Abstract
Research consistently shows that autistic people are more likely to identify outside of cisgender heterosexuality, highlighting the importance of supporting autistic people beyond neuronormative and heteronormative relationship imperatives. This paper explores autistic adults’ perspectives, using queer and neuroqueer theory, to examine how heteronormativity and neuronormativity operate together to constrain autistic people's intimate lives. It also considers how neurodivergence can open alternative, affirming possibilities for intimate relationships and support. Five asynchronous, text-based focus groups were conducted with a diverse sample of 46 autistic adults. Facilitated by an autistic researcher over 6 weeks, these were anonymous, autistic-only spaces. Data analysis included a participatory co-analysis phase. This enabled a rigorous, neuroinclusive qualitative research design that accommodated queer temporalities and enabled attention to intersectional experience. Findings show how neuronormativity and heteronormativity combine to constrain people's intimate lives over the life course, and how autistic people often bring a neuroqueering criticality to these norms. The findings reinforce the importance of care professionals moving beyond heteronormative, neuronormative, ableist understandings of sex and relationships to support autistic people to do relationships in ways that work for them. The paper offers concrete recommendations for practice and advances a neuroqueer ethic of care relevant to health and care systems globally.
Research on autistic people's sexuality and intimate relationships has contributed to well-established stigmatising, infantilising and ableist discourses (Chapman & Botha, 2023). These gendered and often contradictory discourses frame autistic people's sexuality in terms of risk, vulnerability, perpetration or pathology (Huysamen et al., 2023; Margari et al., 2024). They often construct autistic people as inherently disinterested in sex and relationships, or as incapable of intimacy and connection. These discourses are enacted and reinforced through public health and care policy, where autistic people's intimate lives are often ignored or erased, or viewed primarily through the lens of risk mitigation rather than as part of a duty of care to support people's intimate lives (Huysamen et al., 2023; Jay et al., 2024). In contrast, research that centres autistic voices dispels these myths, showing that most autistic people are interested in sex and/or relationships and identify across a broad spectrum of sexual identities, including asexual and aromantic identities (Sala et al., 2020).
Research consistently shows that autistic people are more likely than non-autistic people to identify outside of cisgender heterosexuality (Amrutha & Christie, 2024; Lewis et al., 2021; Sala et al., 2020; Strang & Fischbach, 2023). This evidences the importance of understanding how to support autistic people beyond cisheteronormative relationship imperatives. Despite this, the needs of LGBTQ+ autistic people in health and care policy are often addressed tokenistically to fulfil equality and diversity requirements, if they are considered at all (Huysamen et al., 2023; Jay et al., 2024). This article contributes to a small but growing body of work that adopts a sex-positive approach to autistic people's relationships and sexuality, and recognises the need to support intimate lives beyond heteronormative and neuronormative imperatives (Amrutha & Christie, 2024; Barnett, 2024; Dewinter et al., 2024; Pearson & Hodgetts, 2024).
Theoretical Framing: Queer Theory and Neuroqueer Theory
Queer theory and neuroqueer theory provide the theoretical framework for this paper. Klesse (2025, p. 547) observes that ‘Queer is a “travelling concept”, which is constantly being adapted and taken up in different ways’, but at its core, ‘queer denotes a political disposition to challenge normativity’. We draw on Judith Butler's (1999, 2008) notion of performativity and Sara Ahmed's (2006) work on orientation. Both explore how the repetition of everyday acts is central to the production of gendered identities, arguing that we become gendered through repeating certain, seemingly mundane and natural, acts. Ahmed (2006) contends that in heteronormative societies, our bodies are orientated throughout our lives towards heterosexual relationships, and that social systems pathologise and police bodies that express gender or sexuality in nonnormative ways. This falsely stabilises heterosexuality and makes it appear natural while marginalising or rendering other sexualities deviant or unintelligible. Butler (1999) argues that most people will fail to live up to idealised versions of compulsory cisgender heterosexuality, as they are uninhabitable and unachievable subject positions. However, it is through these ‘failures’, by performing ‘bad’ or ‘faulty’ versions of normative gendered and sexual identities, that norms can be subverted, or queered, opening possibilities for resistance and change. Similarly, Ahmed (2006) suggests that there are possibilities for ‘failed orientations’ – bodies can take up spaces that they are not intended to inhabit and follow lines other than those they have already taken, which can work towards the ‘reorientation’ of bodies and spaces ‘where the “new” is possible’ (p. 61).
Neuroqueer theory builds upon these central tenets of queer theory by extending critiques of heteronormativity to critique neuronormativity and neuronormative ideals for behaving, communicating, thinking and relating to and within the world (Amrutha & Christie, 2024; Stevens & Kirby, 2025; Walker & Raymaker, 2021). As Barnett argues, ‘“Neuroqueer” articulates the queer nature of neurodivergence’ (Barnett, 2024, p. 1). Autistic people's ‘failures’ to perform neuronormative social scripts or their behaving outside of the norm because of their neurodivergence are understood as a form of queering or resisting normativity.
