Although guidelines and recommendations for offering sexuality and relationship education (SRE) exist 1,2, the United States (U.S) lacks a standardized approach to addressing the sexual and socioemotional needs of youth and adults 3,4. This fractured approach to SRE in the US is associated with numerous negative outcomes including higher rates of unwanted and early-in-life pregnancy compared to countries with comprehensive approaches to SRE, elevated rates of sexually transmitted infections (STIs), low self-esteem, and increased risk of sexual abuse 5,6.

Inconsistent SRE delivery is felt acutely by individuals with developmental disabilities. Only 53% of U.S. students with disabilities who could respond to a survey independently reported receiving SRE in school 7. Autism is a neurodevelopmental diagnosis characterized by differences in social communication relative to neurotypical norms, and by sensory and focused interests8. For autistic students in particular, even when SRE is offered, curricula may be inaccessible due to how information is being presented or lack of tailoring to autistic learners. 9. For instance, sexual orientation and gender are both more diverse in the autistic population compared to nonautistic people, yet over 80% of US school-based SRE programs focused exclusively on heterosexual relationships between cisgender people 10. This SRE gap has left autistic individuals more vulnerable to victimization11. Thus, it is important to better understand how and when topics such as gender identity, sexual orientation, and sexual behaviors should be taught.

The topics covered in SRE historically have emphasized the biological aspects of sexuality, such as reproduction, puberty/development, and disease or pregnancy prevention12, instead of the social and sexual aspects of relationships. This is especially true for individuals with intellectual and developmental disabilities 13. This is at odds with what students need and want. US high school students want SRE with information on a variety of sexual identities and types of relationships14. Dating skills such as flirting, dating, consent, and assertiveness are critical skills for healthy psychosexual functioning, yet these topics are underaddressed in SRE programming15,16.

The timing of SRE is instrumental in its efficacy. Concerningly, relevant SRE takes place after first sexual experiences for over 40% of girls and over 50% of boys 17. The emergence of sexual desires and behavior during adolescence are normative developmental milestones. Recommendations on what sexuality and relationship topics should be stressed for neurotypical adolescents have been proposed by experts in the field, but we are still lacking a lifespan approach to sexuality education for individuals with and without disabilities 14. Past research has explored the necessary components for comprehensive and well-targeted SRE programming, typically taught at the onset of puberty 14,18. These targets are also ever changing, with young adults of today having grown up with the internet and exposure to sexual materials prior to adolescence 19. New data on the timing of sexual and relationship milestones could inform a timeline for offering SRE that is more reflective of the experiences of today’s youth. In particular, there is still much to learn about whether these timelines of sexual and relationship milestones are similar between autistic and nonautistic individuals. This information would be best learned by asking autistic and nonautistic people directly about their experiences.

In pursuit of an evidence-based, self-advocate informed model of SRE, we asked autistic and non autistic adults which topics they wanted more SRE on, and when they experienced certain sexuality and relationship milestones. The results here reflect the experiences of US adults who can read at or above a sixth grade level and who can complete an online survey. By simultaneously collecting data from autistic and nonautistic adults, part of our goal is to be able to directly compare where learning needs and priorities align, and whether they differ. Identified differences can provide an important jumping off point for program design and future qualitative work with autistic individuals to best understand when, how, and for which topics we need to design SRE materials.