Three Reasons Sex Can Be Complicated for Autistics and ADHDers
- Jun 19
- 7 min read
Miranda Jane is a Neurodivergent-Affirming Somatic Coach and Consultant, specializing in the masked and late-identified Autistic and ADHD experience. Their personal crusade is to help recently identified AuDHDers understand and appreciate themselves, mind, body, and nervous system!
Sex can be challenging for neurodivergent people. Developing a nuanced understanding of our gender and sexuality is complex enough. Add in masking, pathological demand avoidance (PDA), and a propensity to dissociate, and the whole experience of pleasure and consent can become fraught. The fluid and unpredictable nature of our sensory needs, focus, and emotional impulse control is the cherry on top of this slippery, sloppy ice cream sundae. Please don’t let the ice cream melt before we get to enjoy ourselves!
Masking and consent
Yes, sex can be confusing for most people, but for neurodivergent people, sex comes with a few additional issues. First off, masking can make consent more difficult for Autistic and ADHD folks. Take the most obvious and often most conscious form of masking, known as “people pleasing.”
We can all fall prey to this bad habit of sacrificing our own desires to placate other people. It’s essentially the use of social engagement as currency without any explicit discussion of the terms of the exchange. We do what we think the other person wants and hope we are buying their affection, protection, or some type of goodwill. For chronic maskers, people pleasing can lead to disappointing, unwanted, and even traumatic sexual experiences. For many of us, people pleasing has become a way of life, and we will sometimes default into following along instead of checking inside ourselves to see what we truly desire.
The concept that consent is an ongoing, moment-to-moment process and not an agreement to abdicate future autonomy came as a cognitive shock to me, and I still see those shock waves reverberate through my clients when we discuss consent in this way. The process of maintaining control of your own choices as you move through minutes, hours, and years in a relationship takes skill and practice and pays off in so many ways.
Masking can be conscious, as in people pleasing, but it can also have automatic and completely nonconscious elements. In these forms of masking, our bodies are acting out norms and behaviors we’ve learned over a lifetime. Instead of allowing our behaviors to emerge naturally from our own interests and desires, we’re operating on autopilot. This can lead to engaging in sexual and romantic behaviors that may not be in our own best interests or genuinely desired.
Sometimes people describe to me that they’ve witnessed themselves saying and doing things that they don’t want to be doing… like a little part of them inside is yelling “noooo,” but they can’t quite get the automatic behaviors to stop. The guilt, shame, and remorse that follow sexual experiences like this can be brutal. You may feel violated not just by the other person, who didn’t see through the mask to the real you, but also by yourself. This complicity can cause deep rifts in our relationships, especially our relationship with ourselves.
Pathological demand avoidance (PDA) and sex
PDA and its counterpart, internalized PDA or pathological demand compliance, are another part of the neurodivergent sexuality puzzle.
PDA is an experience that arises in the nervous system when potential threats to our autonomy trigger a fight, flight, or freeze response. It can result in a refusal to “do the thing,” which might end up looking like emotional or romantic avoidance and can be difficult to differentiate from sexual anorexia and even from asexuality. If you don’t realize your PDA is triggered, it might just feel like you don’t want sexual or romantic contact at all. But when you work through the PDA and support your nervous system and your autonomy, the interest and desire may finally have room to bloom.
Then, PDA can be internalized, which I like to call “pathological demand compliance (PDC).” The same thing is happening neurologically as in PDA. A sympathetic arousal is triggered by a perceived threat to the nervous system. But in PDC, the survival strategy is more akin to fawning or placating by complying with the demand to resolve the state of distress.
Sex is complex for our nervous systems. We need to feel excited and aroused, but for Autistics and ADHDers, that can quickly cross the threshold from a fun amount of adrenaline to way too much. Invitations can feel like demands, and our fawning mechanism can kick in. Even though our partner might think we are okay, sometimes we are complying with things we do not really want to do. This is PDC on full display.
