Twitter/X: @autisticmedic

I’m 24 and a medical student in my final year at Imperial College in London before I graduate as a doctor. I’m autistic, which I’ve always known really, and got my diagnosis last year with the help of my uni’s disability team!

I unfortunately have an extensive personal history with what comes under the umbrella of violence against women and girls. I believe that some of this was targeted because abusers could recognise the vulnerability in my autism. This important but under-recognised intersection of issues facing women and girls, neurodiversity and male violence, is what I will be discussing in this blog post from the lens of my personal experiences from the age of 17, while I was at school, to my mid-twenties where I am now, finishing medical school.

Content Warning: discussion of rape and sexual abuse, eating disorders, bullying.

Introduction

Autistic women and girls are over-represented as victims/survivors of sexual assault, harassment and abuse (1). My personal view is that the law, as it stands in the Sexual Offences Act 2003, does not currently do enough to allow the prosecution of sexual offences against autistic women and girls who are, in reality, the most at risk from predatory men.

Missed Red Flags

I’ve been missing red flags of predatory behaviour in boys and men since my first relationship. Being at a girls secondary school shielded me from everything but a few weird comments about flat-chestedness from boys at primary school right up to my late teens. But what happened next, in the sixth form when the girls and boys school started to meet more, was like a wrecking ball of strange behaviour I just couldn’t get my head around.

As often happens in autistic girls, I had a severe eating disorder (anorexia). I was only just beginning the long process of recovery from when I met my first boyfriend. He seemed intensely interested in me, and that had never happened to me before.

I was so excited, but at the same time increasingly uncomfortable with what he was doing. I would try to check with my friends if this was just normal stuff or if it was beginning to become threatening. We all agreed and accepted (this was pre #MeToo) that it was fairly normal to receive pressure as a girl, for sex, and repeatedly saying no to him almost felt like my natural responsibility.

I’d been so used to being made fun of for getting things wrong socially and so viciously bullied for it that I, by my mid teens, made a point of ignoring things until they were completely, undeniably, happening. Out of a kind of self-preservation. It didn’t help that I tended to take things entirely literally. And, being a strongly moral child, believing that everyone on a basic level had good intentions towards others. That they would tell the truth. Including my boyfriend, when he told me I was misunderstanding what had happened, that he hadn’t meant to hurt me at all.

Of course, when these things go unsaid and unseen, they escalate. So, by 18, not long after finishing my A levels to try to meet my offer for medical school, what was undeniably happening to me was serious sexual abuse. Because I could only see it when it was really obvious, by that point it was too late.

When Saying No is Not Straightforward

Just “saying no” to unwanted sexual behaviour from men and boys is not, in my experience, as straightforward as it can sound. Verbal shutdown happens a lot faster in autistic women and girls than for neurotypical counterparts. For me, this would look like freezing and being unable to speak when I’m under extreme stress. That extreme stress can be the threat of sexual violence from men, whether I’ve been in a relationship with them or it’s someone I’ve met on a night out. I can usually articulate a little, like “that’s not OK” or “that’s hurting me” but not typically any more than that before I just go silent. The norm has then been that the perpetrator has taken advantage of my silence to tell himself it’s “not a no” and carry on.

When Understanding What Happened is Not Straightforward

Similarly, understanding what has actually happened to you is often a very complicated process that takes time. For anyone who’s been a victim/survivor of rape and serious sexual assault, it takes time to process. Particularly as around 90% of the time the person was or still is a friend, partner or acquaintance (2).

Being autistic and trying to figure out any social interaction takes time and effort and a lot of thinking power. Trying to understand whether what happened is “normal” or whether you’ve been abused/assaulted is a whole new level of extremely difficult. The clue sadly is that if you’ve read this far, if you’re spending afternoons typing into google “was I assaulted?” in my view the answer is in the fact you’re asking the question.

Autistic vulnerability to gaslighting for me has meant years of my life being manipulated by various abusive exes, and even friends, into a false reassurance that I was overreacting (I wasn’t). You’re not either.

