understanding sex education, particularly among male participants in the study. A significant number of autistic girls in the study reported negative sexual experiences, suggesting potential vulnerabilities related to social challenges and the desire for acceptance. Autistic participants were also more likely to identify with greater sexual and gender diversity than their non-autistic peers (see here and here for two related 2020 research papers).

This 2022 study reported similar findings, that autistic people may “receive limited sex education and are more likely than the general population to identify as a sexual minority, making the need for inclusive sex education especially important.”

Better sex education—presented clearly and inclusively—could help address many of the challenges discussed above. When we understand ourselves better, we can make more informed choices about our relationships and intimate lives. This isn't just about knowledge—it's about empowerment and the ability to build healthy, fulfilling relationships.

I highly recommend Emily Nagoski’s related book Come As You Are, on sex, pleasure, and self-acceptance, though it doesn’t have an autism specific focus.

Alexithymia and Sex

Approximately 50% of autistic people experience alexithymia, making it difficult to recognize, express, and communicate about emotions. Alexithymia is linked to interoception—the awareness of internal bodily states (e.g., hunger, temperature, or the need to use the bathroom). As a result, some may struggle to identify emotions, physical sensations, or even sexual arousal, impacting communication of feelings or desires with partners (see research here and here).

Alexithymia can affect sexual experiences, as difficulty sensing emotions and body signals may hinder the ability to identify and communicate about arousal, manage discomfort, or enjoy fulfilling sexual activities. While the impact varies, research highlights a clear link between alexithymia and sexual health challenges.

Beyond sexuality, alexithymia can also hinder emotional intimacy. Since understanding emotions starts within oneself, people with alexithymia may struggle to engage with others’ complex emotions if they find it difficult to recognize or process their own.

In long-term relationships, emotional intimacy is often important, but communicating emotions can be challenging for people with alexithymia. This can leave all partners feeling disconnected or misunderstood. Without recognizing or addressing alexithymia, these challenges can deepen. When combined with the double empathy problem or various autistic communication differences, misunderstandings can accumulate and potentially strain relationships.

People with alexithymia may hear complaints from partners such as:

• You can be so cold, so detached

• You never open up or share how you feel

• I feel like I’m always the one carrying the emotional load

• You don't seem to care about what I feel

• It feels like you’re emotionally unavailable

• When I’m upset, it seems like you don’t even react

• Why do I always have to tell you how I feel for you to notice?

In addition to those broader considerations, specific research has been done on alexithymia and sex, and male and female experiences with it are worth noting. For example, this 2019 study suggested that for women, “greater alexithymia and lesser interoceptive awareness correlated with lesser arousal, lesser lubrication, more orgasm difficulties, more dissatisfaction, more pain, and more sexual distress. Higher female desire correlated with greater interoceptive awareness, but was unrelated to alexithymia. In men, lesser interoceptive awareness correlated with more difficulties delaying ejaculation, and greater alexithymia correlated with more erectile difficulties.”

Those findings seem to correlate with other similar research, and more broadly, this 2013 study found that “higher alexithymia scores were associated…with sexual shyness and sexual nervousness for both genders. Results also suggested that the correlations between alexithymia scores and sexual behavior are partially influenced by the effect of negative emotions. Overall, it seems that the same detachment which denotes the alexithymic interpersonal style also characterizes sexual behavior.”

This 2007 study suggested that “alexithymic features, and in particular, an externally oriented cognitive style, can be seen as possible risk and/or maintenance factors for premature ejaculation.” Further, they found a positive correlation between alexithymia level and premature ejaculation severity. They speculated that people with higher levels of alexithymia may have difficulty managing stress, leading to sustained arousal or emotional dysregulation, which can exacerbate premature ejaculation. See the articles for treatment implications. This 2013 paper found no connection between alexithymia and delayed ejaculation.

It seems clear that alexithymia doesn't just affect emotions but extends to the domain of sexual health as well. Thus, addressing alexithymia may offer a more holistic approach to improving not only emotional, but also sexual health.

