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sensory trauma Uncategorized

Dear Doctor… a letter about my body

Dear Doctor, Dentist, Hairdresser, Kindly Neighbour reaching out to touch me during conversation…

I may like you, I may not. It doesn’t matter. This is MY body. I do not have to give you access to it.

Please do not presume you can touch me – whatever your motives or profession.

I may ask you to touch me, I may ask you stop. Please respond with respect.

If I react by pulling away, asking you to stop, or acting in any way distressed then stop immediately.

Do NOT ask if I’m OK. I’m clearly not and it is not for me to justify why, it is my choice. Instead consider what you can do to make this easier for me.

Ask me if you can touch me or tell me what you are going to do.

Give me time to process that and wait for me to agree before touching me.

Do not tell me you will be quick; it will soon be over; or it doesn’t hurt. Do not keep going when I say stop. These actions are disrespectful at best and abusive at worst.

Maybe I don’t like being touched by other people because of how my sensory processing system works – many autistic people don’t. Maybe it’s because it triggers memories stored deep inside my body – of abuse, pain and trauma. Maybe I just don’t like it. Maybe one day it is OK and one day it isn’t. That is none of your business. I don’t need to “get over it” so that you can touch me. I don’t have to dissociate so that you can touch me. I don’t have to put up with it so you can touch me. You just need to take my lead because it is my body.

If you are reaching out physically to connect with me emotionally and I don’t reciprocate, then thank you for wanting to connect with me. Please don’t take the reaction of my body pulling away as rejection. Please find a different way of connecting with me that works for us both.

I do not need to give a reason for not wanting to be touched – however, please consider that every person you meet has an inner life that you may know little about. Autism, sensory processing disorder, PTSD, trauma, abuse. Or perhaps they just don’t want to be touched – that’s fine too.

Make no assumptions about how I wish to be touched. There is no hierarchy of body parts that you can have freer access to than others. It is all me and it is all my body. You don’t know how I process the sensation, and you don’t know how I perceive your touch. If I feel violated, frightened or under threat, your motives are irrelevant – telling me you won’t hurt me is irrelevant. Showing me you won’t hurt me by stopping IS relevant.

It is 2020 – this should not need to be said.

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Uncategorized

Autism and Consent.

Sexual consent is a complex topic. As an autistic person I find it particularly difficult to define as there is no straightforward, succinct, universal definition that enables me to firmly place A,B, and C into the category of “non-consensual” and  D, E, and F into the category of “consensual”.

As parents we are doing our best to bring up a child who is as safe as possible from potential mistreatment or abuse, and who understands how to behave kindly and respectfully towards himself and others. As our son entered his teenage years, we recognised just how complicated it is to teach someone “rules” about anything, let alone consent.

I went to the dictionary for my first definition of consent: permission for something to happen or agreement to do something. That is a fair enough definition but leaves far too many questions that my pedantically autistic mind jumps on straight away! It certainly doesn’t take into account the bigger picture where people are duped, coerced or threatened into giving permission to have sex. Or to be touched or touch someone else sexually.

My second definition was from ‘The Code for Crown Prosecutors’ – a public document, issued by the Director of Public Prosecutions that sets out the general principles that should be followed when they make decisions on cases. The definition they use is: Section 74 defines consent as ‘if he agrees by choice and has the freedom and capacity to make that choice’. The Code gives examples and elaborates on issues like conditional consent; intoxication by drink or drugs; and reasonable belief in consent. This felt like a more comprehensive definition to me and includes capacity as well as choice.

In my professional background I have extensive experience of the Mental Capacity Act 2005 and how we assess whether individuals have capacity. The Act sets out 5 principles to consider when deciding if an individual has capacity to make a decision (such as consenting to a sexual act) and only applies to adults. The law is very clear that sex with a child is illegal regardless of whether they have given permission. With adults, there is always an assumption that the person has capacity to consent unless assessed otherwise. The Mental Capacity Act states: “a person lacks capacity in relation to a matter if at the material time he is unable to make a decision for himself in relation to the matter because of an impairment of, or a disturbance in the functioning of, the mind or brain.” Some people may lack capacity on a permanent basis, whereas others have fluctuating capacity that can vary from day to day. This could be because they have a mental health condition or are affected by medication for instance.

