1205630

research-article2023
AUT0010.1177/13623613231205630AutismDouglas and Sedgewick

Original Article

Autism

Experiences of interpersonal victimization 1­–14

© The Author(s) 2023

and abuse among autistic people Article reuse guidelines:

sagepub.com/journals-permissions
https://doi.org/10.1177/13623613231205630
DOI: 10.1177/13623613231205630
journals.sagepub.com/home/aut

Sarah Douglas and Felicity Sedgewick

Abstract
Intimate partner violence and sexual assault are under-researched experiences in autistic people’s lives. Recent research,
however, has shown that autistic people are more likely to have been victimized than non-autistic people. This research,
therefore, sought to explore the firsthand accounts of a range of autistic people about intimate partner violence and
sexual assault. Twenty-four autistic adults with lived experience (6 male, 15 female, 3 non-binary) aged 25–61 years took
part in semi-structured interviews online. They were asked about their experiences of intimate partner violence and
sexual assault, whether and how they felt being autistic interacted with those experiences, and what recommendations
they would have for improving education in the future. Almost all participants had repeated experiences of intimate
partner violence and sexual assault, regardless of gender, and there were clear similarities in their stories. Six themes
with subthemes were identified. These were ‘experiences of abuse’, ‘autism used against you’, ‘poor family models’, ‘impact
of/on friendships’, ‘handling trauma’, and ‘recommendations for future practice’. Autistic people experience many of the same
patterns of abuse as non-autistic people do, but there are unique autism-related vulnerabilities and outcomes. We found
that there were a variety of responses to these experiences, and call for greater understanding so that autistic victims
can be better supported.

Lay abstract
What do we already know?
Autistic people are more likely to have negative life experiences than non-autistic people, from bullying and ostracization,
to being victims of crime, to unemployment and homelessness. This includes being victims of intimate partner violence,
sexual assault and domestic abuse. Quantitative work has suggested that as many as 90% of autistic people experience
these forms of abuse in some form during their lives, but there is little work asking them to talk about harmful relationships
in their own words.
What does this article add?
This article reports on interviews with 24 autistic adults about their experiences of being victims of intimate partner
violence, sexual assault and/or domestic abuse. Some of the themes which came from these interviews are shared with
non-autistic victims, but others appeared unique to autistic people. One of these was evidence for unique autism-related
vulnerabilities, as well as the impact the abuse had on their relationships long term. Participants also talked about how
the sex and relationship education they had received had inadequately prepared them for adult relationships, and how
this had contributed to their struggle to recognize and react to abusive behaviour.
Implications for practice, research and policy
Policies around intimate partner violence and sexual assault need to be updated to account for the different ways in
which neurodivergent people (people whose brains process information differently from the majority) may discuss their
experiences, rather than looking for ‘standard narratives’ as an indicator of a need for support. Relationship and sex
education should be tailored for autistic young people to help them recognize abusive behaviours, and include how to

University of Bristol, UK Corresponding author:

Felicity Sedgewick, School of Education, University of Bristol, 3.05, 35
Berkeley Square, Bristol BS8 1JA, UK.
Email: [email protected]
2 Autism 00(0)

respond to these safely. We recommend that future research tries to focus specifically on the abuse experiences of
autistic men, non-binary and trans people, who have been under-represented in studies to date. In addition, much less is
known about the abuse experiences of autistic people of colour or autistic people with intellectual disabilities, who also
need to be actively included in these discussions.

Keywords
autism, intimate partner violence, relationships, sexual assault

Introduction adults. On a measure of general negative life experiences,

including financial hardship, homelessness and domestic
Autism is a neurodevelopmental condition associated with abuse, autistic adults were several times more likely to
differences in social interaction, executive function, repet- have been in these situations (Griffiths et al., 2019). A fur-
itive behaviours (also known as self-stimulating or stim- ther meta-analysis looking at the prevalence of victimiza-
ming) and intense interests, and sensory sensitivities tion among autistic people showed that 40% of people
(American Psychiatric Association, 2013). Around 1%– reported sexual victimization, 16% reported being abused
2% of the population are autistic, with a gender disparity in as a child and 84% of autistic adults reported having been
diagnosis rates – around three males are diagnosed for victimized in more than one of the potential categories
every one female (Loomes et al., 2017), with an increas- (Trundle et al., 2023). These are stark statistics – it means
ingly recognized pattern of under- or mis-diagnosis for that the majority of autistic adults have experienced at
women (Gould, 2017). Historically, research into autistic least one period of victimization, and most will have been
experiences has focused on males, and particularly on chil- victimized multiple times in their lives, often by people
dren, meaning that the understanding of adult life experi- who they should have been able to trust such as friends,
ences, such as romantic or sexual relationships, and family members or carers. This appears to be particularly
especially those of women and non-binary people, is the case for autistic women and people assigned female at
severely lacking. For a long time, it was assumed that most birth, with between 60% and 90% reporting some form of
autistic adults did not often have romantic or sexual rela- serious sexual assault or domestic violence experience
tionships, and indeed that generally they would not live (Cazalis et al., 2022). Saying that, there is some evidence
independently (Howlin, 2000). While there have long been that autistic men, non-binary and trans people also experi-
a wealth of first-person accounts challenging this stereo- ence elevated rates of unwanted sexual contact (Brown
type, it is only recently that formal research has started to et al., 2017; Brown-Lavoie et al., 2014). For example,
investigate the sexual and romantic experiences of autistic sexual victimization rates have been shown to range from
adults. 27% for cisgender men to as high as 85% for trans men
The first thing to note is that autistic adults can and do (Reuben et al., 2021), showing that this is an important
have sexual and romantic relationships, and that while issue for autistic adults of all genders.
there is some evidence that their relationships may tend to The above articles, and much of the work on autistic
be of shorter duration (Hancock et al., 2020), this is not experiences of abuse and victimization in general, have
universal, and autistic people can be in happy partnerships been quantitative, attempting to gain an accurate picture of
for decades, just as non-autistic people can. Indeed, one the scale of the problem. Less work has been done using a
recent study has suggested that neurodivergent people qualitative approach, where autistic people are asked to
(people whose brains process information differently from share their experiences in their own words. One study
the majority), – in this case, specifically those who were which has done this, however, interviewed more than 100
autistic or had attention deficit hyperactive disorder autistic people about having been victimized by people in
(ADHD) – may show more passionate love in their rela- their lives such as family members, friends and romantic
tionships, rather than less (Soares et al., 2021). Around or sexual partners (Pearson et al., 2023). Starting in child-
half of autistic adults without learning difficulties are in hood, participants shared examples of times they had been
long-term relationships, mostly living with their partner hurt, manipulated and abused by these people, and how
(Dewinter et al., 2017), and when asked about the quality this formed their expectations for relationships in general.
of those relationships, they rate them just as close, support- Another small-scale study into the romantic relationships
ive and important as non-autistic people do (Sedgewick, of autistic women found similar patterns, with most having
Leppanen, & Tchanturia, 2019). been victimized at some point, often repeatedly (Sedgewick,
Unfortunately, what we also know is that autistic adults Crane, et al., 2019). In reflecting on these experiences,
often experience some form of intimate partner violence women also discussed how they felt being autistic had inter-
(IPV) or sexual abuse (SA),more so than non-autistic acted with the malicious intent of their abusers to make
Douglas and Sedgewick 3

