Abstract
Autistic adolescents are often excluded from comprehensive sexuality education (CSE) by schools, parents, and healthcare providers, despite growing recognition of their sexual agency. This scoping review examined 42 U.S.- based studies to identify thematic categories that highlight the recurring challenges and opportunities in providing sexuality education for autistic adolescents. Five themes emerged: (1) pervasive misconceptions about autism and sexuality; (2) inadequate access to formal sexual education; (3) parental and clinician discomfort or lack of preparedness to address sexual health; (4) heightened vulnerability to sexual exploitation and adverse health outcomes; and (5) recommendations for inclusive, affirming, and developmentally responsive curricula. Findings highlight how autistic adolescents often receive fragmented, reactive instruction that prioritizes behavior management rather than proactive skill-building in consent, boundaries, and healthy relationships. Evidence suggests that tailored approaches incorporating visual supports, concrete language, and LGBTQ+ inclusivity improve accessibility and relevance. Addressing these gaps requires proper CSE training for autistic adolescents' family members, teachers, and clinicians to enhance communication, strengthen mutual understanding, and foster more supportive, informed relationships across all parties involved. This review contributes to the growing body of literature that calls for CSE that empowers autistic adolescents to make informed decisions and promotes equitable sexual health outcomes.