Autistic Sensory Differences and Sex

Sensory sensitivities can impact sex, as well as many other aspects of personal relationships. Autistic people commonly experience sensory differences, often having both hypersensitivities and hyposensitivities—and a person can be hypersensitive to things they enjoy deeply or to sensations they find very unpleasant.

Sensory sensitivities are dynamic, meaning they can change based on things like stress levels and burnout. Distress and burnout typically cause a decrease in tolerance for sensory input, while calm or balanced periods may bring relief or an increased tolerance. However, even during generally stable times, unexpected stress can amplify sensitivities. Understanding these fluctuations can help both individuals and their partners navigate intimacy with empathy and patience. A key part of this process is understanding one’s unique sensory profile; you can do screening tests for free or consult an occupational therapist to help identify yours more thoroughly.

The concern here is overstimulation, which can feel very stressful, like panic or intense anxiety. Sexual experience can involve a fairly wide variety of sensory input, of course. Any one of these may be unpleasant depending on a person’s sensory profile.

Some potentially troubling sensory experiences with sex include: unexpected touch, light touch, firm or deep pressure, and kissing—where certain areas of the body may feel comfortable, while others do not. The sensation of wetness, oiliness, or slipperiness (e.g., from lubricant or bodily fluids) can also be uncomfortable. Other challenges may include heat, textures of bed sheets or surfaces, distinct body odours or tastes, certain sounds made by a partner, and so on. Additionally, some sexual experiences could involve intense eye contact (or a partner may expect or request it), which can be very uncomfortable for some autistic people.

Over-stimulation can also be present prior to a sexual encounter, which may lead to a rejection of intimacy—either gently or abruptly depending on how well the person is able to regulate in that moment. A person may initiate a sexual encounter happily but become overstimulated during the experience. They may choose to stop, or provide feedback, or try to “push through,”—a deeply distressing approach that is not recommended. Suppressing needs is tragically common for autistic people, often due to reasons like people-pleasing, uncertainty about how to communicate, fear of criticism, or feeling their request is unreasonable. In sexual situations, shame and difficulty communicating about sex can make these kinds of moments even more challenging.

For example, after a long, exhausting day, I might crave solitude and silence to unwind, only to feel increasingly irritated by the noise of a neighbour’s yard maintenance. When my partner walks by and touches my shoulder unexpectedly, I might reflexively flinch and say, “Don’t touch me right now.”

Partners can easily misinterpret these moments as personal rejection. Now extend my hypothetical example: after months of burnout with low energy and little interest in sex, I’ve been seeking more solitude, often declining bids for intimacy, and, on top of that, flinch when touched. Even if I explain that it’s not about my partner or our relationship, it would be understandable if they still felt worried, hurt, or rejected at times.

Understanding sensory sensitivities can help partners avoid misinterpreting reactions as personal rejection. Open communication about sensory needs is crucial and can foster trust, allowing for more comfortable, meaningful intimacy, even when sensitivities fluctuate. Patience and empathy are key to navigating these moments together.

Balancing Connection and Solitude in Intimate Relationships

The more we understand someone, the more we can empathize with them.

Balancing connection and solitude is essential for many autistic people to maintain well-being in relationships. Deep connection can be beautiful, but love alone isn’t enough to overcome unskilled communication, or to meet needs like solitude, or to overcome sensory sensitivities and burnout. A healthy relationship involves understanding and accommodating each partner’s needs and communication styles—without guilt or shame about differences that can’t be changed (the ND love languages can help, 1, 2). Feeling like a bad partner for not making autistic differences disappear may stem from shame or internalized ableism.

Cognitive, sensory, and social overstimulation are key reasons autistic people often need solitude, getting frequent breaks from excessive input and processing. While comfort can be found in routines and predictability with others, sometimes solitude provides the most reliable sense of consistency. It also offers a break from masking behaviours, though many autistic people still find unmasking challenging, even with supportive partners. Suppressing your needs or masking to be liked is exhausting and unsustainable—it’s essential to find partners who accept you as you are. There are also positive reasons we may seek solitude, such as to engage with the interests we’re passionate about, which are often positive and restorative experiences.

