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Sexualité Un Guide Pour Les Personnes Autistes

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Sexualité: Un Guide Pour Les Personnes Autistes

Sexual Health for Autistic Individuals

Understanding Your Body and Anatomy

Autistic people often benefit from explicit, concrete information about sexual anatomy and physiological processes. Understanding your body helps with body awareness and sensory processing considerations during sexual activities.

Genital Anatomy and Variation

For people with male anatomy, external structures include the penis, scrotum, pubis, urinary opening, and glans. Internal organs include testicles, prostate, vas deferens, and urethra. For people with female anatomy, external structures include the clitoris, labia majora and minora, urinary opening, hymen, and anus. Internal organs include ovaries, fallopian tubes, uterus, cervix, and vagina.

Important for autistic individuals: Genital anatomy varies significantly between individuals, and this variation is completely normal. Understanding these variations reduces anxiety about whether your body is “normal.”

Physiological Processes

Erections occur spontaneously or when sexually stimulated. Ejaculation releases semen containing sperm through the urethral opening. Nocturnal emissions (“wet dreams”) are normal during puberty. For people with vulvas, vaginal lubrication (cyprine) increases during sexual arousal.

Sensory considerations: People with heightened sensitivity to touch, smell, or texture should select hygiene products and sexual practices accordingly. Those with reduced sensation require careful attention to avoid injury during masturbation or penetration.

Puberty, Menstruation, and Body Changes

Puberty occurs gradually between ages 9-16, progressing differently for each person. Physical changes include voice changes, skin darkening of genitals, breast development, growth spurts, muscle development, shoulder widening, penis and testicle enlargement, increased sweating and body odor, acne, oilier hair, and body hair growth on face, chest, armpits, legs, and pubic area. Psychological changes include mood swings, shifting interests, desire for independence, and family conflicts.

Menstrual Cycle Management

The typical menstrual cycle lasts 21-35 days with bleeding lasting 2-7 days. During each cycle, an ovule releases from the ovary; if no fertilization occurs, the uterine lining sheds as menstrual blood. Premenstrual syndrome (PMS) may include bloating, acne, breast tenderness, mood swings, and anxiety appearing days before menstruation.

Menstrual products include:

Critical for autistic individuals: Product selection should prioritize sensory comfort. Some autistic people cannot tolerate scented pads or adhesive materials; alternatives should be explored without judgment.

Hygiene, Body Odor Management, and Sensory Considerations

showering is essential. For genital hygiene: males should gently wash the penis, testicles, and glans (retracting foreskin if uncircumcised); females should gently wash all folds of labia majora and minora using only water or non-perfumed cleanser, rinsing and patting dry from front to back to prevent bacterial transfer.

Hair removal (shaving, waxing, electrolysis, laser) is entirely personal choice with advantages and disadvantages for each method. Critically, the guide emphasizes that body hair removal is never obligatory and that acceptance of natural body hair is valid.

Sexual Orientation, Gender Identity, and the Autism-Specific Framework

Sexual Orientation Patterns

Sexual orientation refers to romantic and sexual attraction patterns. The guide presents multiple orientations as equally valid:

The guide emphasizes that all orientations are valid and may fluctuate over time; individuals need not identify with specific labels.

Gender Identity Considerations

Gender identity (how you feel internally about your gender) differs fundamentally from biological sex assigned at birth. The guide defines:

  • cisgender (identifying with assigned sex)
  • transgender (identifying with opposite sex)
  • Non-binary (not identifying with one gender)
  • Queer (refusing binary categories)
  • intersex (born with characteristics of both sexes)

CRITICAL FOR AUTISTIC INDIVIDUALS: The guide explicitly warns that autistic individuals exploring gender identity require specialized evaluation by both gender identity specialists AND autism specialists. This is a non-negotiable safeguard. Autistic identity development follows a different trajectory and timeline than neurotypical development. Incomplete identity development—normal and expected in autism—can be mistakenly interpreted as gender dysphoria requiring medical intervention.

Understanding Private Vs Public Distinctions

Because executive function and social reciprocity challenges are common in Autism, the guide provides concrete teaching about which topics are appropriate in which contexts and with whom.

