Autistic Sexuality (article)

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Research into the broad autism phenotype, for example, supports the above.

Many still do. I've been seeing a therapist who is blaming my AS issues on the relationship with my mother and ignoring reality. I'm quitting today.

That's possible. But, unfortunately with scientific studies you can't conclude that. There are too many other possible explanations. For example, the differential results could be due to measurement error, a somewhat ineffective or error prone test instrument (the tasks used to stimulate the brain), or interferences from the experimenter. And these are just three potential explanations.

The only thing that can be concluded from the experiment is that there is a statistically significant difference between the two groups.

P.S. I was hoping this thread would discuss sex... But, alas, we are stuck on statistics.

Last edited by No_Exit on 25 Jun 2009, 4:16 pm, edited 1 time in total.

Yikes. I'd quit too! I've been fortunate to find a good therapist who understands AS. What I think is really important is that she understands our strengths as well as our weaknesses. IMO, if we only focus on our weaknesses we lose the battle. Our strengths are quite impressive and when used effectively they are more effective at improving quality of life than addressing our weaknesses.

For example, I just worked three 17 hour days in a row and I was highly productive in each of those hours. The ability to hyperfocus allows us to do this without becoming too terribly exhausted and without a loss of quality in the work.

Even stranger, I spent 8 hours a day (of the 17) in what many would mistakenly assume is a "social" activity. I was meeting with clients on Wall Street. But, by designing my job function around being an "expert" in a field where logic is supposed to be preferred to emotion, I can be logical and "eccentric" and no one thinks twice about it. As long as my arguments are logical and backed by data, I can make social faux pas and show a few tics and no one cares. That takes the pressure off me and reduces the social anxiety.

(But, put me in a room of people who are discussing popular culture, their friends, and sports, and I'll probably want to jump out of a window... So, I avoid that. )

ManErg, I've gone through the first link you gave (http://www.modern-psychiatry.com/asperger%27s.htm) in detail.

Early on, it states:

"Asperger's syndrome is a diagnosis given mainly to boys (4:1), while severe autism is evenly split (JAMA. 2003 Jan 1;289(1):49-55)."

This contains inaccuracy, and the statement itself seems to have no point (e.g., HFA is not mentioned), not reflecting the paper cited. The paper does not give these numbers. It gives sex ratios for IQ level, not distinguishing PDD subgroup. The male:female ratio for those without cognitive impairment is about 7:1. For those with mild or moderate MR, it's about 4:1; for severe MR, it's about 2:1; for profound MR, it's about equal.

A 2008 Review (Witwer, J Autism Dev Disord (2008) 38:1611–1624) also supports this data, showing that the sex ratio differences are related to IQ, rather than type of PDD:

The author of the site you linked to also states: "[...] in fact is almost certainly a combination of different diseases which appear to be unrelated to autism."

This is incorrect. Plenty of studies suggest otherwise. And none were cited to support his statement; but I assume the references lower down the page are supposed to support it. I will explain later how this is not the case. Anyway, referring to the abstract of the above review paper I mentioned:



The authors find little support for current distinctions between ASD subgroups. ASDs are very hard to subgroup.


Even on the verbal-performance IQ differences in Asperger's, they summarise:




On family/genetics, they mention:



The author of the website you linked to misrepresents this question of genetics using another paper on AS, stating "Genetics of Asperger's Different From Autism". In this paper, not titled as that, by the way, the authors clearly state their results are preliminary and that the trends do not reach statistical significance. For example:






This isn't very accurate, which I'll mention below. Concerning the paper you referred to--Investigation of Neuroanatomical Differences Between Autism and Asperger Syndrome--which is, by the way, not titled "MRI Studies Lack Replicability, Stanford Study Suggests Asperger's Not Part of Autism Spectrum", it mentions a lack of replicability in the case of autism:



Therefore, the author of the site you linked to is again misrepresenting. Some more excerpts from the study, indicating this is the case:



Note the word autism. Evidence they find that HFA and AS are on a spectrum:



Evidence they find for a distinction:



Part of their conclusion:





Oh, that's not just the case concerning AS. The same is true for autism. For example, corpus callosum differences have been
detected in some (i.e., not all) with infantile autism.

Another paper you referenced ("MRI Study Finds Only Small Increase in Mild Abnormalities") also mentions this:



And the conclusion is not particularly surprising; especially considering it was the first AS exclusive MRI study.




