Preparing, Not Avoiding: A Parent's Guide to Discussing Sexuality with Autistic Youth

Natasha L. Poulopoulos, PhD (Dr. Tash)

With shows like Love on the Spectrum gaining popularity, more people are seeing something that clinicians and families have always known: autistic individuals want connection, intimacy, relationships, and love just like anyone else.

The show has opened the door to important conversations about dating, vulnerability, and what meaningful relationships can look like for autistic individuals. But it’s also highlighted something many parents quietly worry about:

If my child wants connection, do they have the skills and knowledge to navigate it safely?

That question often brings up another, more uncomfortable one, that I often hear from parents of autistic youth: Have I actually talked to my child about their body, sexuality, and relationships?

If you’re a parent who knows you should talk to your autistic teen about puberty, relationships, and sexuality, but have no idea how to start, you are not alone.

Most parents were never taught how to have these conversations in the first place. Add autism into the mix, and it can feel even more overwhelming. You might worry about saying the wrong thing, introducing topics too early, or making your child uncomfortable.

So many parents cope by avoiding the conversation altogether. But the truth is that avoiding the conversation doesn’t protect your child—it leaves them unprepared and vulnerable.

Why This Matters More for Autistic Youth

Autistic teens often don’t pick up on social rules implicitly. What neurotypical kids may learn through observation or casual conversation, autistic youth often need taught clearly, directly, and repeatedly.

That includes understanding what parts of the body are private, knowing where certain behaviors are appropriate/permitted, learning how to navigate relationships and consent, and recognizing safe vs. unsafe situations.

Without this information, teens are left to figure things out on their own, which can lead to confusion, anxiety, or even unsafe situations. This lack of information also unfortunately contributes to the data that shows that autistic individuals experience significantly higher rates of sexual exploitation and victimization. 

When parents avoid the topic, autistic teens often turn to the internet or peers for answers (very misguided and often inappropriate information), misinterpret social situations, struggle with boundaries, and feel shame, anxiety, or confusion about their bodies.

For autistic youth, confusion and uncertainty can be especially distressing. Physical and bodily sensations can also trigger or worsen sensory sensitivities. 

The Shift Parents Need to Make

One of the biggest mindset shifts I teach parents is the importance of being clear, not vague when communicating with autistic children and youth. We often assume that information about body parts, puberty, and sexuality are innately learned. This assumption is highly inaccurate. 

Parents can start by shifting their language from, “hey, be appropriate” to “your private parts—your penis, vagina, butt, and chest—stay covered in public places like school or the living room.”

That level of clarity isn’t “too much.” For many autistic youth, it’s exactly what helps things click. 

Starting the Conversation about Puberty

As with much parenting communication, the perfect script doesn’t exist per say, you just need a starting point. Here’s one for starting the conversation with autistic youth about puberty (depending on sex assigned at birth):

“Your body is going to change as you grow. This is called puberty. You might notice things like erections or your period. This is normal, and you can always ask me questions.”

This is simple, directive, informative, and open. Most importantly, this creates a door your child or teen can walk back through, as can you because this is not a one-time talk. It’s a series of small, ongoing conversations that build over time. You might start with body parts and privacy, then gradually move into puberty, relationships, and consent. Each conversation lays another brick in a foundation of understanding.

Conversations about puberty are recommended in advance, about 6-12 months before anticipated changes and this is something your pediatrician can guide you through. 

How to Discuss Menstruation

After opening the conversation about puberty. For girls, the next discussion can introduce their first period or menstruation. You can start by explaining, “Your body is going to experience something called a period. This is something that happens to girls and women as they grow up.”

Specify when and for how long: “About once a month for 3-7 days, blood comes out of your vagina. This is normal and means your body is healthy.”

After introducing the topic, preparation is key. You can explain that,  “When you have your period, you will wear a pad in your underwear to catch the blood. When the pad is full, you take the pad off, wrap it in toilet paper, throw it in the trash, and put on a new pad.”

Here’s an example of a step-by-step guide:

1) Go to the bathroom

2) Pull down my underwear

3) Take off the used pad

4) Wrap the pad in toilet paper

5) Put it in the trash (not the toilet)

6) Put a new pad in my underwear

7) Pull up my underwear

8) Wash my hands

*I may need to change my pad every few hours.

Further clarify that, “Changing your pad is something you do in a private place, like the bathroom. You should not show your blood or pads to other people except a caregiver or doctor.”

It’s also helpful to prepare your child about potential sensory and physical experiences during their period.

Here’s how: “You might feel cramps in your lower belly. It can feel like a dull ache, pressure, or a warm feeling. This is normal. You may also feel more tired or emotional during your period.”

How to Discuss Erections

After opening the conversation about puberty. For boys, the next discussion can introduce their erections. Autistic boys may experience anxiety about unexpected body changes and difficulty interpreting bodily sensations.

You can start by explaining, “Your body is going to start changing as you grow into a teenager. This is called puberty. “These changes happen to all boys and are a normal part of growing up.”

Be clear and specific, “During puberty, your body will change in several ways. Your penis and testicles will grow, you will get hair on your body, and your voice may get deeper.”

“You may also start having erections, where your penis becomes hard. This is normal. An erection is when your penis becomes hard. This can happen sometimes for no reason, and that is normal.”

“If it happens in public, you can sit down, adjust your clothing, or wait for it to go away.”

Discussing and concretely teaching about erections normalizes this experience, helps prepare boys, and reduces shame or panic.

Final Thoughts

Better structured information > less information or avoidance 

This actually means:

• Concrete language instead of vague hints

• Step-by-step explanations

• Clear rules about public vs. private spaces and behaviors

• Repetition over time

• A safe person to ask questions

It also means anticipating areas of confusion before they happen. For example, many autistic teens benefit from explicitly learning what behaviors are private, where those behaviors can happen, and what to do if something unexpected occurs (like an erection at school or getting a period in public). When we spell these things out ahead of time, we reduce anxiety and increase independence.

Want More Support?

If this is something you’ve been putting off or feeling unsure about, you’re not alone—and you don’t have to figure it out by yourself. I'm here to help.

Call South Miami Psychology Group at 305-662-2686 to request an appointment with Dr. Tash or click BOOK APPOINTMENT to learn more and get started.