While individuals with autism spectrum disorder (ASD) report similar levels of interest in romantic connections to their neurotypical peers (Hancock et al., 2016; Fernandes et al., 2016), autistic individuals may experience more difficulty establishing and maintaining healthy and safe relationships (Strunz et al., 2017). Social-communication differences, such as difficulty reading non-verbal cues and impairments in risk-perception can leave autistic individuals more vulnerable to interpersonal victimization (Bargiela et al., 2016). Research overwhelmingly supports the idea that autistic individuals are at an elevated risk for sexual victimization as compared to the general population (Joyal et al., 2021; Trundle et al., 2022; Dike et al 2023;). This risk is further increased for women and other gender minorities (Reuben et al., 2021; Cooke et al., 2025). To date, most of the research on sexual victimization in autistic women has focused on individuals assigned female at birth. Given that transgender and gender non-conforming (TGNC) individuals experience elevated rates of sexual victimization in the general population, TGNC autistic individuals may likewise face increased risk. This paper will use the term “autistic women” to refer specifically to cisgender autistic women, while noting the need for future studies which focus on TGNC autistic populations. Given the significant vulnerability of autistic women and TGNC individuals, it is essential for clinicians and researchers to further examine how social communication challenges contribute to victimization and to identify effective strategies for fostering safe, positive, and healthy intimate relationships.
Sexual victimization is pervasive in the general population, with more than 50% of adult women in the United States reporting such experiences in their lifetime (Basile et al., 2022). Autistic individuals, irrespective of gender, are also at an increased risk for sexual victimization– a 2022 meta-analysis across thirty-four studies estimated that 40% of autistic adults have experienced some form of sexual violence in their lifetime (Trundle et al., 2022). Both women and autistic individuals are at a substantially elevated risk compared to the general population, for whom the lifetime prevalence of sexual victimization has been estimated at 13% (Kaul et al., 2024). Autistic women appear to experience a compounded risk, with meta-analytic evidence suggesting that autistic cisgender women experience significantly higher levels of violence than autistic cisgender men (Cooke et al., 2025). Further research has confirmed that rates of sexual victimization among autistic women are elevated. In a French community sample of 225 autistic women, 88.4% reported experiencing at least one form of sexual assault with two thirds of the sample reporting their first instance of victimization before the age of 18 (Cazalis et al., 2022). Another study found that 61% of autistic women without intellectual disability reported sexual violence after age 15, compared to 35% of non-autistic women (Gibbs et al., 2022). An online survey of 687 autistic adults found that 69% of autistic cisgender women reported sexual interpersonal trauma and 57% reported physical assault (Reuben et al., 2021).
Autism has long been understood as a neurodevelopmental disorder that affects biological males at higher rates than females, with estimates ranging from 4:1 to 3:1 (Loomes et al., 2023). Although autism may be less readily recognized in women, particularly those with average to high cognitive abilities, awareness of varied presentations in women is entering the mainstream. While there is great variability in presentation, research has suggested that autistic girls exhibit higher social motivation than their male counterparts (Sedgewick et al., 2016; Harrop et al., 2018; Lawrence et al., 2020). This increased desire for social connections and to “fit in” might lead autistic women towards compensatory strategies (popularly referred to as “masking” or “camouflaging”). These individuals may be able to navigate social relationships with relative success or without “appearing autistic.” However, this surface level competency masks underlying challenges with reading nonverbal cues (Lozier et al., 2013) and detecting risk, manipulation, or coercion (Bargiela et al., 2016). As girls enter adolescence and young adulthood, these difficulties may become more salient in sexual and romantic contexts, where others may overestimate their level of social understanding. Ultimately, this incongruity between interpersonal perception and internal experience can be a risk factor which leads autistic women towards situations that go beyond their competency to navigate.
Additionally, “masking” is also related to suppressing forms of internal expression such as restrictive and repetitive behaviors (RRBs). Common RRBs include repetitive motor movements and can often serve as a means of self-regulation or to communicate intense feelings (Kapp et al., 2019). “I became really focused on stopping my hand-flapping when I was nervous or excited” said a cisgender autistic woman; “in some ways, that meant that I had to learn to ignore my own feelings of discomfort.” Motivations related to social acceptance, combined with difficulties in social communication and interpretation, may contribute to autistic women entering relationships where they encounter challenges discerning others’ intentions and asserting personal boundaries. When the drive for social connection exceeds an individual’s capacity to process and respond to nuanced social information, the ability to recognize or communicate consent may be compromised, thereby increasing susceptibility to coercive, unsafe, or otherwise maladaptive romantic and sexual experiences.
Increasing recognition of the heterogeneity of autism presentations highlights the need for targeted interventions that explicitly support the development of skills related to consent, boundaries, and social risk assessment. Autistic individuals report a lack of access to sex education from trusted sources (Brown-Lavoie et al., 2014) which underscores the importance of programs designed specifically for this population. In the general population, consent education has been effective in reducing sexual violence among adolescents and young adults. For example, the “Enhanced Assess, Acknowledge, Act (EAAA) Sexual Assault Resistance Program,” a group-based educational intervention, has been demonstrated to significantly reduce rates of sexual violence amongst first-year female university students in Canada (Senn et al., 2015). Similarly, the “Shifting Boundaries” program, a six-session classroom-based intervention, was found to decrease peer sexual victimization in New York City public middle schools (Taylor et al., 2013). Programs such as the “Friendship & Dating Program” (Ward et al., 2013) and the “Circles” curriculum (Harvard University, 2016) have been developed for individuals with developmental disabilities and highlight promising approaches that could be adapted for autistic women, TGNC individuals, and the broader autistic population. Adaptations for autistic learners should incorporate explicit instruction, visual supports, behavioral modeling and rehearsal (Hume et al., 2021; Ragaglia et al., 2023; McConnell et al., 2024). Importantly, parent and family involvement is also associated with improved outcomes (Oono et al., 2013; Postorino et al., 2017).
Autistic women experience disproportionately high rates of sexual victimization, a disparity shaped by differences in social communication, the use of “masking” strategies, and gaps in education. Addressing this complex issue requires greater clinical and research attention. Key priorities include fostering awareness of the diverse presentations of autism and implementing autism-informed sex education that provides explicit and skills-based instruction on consent, boundary-setting, risk recognition, and effective strategies for seeking support. Equally important are systemic interventions, such as training emergency responders in trauma-informed care tailored specifically for autistic individuals. Together, these efforts can empower autistic women who wish to engage in intimate relationships that are not only safe but also positive and fulfilling.
Liza Handler, BS, can be reached at Ldh58@cornell.edu.
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