Highly unlikely they'd misdiagnose such a large sample (I cannot tell whether you are joking on this).

This was the first MRI study exclusively on AS. Among the abnormalities it did find, it mentions some of them have also been detected in infantile autism. It mentions the drawbacks to the study, such as how the techniques used did not allow them to investigate the different structures within the areas of abnormality further. They are unable to say whether HFA would be absolutely discernible from AS. There are more up-to-date studies than this.


In the second link you listed, (http://journals.cambridge.org/action/displayAbstract;jsessionid=A55EEA3E459D3E86FD24C02053318BFD.tomcat1?fromPage=online&aid=5446284), there is preliminary evidence for valid autism spectrum subgroups. These studies acknowledge the large overlap between HFA and AS diagnoses as in the DSM-IV, and to make a greater distinction between them, they specify delayed language onset, which is not always the case in those diagnosed HFA. It will take many more studies to determine the validity of autism subgroups. Even so, the magnitude and nature of the differences might differ across development and the subgrouping might not be clinically useful in terms of treatment and outcome. That conditions can be composed of different subgroups is common--and they still come under the same general classification--and finding autism spectrum subgroups would not be equivalent to saying one subgroup is a form of autism and another is not.

Outlier,

You have honed in on one of the strangest things I have run across since my diagnosis less than two months ago. Until reading the "professional" interpretations of empirical reseach on AS, AD, HFD, etc., I had never in my life seen so many incredibly inept, no... make that... horrendous... no... moronic... interpretations of empirical research in my life. How can so many professionals who are purported credentialed and supposedly attempting to help people have such idiotic interpretations of basic scientific results?

The first IQ control that really needs to be applied rigorously, IMO, is a control on author IQ to help prevent the publication of nonsense. What is disturbing is that these purported experts are writing books and other publications wherein they claim to be trying to help people on the spectrum. .. yet they don't actually understand the people they are trying to help.

The really sad thing, IMO, is that many of the patients (or their parents, in the case of minors) do not realize these quacks apparently do not actually understand the condition they are trying to treat. (I am making an assumption here that they are not intentionally trying to misrepresent the condition for their personal gain... Hopefully that is not just optimisim on my part.)

Best (and keep up the good work in debunking such nonsense).

^ That's rather broad. I'm curious, which specific quacks are you referring to? The main theme of the above was that of disputing what the author of the site ManErg linked to was claiming. It's well known the professionals have made a mess of diagnostic practices and classification issues.

Well, I don't want to name names per se, because the misinterpretations seem so widespread. Also, many of the studeis themselves appear to be badly flawed. Some really high level somewhat random examples include:

1. Studies that conclude people with more severe AD have lower IQs. The problem with these studies is that they use IQ test instruments designed for NTs. Why on earth would they expect those instruments to work? This same sort of issue concerns me with respect to IQ controls on aspie studies. I've managed to figure out what NTs look for in terms of intelligence, so I can score high on those tests. But, what about other aspies who perhaps were not exposed to the same environment that I was? Are they equally likely to perform well on NT specific IQ tests?

2. Studies that conclude aspies lack theory of mind. The problem I have with these studies is that what they have actually tested is whether or not we have TOM with respect to NTs. But, given that we are wired differently, isn't that rather tautological. As my experiemental design professor in the PhD program used to say (to dissuade us from making dumb mistakes in design), it is the "no s**t" hypothesis. What these studies do is merely confrim what everyone knows already, that its hard for aspies to figure out what the heck NT's are thinking, feeling, etc. Well, no kidding. A more relevant test would be whether we have TOM with respect to other aspies... I don't think anyone has looked at that. But that would allow them to distinguish between two alternative explanations. Lack of TOM period vs. lack of TOM with respect to people who are wired differently. If the latter were true, then we might also find that other brain wiring types also have difficulty relating to one another, even within the so-called NT class of people (who, btw, is a construct that is also defined rather poorly as the set of all "non autistic" people).

3. No one has yet studied how weak central coherence is a much more likely explanation for the TOM study results. Weak central coherence could easily explain this phenomenon.

4. Thinking more specifically about the professionals who interpret the results of studies, they generally assume that there is something called an NT that is universally accepted. But, as of yet, the only definition that exists is that NT = the set of all non autistic people. This is an absurd construct b because the researchers have made an assumption, with no facts to back it up, that there must be only two brain wiring types. Now how likely is that to be true? I suspect its about as likely as being hit by lightening in the next five seconds. Worse, this mythical NT construct is then somehow used as a benchmark for assessing the characteristics of aspies and other auties.

