Clinical and Educational Perspectives on Affective and Sexual Development in Adolescents and Young Adults with Autism Spectrum Disorder: A Narrative Review

Abstract

In adolescents and young adults, sexuality and affectivity contribute significantly to identity development and quality of life. Regarding individuals with Autism Spectrum Disorder ( ASD ) , older literature has often neglected these domains or portrayed them through infantilizing stereotypes or a lack of interest in intimacy. More recent work, on the contrary, describes affective and sexual needs in line with those of peers, despite specific social, communicative, and environmental obstacles. This narrative review contributes to the main evidence regarding psychosexual development, romantic relationships, sexual orientation and gender identity, vulnerability to victimization, and affective-sexual education in individuals with ASD, with a particular focus on clinical and educational implications. The literature highlights the role of difficulties in social communication, the interpretation of implicit signals, emotional regulation, and sensory processing, as well as the limited availability of educational programs specifically tailored to autism. A higher frequency of non- heterosexual sexual orientations and transgender or non-binary gender identities is also documented, which require an affirmative and non- stigmatizing approach. Vulnerability to coercion, abuse, and victimization represent further critical factors. From this perspective, sexuality education should not be limited to preventing problematic behaviors, but should also promote consent, self- determination, safety, interpersonal skills, and access to fulfilling relationships. Sexual health protection should therefore be adequately integrated into care pathways for adolescents and young adults with ASD, according to a biopsychosocial model centered on the person and quality of life.