Sexuality in people with autism spectrum disorder and its importance for forensic psychiatry and psychotherapy

Abstract

Individuals with autism spectrum disorder (ASD) show the whole range of sexual fantasies and sexual behavior just like their non-affected counterparts. Nevertheless, individuals with ASD show some peculiarities concerning sexual experiences and sexual behavior that can mainly be traced back to the disorder-inherent symptoms. Among these peculiarities are an increased diversity concerning their own sexual orientation and their understanding of gender roles as well as problems concerning the initiation of romantic or sexual partnerships or problems with sexual functioning. Furthermore, some individuals with ASD (especially men) show signs of hypersexual and/or paraphilic fantasies and behavior. So far, there exist no empirical results that would suggest that ASD is a specific risk factor for general or sexual offending; however, based on case studies some authors outlined in how far the disorder-inherent symptoms could have contributed to offending behavior in special cases, which could also be taken into account when assessing criminal responsibility. These include reduced victim empathy, cognitive distortions or deficits in communication or social interaction abilities. Specialized psychotherapeutic and pharmacotherapeutic interventions should be provided for individuals with ASD in order to prevent criminal recidivism.