Neuroqueer theory allows us to examine how neuronormativity and heteronormativity are entangled and operate in concert with one another to produce and naturalise heteronormative and neuronormative subject positions for autistic people (Amrutha & Christie, 2024; Barnett, 2024). We use neuroqueer theory to explore how autistic people are constrained and oppressed by, and also resist, neuronormative and heteronormative ideals. In analysing how autistic people talk about their intimate lives and support needs, we show how autistic people's ‘failures’ to reproduce heteronormative scripts open new possibilities for doing sex and relationships, and for supporting autistic people's intimate lives.
Neuroqueer theory has been productively applied in feminist theory with autistic women and gender diverse people's experience of gender oppression and in research into autistic sexuality beyond cisgender heterosexuality (Amrutha & Christie, 2024; Fox, 2025; Pearson & Hodgetts, 2024). However, it has not, at the time of writing, been applied in research that looks at how social care services can support autistic people (Stevens & Kirby, 2025). This article centres autistic people's perspectives to demonstrate how neuroqueer theory can inform practice in supporting intimate lives.
Methods
This study forms part of a larger mixed-methods participatory research project, ‘Supporting Autistic Adults’ Intimate Lives’ (SAAIL), encompassing systematic policy document analyses, interviews and focus groups. The focus group findings are presented in this paper.
Ethics Statement
The SAAIL project was granted ethical approval by the Health Research Authority, UK (REC reference: 21/NW/0264 IRAS, project ID: 299375).
Asynchronous Focus Groups
Focus groups aim to generate dialogue on a particular set of issues, with emphasis placed on interactions between participants. They are ideal for exploring people's talk, experiences, opinions, beliefs, wishes and concerns, and allow participants to generate their own questions and pursue their own priorities (Kitzinger, 2005). We conducted online forum-style, text-based focus groups utilising the Discourse platform. Online asynchronous focus groups are particularly suitable for research on topics such as sex and relationships, and for doing research with neurodivergent people. Firstly, asynchronous, text-based focus groups allow for participant anonymity, which can be particularly important when discussing topics that may be personal or sensitive. In-person or video-based focus groups inherently limit anonymity, as participants are visible and audible to one another. In text-based focus groups which use social media and social networking platforms, participants often use their personal accounts, which can compromise anonymity. The Discourse platform overcomes these challenges as researchers create profiles for each participant, keeping them anonymous to each other while researchers have access to participant identifying details.
Secondly, text-based asynchronous focus groups allow participants to engage in the research and respond to one another in their own time and at their chosen pace, and in environments and spaces that suit their needs (MacNamara et al., 2021). This allows for an alternative temporality to the more structured and linear schedule of traditional focus groups. It enables participants to immerse themselves in the research at some points, and to distance themselves at others, depending on their fluctuating needs and availability. The asynchronous focus group allows participants time to process and reflect on the questions and conversations unfolding in the group, and to articulate their responses to the questions at their own pace. Making space for alternative temporalities, giving people time to process, articulate and respond to information and interactions, and to engage in their own time and at their own pace, allows for a neuroaffirming research process.
Participants
Forty-six people participated in the focus groups (Table 1). All participants identified as an autistic adult without a learning/intellectual disability. Formal diagnosis was not a requirement for participation. As this research’s funding was focused on informing adult social care in England, all participants either currently lived or had lived in England as an adult. However, questions were framed to allow our findings to have international relevance.
Focus Group Participants.
Note. *Participants were asked to describe their gender, sexuality and ethnicity in their own words rather than selecting from researcher-provided categories and are preseted verbatim here. Some participants used ‘female’ to describe their gender identity and, while the authors would use ‘woman’, we did not edit any demographic details provided by participants.
We aimed to recruit a diverse group of participants who could reflect on a wide range of experiences, lived at the intersections of neurodivergence, gender, sexuality, race, age and other axes of identity and marginalisation. Participants ranged from 19 to 67 years (M = 34.9, SD = 12.1). Participants were asked to describe their gender, sexuality and ethnicity in their own words rather than selecting from researcher-provided categories. 1 Forty-three percent of participants identified as Black or as belonging to a minority ethnic group. Thirty-nine percent identified as cisgender and heterosexual, meaning 61% identified outside cisgender heterosexuality. Specifically, 57% used sexual orientation labels other than heterosexual, and 12% used gender identity labels other than cisgender.
Focus Group Setup
Five focus groups, each with eight to 10 individuals, were conducted. Participants chose which one of the five groups they wanted to join (Table 2).
