Sexual behaviors in autism: Problems of definition and management

George M Realmuto, Lisa A. Ruble

Research output: Contribution to journalArticlepeer-review

96 Scopus citations


Surveys of sexual behavior in autism suggest a variety of behavioral expression. However, the course of sexual development in autism is unplotted, leaving questions about the normalcy of specific behaviors. Even less is known about deviations of sexual development and the incidence of paraphilias in this population. We explore the problems of definition of sexual behaviors and describe a case report that highlights the difficulties of management. An application of a testosterone-suppressing medication and its effect on sexual behavior are reported. After failure of behavioral and educational programs, leuprolide, an injectable antiandrogen, resulted in suppression of behaviors and retention of the participants' community placement. Follow-up for almost 3 years shows no abnormal physical effects. Dosage has been tapered over that period to a low but effective dose. Directions for research are discussed.

Original languageEnglish (US)
Pages (from-to)121-127
Number of pages7
JournalJournal of Autism and Developmental Disorders
Issue number2
StatePublished - Jun 23 1999


  • Antiandrogen
  • Leuprolide
  • Masturbation
  • Sexual behavior in autism


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