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Is autism a risk factor for sexual violence? And if so, in what ways? Are the questions uncomfortable? They certainly are! There are many questions that are, not least by the nature of making us think about things. And certainly asking questions on fragile subjects like sexual violence even more so. But in the same way that we try to encourage the victim of sexual violence to report the situation. It is also fundamental to be able to continue to address the subject, to ask questions and to try to understand why certain situations occur.

For example, it is still often said that the best way to prevent domestic violence is through the implementation of sexual education programmes. And many will say that yes, that is the way. However, sex education programmes have increased, and this has not reduced the numbers. Furthermore, we need to think about the contexts and people in which domestic violence situations occur, both the victims and the aggressors. As such, it is not at all true that only the implementation of sexual education programmes can provide an answer to the reality experienced by many victims.

Sexual violence is a global public health concern which generally refers to sexual activity without consent. That is, a sexual act that is committed or attempted by another person without freely given consent of the person being harmed, or against someone who cannot consent or refuse. Sexual violence involves a range of experiences, including acts of penetration or non-penetration completed or attempted, unwanted sexual contact, and experiences of unwanted sexual non-contact.

Sexual violence is a major problem in society. The World Health Organization (WHO) itself states unequivocally that "sexual violence is a major public health and human rights problem, with short- and long-term consequences for women's physical, mental, sexual and reproductive health.

Whether sexual violence occurs in the context of an intimate partnership, within the larger family or community structure, or during times of conflict, it is a deeply violating and painful experience for the survivor. These wide-ranging consequences include long-term depression, post-traumatic stress disorder, substance abuse and suicide.

There are striking inequalities and disparities in rates of violence in relation to gender, and which are higher in minority communities. It is well demonstrated that women and vulnerable people (children, people with disabilities, the elderly...) are at greater risk of victimisation.

A critical aspect that has been neglected within research on the topic of sexual violence is autism. For example, the prevalence of sexual abuse in adults with Intellectual and Developmental Disabilities is as high as 33%. By an intersectional effect, women with autism and attention deficit hyperactivity disorder are therefore at higher risk of being sexually assaulted.

Sexual victimisation rates represent about one woman in three and one child in ten. Wouldn't you expect such high numbers? Have you read information reporting lower numbers? They certainly have. Not least because estimates of sexual violence depend on (i) the definition of sexual violence; (ii) the choice of investigation methods (analysis of formal complaints at police stations, clinical reports, telephone interviews, internet searches, open questions, etc.); and (iii) the country where the investigation took place.

Given that being an autistic person is characterised by experiencing difficulties in social communication, such as decoding hidden intentions and emotions of others, understanding implicit communication and elements of context, it is expected that autistic women may be at considerable risk of developing sexual victimisation, a hypothesis confirmed by all published studies on the subject.

Being autistic means suffering a 10 to 16% risk of experiencing sexual abuse as a child and a 62 to 70% risk of being sexually victimised in adulthood. Most victims are girls and women: autistic women's risk of being sexually assaulted is between two and three times higher than non-autistic women and about four times higher than autistic men. These figures are consistent with rates in the general population: around 30% of women and 12% of children are sexually victimised in their lifetime.

But again, it is not consensual that the fact of being an autistic woman and with a whole set of characteristics known to her is the explanation for this situation. And this is important to clarify, because these characteristics are inherent to autistic women and this in itself always puts them in a disadvantageous situation and in the role of potential victims of sexual violence.

And there are studies that show that about half of the participants were involved in a relationship and that half of that percentage had been sexually active in the last six months. In other words, we're not talking about autistic women who are in a situation of social isolation.

This gap between aspiration and experience can be partially explained by social factors that are not specific to autistic women. That is, cultural stereotypes, lower proportion of potential partners, etc. But they may also be linked to autistic characteristics, such as camouflage and social imitation strategies that are described in autistic women.

Another partial and cumulative explanation may be that since the vast majority of autistic women participating in these studies are bisexual, we can hypothesize that they simply settled with the type of romantic relationship most available to them.

In addition to the fact that they have a diagnosis of autism, many of these women also have other associated psychiatric disorders, which also places them in a situation of greater fragility.

Among autistic adults, less sexual knowledge was associated with higher risk of sexual violence, and socio-communicative and emotional deficits do not seem to be risk factors for poly-victimisation. These results suggest that prevention strategies targeting caregiver and community teaching of sexual education tailored to (and in partnership with) autistic people may be more useful in reducing experiences of sexual violence than efforts directed at strengthening individual skills. Similarly, autistic adults who are in a relationship appear to be more likely to report sexual violence perpetrated by a partner than non-autistic adults who have been in relationships. This aligns with the potentially increased vulnerability of adulthood in autistic people and suggests the need for enhanced education about safe romantic and sexual relationships.

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