OpenBook.

Most providers believe sexuality sits outside their role. The thinking is that it's a private matter for families, or something a school, a GP or a sexual health service will cover. People with disability are also often treated as perpetual children, and assumed not to be sexual at all. Underneath sits an unspoken hope that if sex isn't raised, it won't become an issue, and a worry that raising it might encourage behaviour that puts someone at risk of harm or of getting into trouble. So it's left off plans, talked around when it comes up, and handed on when it can't be avoided. It's an understandable caution, because nobody wants to overstep.

In reality, autistic people are sexual beings, with the same range of needs and desires as anyone else. Responsibility is shared between families, schools, doctors and disability services, and when it's shared, each can reasonably assume someone else has it covered. Specialist programs exist, but most are school-based or group-based, and often aren't adapted to how the person learns. The health system tends to meet it after something has gone wrong: an STI, a pregnancy, an injury. Good sexuality education doesn't lead people to become sexually active sooner. What raises risk is silence. When a topic is only ever talked around, the lesson is that you don't talk about it, including when something goes wrong. For people who learn best when things are said plainly, being talked around doesn't teach anything at all.

That's why we teach it the way we'd explain any other part of health: concretely, without sugar-coating, and without shame. We can't make the world comfortable talking about sex. We can make sure the person in front of us gets clear, competent sexuality education, one-to-one with a Registered Nurse, working with their other professionals where they have them. Nothing is left implied because it's assumed to be obvious, and every question gets a straight answer.