Private places include your bedroom, bathroom, and home/apartment. Public places include school, library, store, park, bus, restaurant, cinema, and gym changing rooms.

Private behaviors include undressing, touching genitals, masturbating, toileting, and extended kissing (30+ seconds). Public behaviors include walking, sitting, moderate conversation, reading, eating, hand-holding, and brief kiss (5-10 seconds) or hugging.

Private discussion topics include sexuality, personal problems, autism diagnosis, and medical conversations. Public discussion topics include weather, news, sports, art, music, games, school subjects, animals, and TV.

Relationships: from Attraction to Partnership

The Intimacy Staircase

The guide introduces an intimacy staircase describing relationship escalation:

  1. Stranger - No contact, brief greeting, smile
  2. Acquaintance - Greeting, discuss interests/general topics
  3. Friend - Share weekend plans, invite to activities, write texts/emails, invite to home
  4. Best friend - Share secrets, know their secrets, frequent activities together, long-standing relationship, common interests
  5. Partner - Share secrets, frequent activities, physical and/or sexual attraction, emotional/physical intimacy, romantic love (reciprocal)

The key principle: both people must be on the same step.

Recognizing Attraction

Physical attraction involves identifying signals: racing heartbeat, throat tightness, stomach fluttering, difficulty breathing normally, eye brightness, frequent smiling when thinking of the person. Emotional attraction includes feeling very joyful/happy, thinking often about them, wanting to see them, experiencing embarrassment/nervousness/excitement in their presence, admiring what they say/do, noticing many details.

The guide acknowledges that autistic individuals may experience attraction differently or less obviously than neurotypical people. Not all people experience all signs; this list helps identify your own feelings rather than prescribing a standard experience.

Partner Selection Criteria

Partner selection criteria span multiple dimensions:

  • Physical appearance (height, weight, eye color, hair, skin tone, body type, tattoos, piercings, style)
  • Interests (music, technology, sports, art, gaming, travel, cinema, cooking)
  • Personality traits (generosity, kindness, humor, ambition, environmental consciousness)
  • Culture (religion, language, country of origin)
  • Life conditions (autism status, living situation, occupation, children, habits, relationship type—virtual/in-person/long-distance)

The guide recommends treating criteria as wishes, not requirements, through an exercise called “My Top 3, 5, or 10” to help identify what matters most.

Reciprocity in Relationships

Reciprocity is fundamental to health and satisfaction. For relationships to function, both partners should:

  • Give roughly equal affection (caresses, “I love you”)
  • Express needs/tastes/desires
  • Make efforts to be attentive (phone, surprises, gifts, organize activities)
  • Ask what the other wants and help
  • Ensure during sexual relations that the other is comfortable and enjoying

When reciprocity lacks: communicate clearly about your needs; ask what they need; discuss improvements together. If the relationship demands too much effort or if one/both no longer feel good or desire each other, consider couple’s counseling or ending the relationship.

Sexual Orientation Disclosure and Coming Out

Coming out (disclosing your sexual orientation or gender identity) is entirely your choice regarding timing, audience, and method. Possible reactions include joy, relief, surprise, confusion, disappointment, shock, anger, or rejection. You have the right to take time processing others’ responses.

Disclosing an Autism Diagnosis

Autism diagnosis disclosure within romantic relationships requires strategic consideration. Rather than simply stating “I’m autistic,” describe your specific characteristics first, as people have varied autism references.

Examples to explain autism’s impact:

  • “I have difficulty with last-minute changes. If you suggest activities days in advance or give me time to research, I’m more likely to say yes.”
  • “In noisy environments, I struggle to focus on conversation. Choosing quiet places helps me concentrate on our discussions.”
  • “I don’t always understand expressions, jokes, or double meanings. If you explain, I usually appreciate the message.”