them less able to recognize when something was unusual All but one participant reported having formal autism
(even if they knew that they personally did not like what diagnoses, from a range of practitioners, with one person
was happening), to communicate their lack of consent or being self-identified (Mean age at diagnosis = 31.83,
desire to leave a situation, or to see the hidden messages in SD = 15.22, range: 8–59). All participants completed the
other people’s behaviours. Combined with having fewer Autism Quotient – 10 item version (AQ-10; Allison et al.,
friends they could talk to about their experiences and check 2012) to enable description of autism symptomatology in
whether the treatment from the abuser was normal, they a brief manner. Only one non-binary participant scored
often ended up staying in abusive relationships longer than below the recommended cut-off point, but was retained in
they felt they should have, because they lacked the social the sample due to recognized biases in the ability of the
support to recognize domestic violence and then to end the AQ-10 to identify autistic non-males (Mean score = 8.17,
relationship – a crucial factor in leaving safely. SD = 3.15, range: 4–10). Twenty-one participants reported
Participants in these studies especially emphasized how additional physical and mental health diagnoses, with
difficult it was for them to recognize that what had hap- anxiety (n = 11), PTSD (n = 4) and depression (n = 7) being
pened was wrong, and that trying to find ways to socialize the most common. Sixteen participants reported having
safely with a background model of relationships as hurtful more than one additional physical and mental health diag-
was exhausting, difficult and could lead to overwhelm and nosis, and one participant reported co-occurring ADHD.
burnout. These negative impacts of the abuse they had expe- Twenty-three participants identified as White (from the
rienced lasted well past the point of initial harm, with many United Kingdom, United States and Australia), with one
developing post-traumatic stress disorder (PTSD). This is person identifying as Latino (from the United States).
something we see in non-autistic victims as well (Dutton Twenty-one participants were based in the United
et al., 2006), and it is not surprising considering that autistic Kingdom, two in the United States and one in Australia.
people are generally more likely to develop PTSD (Rumball Specific information on sexuality, socioeconomic status
et al., 2020), and to suppress their trauma-related thoughts and educational attainment were not collected.
which can lead to longer lasting harm (Golan et al., 2022). Recruitment took place via advertising the study on
Indeed, the events which lead to PTSD have been shown to social media (Twitter, Facebook), and through the
differ for autistic and non-autistic people, with autistic peo- researcher’s personal networks, calling for participants
ple being much more likely to have been traumatized by a who were autistic and had lived experience of IPV/SA.
social event (Haruvi-Lamdan et al., 2020), which would They were informed that this was an interview-based study
include IPV or SA. It is worth noting, though, that autistic about their experiences, and that they had the option of
women have talked previously about having found ways to communicating via their preferred method, as well as
thrive and be successful despite the trauma they have been being offered the chance to see the planned interview
through and the impact it has on them (Webster & Garvis, questions in advance of taking part. Ethical approval was
2017), something which has not been thoroughly explored. granted by the University of Bristol School of Education’s
The current study sought to expand the body of litera- Ethics Committee, and participants provided written
ture qualitatively exploring autistic people’s experiences informed consent before taking part, along with confirma-
of IPV and SA, explicitly including autistic people of all tory verbal or written consent prior to beginning the inter-
genders. The limited work in this field to date means that view. The sample is majority non-male, which differs to
much is still to be learned and understood about how autis- the general diagnosis pattern for autism, which stands at
tic people understand, manage and recover from these 3:1 male: female (Loomes et al., 2017). While this means
kinds of trauma. Improving knowledge about these topics the sample is not necessarily representative of all autistic
in a more diverse group of autistic people can help to people, it is not unexpected because the majority of vic-
inform education and support practices. We sought to dis- tims of IPV and SA are female, and there is no reason to
cover whether there are common patterns in experiences assume that would differ for the autistic population.
across genders; the ways in which autistic people feel
being autistic impacts their experiences; and what they felt Materials
could have helped them prepare for entering romantic and
sexual relationships more safely. Demographics. Participants verbally completed a short
demographics questionnaire before the semi-structured
interview began, answering questions about their age, gen-
Methods der, ethnicity, autism diagnosis and additional diagnoses.
Participants
Autism quotient – 10 item version (AQ-10). Participants ver-
Twenty-four autistic adults (6 cisgender male, 15 cisgen- bally completed this measure (Allison et al., 2012). The
der female, 3 non-binary) participated in semi-structured questionnaire assesses levels of autistic traits and consists
interviews (Mean age = 39.15, SD = 11.82, range: 25–61). of 10 statements. Participants answered ‘Yes’ or ‘No’
4 Autism 00(0)

Figure 1. Thematic map.

Solid arrows represent direct theme/subtheme relationships; dashed arrows represent connections between separate themes and subthemes.
RSE: relationship and sex education.

(adapted for simplicity) as to whether they identify with themes and as far as is possible, autonomous of the
each statement. Scores range from 0–10, with a cut-off researcher’s preconceptions. This process followed the six
score of six or above being considered to reflect poten- steps outlined by Braun and Clarke (2006). The first three
tially clinical levels of autistic traits. stages were conducted independently by the two authors:
(1) data familiarization, (2) generation of initial codes
Semi-structured interview. The interview schedule was co- from semantic content, (3) searching for themes which can
produced between the two authors, one of whom is multi- be descriptive overviews of those codes. The two authors
ply neurodivergent, including being autistic. Questions then met multiple times to proceed through the final three
covered experiences of IPV and sexual victimization; stages: (4) reviewing themes through discussion between
whether and in what way participants felt being autistic the authors, (5) agreeing on themes and subthemes, and
interacted with these experiences; the sex and relation- naming them and (6) report production. There was a high
ships education they had received; and what they thought level of agreement on the initial codes the authors identi-
could be done to improve this education. The full inter- fied, though this was not quantified, with initial differ-
view schedule can be found in Supplementary Materials. ences in how these were grouped into themes. These
independent themes were refined through discussion into
those presented in this article.
Procedure
Data were collected between May and August 2020, during
Community involvement statement
the early phase of the COVID-19 pandemic. Due to this
global context, all interviews were conducted online. From the start, this has been a co-produced project. The
Participants were offered the choice of video on (n = 20), research team are neurodiverse, with personal experience
video off (n = 1) or to communicate through typed chat of the issues covered, as well as experience in counselling
(n = 3). Non-typed interviews were audio recorded and neurodivergent survivors of abuse. Lived experience has
transcribed verbatim. Participants each received a £20 therefore informed every stage of this project, from con-
Amazon voucher as a thank-you for taking part in the study. ception and interview design, to manuscript production.