Another of the many problems with the mythical NT construct is that so-called NT's also suffer from a whole host of disorders themselves. So when scientists select a control group of "NTs", what exactly are they comparing us to? The NT with the mean or median level and severity of all known non-autistic disorders? A group of people with no clinically significant diagnoses of any sort. Either one is absurd. The first definition is unlikely to exist to any great degree in the population as a whole. The second is also unlikely to exist to any significant degree (given the prevalence of known disorders... let alone those that are as of yet unknown).

5. When comparing to this mythical NT, which I doubt actually exists in any meaningful sense, professionals often make the arbitrary assumption that somehow this mythical NT way of behaving is actually the theoretically correct way of behaving. I doubt that mythical NT way of behaving even works well for most purpostedly NT people, let alone any of the other many brain wiring types that are likely to exist.

Unfortunately, it appears that we are in the very, very early stages of research into AS, AD, etc, and we have a group of professionals who are probably well meaning but they don't understand what the research says, they don't understand the limitations of the research, and they are unaware of their own lack of understanding... yet responsible for advising people on how to deal with the challenges presented by their brain wiring type.

Now, that said, I have found a couple of very good books... none of them written by researchers or professionals. Instead, they are books written by aspies or partners of aspies. What these books do that works is they relate what the experience is like in more or less a field study type methodology (though they probably did not think of it in that context). Whether intended or not, those seem to contain the only useful observations that I've been able to find so far.

Sorry if I seem a little hard on some of the reearchers and professionals. I think there's much work to be done... But I certainly don't want to indict any particular individuals because I know they are doing their best in most cases.

Totally OT, but these words stood out to me. Having AS does not mutually exclude problems in someones relationship with their mother, does it? Or ignoring reality... This is not aimed at you specifically, Outlier as I don't know anything about you! However, is it not possible that having AS could increase the chance of problems in the mother/child relationship?

Psychotherapy obviously can't do anything about AS directly, but when it comes to parent/child relationships and the problems thereof, that's pretty much their area of expertise! In the interests of finding ways of coping, and dealing long term with the secondary psychological issues of AS (which is where I believe the depression comes from), I think it best not to dismiss anything half reasonable without at least exploring it.

(almost) back on-topic. Yes, there are doubts about vast swathes if the autism research at the moment. You make some very good points, No_Exit. It seems to me that many researchers in this field seem to do research that proves what they believed in the first place. There is little rigor when even a total lay-person such has myself can so often pick out and cringe at the total flaws in their methods and conclusions. Anyone can pick and choose the 'research' they like, or even better some opinion from the millions of words written by those with opinions.

I think what makes this On-Topic is that the original article suggests that it applies to some kind of sub-group of the spectrum. Yet people cannot agree on how to divide up the spectrum - or even if it exists as a 'spectrum' - there are still those who believe AS and HFA are different and those who want AS to be removed as they believe it the same as HFA, for example.

This is the core problem. Before going in for the mri scan, the initial categorisation of an experimentee is from a subjective diagnoses. Different doctors use different criteria. For example, some do not use the "Triad of Impairments" at all - it appears that having only 2 or even 1 of the "Triad" is enough to get a diagnosis.

Seems to me that the "Search for the Neurological Basis of Autism/Aspergers" is in about the same position that the Spanish Conquistadors were at while searching South America for the Cities of Gold Have we not found them yet because we haven't searched hard enough? Or have we just not looked in the right place? Do they actually exist at all? Right now, we can not know the answer.

Sure, we KNOW they're to the south west *somewhere* because that's what the natives told us. (so long as we conveniently ignore the natives who told us they were to the north. And those really ignorant ones who keep saying they've "never heard of any such thing as cities of gold".)

As long a there is the occasional glint on the horizon, we know that's the way we must go, unless it's an illusion - sun reflecting off water, perhaps....

With autism research, maybe the City of Gold will be found tomorrow, next month or next year? Maybe never? The rewards are so high to those who will find it, it tends to cloud all judgement.