Relationship Types, Exclusivity, and Communication

Relationships vary based on physical sexuality and emotional intimacy:

  • Physical only (casual sex) - Sexual communication and respect, primarily sexual exchanges (one-night stands)
  • Emotional only (platonic) - Affectionate with tenderness (words, looks, gestures), no sexual relations
  • Physical and emotional - Attention, tenderness, and sexual relations (couples)

Exclusivity Considerations

Exclusivity requires mutual agreement. Traditional monogamy involves one partner per person with fidelity. Non-exclusive relationships (polyamory) allow emotional/sexual investment with multiple people simultaneously. Critical: If one person is forced to adopt the other’s preference against their values or desires, it’s unacceptable and causes suffering.

Signs of Being in Love

Signs of being in love include both physical and emotional indicators. Physical signs include heart beating faster seeing/thinking of them, throat feeling tight, stomach fluttering, eyes seeming brighter, smiling more often, difficulty breathing normally. Emotional signs include feeling very joyful/happy, thinking often about them, wanting to see them, feeling embarrassment/nervousness/excitement in their presence, admiring what they say/do, noticing many details.

Communication for Satisfying Relationships

Effective communication includes:

Conflict Resolution and Relationship Maintenance

Conflicts and disagreements are normal in relationships. When they occur:

  1. Calm down first through activities you enjoy
  2. Discuss calmly to understand causes (not find blame)—acknowledge hurt feelings and apologize if you’ve caused pain
  3. Identify the problem (misperception, misunderstanding, poor communication, unintentional disrespect)
  4. Find solutions (modify your behavior if it hurt them; discuss different opinions; establish a “safe word” to pause sensitive topics before escalating)
  5. Get help if resolving alone is impossible (talk to trusted friends, consult couple’s specialists)

Important: Conflicts are private—avoid discussing with many people or non-intimate acquaintances. Timing matters: Some prefer resolving immediately; others need to calm first.

Breakup, Heartbreak, and Grief

Signs You’re Not Comfortable in a Relationship

Signs of relationship discomfort include: Don’t want to see them, prefer other activities, things about them bother you, frequent arguing, lost physical attraction, interested in someone else, different interests, frequent disputes.

Ending a Relationship

Ending a relationship: Request a private meeting; explain you’re not comfortable and want to end it.

Possible reactions: Agreement, sadness (tears, questions), anger (may not listen to reasons—leave if necessary and cut contact), refusal (discuss when calmer; if certain, leave and block contact).

Heartbreak and Grief Stages

Heartbreak emotions follow predictable stages:

  1. Denial - “This can’t be happening”—only seeing good parts
  2. Anger - Frustration, incomprehension, abandonment feeling, injustice
  3. Guilt - “I’ll do anything to get back together”—regret, self-blame
  4. Sadness - Crying, realization they’re gone, loss of motivation, sleep/appetite changes, isolation
  5. Acceptance - Think less often, less pain, regained confidence, feeling better

Duration varies: Days to weeks to months or years. Coping strategies:

  • Don’t isolate—see friends, do activities for distraction
  • Express emotions or write about feelings
  • Confide in trusted people
  • Live your emotions (cry when needed)
  • Do enjoyable activities and treat yourself
  • Seek advice from experienced people
  • Consult professionals (social worker, educator, psychologist, sexologist) or call Info-Social (811)

Sexual Health and Medical Care

Annual Exams and Medical Appointments

Annual exams are required for everyone—doctor checks overall health. Bring a trusted person if desired. If uncomfortable, request a male or female doctor if possible. Tell the doctor if you’re autistic and your specific challenges (sensory sensitivity, processing speed) so they can adjust.

When to schedule medical appointments:

  • Annually for health checkup
  • If having sexual relations without condoms
  • If condom broke/slipped/was removed
  • Sexual contact with someone who has an STI
  • Sores on genitals/mouth/anus
  • Pain during sexual activity
  • Blood from genitals/penis
  • Difficulty with or maintaining erections
  • For people with female bodies: Prescribing contraception, suspected pregnancy, painful/heavy/irregular periods, severe mood changes before/during menstruation, abnormal vaginal discharge, breast pain, bleeding between periods
  • For people with male bodies: Testicular pain/swelling, burning/pain urinating, unexplained discharge

Medical Exam Process

Male body exam:

  • testicles: Doctor gently presses penis; if uncircumcised, may retract foreskin to see glans; gently palpates each testicle for lumps/swelling
  • Prostate: Walnut-sized gland below bladder in front of rectum. Exam via anus: doctor wears glove, applies lubricant, inserts finger into rectum to feel prostate for swelling/lumps
  • STI screening: Cotton swab inserted in urethra to collect sample for lab analysis

Female body exam:

  • STI screening: Lie on exam table, feet in stirrups. Doctor inserts speculum into vagina, opens it to view vaginal walls and cervix, collects cervical cell sample (Pap test)
  • ovaries: After removing speculum, doctor wears lubricated glove, inserts finger in vagina, gently presses lower abdomen to feel uterus, fallopian tubes, ovaries
  • Breast exam: Doctor gently presses breast tissue with fingers to check for lumps

Stis: Knowledge and Prevention

What Is an Sti?

An STI (Sexually Transmitted Infection) is an infection transmitted sexually or through blood, contracted during unprotected sexual contact (without condom or dental dam) with an infected person.

Serious consequences: Some STIs have no cure and persist lifelong; others treat with medication. Untreated infection transmits to partners.

Common Stis and Treatments

If you suspect STI: Schedule medical appointment for testing. Inform partners: If diagnosed, tell anyone you’ve had recent sexual contact with so they can test.

Condom Use and Sti Prevention

Condoms (sheaths made of latex) protect against both STIs and unintended pregnancy. Types include male condoms, latex squares (dental dams), and finger condoms.

Condom Application Steps:

  1. Check expiration date before opening
  2. Avoid tearing with nails or teeth; open carefully
  3. Place rolled condom on erect penis with tip pointing upward
  4. Gently pinch the condom tip to expel air—this is essential
  5. Unroll to penis base using one condom at a time
  6. Leave approximately 1 centimeter of space at the condom tip
  7. After ejaculation, slowly withdraw while holding the condom ring firmly
  8. Dispose immediately after use

Storage: Room temperature, away from sun. Heat (wallet, car) reduces effectiveness.

If condom tears: Both partners should see doctor or call Info-Health (811).

Dental dam use: Comes in latex envelope; apply few water-based lubricant drops between dam and vulva/anus; hold in place with hands; single use only.

Contraception Methods and Effectiveness

The guide covers multiple contraception options with specific efficacy rates: condoms (85-97%), birth control pills (92-96%), injectable contraceptives (97%), IUDs (99%), vaginal rings (99%), contraceptive patches (99%), and emergency contraception (60-95%). Male condoms are the only method protecting against both STIs and pregnancy.

Hormonal Contraceptives

Emergency Contraception

Emergency contraception is reserved for high-risk situations: forgotten contraception, broken/torn/slipped condoms, missed regular pill doses.

The emergency contraceptive pill contains two tablets; take first as soon as possible after unprotected sex and second 12 hours later. Obtain within 3 days (maximum 5 days) from physician, nurse, or pharmacist.

Sexual Desire, Arousal, and Erogenous Zones

Sexual desire varies by person and life stage; some people are asexual (no sexual desire), which is completely acceptable. Desire can be triggered by seeing attractive people, thinking about exciting scenarios, or engaging in physical contact.

Importantly, love and desire are separate—you can desire someone without romantic feelings or love someone without sexual desire.

Arousal Signs

Arousal signs in people with male bodies include erection, foreskin retraction revealing the glans, pre-ejaculatory fluid droplets, increased testicle diameter, accelerated heart rate/breathing.

Female body arousal includes hardened nipples, vaginal lubrication, redder vulva tone, enlarged clitoris, accelerated heart rate/breathing, desire for physical contact and touch.

Sexual Fantasies

Sexual fantasies are imagined scenarios causing sexual excitement. Many people have fantasies that don’t match their sexual orientation or that are impossible to realize. Fantasies are private; share only if desired with consent.

Erogenous Zones

Erogenous zones are body areas that create sexual pleasure when stimulated. Common zones include hair, mouth, neck, back, breasts, penis, testicles, buttocks, anus, clitoris, vagina, and feet—though variation between individuals is normal.

