By María Merino Martínez
The emotional and sexual lives of women with autism cannot be addressed without adopting a multifaceted perspective, taking into account such influential factors as their support needs, temperament, gender identity, sexual orientation, family background, early experiences, adverse experiences during childhood or throughout their development, self-concept and attachment styles..
If we consider temperament to be the innate predisposition that each person has to react to their environment, we will see that autism is not linked to a single temperament, just as there is no single temperament among non-autistic people. According to Cloninger, there are temperaments that are constantly seeking sensations, whilst others seek to avoid them, or are more or less dependent on pleasing others or obtaining rewards from their environment, and more or less persistent in achieving their goals (Cloninger, 1994). From an emotional perspective, a balance between these inclinations would be the healthiest in relational terms, whilst aspects such as a continuous search for intensity can expose individuals to risky situations; intense avoidance can lead to difficulty in learning from experiences; the desire for reward tends to drive relationships into imbalance; and perseverance can lead to difficulties in processing loss and grief. The sensory and emotional sensitivity of autistic women is linked in their narratives to an intrinsic difficulty in finding a middle ground, and the study of these sensitivities has been approached from the perspectives of psychobiology, sensory integration theories and personality theory.
Factors such as cognitive empathy, which involves understanding emotions through intellectual analysis, as opposed to emotional empathy, which allows us to feel and respond to our own emotions and those of others in an appropriate manner without needing to think them through, hyperempathy or emotional sympathy, in which we feel and react to the emotions or emotional experiences of others in pain as if they were our own, or alexithymia—the difficulty in identifying, recognising or expressing emotions and feelings, and in being able to name them. These are core aspects for the development of emotional bonds with others that are impaired in autism, directly related to sensory hypersensitivity and affective disorders (Liss, Mailloux and Erchull, 2008), and which affect autistic women in a particularly significant way, as women are expected, in accordance with gender roles, to express their emotions, yet historically, excessive sensitivity and emotional dysregulation have been socially penalised; it is worth recalling that etymologically, the term ‘hysteria’ derives from the Greek word ‘hysteron’, meaning ‘womb’.
When considering gender identity and gender expression, there is a growing consensus that there is greater diversity within the autism spectrum, and that women on the spectrum exhibit greater variability. We understand gender identity as an individual’s subjective experience of their own gender, regardless of the sex assigned at birth. Gender variance in autistic children ranges from 5.4% to 7.2%, and 11.3% of autistic adults, compared with 0.7% and 5% in non-autistic adults. (Pecora et al., 2020) Sexual orientation is defined as a multidimensional construct that largely encompasses three domains that form a continuum: sexual identity, sexual attraction and sexual contact.
The family environment is directly linked to the development of attachment styles and to a tendency to repeat relationship patterns in adulthood. Autism is caused by various factors, including genetic, epigenetic and environmental factors, but the role of genetics is undeniable. There is a significant gap between the experiences of adults on the spectrum and those of current generations, marked primarily by the absence or delay in diagnosis. One or both parents’ lack of awareness of their own autism can have a significant impact on the development of the family system, as this lack of awareness may prevent active efforts to influence the way parents and daughters relate to one another, to conceptualise, or even to identify social codes regarding levels of intimacy within the family itself. Among women, there remains a diagnostic delay which also influences their own lack of awareness regarding the origin of characteristics intrinsic to autism; these are erroneously attributed from childhood to laziness, intentionality, or carelessness, without the necessary support or adequate emotional validation. An exaggerated desire to please is a mode of interaction often adopted by autistic girls and women as part of their strategies for masking their condition and conforming to behaviours expected by those around them, which leaves them particularly vulnerable to the erosion of their identity, and with it to the loss of their self-concept and self-esteem, and indirectly but no less dangerously to accepting relationships in which they please others yet are overshadowed, and to childhood sexual abuse characterised by a fundamentally anxious or disorganised attachment style. This particular vulnerability to abusive situations in environments initially considered trustworthy or friendly is known as ‘mate crime’. (Foster and Pearson, 2020; García Molina, 2022)
Women with autism, along with women with other disabilities, are the groups most at risk of experiencing abusive relationships and sexual abuse or violence. Some influencing factors include intellectual ability, with those women requiring the most support being the most vulnerable, particularly due to their difficulty in identifying and communicating the abuse; and in the case of verbal women, this vulnerability is explained by factors such as mentalistic difficulties in interpreting others, a loss of opportunities to learn in a healthy way about emotional relationships and sexuality due to previous experiences of exclusion, rejection or manipulation in key contexts such as the family or school, difficulty accessing knowledge about sexuality, and a sense of missed opportunities in relationships that contributes to thoughts such as the need to please everyone, that sexual relationships make it easier for them to have a stable relationship of whatever nature, or to maintain relationships due to communicative, emotional and pragmatic difficulties in identifying the nature of a relationship and their role within it in a timely manner, as well as key aspects of emotional relationships such as consent, respect for one’s own boundaries and the rejection of any situation involving coercion or imbalance. Variability in sexual orientation is an aggravating factor, as studies indicate that there is greater violence in relationships involving autistic women, lesbians, bisexuals and transgender women. To explain this greater vulnerability, one must consider the cumulative effect of social exclusion and a lack of understanding of sexual diversity, alongside the greater mental health issues that typically accompany these conditions, without ruling out underlying biological factors such as hormonal imbalances or other co-occurring conditions.
REFERENCES
Cloninger, C. R. (1994). Temperament and personality. Current opinion in neurobiology, 4(2), 266-273. Link al documento:
https://www.researchgate.net/profile/Robert-Cloninger/publication/15159835_Temperament_and_Pers onality/links/5a17dd4d4585155c26a79ec1/Temperament-and-Personality.pdf
Liss, M., Mailloux, J., & Erchull, M. J. (2008). The relationships between sensory processing sensitivity, alexithymia, autism, depression, and anxiety. Personality and individual differences, 45(3), 255-259.https://doi.org/10.1016/j.paid.2008.04.009
Pecora, L. A., Hancock, G. I., Hooley, M., Demmer, D. H., Attwood, T., Mesibov, G. B., & Stokes, M. A. (2020). Gender identity, sexual orientation and adverse sexual experiences in autistic females. Molecular autism, 11(1), 1-16.
Link al documento: https://molecularautism.biomedcentral.com/articles/10.1186/s13229-020-00363-0
Forster, S., & Pearson, A. (2020). “Bullies tend to be obvious”: autistic adults’ perceptions of friendship and the concept of ‘mate crime’. Disability & Society, 35(7), 1103-1123.
Link al documento: https://sure.sunderland.ac.uk/id/eprint/11253/1/Mate%20Crime%20Author%20Accepted.pdf
García, I (2023) “Chapter: Dangerous Liaisons: From Harassment to Mate Crime” in Merino M. Women and Autism: The Camouflaged Identity. Book. pp. 249–262. Garraghan Foundation Publishers