Focus Groups
Participant Verification, Consent and Platform Onboarding
Researchers are increasingly concerned with the question of ‘imposter’ or fraudulent participants in online research (Carey et al., 2025; Garcia-Iglesias et al., 2025). These may include participants who pretend they are eligible to take part in the study when they are not, automated bots posing as real participants and ‘trolls’ who join to cause upset, offence or disrupt the study. This is pertinent to text-based focus groups where people can participate without revealing any aspect of their identity. As researchers, it is our responsibility to ensure that the online research spaces we create remain safe spaces for participants. This is particularly important for research where the topics explored, such as autism and intimacy, relate to personal experiences of participants who may identify across multiple axes of oppression and marginalisation.
To help mitigate some of the concerns associated with text-based approaches, we met with most 2 participants online before the focus groups. Some participants were known to us through their involvement in the interview phase of the research. For those we had not met, we arranged a short video call to complete the platform onboarding process. This step helped to assure us that all participants were genuine, and deterred some suspected fraudulent participants who chose not to register for the study. During onboarding, demographic data and written consent were collected, and participants were asked to select an anonymous alias (these were changed for this publication). Participants were given detailed information about the research process and an opportunity to ask questions before consenting to participate. They received one-to-one support and written instructions on how to use the Discourse platform. The research team developed a detailed set of community engagement guidelines (available via the Open Science Framework [OSF]) focused on anonymity and respectful group interaction.
Facilitation and Engagement
The focus groups were facilitated by the third author, an autistic researcher, making them autistic-only spaces. Groups were anonymous and closed and ran for approximately 6 weeks. The focus group schedule included 11 main discussion topics and additional follow-up questions. The schedule (available via OSF) was developed after the interview phase of the SAAIL project. The research team conducted an initial analysis of the interview data to identify key topics raised by participants, which were then used to inform the structure and content of the focus group schedule. We also incorporated vignettes and video clips to help initiate conversation, as well as prompts for discussing what good support for sex and relationships might look like. The facilitator posted a new topic (as a separate discussion thread) approximately every 3 days, and participants received an email notification when a new topic had been posted. The facilitator responded to comments, encouraged participation and summarised discussions. All topic threads remained open for discussion for the duration of the focus group. Participants could message the facilitator privately, but not each other. To increase safety and support, the first author acted as a silent moderator; participants were aware that she was available via direct message to anyone who wished to raise a concern or seek support from someone other than the facilitator.
Data Analysis
Our approach to data analysis is underpinned by feminist poststructuralist epistemology (Weedon, 1987). Poststructuralism is concerned with deconstructing and destabilising existing social categories such as race, class, gender, sex and sexuality. Rather than accepting such categories as natural and essential, poststructuralists unpack these norms, showing how their meanings reside in the historical, social, political, economic and intellectual contexts within which they exist (Gavey, 1989). Feminist poststructuralist theory is particularly useful for understanding research data on sexual topics because of its explicit focus on gender (Huysamen, 2022). Among the central aims of feminist poststructuralism are acknowledging the existing gendered power relations of everyday life, disrupting and displacing dominant knowledge and identifying areas and opportunities for resistance or change (Gavey, 1989; Weedon, 1987).
Data were analysed thematically, using an approach adapted from Huysamen's (2022) A Critical Reflexive Approach to Sex Research. This analytic approach, underpinned by feminist poststructuralism, goes beyond just organising and describing to interpreting the data. It involves identifying common themes and sub-themes while also paying close attention to contradictions and outliers within the text, and returning to, reorganising and refining these themes repeatedly to identify underlying systems of meaning (Huysamen, 2022). This approach to analysis ‘requires commitment to attending closely to the often-implicit ways in which language and power operate in the text as well as a commitment to keeping participants’ narratives whole as much as possible’ (Huysamen, 2022, p. 45). We adapted the analytical process to include a participatory co-analysis element, following the three phases outlined below.
Phase 1: Initial Theme Development
Once the online focus groups had closed, the first author read the discussions from each of the five focus groups in situ on the Discourse platform and made detailed notes. This allowed for participants’ original contributions to be considered within their original context and format. The data were then transferred to NVivo (QSR International) and coded inductively by the first author, coding for large sections of text to keep narratives intact where possible. Automated analysis was not used in the analysis of these data. Through a cyclical and iterative process, coded sections of text were interpreted and grouped to develop broad themes: being autistic and queer; communication and consent; managing rejection; and towards a menu for support in social care.
Phase 2: Participatory Co-analysis
These initial themes were presented in an online co-analysis workshop involving research participants, autistic adults and advocates, autistic academics and health and social care practitioners (many of whom were autistic). The themes, with anonymised excerpts, were shared with workshop participants using collaborative digital pinboards which were accessible to participants before, during and after the workshop. Participants discussed the themes in small groups and posted responses on the digital pinboards in the form of typed comments, images and links to documents and resources. These multimodal contributions were treated as part of the analytic process. This consultative phase enhanced rigour by integrating multiple perspectives and creating opportunities to challenge, refine and expand the researchers’ interpretations.
Phase 3: Refinement
Following the workshop, the first author revisited the themes and further developed them to incorporate insights from the group discussions, pinboard contributions and their suggested literature and resources. Through further iterative cycles of coding, reflection and interpretation, sub-themes were developed under each of the four themes, reflecting more nuanced patterns of meaning.