Masturbation and Self-Exploration

Masturbation involves touching and caressing genitals for sexual pleasure. It’s healthy, not shameful, and helps people discover their bodies and what feels good.

For People with Penises

Before masturbating, ensure privacy, have lubricant available, and keep tissues/washcloth nearby. Techniques include caressing erogenous zones and testicles, gently squirming penis in hand, stroking up-and-down with lubricant, or inserting finger/object into anus.

For People with Vulvas

Before masturbating, ensure privacy, have lubricant available. Techniques include caressing erogenous zones, touching/caressing lips and clitoris with small circular motions, inserting finger/object into vagina or anus.

Sensory Variations

Hypersensitivity may be addressed with lubricant for gentler gliding sensations. Hyposensitivity requires careful attention to avoid injury—decrease penetration depth, reduce pressure/force.

Foreplay and Preliminary Activities

Sexual activities before penetration are called foreplay or preliminary activities. Purpose includes increasing desire and excitement, giving and receiving pleasure, and relaxing bodies.

Activities include: creating pleasant ambiance, speaking pleasurable words, intense kissing, partial or complete undressing, sensual massage, mutual caressing of erogenous zones, mutual masturbation, oral sex.

Oral Sex Activities

Penetration and Safety

Penetration involves insertion into vagina (vaginal penetration) or anus (anal penetration) using fingers, penis, or sex objects. To prevent injury: keep nails short, wash hands, and ensure adequate lubrication.

Critical: Anus requires lubricant—it doesn’t naturally lubricate. People have the right to refuse touching their vagina or anus, and partners must respect this refusal.

Sexual Objects and Safety

Sexual objects (sex toys) safety guidelines:

  • Request help from trusted persons or professionals
  • Avoid cheap Internet-purchased objects
  • Follow cleaning/maintenance instructions precisely
  • Don’t share objects for hygiene reasons
  • Apply condoms to objects before penetration
  • Select objects specifically designed for anal penetration
  • Stop using objects showing infection signs or causing pain

Sexual Positions

Sexual positions are numerous with infinite combinations. Some feel more comfortable; others require flexibility, balance, or muscle endurance. Not all positions must be tried. Finding positions pleasing both partners matters more than variety.

Consent requires explicit agreement from both partners for each sexual activity, each time it occurs. Consent is invalid if the person is sleeping, unconscious, intoxicated by alcohol/drugs, threatened, forced, or under someone’s authority.

Agreement: saying “yes,” expressing desire, asking if the other wants sexual relations. Refusal: saying “no,” refusing, claiming they’re not ready, or asking to stop.

Non-verbal agreement: nodding yes, leaning in close, relaxed body, showing pleasure. Non-verbal refusal: shaking head no, moving away, rigid/tense body, appearing angry/frightened.

Critical concept: Physical arousal signs (erection, lubrication, hardened nipples) DO NOT equal consent—partners must ask directly.

Consent can be withdrawn anytime during sexual activity; both partners must stop immediately or it becomes sexual assault (which is illegal).

For people with Autism: Understanding and communicating consent requires explicit teaching because the social subtlety of non-verbal cues is easily misinterpreted. Autistic individuals must learn to:

  • Ask directly rather than relying on non-verbal signals
  • Accept direct questions about their consent without embarrassment
  • Practice saying “yes,” “no,” and “I want to pause” aloud
  • Recognize that a partner freezing, going quiet, or tensing up means withdrawal of consent

Orgasm and Sexual Response

Orgasm Experience

Orgasm is a brief moment (seconds) of intense bodily pleasure when excitement signs increase: accelerated breathing, increased heart rate, muscle contractions. Afterward, excitement signs disappear rapidly creating rest, calm, fatigue, or well-being feelings.

Male Orgasm

Orgasm occurs when highly excited, body contracts seconds, and semen (containing sperm) rises into penis exiting through the urethral opening. Partners should pre-agree on ejaculation location.

Female Orgasm

Orgasm occurs when highly excited, body contracts several seconds providing intense pleasure. During orgasm, female ejaculation may occur. Female bodies can orgasm through vaginal stimulation, clitoral stimulation, anal stimulation, or G-point stimulation.