By regulating overstimulation and emotional energy, solitude makes connection more sustainable. Communicating our needs respectfully can reduce misunderstandings and allow for greater empathy in relationships.

Taking space when needed isn’t selfish nor does it imply rejection of a relationship. It’s normal to need varying amounts of solitude, and the right balance varies across relationships and can change day to day. Each of us has the right to define what a fulfilling relationship and meaningful connection look like.

Each of us is responsible for communicating our needs assertively—kindly, clearly, and directly—and helping partners understand why these needs matter, as understanding fosters empathy. Clear communication starts with internal work to recognize how we feel and what we need. Tools like therapy, journaling, meditation, or discussing with a trusted friend can support this process.

It’s important to communicate the need for solitude without dismissing a partner’s bid for connection (e.g., “I care about you, and I need some quiet time right now. My day was draining, and I’ll be ready to connect in a few hours”). In long-term relationships, establishing routines and more clearly stating expectations can help. For example, a past partner and I lived together for ten years, and we both worked in healthcare. Since we often came home feeling drained, we developed a routine: whoever arrived home was greeted warmly and offered support if needed, but it was understood they would take some solitude—deciding for themselves how long they needed before reconnecting, whether five minutes or an hour. This approach ensured both rest and meaningful connection on our own terms. This reminds me of the HALT acronym: when we’re Hungry, Angry, Lonely, or Tired, we may be best served by taking a break to regulate before responding to situations.

Maintaining intimacy while respecting the need for solitude requires empathy, patience, and open communication. Taking space isn’t a rejection but a way to recharge, to make future connection more sustainable, and to respect a partner’s needs. By understanding and accommodating each other’s needs, partners can deepen trust and create a relationship where everyone feels valued and supported, just as they are.

Social Masking and Intimacy

Masking—adapting or suppressing autistic traits to conform to social expectations—can appear in any social situation, including romantic relationships and sex. Sex can feel performative for some people, often due to societal or gender-based expectations. Masking during intimate moments can make sex especially disconnecting, exhausting, and unsatisfying. Early socialization often shapes these behaviours and can be linked to shame, as discussed above.

Ideally, intimacy should feel safe, with space to communicate openly and experience pleasure authentically—free from performative expectations. Building safety and trust during sexual experiences also depends on creating these qualities outside of sex, through healthy communication and emotional connection. Doing the internal work of understanding and accepting yourself can better equip you to share your authentic self with trusted partners, if and when you choose to do so. I don’t mean to suggest that sex should only occur within long-term relationships; even in brief encounters, everyone should ideally feel safe, with their needs respected and heard.

Communication about Sex

For autistic people, differences in affect as well as interpretation of social cues have the potential to complicate any social interaction. The more complex the situation, the more likely we might be to miss a cue or approach a moment quite differently than how a partner is expecting. A rough order of ascending conversational complexity might be:

• Discussing a strong shared interest with a friend

• Structured conversation or activities (e.g., a work meeting, or playing board games with friends)

• Small talk

• Communicating feelings about unexpected changes in plans or routines

• Navigating humour with newer people

• Setting or enforcing personal boundaries

• Disclosing something vulnerable to a friend

• Repairing misunderstandings or resolving conflicts

• Navigating flirtation (this may vary in difficulty for different people)

• Navigating early romantic encounters with someone you really like

• Discussing sex before, during, and after (more challenging if sexual shame is present)

The list’s order will vary for each person. Regardless, without masking, autistic people can learn to express their interests, wants, needs, consent, and feelings in romantic and sexual experiences—and be curious about those of partners. Misunderstandings or missed cues can be common but should be explored with compassion, not shame.

Some people find text-based communication (e.g., messaging apps, emails) effective for expressing complex thoughts about intimacy. This is a valid and normal approach for building trust, clarity, and comfort. However, since a lot of intimacy often happens in person, it can also be important to develop comfort communicating in person with partners as well. If you use text-based methods, consider letting the other person know you’re open to discussing the topic further in person or over the phone when they’re ready. In some cases, you might write a note and read it together in the same room. The goal is to communicate thoughtfully, not avoid connection. Text-based communication can also support autistic people when they are non-verbal, with tools like communication cards providing helpful alternatives.