Due to the richness of the data, this paper focuses specifically on the theme ‘being autistic and queer’, which is explored in the following Findings and Discussion section through five sub-themes.
Findings and Discussion
Beyond Normative Identities and Labels
Across all five focus groups, there was discussion and broad consensus that autistic people are more likely than people who are not autistic to identify outside of cisgender heterosexuality, or to feel that these normative gender and sexual identity labels do not entirely reflect or align with their identities, practices or experiences. This view was reflected in participants’ demographics, with 61% reporting that they did not identify as both cisgender and heterosexual (Table 1). Some participants suggested that this reflects the intersection between cognitive differences, in how autistic people might make meaning of normative identity labels, and the broader experience of occupying a nonnormative position in a neuronormative society: I describe myself as heterosexual for ease and because a label doesn’t really make a difference to me, it doesn’t affect who I am, even though from the age of about 8 I’ve always thought the idea that you would be attracted to a specific gender rather than a person quite unlikely and bizarre. In practice, I’m probably pansexual. I think autistic people are more likely to identify with other sexual identities because we are used to being outside the ‘typical’ and because we see the nuances, detail and meaning behind the terms. (Velvet_LaRoux, 33, female, heterosexual, LGBTQ+ group) I think also that autistic people are more likely to reject social constructs that don’t make sense to them so are more likely to have non-monogamous relationships. (Ridgerambler, 40, female, heterosexual, women's group)
While participants used a range of identity labels themselves, they spoke about the potential limitations of identity labels. Velvet_LaRoux explained that when interacting with health and care systems, she may identify herself as heterosexual ‘for ease’, despite finding the idea of identity based on attraction to a gender ‘bizarre’. Another participant explained that she often used the label of heterosexual to identify herself to professionals because it was accurate in terms of the gender of her preferred partners. However, in reality, she felt it did nothing to describe the nature of her Dominant/submissive (D/s) relationship with her partner, which revolved entirely around BDSM (bondage, discipline, domination, submission, sadism and [sado]masochism) practices. QuantumSpore (25, male, gay, men's group) said, ‘I know I said in the introductions that I’m gay, but I only said that because that's the checkbox-type answer that most people will understand without me having to go into details’, reflecting on how labels such as ‘gay’ and ‘queer’ fail to describe how he identifies and how he experiences his sexual identity in relation to others.
These findings have implications for professionals supporting autistic people. Some people may use labels to identify themselves to professionals that do not necessarily fully represent or reflect their lives and needs for the sake of ease of communication, to move through systems more easily and to make themselves more intelligible to others. It is no surprise that autistic people may do this in a hostile society: Autistic people are regularly misunderstood and misread, including in health and social care systems, which are often difficult and traumatic to negotiate and move through both as a queer and autistic person (Chapman & Botha, 2023). Therefore, professionals should treat identity labels as a starting point for conversation, not as a substitute for it, and avoid making assessments and decisions based on narrow interpretations of these labels without further dialogue.
Some participants identified as asexual or aromantic, and they took part in this study about supporting the intimate lives of autistic people specifically to share their perspectives. Our study thus highlights the importance of recognising asexual and aromantic identities as queer, nonnormative sexual identities, rather than as an absence or erasure of sexuality. Given the long history of autistic people being systematically desexualised, with asexuality being weaponised as part of a broader machinery of infantilising autistic people, we were cautious of how the data from this study might be used. However, participants spoke clearly about their experiences, needs and desires as asexual and/or aromantic individuals, disrupting not only assumptions about autism and sexuality, but also queering compulsory cisheteronormative imperatives of sex and relationships.
The Importance of Queer-Affirming Care: The Consequences of Not Knowing and Not Being Supported to Know
While discussions on why autistic people might be more likely to identify outside of cisgender heterosexuality contained theoretical and philosophical elements, these deliberations have direct and material implications for how professionals should provide care and support. The following quotes reflect core sentiments, shared across all groups, about what support for intimate lives should, and should not, look like: I think we need [support] to be made explicitly inclusive and told it is ok to find our own ways to have relationships that work for us whether this conforms with NT [neurotypical] ideas or not. Any support that defines ‘normal’ sex and relationships in too prescriptive a way should be avoided. As we have discussed in other threads, it does seem like autistic folk are more likely to not conform to cishet monogamous relationship standards and I think any support needs to be open and accepting of other forms of relationships. In fact, I feel it should openly talk about and discuss subjects like polyamory, BDSM, and asexual or aromantic relationships so that those who prefer these have the option and support to do so safely and happily. I often think that if I had known polyamory was a thing when I was younger I would have chosen to form relationships in this way, but I was never taught this was an option or how to navigate these types of relationships. (MerryFennel, 39, female, bisexual, women's group) I think that autistic people should be able to embrace their own way of getting into a relationship but at the same time I feel that some need guidance on how to embrace their way. (L09, 22, male, heterosexual, men's group)
MerryFennel and L09's quotes call for support that goes beyond just recognition and acceptance of nonnormative sexual identities to actively provide discussion, education and the information they need to safely navigate and explore their own ways of doing relationships. All participants said that they had not received accessible or appropriate sex education at school, consistent with research evidencing an almost universal failure to provide autistic young people with adequate and inclusive sex education (Ragaglia et al., 2023; Smusz et al., 2024). As adults, participants reported a continuation of this failure to support, saying health and care professionals never asked about their intimate lives or how they could support them.