Even if You Do, Reporting it is Not an Easy Decision

Even if you do understand what happened to you as sexual assault, reporting it is not a straightforward decision. The law as it stands is not made with autistic women and girls in mind. The Sexual Offences Act 2003, the only update since 1956, (3) defines the legal parameters of rape, serious sexual assaults and other sexual offences in the UK. The 2003 Act defines consent as an agreement “by choice” and with “the freedom and capacity to make that choice”. Physical disability is cited within the Act (section 75, e) with reference to “a physical disability which prevented them from communicating consent”.

However, as this is a law written long before today’s discussion around #MeToo and consent and also around the prevalence of neurodiversity in women, none of this features in this section of consent law. What this means is that when I have been myself in the horrible position of having to report a rape to the police, I faced a barrage of questions around why I didn’t say no. Why I didn’t say no more frequently, more clearly and more emphatically than I did.

Consent law is a contentious area, but for me what is missing is the simple fact that in autistic women and girls, communication is so different. Especially under stress, we can be totally silent and numb and compliant with an abuser but that is not consent.

When Autistic Women and Girls are Repeatedly Retraumatised

What happens then is too many autistic women and girls like me are repeatedly revictimised by predatory abusers. These abusers unfortunately target us, in my experience, because they can. It’s hard to even count the number, between leaving school and the end of my university life, of boys and then men who saw me as an easy target.

Rape and serious sexual assault happened to me from a young age and kept happening.

Before I started university, as a scared teenager at a house party targeted by a much older friend of a friend, a few years later when I was drunk to the point of being near-passed out, towards the end of my degree when I was spiked by a date, and even within a long term otherwise entirely healthy relationship with someone I loved very much*.

It has happened to me again and again in a sometimes hopelessly repeating cycle of abuse that I’ve always been desperate to stop. I just couldn’t see how to stop it. Until my autism diagnosis in 2023 identified the area of vulnerability I’d been targeted for.

Knowing this, I was able to reach out for support and therapy early this year. It’s been a big year. It’s helped me understand why I was being repeatedly revictimised and, most importantly, that it wasn’t my fault. If this has happened to you, if it’s a cycle you feel stuck in, it isn’t your fault either. That responsibility really is always with the abusers.

But before now, it was a pattern I fell into that kept repeating for all of my early adult life. I certainly spent the whole of that time not really seeing myself as attractive, that’s how deep childhood bullying from a particular group of “mean girls” at school had set in. I became so used to it, in all my friendships and relationships, used to feeling utterly worthless and hopeless about the future.

Even now, when things have obviously moved on and changed and that’s no longer my reality on the outside. On the outside, I’m a seemingly successful medical student and wannabe surgeon, starting as an NHS doctor next year. On the inside, I’m always scared I’ll somehow lose it all and go back to that terrified thirteen year old who couldn’t fit in.

Conclusion

As an autistic survivor of rape, my perspective is that the law is failing women and girls in my position who are left to be revictimised over and over. Society is rightly engaging in a big conversation, firstly with #MeToo and now the spotlight on autistic women. We are moving in the right direction. My view is that what we need next is a change in the law to reflect that and protect autistic girls from abuse. In my view, juries in UK criminal courts need to be given direction to specifically understand features of autistic communication differences that are not as simple as “just saying no”.

Quotes and References

Quote that best describes me:

“I inhaled books like other people breathe oxygen. I didn’t just read for knowledge or pleasure, I read to live.” ― Yeonmi Park, In Order to Live

(1) BBC iPlayer – Christine McGuinness: Unmasking My Autism

(2) Rape, sexual assault and child sexual abuse statistics | Rape Crisis England & Wales

(3) Sexual Offences Act 2003 (legislation.gov.uk)

Appendix

* ​some identifying details have been changed to preserve anonymity of anyone discussed.

I want to clearly express that although I am using the language “autistic women and girls” the issue of male violence of course affects everyone, including male, non-binary and gender-non conforming autistic people.

The intention is very much not to exclude these groups as although my personal experience is as an autistic woman I very much appreciate the problems are not exclusively experienced by cisgender women!