Of course, there are many related topics I could cover here—like consent, boundaries, and emotional expression—but my focus is on how being autistic specifically affects communication around sex. Alexithymia is worth consideration here; see that section earlier in this article.

Effective communication about sex can be challenging, but autistic individuals can build comfort by using strategies that work best for them, like text-based methods, structured conversations, or therapy. The key is to approach these conversations with curiosity and compassion—for yourself and your partner. Over time, developing both written and in-person communication skills can help create more meaningful, satisfying connections.

Autistic Burnout and Sex

Autistic burnout is similar to “regular” burnout: chronic physical, mental, and emotional exhaustion, often triggered by sensory, social, or cognitive overload. It develops gradually over weeks or months, and recovery often takes just as long. Burnout can build up gradually enough that many autistic people acclimate to it so it feels “normal,” with some people experiencing low to moderate burnout for years without realizing it. Periodic burnout screening can increase awareness.

Autistic people are more vulnerable to burnout due to having additional factors that contribute to us feeling overloaded, such as sensory sensitivities, social masking, suppressing stimming, and a strong need for solitude, routine, or sameness—causing distress when these needs are unmet. Emotional regulation difficulties, such as irritability or shutting down, add to the overload. Due to these same vulnerabilities, recovery can be harder—especially if a person is autistic but doesn’t know it. When an autistic person is burned out, these same traits often intensify (e.g., more easily overstimulated, stimming more, needing more solitude, becoming more intent on routine or sameness, etc.).

Burnout reduces energy, emotional availability, distress tolerance, and concentration—factors that can naturally diminish interest in sex. This 2020 study found that “personal burnout was observed to be associated with sexual dysfunction in men whereas job stress correlated with female sexual problems.”

Burnout may lead to regularly declining bids for intimacy, leaving partners feeling disconnected or rejected. The burnout itself can make it harder to communicate about our difficulties, emotional experience, wants, and needs—precisely when clear communication is most needed.

Burnout is an awful and tragically common experience for many autistic people. It can disrupt anyone’s sex life, but autistic people are especially vulnerable to burnout, making it crucial to monitor and manage. Recovery requires rest, patience, support, and long-term lifestyle changes to prevent relapse. This may involve taking breaks from work, school, or other obligations. Balancing responsibilities with rest and self-care is crucial. Supportive, respectful relationships can make burnout more manageable, and prioritizing sustainable routines helps prevent future burnout.

Conclusion

Understanding the intersection of autism and sexual intimacy is crucial for fostering more inclusive, compassionate conversations about sexuality. Autism can affect sexual experiences—through sensory differences, alexithymia, or communication styles—but these differences don't diminish anyone's right to explore and enjoy healthy, consensual sexual relationships. By acknowledging these experiences openly, we can help reduce shame, improve education, and create more supportive environments for autistic individuals to navigate their sexual lives authentically.

This article aims to offer both validation and education, highlighting that your needs matter just as much as anyone else’s. Intimacy should feel safe, respectful, and, ideally, pleasurable—on your terms. By fostering empathy, patience, and clear communication, autistic people and their partners can create supportive relationships where everyone feels valued and accepted as they are. If you’d like to, I encourage you to explore your sexuality (in safe ways, both alone and with others). Be curious, be open, and let yourself be surprised by what you find pleasurable.

In future, I may add sections on:

• executive functioning differences and how those may impact initiating or planning intimate encounters, managing hygiene, contraception

• intersectionality: gender, sexual orientation, and neurodivergence

• how special interests can interact with sexuality

• increased need for processing time during or after sexual experiences

• spontaneity versus planned experiences (and preference for sameness)

• a closer look at high rates of sexual trauma among autistic people, and so on.

Suggested Reading:

• Emily Nagoski’s book Come As You Are

• How Does Autism Affect Sex and Intimacy?

• Autism and Intimacy: Navigating Relationships on the Spectrum