When risk assessing situations in my professional role, I have found that supporting autistic people to take positive risks, where they have the same rights as everyone else to make mistakes or poor decisions, is complex. It can be fairly straightforward to identify sexual risk in a person who is vulnerable because of a very low IQ and severe communication problems that means they are unable to weigh up the information and make a decision. But when I am supporting people who are perfectly able to think through complex problems and access the same pubs, clubs and social events their non-autistic peers do, it becomes more difficult. I know from personal experience that my cognitive processing is adversely affected when my brain is having to process excessive sensory information. (For those of you reading this who aren’t autistic, imagine how it feels when you are trying to think about something important and your partner has their music turned up full volume on the radio – that level of not being able to think straight is commonplace for many autistic people all day every day. Many of us are hypersensitive to sounds, aromas, and visual information and find the typical background noise, light, and smell feels intensely overwhelming). The types of venue where people often meet up to form relationships tend to be overwhelming on a sensory level. Possibly not a good starting point for an autistic person. And this is before we even factor in all the social demands, the reading of body language, interpreting whether someone is interested in you or not, or what you may or may not feel about them.

I’d like to take you back to the 1970s and 1980s when I was growing up. I learned about the biology of reproduction as a child. Like many children, autistic or not, it didn’t really make a lot of sense to me at first but following science lessons at secondary school I had a fair grasp of the mechanics of it and its purpose for reproduction.

It was many years before I appreciated that sex could also be fun, loving, exciting, a mutual experience and a choice.

I learned about something else in a school talk, although it didn’t mention sex at all. This was possibly dangerous and disastrous for many children. We watched a film about not talking to strangers who stop their cars and offer you sweets or visits to their house to see their puppies. I had absolutely no idea this was about sexual abuse at all. I imagine that many children would not have applied the  messages of this film across other contexts e.g. someone that wasn’t a stranger grooming them for sexual contact.

I learned the playground language of relationships but had no idea of the meaning of some of the terms. Consider for a moment how autistic people may have a tendency to interpret language literally. I am well aware that lots of spoken and written language has more than one meaning and I’ve learned lots of idioms and metaphors off by heart. However, I mask my autism quite frequently in order to look like I have some sort of a clue about what is going on! If I didn’t, I’d be asking questions endlessly, and I am well aware this can make me appear stupid, inattentive, or naïve. I am less bothered by this as a middle-aged woman, but as a teenager I had enough problems already without adding to them! I am sure you can all think of some sexual terms of your own – take a step back from what you know they mean and just think about the words – it is ok to laugh about any potential disastrous misunderstandings!. I’ll give you an example to start you off. Words used to describe kissing someone passionately: Snogging, necking, getting off with, making out, French kissing, smooching.  None of these can be interpreted in a logical and literal way to help you work out what you are actually meant to ‘’do”. How do you consent to something you don’t understand? Especially when you are putting so much energy into just working it all out.

Many of the girls at school read teenage magazines, and studied and giggled at the problem pages and articles on how to know if a boy fancies you and how to flirt and so on, so I joined in. This was useful because it gave me some proper concrete information on how to have relationships with boys. I wasn’t interested in having a boyfriend but knew it was a normal part of growing up. I didn’t enjoy eye contact or close physical contact and I struggled to read body language and interpret other people’s emotions but at least these magazines gave me some tips.

I worked on how to flirt and how to tell if a boy was interested in me but unfortunately knew nothing about consent and I had absolutely no feelings towards anyone at all back then. It was a purely scientific approach to ‘getting it right’ and not based on what I wanted for myself. In all honesty I had no idea what I wanted, but was desperate to mask my awkwardness and lack of understanding. I had brief relationships and encounters with boys in order to fit in.