Certainly. However, she was blaming all the AS issues on such things. Not having any experience with AS/autism (I couldn't afford a specialist in such), she thought my executive dysfunction and sensory issues around food were attention-seeking behaviours related to the past mother-daughter relationship. I would try to explain these exec. and sensory issues were part of AS/autism, and how how her hypotheses did not fit with my daily reality, but she would not listen.

I wrote her a letter explaining why I had to leave and was finding the sessions harmful. She said she understood and hopes I find a specialist. I also provided some information she'd not read before (on AS/autism, eating disorders etc.), which she plans to share with her colleagues. Overall, her response was positive; I'd had no idea what to expect.


No_Exit: Ah, I get the gist now; especially wrt IQ testing. I don't have time to reply properly right now about the topic (as I'm about to depart for a short trip).

Very funny and appropriate analogy as far as the perception of rewards that could accrue for the scientist(s) who could one day find a unified theory of autism. That said, it's not clear that the untold wealth they are expecting is necessarily going to provide the utils they desire.

Returning to the Spanish conquistadors, if they'd found the "Lost City of Gold" it would probably have made their nation's economy even worse. As it turned out, even without finding the "Lost City," the flood of gold that they did put into the system created massive problems for them because the price for gold plummeted. At the same time, they were producing little else of value relative to other competing nations at that time. It was more or less the beginning of the end for Spanish dominance.

Around that same time the concept of credit (and currency made of substances other than precious metals) was beginning to take hold. While it would lead to some fairly large cyclical ups and downs for those who adopted the model, they were ultimately much more successful in driving their economies forward.

How does this relate to autism? I'm not sure... But here are some thoughts as to how the "City of Gold" might not be all that is imagined.

1. If we discovered a "cure" for autism, would we inadvertently eliminate one of the most important evolutionary paths that nature has set for us? IMO, aspies are more well suited for living in a technologically dependent society. Like it or not, that's where we are headed. Perhaps autism is nature's way of evolving humans to better exist in the environment we are creating? Just a theory... It could be wrong. But, it if were so, the consequences of doing the wrong thing could conceivably be very bad.

2. If we discovered a "cure" for autism, would the next logical step be eliminating anything society finds unpleasant about what has (or will) evolved naturally? Sure it might be great if we could eliminate something like bad breath genetically. (That was a joke.) But, what if someone decides we should eliminate certain ethnicities? I know we all like to think of ourselves as nice and tolerant, but some of the better research in human behavior has shown that, at the end of the day, all it takes is a few bad guys with charisma to make most everyone else follow their lead and start electrically shocking subjects or torturing prisoners. (Indeed recent experience in Iraq again confirms how we haven't yet grown out of this tendency.)

3. Or, what if society did in fact become tolerant of things like skin color and religion, and it just wanted to eliminate the pain and suffering from "disorders" like (in addition to autism) depression, ADHD, anxiety, OCD, bipolar, ... , to "disorder X"? How do we know that there isn't some good reason why the brain has evolved in such a way that these so-called "disorders" are actually quite useful (perhaps even necessary) to our survival? For example, fear is pretty darned useful. What if by eliminating anxiety we also eliminate fear? Creatures that do not fear the appropriate risks (like many large mammals who had never encountered humans until they got bonked on the head) tend to become extinct.

These are just a few potential problems with this whole line of thinking regarding the autism "pot o' gold." It might not be a pot of gold at all... It may just be a pot of toxic waste, to continue the metaphor.

While I was disappointed that we never discussed sex (just kidding), I agree with you as to the above. It's kind of a chicken and egg problem. First, we don't have any agreement (let alone much in the way of consistent evidence) as to the cause(s) of autisim. But, without that, how can we develop a meaningful definition of the spectrum? Second, we still need a reasonably accurate description of the spectrum to help diagnose people. But, but we have very little agreement on what the spectrum should look like for now, pending better evidence on the cause(s) of the various conditions, including AD, HFA, AS... and possibly others. BTW, I mention "possibly others" above because, while some researchers seem to want to remove AS from the "approved" list of ASD, others apparently want to add ADD/ADHD (and possibly other conditions).

Lastly, just one other slightly on/off topic comment... I don't even see why we are assuming at this point that AS is a "disorder." I would argue that it is a condition that have a tendency to produce a certain set of strengths and weaknesses. Likewise, those who are classified as NT, or those who are in the set of all non-autistics, have a tendency to exhibit a somewhat different (though perhaps more highly varied) set of strengths and weaknesses. Here's just a few examples:

The AS (NT) condition apparently tends to lead to better (worse) performance in tasks that require logic. The NT (AS) condition tends to lead to better (worse) performance in tasks that require the integration and interpretation of multiple signal inputs.

