INSAR 2019: Gender, Sexuality, and Romantic Relationships

Today's INSAR 2019 Special Interest Group (SIG) on Gender, Sexuality, and Romantic Relationships was led by Laura Graham Holmes and Jeroen Dewinter, and co-led by Anna van der Miesen. Essentially, relationships and sexuality are central to everyone's health and well-being. But there isn't enough useful research and materials available fo autistic people of all ages and abilities, their families, and healthcare professionals, and many have expressed the need for research and guidance. So that's what the SIG leaders and the participants in this well-attended session talked about. Any errors or omissions in the highlights below are on us.

SIG participants Sara L, Dori Z, Jac dH, and Christina N, in discussion
[image: Four people of varying gender identities and neurotypes,
talking at a conference table.]

Last year’s Gender, Sexuality, and Romantic Relationships INSAR SIG was about determining the most important issues for the autistic community, in terms of gender and sexuality and relationships. The ultimate goal for this SIG is to create a resource hub.

The SIG leaders started out with the World Health Organization (WHO) guidelines:

"Sexual health is a state of physical, mental and social well-being in relation to sexuality. It requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence."

Sexuality is a holistic concept. It’s not just about risk reduction. It’s also about living good lives.
Sexuality is for everyone, not just those who have relationships with partners.

Gender is separate from sexuality. A useful resource is The Gender Elephant, "an educational tool that can be used by anyone to help learn and teach the concepts of gender identity, gender expression, sex, physical attraction, and romantic attraction."

The Gender Elephant teaches gender and romantic concepts with simplified visuals
[image: Illustration of a pink elephant in a gray suit, next to a visual chart explaining gender
 identity, gender expression, sex assigned at birth, physical attraction, & emotional attraction.]

Most available research about autism and sex is about sexual behavior, knowledge, and attraction, and also identifying as LGBTQ+. Which is good, bt we want more research on matters that can contribute to autistic people’s quality of life.

We need to incorporate concepts like self-determination.

Previous autism & sexuality SIGs revealed three major areas of interest:

1. Getting a better understanding of autism, sexuality, & relationships.
2. Supporting sexual wellbeing and relationship satisfaction.
3. Autistic perspectives in research, healthcare, and society.

We need to take this research on autistic sexuality realities, and bring it back to the community to help counter myths about autism and sexuality, and get people the resources that will actually improve their life quality.

Working closely with autistic people on autism and sexuality matters makes research better and leads to more useful supports.

Commentary: The best information about sexuality and autism is coming from the autistic and advocacy communities right now, not the research community. We need more practical and applied resources.

Seems like lots of people in the autism and sexuality SIG are looking for collaborators. Some folks are working on tools to help autistic young adults have open conversations about autism and sexuality and their personal experiences.

We need to help clinicians break down the uncomfortable conversations about autism and sexuality, especially since these topics should but rarely come up in autism evals like the ADOS. How do we get relevant gender and sexuality questions into autism studies other people are already doing?

We then moved to the discussion group on including and reaching non-speaking people and people with intellectual disabilities (ID).

Sara Luterman talked about the utter lack of sexual resources for people with ID resources, especially for LGBTQ+ needs. People with ID are complicated sexual being too, and autistic people are more likely to be LGBTQ+.

Carol Greenburg, who is both autistic and the parent of a partially-speaking autistic teen, mentioned Autistic people with ID need to learn about health boundaries: Pulling a girl’s ponytail because a kid is attracted to her is NOT OK, with kids w/ID or no.

Sara Luterman reminded group that teens look at pr0n! So how do we support that healthily?

Parent reports on sexuality are NOT going to be accurate. Again, this is true for autistic people w/ID and people with neither of those traits.

To teach sex ed properly, we have to talk the variety of ways in which people express their sexuality. Parents tend to be OK with it, sort of, until LGBTQ+ and tech (vibrators etc.) aspects arise. Then it's considered off-color.

What teaching health sexuality boundaries for people with ID can look like: IT’s OK to take pictures of your own bits, but it is NOT OK to send those pictures to other people without their consent.

What do visual supports for people with ID, in terms of sexuality materials, look like? Is there a SymbolStix symbol for a penis? And visual materials like po_rn are not realistic at all.