Analysis Results
Transcripts were subject to inductive thematic analysis, Six themes were identified in the data, with additional sub-
that is, without any theoretically grounded, predetermined themes. These are visualized in Figure 1. Solid arrows
Douglas and Sedgewick 5

denote connections between themes and their subthemes, autistic people in this study also aligned with the com-
dashed arrows denote connections between separate monly recognized behaviours in abusive relationships.
themes and subthemes. Please note that due to some poten- Examples such as gaslighting (psychologically manipulat-
tial participants withdrawing between registration and tak- ing someone into doubting their own recollections of
ing part in the interview, participant numbers go to 29 events or their mental health), coercion, physical, financial
although 24 people were included in the final dataset. abuse and isolation are outlined below:

Gaslighting: ‘the guy actually said to me it’s all in my head,

Experiences of abuse you know, it didn’t really happen, so it’s actually made me
There were striking similarities in the stories of our partici- think not to say anything in the future’. (Participant 14,
pants – although the specific ways in which they had been autistic woman)
abused may have been different, they described similar
Coercion: ‘being pressured into doing stuff that I wouldn’t
patterns of prevalence of abuse, persistence of abuse, fea-
normally do to get a job and stuff like that’. (Participant 4,
tures of their abusers and abusive relationships having autistic woman)
been a recurring pattern in their lives.
Physical abuse: ‘he headbutted me and left a goose-egg on
Sexual assault and rape. The majority of our female and my forehead’. (Participant 3, autistic woman)
assigned-female-at-birth participants had been physically
sexually assaulted or raped, both by strangers and by Financial abuse: ‘what I hadn’t realised is that she’d been
friends or acquaintances, as had some cisgender male par- siphoning money off to herself . . . put [joint savings] into her
ticipants. This form of victimization was something that own account’. (Participant 15, autistic man)
they had encountered within multiple types of interper-
sonal contexts, both inside established abusive relation- Isolation: ‘she told all her friends I was abusive . . . she spent
ships and by people who they had no previous interactions a lot of time making sure she spoke to the right people about
with: how horrible I was . . . I got pushed out, especially in our
church’. (Participant 12, autistic man)
I was raped when I was 17 . . . [by] a friend of a friend,
somebody I knew . . . and it’s sort of happened a couple more Equally, other people found that abusers tried to use
times since then. One time I was drugged in a nightclub. systems of power to continue to hurt them or impact their
(Participant 4, autistic woman) lives, such as blocking a path to university (a physically
and sexually abusive father exercising coercive control),
I also was assaulted by a random stranger once on a bus . . . trying to take more than what was fair in a divorce (an
he started putting his hands under my clothes and he tried to abusive ex-husband) or weaponizing the legal system to
get me to put my hand on his penis. (Participant 8, autistic continue sending abusive messages:
woman)
initially there was a refusal of contact with the child which we
I was raped by an older boy in primary school . . . and I was had to go to court and get resolved, we now have the Court
sexually assaulted by a teacher in secondary school. Order . . . there are repeated calls to Social Services with
(Participant 16, autistic man) made up allegation’. (Participant 15, autistic man)

In addition, participants of all genders talked about hav- I still have to be in contact with him [for the kids], he still is
ing been coerced into having sex or specific sexual activi- abusive over text message. (Participant 3, autistic woman)
ties by their partners:
Partner characteristics. There was a significant diversity
if I like, just wasn’t in the mood, she would make me feel really among the perpetrators of abuse against our participants,
guilty and say that it meant I wasn’t attracted to her, that I including family members (in childhood), teachers (also in
didn’t love her. (Participant 2, autistic non-binary person) childhood), friends or peers (at school or university),
opposite- and same-sex partners and strangers. For those
You do actually get to the point where you just think ‘Actually, who were recounting abuse at the hands of romantic part-
if I fight this, it’s going to be hell anyway, one way or the
ners, a shared pattern was that those partners were also
other’. We might as well get [it over with.] (Participant 17,
neurodivergent in some way, had mental health issues or
autistic woman)
had traumatic life histories:

Classic abuse tactics. In addition to sexual assault, which he was autistic too, and would say that what he did was my
was as often reported being committed by strangers as fault because I was triggering him, his sensory stuff, or
established partners, tactics which abusers used against the because I was being unreasonable in asking for my
6 Autism 00(0)

accommodations so he had to do these things to show me how was something which all our participants experienced.
to properly be his partner. (Participant 17, autistic woman) They talked about the fact that they felt particularly vul-
nerable to it, though, because they were autistic and were
she had her own emotional issues, she was a narcissist . . . used to being the one who ‘got things wrong’:
she came from a very controlling environment and learned it
all from her mother. (Participant 12, autistic man) I thought I was misinterpreting myself . . . they’re saying this
is enjoyable and this is fun, but I’m not liking it . . . in general
These characteristics were then seen as underlying in any kind of social situation I always got things wrong.
causes for the abusive behaviour of their partners, and so (Participant 2, autistic non-binary person)
the autistic victims spent a lot of time rationalising how
they had been treated: I grew up being told I was wrong, too sensitive, too serious,
not ladylike etc . . . for a long time I wasn’t even sure who I
he did get a diagnosis of BPD (Borderline Personality was . . . being involved with domestic violence does that too.
Disorder) . . . he was medicated for a little bit and the abuse (Participant 28, autistic woman)
stuff got better, but he got allergic to the medication, and
that’s when the final break happened ‘cause it just got really By undermining the participant’s sense of self along
bad really quick . . . got pushed into walls, pushed into with their sense of the relationship, the abusers were able
counters . . . [it was] emotional, verbal, very nasty, mean- to play on a lifetime of messages that the autistic people
mouthed. (Participant 3, autistic woman) ‘get it wrong’ to perpetuate the abuse. The other way in
which abusers often used the diagnosis to undermine autis-
I didn’t realise that people deal with these things different
tic people was in the eyes of other people – making them
than I would, I was kind of like ‘oh you’ve had a bit of crap
out to be unstable, or unreliable narrators of their experi-
growing up, you’ve gotten over it, you’re a functioning human
being’ but obviously he was deeply, deeply affected by stuff ences, for example. By doing this, the abusers created dis-
and it came out with him not being the nicest person to me. tance between the autistic victims and those who could or
(Participant 4, autistic woman) should help them, making it harder for the victim to leave.
This is an example of classic abuse tactic of isolation, but
for our participants it often had the added factor of telling
Autism used against you other people that the victim was autistic, playing on stereo-
Just as some abusers used their own neurotype, mental types about autistic people as being ‘bad at understanding
health or life history as excuses for their behaviour, many other people/social situations’ to minimize or dismiss
found ways in which to exploit or manipulate the autistic accounts of their abuse:
victim based around being autistic.
[he] didn’t want me to see friends and family without his
Abusing through autistic traits. There was a clear pattern consent . . . he told them I was autistic and that I thought every
little argument was abusive. (Participant 14, autistic woman)
of abusers using the fact that the victim was autistic against
them in some way to make the abuse more effective – many
she made me cut off all relationships I had with female friends
of them deliberately, as many participants had their diag- . . . male friends it was more subtle . . . making it known she
noses at the time they were in these relationships. Beyond was disappointed I was going to see them, or talking about all
the ways in which being autistic could be used to identify the ways I was ‘bad at relationship’, when we did to undermine
someone as a target for abuse ( ‘I think I appeal to that me. (Participant 15, autistic man)
kind of person, because I’ve always been a bit of a loner,
not had someone to talk to, to tell’ Participant 29, autistic Misinterpreting harmful intentions. All our participants had
woman), participants specifically talked about their abusers been sexually assaulted and raped more than once, or had
deliberately triggering meltdowns, so that the abuser could been in more than one abusive relationship. Many attrib-
then present the autistic victim as the ‘unreasonable one’: uted this to not recognizing the signs of abusive behaviour,
or of malicious intent in others:
she played on my autism quite a lot . . . she would use stuff
against me, she’d like trigger me to have a meltdown . . . then as I trusted people to not do horrible things ‘cause I would never
soon as I had the meltdown she’d be like ‘see, you’re the problem, imagine that they would do those thing. (Participant 4,
I have to put up with this’. (Participant 7, autistic woman) autistic woman)