In the context of the above pair of offsetting strengths and weaknesses, I see no obvious way of classifying either condition as a "disorder." As least with respect to these characteristics, they just look like to conditions with unique sets of strengths and weaknesses.

Not to make this too personal, but I have apparently had AS for nearly 47 years, but only two months ago did I learn that I have a "disorder" ((by the full triad of criteria). But, I don't see it as a disorder at all. Admittedly, I may have had more than my "fair share" of suffering (whatever that means) as a child growing up with a condition that by and large no one had any knowledge of, as an adult I've rather enjoyed having AS. I have no desire whatsoever to be a member of the NT group. (I have nothing against them and I generally like them just fine. I just wouldn't want to be one...)

Does anyone know how new forums get created? I've only been on here a few months. But, there are a lot of really smart people here who I believe could make a very significant difference to the AS/autism community in general if the effort were directed towards a few areas that, thus far, seem to have been largely ignored by those with AS (as best I can tell in admittedly only two months of analyzing the situation).

(1) I believe we should have a voice in the research process! If we want to be understood by those who are different than us, we need to help point the way to developing that understanding. I was hoping to convince the powers that be to create a forum for discussing research on autism and AS, in an academic fashion. I envision more or less a virtual academic seminar of sorts wherein research papers are critiqued by the members (discussants/reviewers). The goal would be to have input into the science that is attempting to understand our condition by providing solid critique of existing research, suggesting new or modified theories, and identifying additional avenues for research.

(2) I would like to see a forum for discussing the positives of AS (how we use our strengths to make our lives better). It appears to me that the vast majority of the focus is on what doesn't work. But, to me, that's just the part of the glass that is half empty. And by neglecting the part that is half full (and contains more mass, at least in the context of the typical half glass scenario) I think many people (AS children, their parents, and AS adults) are unknowingly losing the battle (or at least getting knocked around much more than needed).

Aahh, well, that's just it. There are volumes of very frank, open discussion on exactly that subject on WP. And there is very little 'common experience', which is a big minus sign against the article that started this thread (hey, are we back on topic?). And what's obvious is the HUGE range of experience, from many people whose sexuality would out-NT the average NT, all the way through to the 'very unusual' In other words, more or less the same as NT sexuality in that everyone of us is different!

Imagine if there was an article on "NT sexuality" that was as short and as narrow as the one quoted? It would be clearly farcical. Why the desire to pigeon hole autistics in the first place? To even attempt to suggest that all on the broad AS spectrum have some kind of common sexuality? Sexuality is influenced hugely by environmental circumstances and childhood experience. To pigeon hole it is sheer idiocy...

PS I suppose all scientific enquiry is a bit like the search for cities of gold. It is so easy to conveniently ignore the glint to the east when we passionately believe the gold is to the south... And research can only find what it is looking for. If millions of dollars were spent on trying to find the neurological or genetic cause of say, liking football, some scientist would eventually find something.

Difficult, this. I work with and use technology all the time. Yet I have strong 'primitivist' yearnings. There is nothing 'wrong' with 'anyone', or 'anyones' sexuality - until civilisation intervenes with it's insane ideas of 'normality', herd behaviour etc.

Civilisation helps improve life in many ways, yet has a cost - which seems to be sentencing many to lives of dispair. Is this cost acceptable for the returns?


So true! And depression. Seems to me the concept of 'chemical imbalances' is ultimately as mysterious as 'evil spirits'. Depression may be a symptom of the sickness, the fundamental rottenness of our culture.

That's not surprising. It goes to the adage that, "if you've met one aspie... you've met one aspie."



I think it goes to the bias that results when a scientist erroneously assumes--without any proof--that condition that is quantitatively in the "minority" is also qualitatively lesser than the "majority" group s/he is a member of.



One of the issues that concerned me when I was publishing in academic journals was the fact that it was virtually impossible to get a study published when you failed to find what you were looking for. Shouldn't that be equally interesting (other things equal)?

You are entirely correct that, as soon as it were declared that society needs to understand why people like football, there would be a whole slew of research into genetic predisposition for football, environmental factors driving the affinity for football, sexual tendencies of those who like football, and even whether or not those on the spectrum are more or less likely to enjoy football.