Abstract Introduction Individuals with autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) face distinct challenges in relation to sexuality compared to their neurotypical peers. These include greater diversity in sexual orientation, an increased prevalence of sexual dysfunction, difficulties with communication and social interaction, and an elevated risk of engaging in inappropriate sexual behaviours and experiencing sexual victimisation, particularly among women. Anxiety related to relationships and negative sexual experiences is common, and there are frequent reports of lower satisfaction in sexual and emotional relationships. In individuals with ADHD, impulsivity and emotional dysregulation can lead to risky sexual behaviours and relational dissatisfaction. Objective To explore the current literature on sexual experiences, vulnerabilities and educational needs among individuals with ASD and ADHD, and to contrast this with that of neurotypical populations, identifying areas for future intervention. Methods A literature review was conducted to explore studies that compare the sexual orientation, behaviours and experiences of individuals with ASD or ADHD with those of neurotypical populations. Data were obtained from systematic reviews, qualitative interviews, and clinical guidelines. Results People with ASD are more likely to identify as non-heterosexual and report difficulties with communication and social interaction, which can act as barriers to forming emotional and sexual relationships. Both autism and ADHD are associated with higher rates of sexual dysfunction, risky sexual behaviours and victimisation. These outcomes are more pronounced in women. In individuals with ADHD, impulsivity and emotional dysregulation can lead to an earlier onset of sexual activity, having multiple partners, infidelity and hypersexuality, all of which can negatively impact relationship quality. The presence of autistic traits in adults with ADHD is associated with greater emotional vulnerability and affective comorbidity. There is a consensus that conventional sex education is inadequate and that adapted programmes addressing social skills, consent, abuse prevention and healthy relationship building are required. Family and peer involvement, as well as ongoing support beyond adolescence, are critical for promoting autonomy and sexual well-being. Conclusions Individuals with ASD and ADHD have less satisfactory sexual experiences and are more vulnerable than their neurotypical peers. Multidisciplinary interventions and personalised sex education are essential to mitigate risks and promote sexual health in these populations. The literature emphasises the need for adapted programmes centred on individual needs to ensure the right to healthy and safe sexuality. Disclosure No
Pinhel et al. (Mon,) studied this question.