Of course, if people are having lots of relationships because they think it is what they ‘should’ do, they run the risk of appearing promiscuous. Peer pressure is inevitable for young people growing up. It is also very powerful – as is gaining a reputation as someone who is promiscuous. Autistic people have told me that they have developed reputations and attracted lots of unwanted sexual interest from others  because they are perceived as ‘easy’. Instead of it helping them to fit in with their peers, they have felt excluded, labelled and their self-esteem has plummeted further. It can be common for autistic people to continue doing things in the same way, even if they don’t work. I blame this on our society’s focus on “just try harder”. If I am doing X in order to fit in, and it isn’t working, I need to try harder and do X even more!

Masking is a topic I have written about elsewhere. It plays a significant part in any discussion about consent. I wasn’t really masking my autism as such. For a start I didn’t realise that my awkwardness and differences were autism. I masked my needs. My need for clarity – by not asking the questions I needed an answer to. I masked my need for sensory regulation – by suppressing any desire I had to intuitively move my body in ways that were calming, soothing or helped me to concentrate or simply feel joy. I copied my peers way of talking and acting in certain situations in order to fit in better – mostly I was happy being a loner with unusual hobbies, I had a strong sense of knowing what I believed in and was interested in, but I also knew that if I looked any weirder than I already did, I would probably continue to be bullied and teased. I felt quite sad that people thought there was something wrong with me. My self-esteem was already low because I knew full well there was something different about me. I tried my best but was frequently bullied. This knocked my self-esteem down further. I tried even harder to get it right.

EPSON MFP image

I will recap on the themes I’ve touched on above and relate them to the issue of consent.

  1. Capacity fluctuates. Autistic people often find the world overwhelming, and the more overwhelmed we are, the more difficult it is to make an informed decision around consent.
  2. Autistic people may take language literally. Any topic that is taboo (sex, death, finances etc.) has lots of euphemistic language associated with it that makes it even more difficult to understand. We may not generalise information very easily and therefore not realise that the ‘stranger asking you to go see his puppies’ is referring to a similar scenario as ‘an adult relative or friend of the family asking you to engage in sexual touching’.
  3. Autistic children may try and fit in with their peers by copying behaviour, doing what they feel is expected, or obeying adults.
  4. Understanding body language, subtleties in conversation, flirting and whether someone fancies you is complex and easy to get wrong.

­Educating people about consent and how to recognise and avoid situations and interactions where consent may become an issue

We have had discussions with our teenage son about consent and never pushed him as a young child to kiss relatives or accept hugs unless he wanted to. He knows that people may feel under pressure to conform in relationships – either to a partner’s requests, or a peer group, or societies expectations.  It is a complex subject with no rules to fit all circumstances. My best advice to others has been, if the situation is not clear cut or you are not sure then don’t do it. Outside of a relationship where you 100% know the consent is there then it is better to regret not doing something than to do it and wish you hadn’t. Consent is about having a choice. If it doesn’t feel like you can choose or the other person can choose, then it’s not consent.

Teaching children to do what adults say because they are adults is not a good idea for anyone, let alone an autistic person who takes things literally. It is difficult to teach rules about sexual behaviour and how to spot potential abuse or grooming activity. The only thing I feel I can do as a parent is to be open and willing to discuss anything with my child.

Sex education needs to include more than biology. I believe that people are at risk because of a lack of the right knowledge about sex and relationships – it’s like teaching someone mechanics and expecting them to not get run over just because they know how a car works.

Sensory processing and consent

I was very vulnerable because of my lack of understanding of sexuality. I knew the facts but knew nothing about the existence of desire as a teenager. Our interoception (the sense system that lets us know how we feel internally) is significant in issues relating to consent. I can’t remember having feelings towards other people as a child, sexual or otherwise. I didn’t like or dislike people. I didn’t look at someone and find them attractive. I knew how to behave appropriately though. I was polite, I did what I was told, I obeyed adults. I also tried to “act normal” and fit in with my peers. This coupled with my particular interoceptive processing means I can put a lot of effort into getting things right, rather than considering my own feelings. I have autistic friends whose interoceptive processing works in a very hypersensitive way compared to my hyposensitive interoceptive processing.  They feel sensations intensely and frequently whereas I feel fewer emotions or sensations. They too may have experienced issues with consent. Someone like me may not feel any attraction to another person but go out with them because it is the proper thing to do. My hypersensitive friend may feel attracted towards people instantly and passionately and pursue a relationship or sexual encounter without fully considering if it is what they want.