As a result, many participants felt they lacked basic information about sex and relationships and had been unaware of the range of sexualities and relationship models and practices that might have better aligned with their needs and preferences. This left many people, especially older participants who had not had access to the internet as adolescents or young adults, with little knowledge and information to make informed choices about sex and relationships that could have been right for them. This was particularly evident in the narratives of participants over the age of 50, such as in NeuroGator’s and Indigo_Regent’s quotes: I strongly agree that autistic people shouldn’t feel they have to do things in neurotypical ways, and should be given support to do so. I struggled in my early 20s when I first tried to date in a neurotypical way and follow conventions, I did not know that there was more than one way of doing it. I think it's important that autistic people have as much information as possible about different approaches to dating and relationships. (NeuroGator, 50, nonbinary, lesbian, LGBTQ+ group) At the ripe age of 67, l can honestly say l wished l had followed less conventional relationships. With two failed heterosexual marriages (three kids all following pretty straight stuff) and a non-live-in 7 year partnership l feel like l missed out on aspects of love and intimacy just by responding to the nearest easiest offers. (Indigo_Regent_She_Her, 67, female, pansexual, mixed group)
Together, these narratives reveal the consequences of not knowing – and not being supported to know – about possibilities for intimate relationships beyond cisgender heterosexual monogamy. As they tried to approximate what Butler (2008) describes as the idealised and largely uninhabitable subject position of cisgender heterosexuality, some participants internalised their ‘struggles’ and ‘failures’ in relationships as evidence of their own inadequacies or deficits. This reflects a kind of institutional straightening in which only certain orientations are made visible, intelligible or liveable (Ahmed, 2006).
Yet these accounts also gesture towards the transformative potential of adequate support that explicitly affirms difference. Participants reflected not only on what had been foreclosed, but also on what might have been possible had they received affirming, inclusive information and support around their intimate lives earlier in life. In doing so, they make visible the trajectory-shifting possibilities of care practices that respect and actively support neurodivergent ways of doing intimacy.
Sexual (In)Experience and Neuroqueer Temporalities
Becoming sexually active is a normative milestone, a marker of adult status in society, while adults who are seen to lack sexual experience are infantilised and positioned as ‘delayed’ or ‘lacking’ (Freeman, 2010; Halberstam, 2005; Kulick & Rydström, 2015). Some (but not all) participants described feeling sexually and romantically inexperienced compared with their neurotypical peers, often due to having fewer social opportunities for romantic or sexual encounters. They traced this lack of opportunity to early, often traumatic, experiences of social exclusion and social anxiety linked to being neurodivergent in a neuronormative society. This inexperience produced feelings of shame and anxiety, leading some to avoid potential sexual encounters where their lack of experience would be exposed. As a result, some people reached older adulthood with little or no sexual experience, leaving them feeling excluded. Some participants described feeling ‘out of time’ – because they were out of sync with normative sexual milestones, they felt they had run out of time to build an intimate life.
This sense of temporal exclusion echoes queer critiques of normative timelines of sexuality and intimacy (Halberstam, 2005). Chrononormativity can be defined as the normative and ableist expectation that people's sexual lives all follow the same timeline – a heteronormative trajectory of progression marked by meeting predetermined milestones, such as sexual debut during adolescence leading to a sexually experienced adulthood (Freeman, 2010). Scholars across disciplines have argued how these normative temporalities and understandings of progress are ableist and perpetuate exclusion (Clough, 2025; Kafer, 2013; Morgan & Tutton, 2025; Pyne, 2021). Our findings show how chrononormativity operates to produce avoidance behaviours that are not only a response to a lack of experience but also a cause of it, contributing to a cycle of exclusion and shame for autistic people.
