Healthy Sexual Relationships Come From Healthy Relationships

Karen Lean

Karen Lean

About the Author

Karen Lean has sat on the Board of Directors and various committees, has given numerous keynotes, panel appearances, and led workshops for AANE. Her writing appears in the book of essays, “Sincerely, Your Autistic Child.” Originally from Canada, she lives with her husband in New Hampshire where she works in Healthcare IT.

Content note: This article contains descriptions of sexual encounters.


In my experience and observation, a great number of people struggle with healthy relationships. This often translates to a struggle with healthy sexual relationships, but since I can’t observe this directly, I’m only guessing. Autistic people, because we’re human, have as many of these struggles as anyone.

The problem can start with assuming autistic people don’t really have sexual relationships. But even for those of us who didn’t grow up with the label of autistic (I was diagnosed later in life), we may have escaped this terrible assumption but didn’t come through our child, teen, and young adult years any less affected – whether by our particular challenges with social communication and sensory differences, or just from growing up in a culture that simultaneously puts a lot of sexually charged content in front of us, and shames us for those very same things. It’s rightly confusing.

I think I had a good foundation for healthy sexuality. I credit my parents for being open and educating me when I asked questions, with respectful and honest answers. They gave me books and access to resources. I grew up being taught not to be ashamed of, or fear my body. As far as I know, I was not assaulted as a very young person. My teen years, unfortunately, gave me some negative experiences, but because I had some foundational education, I was able to seek support. It took a long time to heal from those experiences.

One challenge for me, which took many years of struggle, was learning how to say no, and deal with people who wouldn’t take no for an answer. I felt very slow in my auditory processing – I often felt like I had to answer people right away, and the task of listening to someone’s speech and understanding quickly enough to respond gave me anxiety. It was tough to read body language, and that made it difficult to perceive others’ intentions. Flirtation and banter felt inaccessible. 

I shied away from dating experiences in my teens and twenties. I did get in longer term relationships in my twenties and thirties, dated in my late thirties, and now, in my forties, I’ve been in a stable, loving marriage and gotten to enjoy really healthy sexual dynamics. 

I’ve had some experiences in relationships that ranged from unfortunate to unacceptable: a porn-addicted partner; someone who struggled with erectile dysfunction and a rather large amount of resentment towards women; someone who was too drunk and wouldn’t listen when I wanted to use a condom; someone who had to get into a shower immediately after having sex. However these sexual dimensions were only one part of some not-great relationship dynamics, and the sexual problems were a symptom of a larger issue, whether in the relationship, or for one or both of us as individuals. In common in all of these, perhaps, was a lack of honesty or partners who had a great deal of shame about themselves, that led to difficulties connecting. 

I think that our culture has few examples of truly healthy sexual relationships. Storylines in movies and television often use relationship dysfunction as a narrative device, and the sexual encounters can depict unhealthy or even unsafe behaviors. This can be titillating but also misleading about how, why, and when sex happens in relationships.

In preparation for my second marriage, the pastor encouraged us to think of sex in a relationship as another form of communication. This was really helpful to me. Like a lot of other communication, trust is a big factor. If trust is not there, it can be very difficult to relax, and be open and receptive with another person. Healthy sexual relationships involve paying attention. I remember when I first met my current husband. I was so amazed with how skilled and responsive he was. I felt very comfortable with him, and things felt fun, pleasurable and easy. I remarked to him how much better our sexual relationship was than with past partners, and he replied, “It’s because I’m paying attention.” I have developed some of these skills myself. It makes a big difference to notice what my partner is responding to, and develop a vocabulary together about what feels good, what doesn’t feel good, and what we both want. 

I believe a healthy sexual relationship involves a lot of this kind of talk. While it’s not “sexy” to interrupt things in the moment and explain some discomfort, or ensure we get a cover to protect the bed, it does ensure overall a happier experience for us. It’s amazingly helpful to have a partner who doesn’t want me to endure discomfort – who isn’t actually getting pleasure unless I am also enjoying myself. 

We also enjoy a really healthy acceptance about the ebbs and flows of desire and libido. Some periods of our multi-year relationship have involved a lot of sex, and other times have been less active. We would acknowledge, in periods of being more active, that this may not last. It’s also important that we don’t lament too hard about the fallow times, because they likely won’t last either. 

Sensory processing sensitivities can make the bodily aspects of sex challenging. Whether it’s temperature, texture, smell, or the touches themselves, it’s important for us to communicate about what is working and what isn’t, at the same time, not to shame self or the other about their own body – whether it’s about how it looks, feels or smells. My husband doesn’t ask me to remove body hair, for instance, and this has been a really healing and helpful thing for me. He isn’t averse to my menstrual blood, nor his own body fluids. For my part, I sometimes have to move his beard out of the way if it’s tickling my neck, and there are other little things I have to adjust because of chronic pain, or sensory issues. We take these things in stride. All of this acceptance and accommodation means that our relationship makes room for both of us to be ourselves in what we want and need. 

Creating a lot of psychological safety, about our bodies and also our desires has been a key to the great relationship we have. I also credit compatibility – which we couldn’t have known unless we really talked about what we wanted and what worked for us. It was hard to know what that kind of compatibility would feel like until I experienced it. Compatibility for us includes a similar cultural, religious, and economic background, both of us raised by two-parent households, having siblings, being well-matched intellectually, and both of us introverted, creative types. I think for every couple, compatibility doesn’t have to match up on every aspect, and sometimes “opposites” can work well. But I did notice how much less I had to work at mutual understanding in some of these areas. 

So much of our relationship hinges on this mutual understanding, not just sexually. We take a great deal of care to be clear about our emotions, and not take them out on each other. We work to avoid projection, which can lead to attributing problems to the other person and evading personal responsibility in improving what we want to make better. We ask, instead of tell. We let ourselves be vulnerable about our feelings. We resolve conflicts right away, rather than waiting and stewing about them. We check our own defensiveness. We focus on caring for the other person, rather than what we are getting. But we also recognize that we each are responsible for meeting our own needs. Resentments don’t build up around unspoken expectations. We ask for what we need, and accept “no” if the other person can’t provide. We check in regularly, and share in a self-owning way if we are stressed, sad, or angry. We are rarely mad at each other. 

Healthy relationship skills are necessary for a healthy sexual relationship. I’m grateful for the opportunity to experience this in my life, and I know it’s taken a lot of personal work to get here, by both my husband and me. This gratitude keeps us inspired to protect and nurture what we have for as long as we have this precious time together.

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