I had the meltdown and he just said I’m being really emotional, he was the last in a line of people that kind of took advantage
really crazy. (Participant 14, autistic woman) of me when I was younger . . . I didn’t really understand, you
know, what really it would look like if somebody was interested
Undermining the autistic victim. One of the classic in you . . . so technically [there] was consent, but not informed
abuse tactics mentioned above is gaslighting, and this consent. (Participant 3, autistic woman)
Douglas and Sedgewick 7

I went straight out of that situation into an abusive relationship my parents would not have passed an exam for being parents
with my ex . . . that felt better, because I was like ‘yes, well . . . my father’s idea of telling us we were bad was give us a
she’s not doing these things to me, so it must be fine’’. backhander across the face, very fond of using pain . . . we
(Participant 7, autistic woman) were abused children and we accepted that was natural, well
that’s how it happens. (Participant 12, autistic man)
Participants emphasized that this was one areas where
they felt that being autistic most strongly intersected with In the case of some participants, family members were
their experiences of victimization. This was because they their original abusers, adding another pattern to
assumed the best of other people, they struggled to believe ‘Experiences of Abuse’, from our earlier theme. This meant
people could want to do something other than what they that from an (often incredibly) early age, sexual, physical
literally said, or they felt that being autistic made them and psychological abuse was part of their lives.
stand out as different, and therefore as a potential target:
my father used to molest me . . . I remember him doing it from
‘I did not read intentions well at all so I always felt sorry for the age of 6 or so, but I don’t remember when it started. He
him, I was like ‘oh there are all these reasons why he is being used to put his hands down inside my underwear, I used to roll
like this’ . . . he trapped me in his room, I couldn’t get out for away but he kept coming back. (Participant 2, autistic non-
the whole night. (Participant 7, autistic woman) binary person)

when I was only three I was sexually abused by my male

Now I look back and think how obvious it was right from the
paternal cousin. (Participant 9, autistic woman)
start that something wasn’t right . . . I take everything on face
value, I am not good at reading between the lines. (Participant
28, autistic woman) This obviously has nothing to do with the participant
being autistic and is entirely to do with the abuser – which
Some participants felt that being autistic meant that is the case in any situation where someone chooses to
they had difficulties understanding norms in relationships, abuse another person – but it is worth recognizing that
and therefore they were vulnerable to abusive partners being autistic can be a risk factor for abuse in childhood,
because they were less likely to challenge behaviours, especially when there are co-occurring cognitive or lan-
even if they didn’t like them: guage delays. Our participants did not report having these
delays, but their childhood experiences had a long-lasting
He would have sex with me, whether I wanted to or not . . . impact as they set a pattern for what they thought were
part of it was my lack of understanding about how relationships normal interactions:
work, and that my own feelings and wants and needs were as
important. (Participant 29, autistic woman) I actually have always ended up with quite exploitative
relationships, honestly. (Participant 18, autistic woman)
One participant summed this up by saying:
The other way in which experiences with families, and
I suspect autistic women are less well-equipped . . . to identify at school, were important was around learning about sex
people’s motivations, we’re less well-equipped to know what and relationships. Most participants, with a couple of nota-
to do in response when someone makes us feel bad, because ble exceptions, had no conversations with their parents
we’ve been made to feel bad since we were three years old. about what to expect from sex or romantic relationships,
(Participant 17, autistic woman) which they felt left them unprepared for the reality of this
aspect of life:
Poor family models from my parents, no – like we didn’t talk about it at all, very
Many of our participants talked about the fact that they felt repressed family, pretty sure my parents are both on the
they had poor family models of relationships, and that this spectrum somewhere (Participant 4, autistic woman)
meant they were primed not to recognize abusive behav-
iour, or to misinterpret or excuse abusive behaviours, the parents kind of all assumed that the school would sort
because it was the norm within their family: everything out, and the school always assumed that the parents
would sort everything out. (Participant 17, autistic woman)
[my mother] will tell you that she got knocked up at 17 and
married an abusive drunkard. (Participant 3, autistic woman) Impact of/on friendships
mother [was] neglectful when we were very little, physically Along with family relationships, friendships were repeat-
abusive, always threatening to put me in care. Father: edly mentioned by our participants as being important in
physically and verbally abusive, and a gaslighting shit to this their experiences of abuse. Some had friends who were
day!. (Participant 9, autistic woman) themselves manipulative or abusive:
8 Autism 00(0)

an old best friend when we were about 12, we’d gone to the I didn’t have that girl group that would normally be like ‘no
swimming pool together and afterwards we were in the dude, don’t get involved with that guy’ because those girl
changing rooms . . . .he threw my clothes and my swimmers groups, in my case, they weren’t around. (Participant 3,
which I’d taken off into his cubicle . . . he wanted me to do autistic woman)
everything. (Participant 2, autistic non-binary person)
This meant that our autistic participants were relatively
she had bullied me before . . . I pretended to be friends with isolated even before their abusers started to cut them off
her for an easier life. (Participant 9, autistic woman) from the few friends and connections they had. They were
therefore more reliant on their abusive partner as their
Some participants also talked about the fact that they main relationship than many non-autistic people would
deliberately mimicked certain peers or friends who they be, again making it harder to leave or challenge the
thought were socially successful, and that this led them behaviours.
into behaviours which they would not have necessarily
chosen otherwise: I used to rely all on one person, that’s one thing you shouldn’t
do . . . whoever you’re with. (Participant 22, autistic woman)
one of my only friends, basically, that I had for a long time . . .
she is the one that talked me into basically trying [sexual] Losing friends due to disclosure. Another aspect of interac-
things with the boyfriend at the time, dating older guys who tions with friends which several participants discussed
were not really appropriate. (Participant 3, autistic woman) was their friends’ reactions to being told about the abuse
the autistic person had experienced. While some had
This kind of masking was something which several par- supportive friends, or family members, many had much
ticipants had experienced. They did not always feel that more negative reactions from those around them. For
this contributed to abuse in their lives, but that they did end example, some had friends who denied that the assault or
up behaving in line with their ‘masked persona’ rather than abuse had happened, or who ended the friendship over
their authentic selves, which impacted relationships: the disclosure:

over time I became the funniest guy in the group which gave my friends . . . hadn’t believed me – like my best friend, who
me acceptance, a very false acceptance . . . I land up sleeping kept saying ‘Oh, I just think it’s the dynamic between you
with a girl that I had absolutely no emotional feelings for or two’. (Participant 17, autistic woman)
even sexual feelings for. (Participant 12, autistic man)
I tried to tell a friend, whose friend it was that [raped me], on
Both in regards to friendships and romantic relation- the first occasion, but it didn’t go well . . . I lost a friend
ships, participants talked about the impact of unmasking as because of it . . . she didn’t want to deal with it, it was better
much as the impact of masking. Often, when they were to pretend it didn’t happen, or didn’t happen how I was saying
unable to maintain their masked persona for some reason, it happened. (Participant 4, autistic woman)
or when they chose to behave in a more authentic way, this
was received negatively by those around them: Overall, the lack of social support autistic victims felt
was available to them had a significant impact on their
after I got pregnant and the hormones kicked in, I had zero ability to recognize abusive behaviour, and then to seek
spoons [energy] for anything else. I couldn’t mask anymore help with addressing that abuse. Many felt that they were
. . . he found that difficult and so things got worse. (Participant left to manage their experiences and their trauma alone,
28, autistic woman) which leads into the next theme.
after [the rape] I really struggled to keep up my mask in big
groups and social situations, especially parties like where it Handling trauma
happened . . . some of my friends kind of dropped me and All our participants recognized that the experiences they
stopped inviting me because ‘I wasn’t like before’. (Participant
had been through would generally be considered trau-
4, autistic woman)
matic. For some, this had the same kind of impact as
expected on non-autistic people, such as feeling anger or
Lack of protective friendships. For most participants, developing PTSD:
though, the main thing they focussed on was a lack of
friendships across their lives, which meant that they I was absolutely ragingly angry with everybody . . . it’s not
missed out on the protective advice or intervention their fault but it just really had an impact on our relationships.
which many non-autistic people benefit from. For exam- (Participant 18, autistic woman)
ple, they had no-one to talk to about it when they were
abused, or to check whether what they were going I had to have quite extensive therapy for PTSD. (Participant
through was normal: 20, autistic woman)
Douglas and Sedgewick 9