Systemic failures to provide inclusive, affirming education and support are compounded by normative social conditions that constrain autistic people's opportunities to gain sexual experience. This is often intensified for queer autistic people, as illustrated in the quotes from Splashboy and Vero: There is sadly still a huge stigma to being an adult who lacks in experience of sexual, romantic or even platonic relationships. This is an assumption that most people experienced a normative trajectory which meant that they began dating and forming relationships in their teenage years. I was brought up in the 1980s and 90s when there was very little sex education for anyone, and section 28
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meant that there was no talk of LGBTQ+ identities and certainly no mention of being transgender. This made for a very isolated existence as a young trans person, and it probably kept me from embracing my gender for years … On a personal level I feel that I would benefit from knowing that I am not alone and there are other autistic people that are also in their 30s, 40s, 50s and beyond that have limited experience with intimate relationships, still struggle to truly understand their sexuality, and find it difficult to access the language to express things such as desire. Just hearing that I’m not the only one in this situation would be helpful. (Splashboy, 46, trans male, gray ace, LGBTQ+ group) I am not that ‘experienced’ or I guess educated but a lot of that comes from being queer I think, when that was 100% not covered in schools. (Vero, 32, female, queer, LGBTQ+ group)
Splashboy's narrative powerfully reflects the need for professionals to move beyond assumptions underpinned by normative and ableist temporalities and to recognise and respect queer temporalities and trajectories that may not follow normative milestones or conventional understandings of progression and development (Halberstam, 2005). Participants were clear about the implications for practice: Professionals must not infantilise or desexualise autistic people for lacking sexual experience or knowledge nor assume knowledge or sexual experience based on age or other normative milestones like career progression. Rather than assume, ask – and meet each person where they are.
Sex and Relationship Education and Support as an Obligation, and a Matter of Supporting Sexual Safety
We have shown how a lack of access to good education and opportunities to explore sexuality can limit people's ability to make informed choices about sex and relationships that are both safe and responsive to their needs. Chin's (2024) structural desexualisation of disability framework identifies the often invisible ways in which legal, social, political, historical and economic structures and norms act in concert to maintain and perpetuate the harm that people with intellectual and developmental disabilities experience in relation to sexuality. In its failure to recognise, educate and provide necessary support, the state is positioned as responsible for causing this harm. Following Chin, we assert that providing adequate education and support for autistic people's intimate lives is part of the state's responsibility to support autistic people's sexual safety.
In the excerpt below, AeroSaur, elaborating on her limited knowledge and experience regarding sex and relationships, explains that good support would help her unpick the difference between relationships that deviate from ‘movie picture’, idealised relationship norms and relationships that may be harmful to her: Things in which I may be different from the ‘movie picture’ … There are things that are different and safe and normal (sexual orientation, the level of sexual attraction, what if I am polyamorous, what if I have my first sexual experience at 35?) and other things that are different and may be dangerous (e.g., big age gap in a relationship when you are a teenager; how to recognise emotional abuse and microagression, etc). (AeroSaur, 25, female, biromantic asexual, women's group)
Numerous participants, particularly autistic women and trans and nonbinary people, spoke about their challenges around articulating their needs and negotiating their own boundaries in relationships: I’ve been so programmed to mask, and spend so much energy and intellect trying to read people, and meet their expectations, I simply lose touch with my own needs far too easily!!! It's like a delayed reaction. My instant reaction is the one I’ve learned, the socially accepted reaction, and then it takes me a while to actually process what happened and feel my own response to it! (Jane, 49, female, bisexual, women's group)
Numerous participants identified BDSM/kink communities and practices as autism-friendly spaces where they felt safe and contained to explore their desires, needs and sexual interests. Mirroring Pearson and Hodgetts’s (2024) research, participants said that these environments were particularly safe spaces for those who struggled, like Jane, to fully connect with their own needs and boundaries in the moment. These spaces were valued because of the clear structure and explicit ways in which consent, intent and needs were articulated and continuously negotiated, and for the opportunities to explore sensory needs and pleasure that they afforded (see also Pearson & Hodgetts, 2024). However, while these spaces offered the potential for sexual safety and sensory joy, participants stressed the importance of providing autistic people with the information and support to navigate and participate in these spaces safely.
Victim–perpetrator discourses that are dominant across social care policy and practice (Chin, 2024; Huysamen et al., 2023; Jay et al., 2024) position autistic people, particularly autistic women, as passively in need of protection from sex and relationships, and assume their ignorance around their own vulnerabilities. Contrarily, these findings show how many participants understood their own vulnerabilities, their root causes and how they could be best protected and supported. Rather than framing autistic people's intimate lives through discourses of passive victimhood or pathology, our findings highlight the importance of listening to them and providing nonstigmatising education, information and sex-positive support. This is vital to enable autistic people to explore intimacy on their own terms as part of a professional obligation to support their sexual safety (Chin, 2024).
Doing Relationships Differently: Resisting Normativity, Embracing Difference
Thus far, this paper has discussed the importance of recognising and supporting those whose gender and sexual identities fall outside of cisgender heterosexual monogamy. Participants also called for professionals to recognise diverse relationship practices – queer ways of doing sex and relationships – regardless of sexual orientation. Participants’ perspectives challenged dominant ideas about what counts as a ‘real’, ‘legitimate’ or ‘healthy’ relationship, advocating instead for recognition of, and support for, relationships that best work for each person.