The G-point is an erogenous zone 3 cm inside the vagina toward the abdomen, a tissue complex including clitoral parts.

Important: Many people with vaginal penetration don’t experience first orgasm until years after beginning sexual life—this is normal.

Post-sexual Recovery and Communication

After sexual relations, the recovery phase allows mental/energy restoration. Each person differs in preferences: sleeping, showering, talking, listening to music. It’s beneficial to urinate afterward preventing urinary tract infections.

Partner Preference and Sexual Satisfaction Discovery

A discovery exercise called “Découvrons-nous” (Let’s Discover Each Other) helps partners identify each other’s preferences:

Each partner draws front/back body outlines, marking with X areas they don’t want touched and hearts in varying sizes on areas they like caressed. Discuss drawings with partner sharing appreciated sensations during relations.

Online Safety and Digital Boundaries

Online Dating and Catfishing Prevention

Online predators use romance-building tactics, create barriers to in-person meetings, share sob stories to build sympathy, and request money—all red flags requiring immediate discussion with trusted adults.

Never send intimate photos to anyone, even people you trust. Once created, you permanently lose control. Screenshot, hacking, device theft, and partner betrayal all threaten intimate images.

For minors: Receiving intimate photos of people under 18 is a criminal offense. Delete immediately and don’t forward.

Sextortion (blackmail using intimate content) is illegal with criminal consequences for perpetrators.

Pornography and Misconceptions

Pornography is fiction, not reality—scenes are exaggerated (unrealistic body types, no clear consent, no emotions, no protective equipment, immediate arousal, always orgasms). Pornography depicts degradation and violence not reflective of respectful sex.

Using pornography as sex education leads to harmful expectations and disrespect. Real sex involves communication, preparation, emotion, and enthusiastic consent—the opposite of typical porn.

Cyber Flashing and Harassment

Cyber flashing (sending unsolicited intimate photos) is illegal and constitutes sexual harassment.

Abuse Prevention and Safety Planning

Warning Signs of Abuse and Exploitation

If someone you’re dating:

  • Isolates you from friends and family
  • Prevents you from doing activities you enjoy
  • Demands specific clothing choices
  • Controls your finances
  • Makes you feel constantly anxious or scared
  • Pressures you for sexual activity despite your objections
  • Won’t let you tell others about the relationship
  • Refuses to accept “no”
  • Insists on secrecy

This is abuse. Tell a trusted adult immediately. Contact SOS violence conjugale (1-800-363-9010), Info-aide violence sexuelle (1-888-933-9007), or emergency (911).

Emergency Safety Plan

Create an Emergency Safety Plan with a trusted person covering: alert words you’ll use (“Stop! I don’t want to!”), body responses (hand signals), safe places to go, who to tell, and emergency codes.

Alcohol and Assault Prevention

Alcohol dramatically increases assault risk: Over 75% of sexual assault victims had alcohol in their system when assaulted. Never consume drinks you haven’t controlled; never accept drinks from strangers; never leave your drink unattended.

In Quebec, the age of consent is 16 years old for all sexual activities. Consent must be enthusiastic, informed, specific, and continuous.

Confidentiality and Privacy

People 14+ have confidential medical consultations—doctors won’t inform parents without permission about STI treatment, contraception, pregnancy, etc. You decide whether to tell trusted adults.

Harassment Laws and Protection

Intent doesn’t matter for harassment—impact does; even unintentional behavior constitutes harassment if the other person feels uncomfortable. Unwanted repeated sexual behaviors or words are illegal.

Mental Health and Sexual Wellbeing

Trauma Response and Dissociation

If you’re experiencing confusion about your sexuality or identity that prevents normal functioning, call Info-Social (811) for specialized help.

Dissociation during sexual activity is a warning sign that something is wrong.

Body Image and Self-Acceptance

Self-acceptance is crucial for sexual wellbeing. Body image concerns are common but can be addressed through self-care, positive self-talk, and focusing on what your body can do rather than how it looks.

Support Resources and Professional Help

Quebec-Based Support Organizations

Crisis and Support Hotlines

Digital Safety Resources

Educational Resources and Further Reading

Online Resources