However, many said that they felt the events did not didn’t trust myself to know I had read the situation right.
hold an ongoing power over them, instead minimizing the (Participant 7, autistic woman)
impact or seeing it as a separate or inevitable part of life:
Long-term impact on relationships. Understandably,
I did what some [autistic] people tend to do, we compartmentalise while some participants felt that there had been minimal
it, so I just put it away for a while. (Participant 22, autistic impact from their abuse, the majority said that these
woman) experiences had significantly changed how they
approached relationships. For some, this impact was to
there’s a sort of general acceptance because it’s so horrifying, help them make better and safer relationship choices,
you’re so powerless to do anything about it, so you have to because it showed them what signs to look out for, and
accept it on some level . . . it’s almost like you’re in trauma or it’s they knew that their current relationships were healthy
over, it’s just black and white. (Participant 25, autistic woman)
because they did not have the same behaviours as previ-
ous ones:
This response appears to be trying to neutralize the
traumatic experience as part of someone’s biographical there was a couple of times when I was like ‘oh, this is a red
sense of self. Some participants put this down to their abil- flag for me’, and we’d talk it over . . . I’d be worried if she
ity to remove emotion from how they reacted or thought didn’t want to talk. (Participant 7, autistic woman)
about something, which they felt was a strength of being
autistic in these difficult situations: I’ve developed skills to identify my boundaries and the kind of
boundaries I don’t want people to cross . . . I trust him, I don’t
I approach decisions with an excruciating level of rationality think he’s going to be scheming for ways to manipulate me.
and logic . . . it’s mostly been quite helpful, I’ve taken a very (Participant 20, autistic woman)
practical view on everything. (Participant 15, autistic man)
A minority of participants, though, found their experi-
Shutting down. Most of our participants recalled that as ences had the opposite effect. Rather than giving them an
things were happening to them, their automatic response indication of what good relationships looked like, their
was to shut down, and try to shut it out, rather than to react experiences left them scared and suspicious of anyone who
aggressively or even by trying to run away: sought out a relationship with them:

I think that predisposed me to . . . I was less likely to put up I used to assume the best intentions, and now I just go ahead
resistance and more likely to blame myself. (Participant 20, and assume the worse. (Participant 3, autistic woman)
autistic woman)
I avoid people in general as much as humanly possible.
I was very, very passive . . . I’d just float along, a situation (Participant 4, autistic woman)
would happen to me. (Participant 22, autistic woman)
I see the vast majority of men as potential sexual predators,
Many attributed this to ‘passivity’ – both in terms of whereas a neurotypical person would think ‘ok, this has
things being done to them, and in terms of appearing as happened but not all men are like that’. (Participant 9, autistic
someone whom things could be done to. Because of this woman)
passivity, which was often a learned response to a lifetime
of being told that their natural responses were wrong both A minority took this to the point of extrapolating from
at home and in school, many victims were then reluctant to how they had been treated by one person to ‘all people are
report what had happened to them. Many felt that they like that really, so I might as well do what I want’, and
wouldn’t be believed, because they hadn’t said ‘no’, or becoming very cold and transactional in how they talked
thought that they had not said it ‘the right way’: about sexual partners:

I didn’t tell anyone! I just thought I’d get in trouble . . . I just I’ve found for myself many time the trade-off is sex . . . if I
didn’t think I’d be believed, to be honest. (Participant 22, sexually satisfy you . . . .you can tell me about normal life.
autistic woman) (Participant 12, autistic man)

Autistic people also explicitly talked about blaming It is not surprising that a range of different people would
themselves for what had happened based on their response, have a variety of long-term responses to repeated victimi-
or lack of response, and their perceived difficulties in zation. This variation highlights the need for better under-
interpreting social interactions: standing of these experiences among autistic people, and
support for those who have been victimized, to try to
At the time I felt like, I’d definitely done something wrong and ensure that future relationships are positive rather than
I was very worried about getting him into trouble, because I leading to further isolation.
10 Autism 00(0)

Recommendations for relationship and sex and break, if education is not supporting younger autistic
education (RSE) people to develop healthy relationships.

We also asked our participants what they wished they had

been taught earlier in life, considering that they had gener- Discussion
ally had very little RSE. Along with the lack of open and
This study presents a qualitative exploration of autistic
honest discussions about sex and relationships mentioned
people’s experiences of IPV, SA and domestic abuse.
in Poor family models, the RSE our participants had
Many of the incidents and themes described reflected clas-
received at school was felt to be woefully inadequate.
sic abuse tactics and experiences, but participants dis-
Some had no RSE, due to their age or location, and most
cussed the ways in which they felt being autistic had
had classes which focussed solely on the biological and
intersected with their relationships to mark them out as
physical mechanics of the process, with no discussions of
potential targets, or made it harder to recognize and
healthy relationships or consent:
respond to the abuse. They also discussed the lack of edu-
cation they received, which meant they were unprepared
I think we just had some kind of basic biological teaching . . .
as if it was the 1950’s. (Participant 25, autistic woman) for relationships, and the kind of things they would have
liked to have learned to equip them better.
it was more about biology than anything else, nothing about The findings in this article, that autistic people have
relationships. (Participant 27, autistic woman) often been multiply victimized, either through repeated
assaults or multiple abusive relationships, directly echoes
Most participants said they wished that they had been the findings from larger-scale interview–based work with
taught about healthy relationships, not just about the phys- autistic people (Pearson et al., 2023). That study also found
ical acts of sex and pregnancy; about consent; and for edu- that participants had multiple experiences of victimization,
cation to be more gender balanced: though they were exploring a broader range of types of
victimization, such as including mate crime and difficult
[they need] this is what it looks like in a good relationship, employment situations. While this study specifically
this is what consent actually looks like out in the real world. recruited people who had experienced IPV or SA, the
(Participant 3, autistic woman) extent, severity and frequency of childhood abuse was
greater than would be expected in a non-autistic group of
you’re not equipped to know how do you tactfully, or even people, and is in line with other work about the prevalence
un-tactfully, just say, well, no . . . they’ve ended up doing
and age of first instance among autistic people (Cazalis
things that they didn’t really want to do because they just
et al., 2022). Taken together, this study and previous work
didn’t know how to say no. (Participant 17, autistic woman)
reinforce that experiences of abuse are incredibly common
I think, it’s kind of quite easy to be the stereotype of the boy among autistic people.
pushing for things . . . but I think the [idea that women can be This study sought to build on that knowledge by explor-
abusive], helping to recognise that that’s not healthy as well, ing how autistic people felt that being autistic had inter-
that would be useful. (Participant 15, autistic man) acted with or contributed to their experiences of abuse.
This is not to apportion blame to the autistic individuals,
This highlights the significant gaps in what young because it is always the perpetrator’s choice to abuse, but
autistic people have generally been taught about sex and to understand how being autistic may shape these experi-
relationships, as it cannot be assumed that they will get ences and how people handle them. Most participants felt
information from their peers in the same way as non-autis- that being autistic had contributed in some way, often say-
tic teenagers do. Indeed, one 25-year-old participant high- ing that they felt they presented an easier target for abus-
lighted that she had almost entirely learned about sex from ers, because they were more trusting, found it harder to
pornography, and that while she knew this was not neces- communicate a lack of consent or distress, or because they
sarily realistic, she had no other models of what to expect, lacked the social support to recognize abusive behaviour
so she planned to avoid sex altogether: and then leave. This supports previous work with autistic
women, who talked about struggling to recognize mali-
I wouldn’t want to have sex with anyone . . . I genuinely don’t cious intent in others or to ‘read between the lines’ when
want to. (Participant 8, autistic woman) being propositioned, and how being autistic meant that
they found it harder to identify whether something had
While our participants covered a wide age range and been SA or abuse (Sedgewick, Crane, et al., 2019).
therefore a variety of educational experiences, that even Similarly, research has recognized that especially for autis-
younger participants felt so unprepared was concerning. It tic children and young people who have cognitive and/or
suggests that the patterns of negative experiences related language delays, these factors may embolden abusers or
by our participants may still take some time to challenge influence which child they decide to victimize (McDonnell
Douglas and Sedgewick 11

