Autism and sexual assistance: A qualitative study of experiences from sexual assistants and autistic adults

Background:
Most autistic adults report partnered sexual experiences, but some experience challenges in navigating sexuality and intimate relationships. Sexual assistance (SA) aims to support individuals living with disabilities in their sexuality. This phenomenological interview study explored (1) reasons why autistic adults apply for SA and (2) helping and hindering aspects to explore and enjoy sexuality in the interactions between autistic adults and sexual assistants.
Methods:
We conducted semi-structured interviews with autistic adults (n = 4) and sexual assistants (n = 14) who collaborated with Aditi vzw, a Belgian organization for SA. We analyzed all interviews according to the Qualitative Analysis Guide of Leuven.

Results:
The main reasons for requesting SA were a desire for safe intimate and sexual relations, to gain sexual experience, and to develop as a sexual being, combined with a lack of opportunities or previous negative experiences. In the accounts on the interaction between the autistic adults and sexual assistants (1) building safe and supportive interactions, (2) exploring sexual scripts, and (3) attuning to information processing needs were the main themes. The organizational framework around SA and collaboration with families and professionals appeared in the interviews as pivotal preconditions.

Conclusions:
SA addresses barriers to experience intimacy and partnered sexuality for a group of autistic adults who otherwise might be deprived of positive intimate and sexual experiences and facilitates experiential learning. However, legal, ethical, and moral issues exist and also appeared in the interviews that need to be considered. Also, SA should be embedded in a larger set of interventions to guarantee the sexual rights and sexual citizenship of autistic people who experience barriers to partnered sexuality.