We also need good guides about things like masturbation, and consider that parents can introduce the materials, but then have the teens/clients watch the materials on their own. (We recommend Diverse City DVDS) A problem, though: many group homes are run by religious groups, and/or only have one computer in a public place. This means that not only do autistic people not have access to sexuality materials, but if they do, there’s no place to use them in private.

Another autism and sexuality complication for autistic people, from Sara Luterman: When you need more support, then functionally, you have less privacy.

Also: Even in mainstream sex ed, there’s a lot about how to say NO, and not a lot about how to say YES.

Sexuality is not unhealthy! So let’s talk about pleasure and well-being instead.

We also need more training materials about sexual identity matters, as those tend to be lacking in autism contexts.

John Elder Robison: Is the autism neurotype a key matching factor for successful relationships for #autistic people?

Also the complementary neurotype of an emotionally aware and sensitive person that can understand autistics

— John Elder Robison (@johnrobison) May 4, 2019

We need a self-advocacy curriculum for kids, because sometimes it’s not safe for adults to be involved, and kids need to know when and if to approach adults about sexual safety matters.
Kidpower California was suggested as a resource, but we have not verified it.

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Under a Double Rainbow: Autism and LGBTQIA+

Photo © Ted Eytan | Creative Commons/Flickr
[image: Multiracial crowd rallying with flags and signs behind a banner reading
"Trans Solidarity against transphobia for justice".]

Maxfield Sparrow
unstrangemind.com

Ten years ago, I wanted to write a paper about autism and gender issues for a gender and sexuality conference at which I had previously presented. I started the research, then dropped into a depression after realizing how little material was available, and that the existing research about autism and gender was both dismal, and erasing. The medical journals talked about transgender autistic children as if their gender issues were delusions, mere symptoms of their autism. I never wrote that paper.

Today, not only is there good autism information available, but the “double rainbow” of being both autistic and LGBTQIA+* is just beginning to be more accepted and understood. We have a long way to go, but people are beginning to understand that autism does not guarantee asexuality, nor are Autistic people’s identities always heterosexual and cisgender**.

In fact, there’s even an organization, Twainbow, started by Louis Molnár in 2015. Molnár was diagnosed with Asperger’s in 2013, and noticed both the dearth of resources for “double rainbow” people, and the similarities between coming out of the closet as a gay man and coming out of the closet as Autistic. Writing in The Advocate, Molnár said,

“For many decades the blame was on just about anything from poor parenting to vaccines. Homosexuals were subjected to behavioral conversion therapy, shock therapy, injections, beatings, removal from imaginary catalysts, and social shaming to drive the gay out of them. These very things currently happen in the autism world.”

Steve Silberman, author of the autism and neurodiversity history best-seller NeuroTribes, spoke about Twainbow, saying, “Any organisation that fights for the civil rights of LGBT+ folks on the spectrum, raises awareness of the special challenges and joys of living under the double rainbow, promotes pride and self-confidence, builds alliances, and condemns bullying, systemic ableism [i.e., the discrimination of people with disabilities] and homophobia is doing really important work.” Silberman is right: acknowledging, understanding, and supporting our “double rainbows” is a crucial part of autism acceptance and raising Autistic children to be happy, healthy, fulfilled Autistic adults.

If you are an Autistic person who lives under the double rainbow, rejoice! You are not alone! Molnár estimates that over five million people world-wide are “double rainbows.” I would not be surprised to learn that Molnár’s estimate is far lower than the reality. Last year, I did a literature review and analysis of the research on autism and gender variance, and discovered that people who were surveyed at gender clinics were ten times more likely to be diagnosed or diagnosable with autism, compared to the general population. Additionally, Autistic people are seven times more likely to be gender variant than the general population. And those figures are just for gender issues, independent of sexual orientations.

If you are a parent of an Autistic person who is or might be a double rainbow, you may be concerned. Either you are worried for your child or you are worried for yourself (or both.) You might worry that your child is already facing so much stigma and discrimination due to being Autistic and a non-mainstream sexuality or gender will make life that much harder for them. You also might be struggling with worries about attitudes from extended family or from those in your family’s religion. You also might be worrying about your ability to parent a child who has “fallen so far from the tree.” If you aren’t Autistic and you are heterosexual and cisgender, you might worry about your ability to support and mentor a child whose life experiences are so very different from your own.