According to hegemonic ideals of cisgender heterosexual monogamy, relationships are expected to follow a standard linear trajectory over time. The ideal heterosexual relationship is expected to progress – in a straight line – from dating to exclusivity to cohabitation to marriage to having children and lifelong monogamy. Each step is understood as both leading to and signalling a deeper level of commitment. Some participants referred to this as the ‘relationship escalator’ (Gahran, 2017). Heterosexual monogamy has also historically been predicated on dependence, and today, a high level of dependence is still a value marker of a successful heterosexual relationship. These normative temporalities, or chrononormativities (Freeman, 2010), govern dominant ideas of relationship progress and legitimacy.
Queer theorists critique these normative temporalities (Freeman, 2010; Halberstam, 2005; Walker & Raymaker, 2021) that construct this structured linear progression of relationships and milestones over time as natural and universally desirable (Freeman, 2010; Halberstam, 2005; Walker & Raymaker, 2021). Critical feminist scholars have long challenged the values of complete dependence, arguing that rather than being natural or a reflection of the quality of a relationship, it functions politically to uphold patriarchal and heteronormative power structures (Rich, 1980; Wittig, 1992). Together, these theorists argue that these heteronormative and neuronormative relationship ideals and expectations operate to discipline and direct bodies towards reproductive and economic productivity.
Expectations that relationships will progress down a well-trodden path defined by cohabitation, cosleeping and codependence were unrealistic and uninhabitable arrangements for some participants. For others, these arrangements did not suit the rhythms of daily routines, their sleeping patterns, work schedules or their hobbies or interests: I tried sharing a home with a partner in the past, and it did not work for me. I prefer being in control of my own home environment and having a flexible schedule. I also prefer being by myself when I am not feeling well, particularly when I am not feeling well mentally. (PhotonPulse_he_him, 47, male, heterosexual, men's group) Thinking about what life would look like, I hate sharing a bed to sleep in but not many people are up for considering living separately or in separate rooms. I like my space. I like my independence (although need social care support daily to facilitate that). I think I get a lot of what I need in life from friendships (even with a limited number of people) I do worry about growing old alone though. (Vero, 32, female, queer, LGBTQ+ group)
Narratives like these highlight how heteronormativity is deeply entangled with both neuronormativity and ableism (Klesse, 2025). Examples of how racism and colonialism are also entangled emerged, particularly in our interview data; we will discuss these dynamics in a forthcoming paper to do them justice. Being neurotypical and able-bodied may bring one into closer proximity to idealised cisgender heterosexuality, while being neurodivergent or disabled may mean one is less able or willing to approximate these ideals. Following Derrida (1982), our findings show that neuronormativity and heteronormativity are not merely parallel logics but are articulated and constituted through one another: heteronormativity is always already inscribed in neuronormativity, just as neuronormativity is always already haunted by heteronormativity.
Some participants internalised the dissonance between these normative relationship ideals and their own desires and needs as a barrier to sustaining meaningful intimate relationships. This is reflected in Vero's narrative, where she says that despite enjoying her independence, she ‘worr[ies] about growing old alone’ because ‘not many people are up for considering living separately or in separate rooms’. Her concern reflects the potential exclusion and isolation that those who do relationships in ways that do not conform to dominant temporal logics of proximity and cohabitation may experience.
However, rather than internalising these ‘failures’ to reproduce heterosexual ideals, many participants rejected the assumption that there is only one legitimate linear pathway that relationships follow across time. Mirroring the central critiques of queer and neuroqueer theory, participants were critical of how these normative constructions of relationships did not accommodate diversity and variation. As Liriava (53, genderqueer, pansexual, LGBTQ+ group) articulated, ‘There are a great many social normativities … and “social scripts” such as the relationship escalator, all of which are based around the false assumption that humans don’t vary’. Participants offered alternatives that queered these norms, reflecting on the possibilities of these ‘failed orientations’ to allow for different ways of doing relationships, ones that prioritised comfort, safety and pleasure: [I’m in] a fairly long term relationship where I don’t think we have any plan to move in together or do various things that would conventionally be seen as the classic relationship escalation pattern. (B512, 37, male, heterosexual, mixed group) There are concepts such as Living Apart Together and solo polyamory which address the idea that relationships must include cosleeping and cohabitation. (Liriava, 53, genderqueer, pansexual, LGBTQ+ group) I find there's more excitement created if there is less expectation on sharing the same bed every night, even on a holiday. I’m in total empathy with couples who have two double bedrooms within one space or choose to split time across two houses/flats. (Indigo_Regent_She_Her, 67, female, pansexual, mixed group)
Concluding Discussion: Towards a Neuroqueer Ethic of Care and Support
In this paper, we apply queer and neuroqueer theory to autistic people's accounts of their intimate lives. Drawing on these theoretical frameworks, we examine how heteronormativity and neuronormativity fuse to shape and constrain autistic people’s experiences of sex and relationships while also illustrating how neurodivergence can open space for intimate lives beyond these norms. The study offers insight into how care services can both support and limit autistic people's relationships, mobilising theory toward concrete, practice-based applications.