et al., 2019; Pfeffer, 2016). It is likely that, even though and healthy relationships they had been in, and how in
our participants were mostly verbal and did not have co- good relationships, their partners had acknowledged the
occurring intellectual disability, aspects of being autistic differences which came with their neurotype, but did not
made them stand out to perpetrators in similar ways. use these to harm or manipulate them as abusers had.
One of the novel findings of this work is the descrip- That several of our participants discussed ways in
tions of ways in which abusers deliberately ‘weaponised’ which patterns of abuse had been present in their lives
features of autism against the participants. The most com- even from childhood was an unexpected finding. Research
monly discussed were, first, playing on the victims history with non-autistic people has previously shown that chil-
of difficulty in social situations to reinforce and strengthen dren who grow up in households where domestic or sexual
gaslighting tactics – emphasizing the message that they abuse is present are more likely to be in abusive relation-
didn’t understand social interactions properly to pretend ships as adults. This appears to apply to autistic people as
that behaviours weren’t abusive. Second, by deliberately well, and may be especially important in making it hard for
triggering meltdowns (an abusive behaviour in itself), and them to identify healthy and unhealthy relationship behav-
then using that to present the autistic victim as overly emo- iours from others, because they are likely to have fewer
tional, irrational and potentially even dangerous, both to alternative models for social interactions outside the fam-
themselves and to people outside the relationship. This ily, due to their social differences and often social isola-
acted to undermine the autistic person if they did tell some- tion. As autistic children whose parents report adverse
one what was happening or try to reach out for help, childhood experiences (ACEs) are themselves more likely
because people in their lives were predisposed to think that to have ACEs (Andrzejewski et al., 2023), it is likely that a
the autistic person was an unreliable narrator of events. similar inter-generational pattern can occur around abu-
Participants described this being the case with friends, sive relationships.
church communities and even family members, and how Another important finding in this study was the variety
these relationships sometimes suffered after they had left of ways in which autistic people described responding to
their abuser because those people felt it was the victims’ having been assaulted or in abusive situations. Some were
fault in some way. While this is not unusual for autistic or very matter-of-fact about their experiences, and felt that
non-autistic survivors, but where our participants and their they had moved on by drawing clear boundaries around it.
abusers knew that they were autistic at the time of the This type of compartmentalization or minimization could
abuse (often the case in adult romantic relationships), the be seen as a parallel to the dissociation which is common
abuser had often specifically played into stereotypes about as a response to trauma – one which often interferes with
autistic people’s social capacity to convince other people healing from the experiences. It has been shown to be a
that the participant had interpreted the situation wrongly. common experience among autistic adults who have expe-
Using autistic features to harm an autistic person is rienced interpersonal trauma (such as SA or IPV) (Reuben
stigma and prejudice in action, and could be classified as a et al., 2021). That this is such a widespread response
hate crime. Experiences of aggression, and oppression, among autistic people who have been through these kinds
based on being autistic, have been explored by autistic of trauma is important for authorities and support provid-
scholars through the lens of Minority Stress Theory ers to know, as it will influence the ways in which they
(Meyer, 1995). Minority Stress Theory argues that people work with survivors.
with minority or marginalized identities experience more Other participants discussed how there had been long-
stressors in their everyday lives, and that this contributes term impacts on their romantic and sexual relationships,
to poor mental health and overall outcomes. Autistic peo- from helping identify healthy and positive behaviours in a
ple are a neurominority, being neurodivergent in a majority partner to a generalized suspicion (particularly of cisgen-
neurotypical world, and therefore can experience identity- dered men) and reluctance to engage in new partnerships.
based discrimination in the same way as minority ethnic or Our participants also talked about having developed PTSD
sexuality groups can, with similar negative impacts on in response to their experiences. PTSD is a common
their mental health (Botha & Frost, 2020). In terms of response to having been a victim of IPV (Dutton et al.,
autistic experiences of abuse, Pearson et al. (2023) explic- 2006), and it is not surprising that this was also the case in
itly placed their research within Frost’s model of social this sample. As mentioned previously, autistic people are
stigma and its consequences (Frost, 2011). Through this more likely to have PTSD than non-autistic people, espe-
lens, they argued that abuse should be seen as a form of cially around social incidents (Haruvi-Lamdan et al., 2020;
‘situational’ vulnerability rather than personal vulnerabil- Rumball et al., 2020, 2021), and this study emphasizes that
ity – that being in a situation where the other person is message. It is possible that for autistic people, who are
willing to manipulate features of your neurotype to harm often already socially marginalized, the impact of relation-
you is not something which should be seen as the victim’s ship-based abuse is more intense than for non-autistic peo-
fault. This was echoed in interviews with our participants, ple, and therefore may contribute more to the development
who talked about the differences between the unhealthy of PTSD. More work needs to be done to understand the
12 Autism 00(0)