When it comes to fears of stigma and ostracism from society, family, school, church, and more, I recommend finding other parents in your situation to share hopes and fears, tips, and ideas. While there are not yet many organizations supporting double rainbows and our families, if you are in the United States, you can meet other parents of LGBTQIA+ children at your local chapter of PFLAG (Parents and Friends of Lesbians and Gays). Of course those parents may not be familiar with the needs of double rainbows like your child, but they are great people to talk with about issues of rights, safety, stigma, and more.

Some other organizations that might be helpful to you and your child include True Colors, GLSEN, and Queerability in the U.S.; Stonewall, Mermaids, and Gendered Intelligence in the UK; and Minus18 in Australia.

Some other important things to remember as the parent of a double rainbow or potential double rainbow:

• Be open to listening to your child, even when the topics get difficult. LGBTQIA+ interests might indicate something about your child’s identity...or not. Listen without judgment, and let your child lead the way with the conversation. Ask questions that show your interest but try not to jump to assumptions about your child either way.
• Be ready to hear some challenging language. Your child might use words that make you uncomfortable like “queer” or even words that are considered slurs among some people, like “faggot,” “dyke,” or “tranny.” If your child identifies with a challenging word, ask if you should also use that word or if your child wants you to use a different word. Sometimes minority groups reclaim language for their own use but do not want people who are not a member of that minority to use those words. Even if the words make you uncomfortable, strive to keep any sense of judgment out of your questions and comments.
• Your child may need gender or sexuality support at school. This could include a gender neutral bathroom to use, uniform change or discussion of clothing changes, social stories about gender and/or sexuality roles and issues, staff training, and more. Joe Butler goes into more detail on some of these points in the article Supporting Trans and Gender Questioning Autistic Pupils.
• Seek peer support and double rainbow mentorship if possible. In addition to some of the regional organizations listed above, some writers to look at include Caroline Narby and her Double Rainbow series; Dr. Dawn Prince-Hughes who writes in her memoirs about life as an Autistic lesbian; John Scott Holman, a now-deceased gay Autistic man who wrote frankly about his struggles with addiction as well as the challenges and joys of being a double rainbow; Lydia X. Z. Brown, a genderqueer activist and law student; Wenn Lawson, who wrote for years about life as an Autistic lesbian before coming out transgender.   
• Be prepared to learn. You might not be aware, for example, that some transgender people are non-binary, meaning they do not identify as either male or female. Some transgender people do not seek to medically transition their bodies. Some people have a different identity for their sexuality and their romantic interests, leading to combinations like “asexual homoromantic.” If you’ve never learned about much beyond gay/lesbian/straight/transgender, be prepared to be a little overwhelmed by the information and options out there. You’ll need at least a surface understanding in order to help your child navigate to an understanding of where they stand in all the gender, sexuality, and relational spectrums.
• You don’t need to be told this, but I’m rounding out the tips with it anyway because it’s so important: love your child. You already know, having an Autistic child, that parenthood carries no guarantees of what sort of family you will end up building. Odds are, you didn’t expect an Autistic child, but you love them so much and would never erase them to try to get a non-autistic child instead. Take that love and acceptance with you when helping your child figure out their gender and sexuality. Maybe your child is cisgender and heterosexual. Maybe not. So many of us are LGBTQIA+ that you serve your child’s best interests by assuming they might turn out to be any of the identities represented in that acronym, just in case they do. If your child turns out to be a double rainbow (or even a triple rainbow like me: Autistic, Transgender, and Gay) you’ll want to be ready to be there for them, offering the same love and guidance you’ve offered through every other facet of their beautiful life.

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*LGBTQIA+ is an acronym meaning lesbian, gay, bisexual, transgender, queer, intersex, asexual, and others not specifically named, leaving room for increased future understanding of non-mainstream gender and sexual identities

** Cisgender or 'cis' is a word that means identifying with the gender a person was presumed to be when they were born, and people looked at their genitals then declared with excitement, “it’s a boy!,” or “it’s a girl!” If that presumption turns out to be what the baby grows up to feel comfortable with, then that person is cisgender rather than transgender.

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