Methodologically, this study offers an approach to conducting critical qualitative research with autistic people that is both neuroinclusive and rigorous. Asynchronous focus groups, facilitated by an autistic researcher, provided accessible, autistic-only, anonymous spaces where participants could contribute in their own time and at their own pace. We recruited a diverse sample of 46 participants with unusually strong representation across age, gender identity, sexuality and ethnicity (Malone et al., 2022). Asking participants to self-select into focus groups that aligned with their own identities enhanced the study's capacity to attend to intersectional experiences and enabled us to explore how intimate lives and support needs are shaped by overlapping systems of power. The inclusion of a co-analysis workshop involving autistic people in shaping the framing and interpretation of findings strengthened the rigour of the research. Together, these methodological choices provide a model for conducting qualitative research with autistic people that centres rigour, inclusivity and a commitment to social justice.
We show that social care practice that is grounded in a commitment to challenging heteronormativity and neuronormativity holds transformative potential for autistic people's lives. The practice recommendations emerging from our findings are not wholly contingent upon increased budgets or large-scale interventions. Improvements to support can begin without waiting for these, through a shift – or queering – of the hetero- and neuronormative values that govern and constrain relationships in society and that continue to underpin social care systems. These findings speak to foundational systems of value and power. As such, the recommendations are relevant to health and social care across international contexts, wherever heterosexuality and neurotypicality continue to operate as dominant normative frameworks.
In articulating what good support for intimate lives looks like, participants felt that all autistic people should know that they need not be limited to the narrow heteronormative, neuronormative ways of doing sex and relationships, and that they are not alone in wanting to do relationships differently. Good support, they contended, entails helping autistic people realise this, while actively supporting them to navigate and build intimate relationships on their own terms.
This research shows that becoming aware of, and being supported to safely explore, alternative ways of doing relationships opens choices and avenues with the potential to shift the course of people's intimate lives. Moreover, participants’ narratives reflect the value of learning that one's experiences, desires and needs are shared by other autistic people. Realising that one is not alone in deviating from normative sex and relationship milestones, or in wanting to be in relationships that look different to the normative ideal, can reduce feelings of shame, stigma and isolation.
Participants explicitly spoke against support that is premised on helping autistic people to more closely approximate unrealistic and uninhabitable heteronormative and neuronormative ideals, often at the cost of suppressing their own needs and therefore increasing their vulnerability. Through a structural desexualisation of disability lens (Chin, 2024), we have evidenced how support and care systems that fail to provide the education, information and support advocated for in this paper actively limit people's intimate lives. These systems are implicated in and responsible for the harms that autistic people experience in relation to their intimate lives.
These findings show that, ultimately, good social care and support for intimate lives is underpinned by a neuroqueer ethic, one which affirms difference and divergence from the norm and supports autistic people to build intimate lives in their own time and in ways that are pleasurable, safe, and affirming to them. This has important implications for how support is assessed, delivered and evaluated across health and social care contexts. Professionals who hold power in autistic people's lives must be equipped to recognise and legitimise a range of alternative sex and relationship structures and practices. This includes professionals who make decisions about people's support needs and living arrangements; make judgements about their relationships or sexual practices; or evaluate their knowledge of sex, sexuality, relationships or their parenting capacity. Nonnormative relationship structures and temporalities may not align with dominant ideas of what intimate relationships should look like or how they should progress, but they can be neuroaffirming, safe, fulfilling and pleasurable.
Footnotes
Acknowledgements
We would like to thank the SAAIL participants and the autistic advocates, autistic academics, health and care professionals and others who have supported and shaped the SAAIL project. A special thank you to those who attended our co-analysis workshop. Many thanks to Dr. Nóirín MacNamara, who so generously provided a great deal of methodological and technical advice around using the Discourse platform to conduct asynchronous focus groups for research on sensitive topics. We would like to acknowledge Dr. Bethany Jay's contribution to supporting the facilitation of the co-analysis workshops. Many thanks to Dr. Georgia Rivers for helping us think through questions around language, gender, power and representation. We are grateful to the peer reviewers and editor at Feminism & Psychology for their thoughtful and generous engagement, which has strengthened the paper.
Ethical Approval and Informed Consent Statements
This research was granted ethical approval by the Health Research Authority, UK (REC reference: 21/NW/0264 IRAS, project ID: 299375). All participants were provided with comprehensive details about the research aims and processes, and they provided written informed consent before the study commenced. All data presented and quoted have been fully anonymised.
Author Contributions
MH: conceptualisation, methodology, data collection, data curation, data analysis, project administration, resources, supervision, writing – original draft, review and editing, funding acquisition. CH: methodology, supervision, writing – review and editing, funding acquisition. MK: methodology, data collection, data curation.
Funding
This project was funded by the National Institute for Health and Care Research (NIHR) School for Social Care Research (SSCR). The views expressed are those of the authors and not necessarily those of the NIHR SSCR, NIHR or Department of Health and Social Care.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.