Autism, dissociation and sex
Many of my clients come to me for help with dissociation. The Autistic experience tends to include a lot of sensory and emotional overwhelm, which is not a thing you can fight or run away from. Dissociation is nature’s gift to those of us in pain. It numbs the pain and puts our brain into a foggy state so that it can almost feel like we’re not even there, experiencing the present moment. For some of us, this becomes an automatic and chronic response to even small amounts of discomfort.
In the context of neurodivergence and sex, we need to have a pretty high threshold for discomfort to stay present. We’re navigating rapid shifts in our internal environment (arousal, increased heart rate, changes in body temperature), which is very stressful for many of us. Simultaneously, we’re in a complex social interaction, which may include eye contact and touch. We may also be managing difficult sensory experiences like moisture, sweat, human smells, etc.
On top of all that, we may struggle with executive functioning, especially ADHDers. So we may have a hard time getting sexually aroused and staying focused. It may feel like a battle to get your mind to calm down and stay present long enough to bring your body into the present moment. This can lead to performance anxiety, which bumps us over the fun threshold into a fear or threat response state. Physiologically, this can look just like PDA and PDC, but in this case, it results in dissociation. Endogenous opioids are released, and you may feel as though you are watching yourself from outside of your body instead of seeing things through your own eyes.
It is easy to see how masking, PDA and PDC, and dissociation are major risk factors for sexual trauma. When we are at the whim of our nervous system, we do not have the full freedom to think through our options and choose what we say or do. Our actions look to others as though they are taken in free will, but the lived experience from the inside can be quite different. Studies show that 40 to 50 percent of Autistic adults have experienced sexual trauma. In Autistic women, that percentage goes up to as high as 90 percent. Once you’ve experienced sexual trauma, it is very common for the nervous system to start to associate sex with a life threat, making it that much more likely we will dissociate and mask in sexual situations.
Safety, sex, and solutions
What neurodivergent people need around sex is a profound sense of safety at the nervous system level. We need to be able to become excited and aroused without flipping into so much fear that our life threat defenses kick in.
One thing that can help with this is a clear and explicit understanding of what your partners want and do not want, and their understanding of you. Having practiced safe words and predetermined boundaries helps keep sexual play fun and safe. Remember, your sensory needs are important to consider!
For lots of neurodivergent people, sex is thrilling, pleasurable, socially stimulating, and basically one of the best parts of their lives. It comes naturally to them, or their relationship to sex was hard-earned but is now a source of strength and abundance. While I do not have statistics, I sense that the kink community is filled with neurodivergent people, and many of my clients have found their kink communities to be deeply affirming and supportive opportunities for sexual self-actualization and intimate connection. I particularly appreciate how the kink community has turned consent from a legal term into a concept that is now widely understood to be the bedrock on which pleasurable sexual experiences are built.
Polyamory is also widely practiced by neurodivergent people. We are known for seeing things in new or different ways from the norm, and traditional relationship structures do not always make sense to us.
But for most of my clients who struggle with masking and dissociation during sex, a consciously therapeutic approach to sex with a committed partner, at least for a few months or years, is usually what makes the difference. They work together to build secure attachment and to explicitly discuss what they are each looking for and what they need.
Over time, your partner can get to know you so well that they can feel you dissociate even before you notice it yourself. With practices in place for how to proceed when dissociation is present, you can support your nervous system to come back into your body more and more easily, and to stay present for more and more of your sexual life.
If you are interested in coaching to address dissociation during sex, check out our website.
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Read more from Miranda Jane
Miranda Jane, Neurodivergent Affirming Nervous System Coach
Miranda Jane is a late-identified Autistic ADHDer with a passion for helping people like them lead more pleasurable and fulfilling lives. They work with adults who are “twice exceptional” (2e), in many ways brilliant and in many ways struggling to function and disabled in their everyday lives. This particular blend of special skills and (often invisible) disability is particularly dangerous, leaving those who are 2e feeling thwarted in achieving their goals and leading to high rates of self-loathing, despair, and suicidality.
