An Empirical Qualitative Investigation into Psychosexual Development in and Sex Education for Autistic Youth: Insights from Autistic and Non-Autistic Young Adults

The present study was designed to examine autistic and non-autistic young adults' lived experience in psychosexual development and sex education and to solicit recommendations on how to improve sex education programs. Participants included 10 autistic young adults and 10 non-autistic young adults aged 18 to 24 years. The two groups were matched for sex and education level. One-on-one semi-structured interviews were conducted. Participants' responses were analyzed using comparative interpretative phenomenological analysis. Four superordinate themes emerged: (1) "Who am I as a sexual being"; (2) Making sense of psychosexual development; (3) Sources of information; and (4) "Dear developers of sex education programs". Most autistic participants shared feelings of intense anxiety about romantic and sexual relationships, in part due to anticipated difficulties in social communication. Interestingly, although interview questions mostly focused on sex and adolescence, issues surrounding romantic relationships and their links to current self-concept were prominent themes in many autistic participants' responses, suggesting that autism-friendly sex education programs need to address issues related to romance and should target not only adolescents but also young adults. Also, autistic participants learned from peer interactions within the autistic community, highlighting the importance of facilitating peer exchanges and continuous learning beyond completing a program. Regarding delivery format, autistic participants valued concreteness and a mixed-sex small-group setting, and recommended using visual cues, real life examples, and role play. Autistic individuals have unmet psychosexual educational needs. Further research may consider their needs, lived experience, and recommendations when developing new autism-friendly sex education programs.