ways in which PTSD among autistic people based on IPV likelihood of warping the interpretation. The separate initial
and SA develops and is experienced, so that more effective coding of the data also ensured independence and gave
support can be designed to help this particularly vulnerable space for discussion about where authors may have brought
group. That several participants talked about their experi- their personal views into their codes. We would argue that
ences in ways which might appear unusual to professionals the make-up of the team was a strength of this work, and
who are not knowledgeable about autism could become a ensuring the input of people with lived experience is valua-
barrier to accessing support, as has been seen in physical ble in any study in this area. It meant that the measures could
health settings (Doherty et al., 2022), and policies for be designed collaboratively and phrased in ways which
working with neurodivergent victims are needed to were likely to be the least distressing for participants, for
improve care and potential prosecution rates. example. Most importantly, it meant that participants felt
Another form of support which was lacking in the expe- they could trust that researchers would understand what
rience of our participants was adequate RSE. Many had they were talking about and were therefore more able to be
only received basic instruction in the biology and mechan- open and share the truth of their experiences – incredibly
ics of sex, with no discussion of consent or good versus valuable in qualitative research on sensitive topics.
abusive behaviours, meaning that they were, in the words
of one participant, ‘ill-equipped’, for the reality and nuance
Limitations
of adult relationships. This lack of high-quality and wide-
ranging RSE for autistic young people has been discussed As with all research, there were limitations to this project.
in previous literature, highlighting that many are not taught First, the relatively small sample size means that the find-
what are appropriate behaviours either for them to engage ings should not be over-generalized. This is not unusual for
in or to receive from others (Beddows & Brooks, 2016; qualitative work, and the representation of autistic people
Hannah & Stagg, 2016). This has been shown to be a fac- of many genders is a strength of the sample, although this
tor in vulnerability to SA and IPV for autistic people of all would ideally be more equally balanced to ensure explora-
genders in adulthood (Brown-Lavoie et al., 2014). Even tion of the abuse experiences of men and non-binary people
our younger participants had struggled to access good who are often overlooked in victimization research. Second,
RSE, despite being of an age where RSE was mandatory we recognize that the sample is highly uniform in being
during their school years, instead often finding out infor- majority White, late diagnosed and mostly using verbal
mation themselves from less reputable sources, and this communication. It is likely that autistic people of colour,
left them with potentially harmful models of what to who are multiply marginalized, will have somewhat differ-
expect in a sexual relationship. It is also worth noting that ent experiences of abusive relationships, and of seeking
none of our participants explicitly mentioned that they had formal support, which are not included in this study. Those
attended anything other than mainstream schooling, and so who are diagnosed later in life are likely to have different
autistic people in special educations settings may receive vulnerabilities and experiences than those who have an ear-
even less effective RSE, where it may be assumed that lier diagnosis, which often accompanies more obvious sup-
young people do not ‘need’ it due to stereotypes about their port needs. This is especially the case for those who may
likelihood of engagement in romantic or sexual relation- rely more on caregivers, or be less able to communicate
ships (Sedgewick, Crane, et al., 2019). While there is rela- things that have happened to them, particularly in child-
tively little work on RSE for autistic young people, studies hood. Equally, those who use non-verbal communication
consistently show that this group feel they would benefit will have different experiences and challenges around the
from more, and more tailored, RSE (Cheak-Zamora et al., topic which would be valuable to further research. We did
2019; Hannah & Stagg, 2016). Considering that all chil- not collect information about sexual orientation from all
dren and young people in the United Kingdom now have participants, although participants discussed both differ-
to receive some form of RSE as part of their compulsory ent- and same-gender experiences – future research
schooling, this seems like an obvious target for improving should do so as non-heterosexual people may be more
the information given to young people of all neurotypes likely to experience interpersonal victimization, and less
about healthy relationships. Doing so may help to prevent likely to seek support (Rothman et al., 2011; Tillewein
future instances of autistic people being victimized, and et al., 2023). It is also worth noting that it was beyond the
the accompanying long-term mental health consequences. scope of this study to evaluate the impact of co-occurring
The research team and advisors were neurodiverse with neurodivergences or mental health diagnoses on autistic
varied lived experiences of sexual victimisation (SV) and people’s experiences of victimization, something which
IPV. These personal perspectives on the issue have the future research should investigate. Finally, this study did
potential to introduce subjectivity, as with any form of not focus specifically on experiences of interacting with
‘insider research’. However, the range of experiences dis- services, which would be a crucial issue to understand in
cussed by participants did not directly match with those of more depth to create recommendations for best practice in
the study team, giving some distance and reducing the supporting autistic abuse victims.
Douglas and Sedgewick 13

Conclusion autistic children and their caregivers: Examining intergen-

erational continuity. Journal of Autism and Developmental
This is one of the first studies to interview a wide range of Disorders, 53(7), 2663–2679. https://doi.org/10.1007/
autistic adults about their experiences with IPV, SA and S10803-022-05551-W/FIGURES/5
domestic abuse, and to ask for their reflections on how this Beddows, N., & Brooks, R. (2016). Inappropriate sexual behav-
interacts with their diagnostic status. We found that many iour in adolescents with autism spectrum disorder: What
autistic people’s experiences were in line with what is education is recommended and why. Early Intervention
known about general patterns of abuse, such as the tactics in Psychiatry, 10(4), 282–289. https://doi.org/10.1111/
used to perpetuate it. However, we also showed that there EIP.12265
Botha, M., & Frost, D. M. (2020). Extending the minority stress
are important ways in which being autistic changes or
model to understand mental health problems experienced by
shapes these experiences, in terms of being targeted, strug-
the autistic population. Society and Mental Health, 10(1),
gling to recognize the abuse and their abuser using autism 20–34. https://doi.org/10.1177/2156869318804297
against them in various ways. Developing better RSE for Braun, V., & Clarke, V. (2006). Using thematic analysis in psy-
autistic young people in school, and supporting families to chology. Qualitative Research in Psychology, 3(2), 77–101.
talk about safe and healthy relationships at home, would Brown, K. R., Peña, V., & Rankin, S. (2017). Unwanted sexual
empower autistic people to recognize and respond to abu- contact: Students with autism and other disabilities at greater
sive behaviour from the first instance, and potentially to risk. Development, 58(5), 771–776. https://doi.org/10.1353/
avoid people who display warning signs altogether. csd.2017.0059
Similarly, working with autistic people who have experi- Brown-Lavoie, S. M., Viecili, M. A., & Weiss, J. A. (2014).
enced abuse to design and implement training for social Sexual knowledge and victimization in adults with autism
spectrum disorders. Journal of Autism and Developmental
workers, police and survivor’s charities could go some
Disorders, 44(9), 2185–2196. https://doi.org/10.1007/
way towards improving the support available. It is impor- s10803-014-2093-y
tant for families, schools and support workers to under- Cazalis, F., Reyes, E., Leduc, S., & Gourion, D. (2022). Evidence
stand how autistic people may experience abuse differently that nine autistic women out of ten have been victims of sexual
to non-autistic people, so that better systems can be cre- violence. Frontiers in Behavioral Neuroscience, 16, Article
ated to catch these instances earlier and put a stop to them, 852203. https://doi.org/10.3389/FNBEH.2022.852203
and to help autistic survivors recover from their experi- Cheak-Zamora, N. C., Teti, M., Maurer-Batjer, A., O’Connor,
ences as positively as possible. K. V., & Randolph, J. K. (2019). Sexual and relation-
ship interest, knowledge, and experiences among ado-
Declaration of conflicting interests lescents and young adults with autism spectrum disorder.
Archives of Sexual Behavior, 48(8), 2605–2615. https://doi.
The author(s) declared no potential conflicts of interest with org/10.1007/S10508-019-1445-2/TABLES/1
respect to the research, authorship, and/or publication of this Dewinter, J., De Graaf, H., & Begeer, S. (2017). Sexual ori-
article. entation, gender identity, and romantic relationships in
adolescents and adults with autism spectrum disorder.
Funding Journal of Autism and Developmental Disorders, 47(9),
The author(s) disclosed receipt of the following financial support 2927–2934. https://doi.org/10.1007/S10803-017-3199-9/
for the research, authorship, and/or publication of this article: TABLES/3
Funding for this project was provided by the University of Bristol Doherty, M., Neilson, S., O’Sullivan, J., Carravallah, L., Johnson,
School of Education Grant Capture Fund. M., Cullen, W., & Shaw, S. C. K. (2022). Barriers to health-
care and self-reported adverse outcomes for autistic adults:
A cross-sectional study. BMJ Open, 12(2), Article e056904.
ORCID iD
https://doi.org/10.1136/BMJOPEN-2021-056904
Felicity Sedgewick https://orcid.org/0000-0002-4068-617X Dutton, M. A., Green, B. L., Kaltman, S. I., Roesch, D. M.,
Zeffiro, T. A., & Krause, E. D. (2006). Intimate partner
Supplemental material violence, PTSD, and Adverse Health Outcomes. Journal
Supplemental material for this article is available online. of Interpersonal Violence, 21(7), 955–968. https://doi.
org/10.1177/0886260506289178
Frost, D. M. (2011). Social stigma and its consequences for the
References socially stigmatized. Social and Personality Psychology
Allison, C., Auyeung, B., & Baron-Cohen, S. (2012). Toward Compass, 5(11), 824–839. https://doi.org/10.1111/J.1751-
brief “red flags” for autism screening: The short autism 9004.2011.00394.X
spectrum quotient and the short quantitative checklist in Golan, O., Haruvi-Lamdan, N., Laor, N., & Horesh, D. (2022).
1,000 cases and 3,000 controls. Journal of the American The comorbidity between autism spectrum disorder and
Academy of Child & Adolescent Psychiatry, 51(2), 202–212. post-traumatic stress disorder is mediated by brood-
American Psychiatric Association. (2013). Diagnostic and statis- ing rumination. Autism, 26(2), 538–544. https://doi.
tical manual of mental disorders (5th ed.). org/10.1177/13623613211035240
Andrzejewski, T., DeLucia, E. A., Semones, O., Khan, S., & Gould, J. (2017). Towards understanding the under-recognition
McDonnell, C. G. (2023). Adverse childhood experiences in of girls and women on the autism spectrum. Autism: The
14 Autism 00(0)