Our other senses play a significant role too in relationships and issues of consent. Some people are hyper or hypo sensitive to touch. They may excessively seek physical contact or avoid it. Either of these responses can impact on the ability to consent. The person who needs lots and lots of physical contact in order to register the sensation, may invade other’s spaces or touch them more than is acceptable – there is a risk of them being accused of sexually inappropriate behaviour or being seen as initiating sex. The person who recoils from gentle touch because they need firmer touch may be drawn to sexual partners that are rougher. Other senses play a part too – sex is a multisensory experience. Autistic people often process sensory information in muted or intense ways. None of these sensory processing issues are insurmountable in an established relationship – mature sexual relationships are based on partners being responsive and considerate, the difficulties tend to be more problematic when building relationships or choosing potential partners.

Some people cope with sensory overload by shutting off or zoning out mentally. This may increase vulnerability because their capacity for making decisions about consent is reduced.

How do we help people make informed decisions about consent?

Consent is a difficult concept to capture in a universal definition. Capacity to consent fluctuates too, particularly for autistic people who often have atypical combinations of strengths and needs. Someone may have excellent verbal skills and be extremely articulate and able to problem solve a theoretical problem, but struggle to multitask the sensory, social, and interpersonal aspects of relationship building. On first impressions this person may appear completely able to consent but actually he or she is extremely vulnerable.

Explaining your potential difficulties, saying that you are disabled or autistic may be useful (or not!) for getting help when struggling at the supermarket, at college or in work. It could increase your vulnerability in a potential sexual encounter though. A decent person would understand, back off and take their time. Other people may take advantage of your vulnerability.

Denying autistic people the opportunity to take risks and make mistakes won’t help them develop skills in learning about what they want from relationships. Open discussions using accurate, frank and honest language with our autistic children, family and friends may help them explore issues and develop strategies that keep them safer and help them make informed choices.Giving autistic people accurate and explicit information about sex, where they can ask honest questions without fear of ridicule or exploitation in a safe environment is essential. There are very few opportunities for this sadly.

Teaching people the reasoning behind rules may be more effective than teaching rules. We may hear that “Yes means yes and no means no”. It’s quite easy to opt for simple rules when you are a very rule driven autistic person. This sounds ok on the surface but actually there are lots of times that yes means no. There are even times when no means yes. It is unlikely that you can learn every variable so asking yourself questions about whether this is something that is safe, is legal, is something you may regret afterwards, can be more effective than rules. And for me, the big question is “do I have a choice?” If the answer to that is no, then it is not consenting. Similarly, if my partner does not have a choice then that is not consensual either.

A difficulty with having a rules-based approach can be the inevitable exceptions to the rule. Think about this scenario… I tell my son that he must never show his private parts to an adult. OK – so what about a doctor? A doctor’s OK. But unless I specify that I only mean medical doctors; that you are visiting specifically about your private parts; in their surgery at an appointment and not anywhere else; etc etc. there will always be exceptions to the rule. Autistic people may struggle to place learning from one context into another context. We run the risk of the “Don’t talk to strangers” campaigns from my youth that failed to mention that most abuse is perpetrated by someone you know – and has nothing to do with puppies.