International Journal of Research and Practice, 21(6), 703– adults. Autism in Adulthood: Challenges and Management,
705. https://doi.org/10.1177/1362361317706174 3(3), 247–256. https://doi.org/10.1089/AUT.2020.0073
Griffiths, S., Allison, C., Kenny, R., Holt, R., Smith, P., & Baron- Rothman, E. F., Exner, D., & Baughman, A. L. (2011). The
Cohen, S. (2019). The Vulnerability Experiences Quotient prevalence of sexual assault against people who identify as
(VEQ): A study of vulnerability, mental health and life sat- gay, lesbian, or bisexual in the United States: A systematic
isfaction in autistic adults. Autism Research, 12(10), 1516– review. Trauma, Violence, & Abuse, 12(2), 55–66. https://
1528. https://doi.org/10.1002/AUR.2162 doi.org/10.1177/1524838010390707
Hancock, G., Stokes, M. A., & Mesibov, G. (2020). Differences Rumball, F., Brook, L., Happé, F., & Karl, A. (2021).
in romantic relationship experiences for individuals with an Heightened risk of posttraumatic stress disorder in adults
autism spectrum disorder. Sexuality and Disability, 38(2), 231– with autism spectrum disorder: The role of cumulative
245. https://doi.org/10.1007/S11195-019-09573-8/FIGURES/3 trauma and memory deficits. Research in Developmental
Hannah, L. A., & Stagg, S. D. (2016). Experiences of sex edu- Disabilities, 110, Article 103848. https://doi.org/10.1016/J.
cation and sexual awareness in young adults with autism RIDD.2020.103848
spectrum disorder. Journal of Autism and Developmental Rumball, F., Happé, F., & Grey, N. (2020). Experience of trauma
Disorders, 46(12), 3678–3687. https://doi.org/10.1007/ and PTSD symptoms in autistic adults: Risk of PTSD devel-
S10803-016-2906-2/TABLES/2 opment following DSM-5 and non-DSM-5 traumatic life
Haruvi-Lamdan, N., Horesh, D., Zohar, S., Kraus, M., & Golan, O. events. Autism Research, 13(12), 2122–2132. https://doi.
(2020). Autism spectrum disorder and post-traumatic stress org/10.1002/AUR.2306
disorder: An unexplored co-occurrence of conditions. Autism, Sedgewick, F., Crane, L., Hill, V., & Pellicano, E. (2019).
24(4), 884–898. https://doi.org/10.1177/1362361320912143 Friends and lovers: The relationships of autistic and neuro-
Howlin, P. (2000). Outcome in adult life for more able individu- typical women. Autism in Adulthood, 1(2), 112–123. https://
als with autism or asperger syndrome. Autism, 4(1), 63–83. doi.org/10.1089/aut.2018.0028
https://doi.org/10.1177/1362361300004001005 Sedgewick, F., Leppanen, J., & Tchanturia, K. (2019). The
Loomes, R., Hull, L., & Mandy, W. P. L. (2017). What is the Friendship Questionnaire, autism, and gender differences:
male-to-female ratio in autism spectrum disorder? A sys- A study revisited. Molecular Autism, 10(1), Article 40.
tematic review and meta-analysis. Journal of the American https://doi.org/10.1186/s13229-019-0295-z
Academy of Child & Adolescent Psychiatry, 56(6), 466– Soares, L. S., Alves, A. L. C., Costa, D., de, S., Malloy-Diniz,
474. https://doi.org/10.1016/J.JAAC.2017.03.013 L. F., Paula, J. J., de Romano-Silva, M. A., Miranda,
McDonnell, C. G., Boan, A. D., Bradley, C. C., Seay, K. D., D. M., & de. (2021). Common venues in romantic
Charles, J. M., & Carpenter, L. A. (2019). Child maltreat- relationships of adults with symptoms of autism and
ment in autism spectrum disorder and intellectual disability: attention deficit/hyperactivity disorder. Frontiers in
Results from a population-based sample. Journal of Child Psychiatry, 12, Article 593150. https://doi.org/10.3389/
Psychology and Psychiatry, 60(5), 576–584. https://doi. FPSYT2021.593150/BIBTEX
org/10.1111/JCPP.12993 Tillewein, H., Shokeen, N., Powers, P., Rijo Sánchez, A. J.,
Meyer, I. H. (1995). Minority stress and mental health in gay Sandles-Palmer, S., & Desjarlais, K. (2023). Silencing
men. Journal of Health and Social Behavior, 36(1), 38–56. the rainbow: Prevalence of LGBTQ+ students who
https://doi.org/10.2307/2137286 do not report sexual violence. International Journal of
Pearson, A., Rose, K., & Rees, J. (2023). ‘I felt like I deserved it Environmental Research and Public Health, 20(3), Article
because I was autistic’: Understanding the impact of inter- 2020. https://doi.org/10.3390/IJERPH20032020
personal victimisation in the lives of autistic people. Autism: Trundle, G., Jones, K. A., Ropar, D., & Egan, V. (2023).
The International Journal of Research and Practice, 27(2), Prevalence of victimisation in autistic individuals: A
500–511. https://doi.org/10.1177/13623613221104546 systematic review and meta-analysis. Trauma, Violence
Pfeffer, R. D. (2016). Childhood victimization in a national & Abuse, 24(4), 2282–2296. https://doi.org/10.1177/
sample of youth with autism spectrum disorders. Journal 15248380221093689
of Policy and Practice in Intellectual Disabilities, 13(4), Webster, A. A., & Garvis, S. (2017). The importance of critical
311–319. https://doi.org/10.1111/JPPI.12203 life moments: An explorative study of successful women
Reuben, K. E., Stanzione, C. M., & Singleton, J. L. (2021). with autism spectrum disorder. Autism, 21(6), 670–677.
Interpersonal trauma and posttraumatic stress in autistic https://doi.org/10.1177/1362361316677719