It is likely that people will end up in situations that they wish they hadn’t.  Some people will have non-consensual sex. This non-consensual sex could be in the form of rape (as defined by the legal system), or it could be other forms of illegal or coercive sex. The person may have given permission but not technically consented. They may have felt OK at the time but regretted it later. Some people will encourage other people to engage in non-consensual sexual activity, this could be forceful or manipulative – they may or may not recognise the other person’s lack of capacity. The participants may or may not consider whether they were consensual experiences or not. Both partners may be non-consenting. People may consent at the beginning but change their minds. There are far more complex situations than there are simple “this was right and that was wrong” situations. In my professional capacity I have been involved in many, very complex safeguarding situations.  Most aren’t black and white.

The complexity may mean it is difficult to apportion blame. Sometimes the fault is easy to identify. The law and public opinion is clear about particular acts. It may be more productive to move away from blame and fault when discussing consent in the less clear-cut issues and move towards the impact of the encounter. How has it affected the person? What can they learn from the encounter to help them be safer in the future? Feelings of guilt may or may not occur relating to any sexual activity.

It can be said that autistic people struggle to understand the intentions of non-autistic people. To an extent, I would agree. I may experience this as some non-autistic people being liars, full of hidden meanings and insincere. Of course – this mass generalisation is grossly unfair, and as untrue as autistic people being perceived as blunt, unemotional and rude. The ‘double empathy problem’ theory in autism explains this well. We can all have difficulties in understanding each other, regardless of our individual neurology, but when people of different neurotypes interact, there can be added dimensions to this.

Autistic people are frequently infantilised. Disabled people are often thought of as non-sexual beings. Social situations can be tricky to navigate because of all the sensory processing, unwritten rules and complex protocols that others seem to intuitively know but we don’t. This all adds up to put autistic people at a disadvantage when making choices. We have the same rights to make mistakes as anyone else. But we need to be on an even playing field.

It may be helpful for autistic people to learn assertiveness skills and about boundaries. This can help us advocate our needs and reduce the need for masking. Masking often leads to small issues building up into bigger and bigger ones because our needs aren’t shown, recognised or met. Learning to identify what we want and ask for it effectively can be powerful.

Learning about our bodies, emotions and senses is important too. Having a lifestyle where  we regulate our senses and emotions as part of our daily life will help us be in a better place for making decisions and choices. For those of us that have sensory processing issues that impact on our ability to consent – we may need to find strategies that work as an alternative. For me, I don’t feel like or dislike or desire towards people instantly. My interoceptive sensory processing is slow and it can take time to know how I feel about someone. If I was single, I would make a strategy for myself that said “don’t have sex with that person straight away even if they say they really like you. Have a few dates first and find some things you have in common”. My autistic friend who quickly develops intense feelings for other people may devise a similar strategy “don’t have sex with that person straight away even if you really fancy them. Have a few dates first etc”. It’s up to us as individuals to create the strategies that keep us safe and fit our individual lifestyles and beliefs.

Many of my blogs end with a paragraph about us all being human beings and how we should be kind to each other. This one is no different. It is likely that any of us, autistic or not, will find ourselves in situations relating to consent that don’t go to plan. Before we act, we could think about whether we are about to be kind to ourselves and kind to others. It’s a good starting point for deciding if we should consent or not.

I have had feedback about previous blogs where I explore issues like identity and body image. These topics may be painfully relatable for some people. I’d like to share the following:

No one is ever to blame for sexual activity they did not consent to.

No one is ever to blame for consenting and then later regretting it.

No one is to blame for making mistakes or acting in the best way they could at a time when they only had some of the information they have learned since.

There are many reasons for why we do what we do. If you need help or if reading this blog feels distressing then please reach out to someone.

Here are some links to sources of support:

Mind has a list of resources on this page: https://www.mind.org.uk/information-support/guides-to-support-and-services/abuse/sexual-abuse/

http://www.thesurvivorstrust.org

http://www.rapecrisis.org.uk

http://www.safeline.org.uk

http://www.nspcc.org.uk

http://www.survivorsuk.org

References:

https://kar.kent.ac.uk/67614/     Damian Milton Double Empathy Problem

https://www.legislation.gov.uk/ukpga/2005/9/contents  Mental Capacity Act

https://undercoverautism.org/2020/05/31/masking/ A personal blog about masking