This article is part of my Neurodivergent Sex & Intimacy series – PART 4, written with ADHD and other neurodivergent brains in mind. Many of the ideas here are also relevant more broadly TO EVERYONE ELSE AS WELL.

Many people with ADHD and other neurodivergent brains tell me that sex, consent, and safety feel more complicated than the simple “yes or no” they are often taught. They can look like they are going along with something on the outside while feeling frozen, panicked, or far away on the inside.A trauma-informed approach matters here. Many difficulties around sex, desire, closeness, consent, and relationship intensity make more sense when we understand the role of the nervous system, past hurt, overwhelm, safety, and the ways power can be misused. This is not about asking “What is wrong with you?” but “What has happened to you, and what does your system need now?”

I also want to say this clearly from the beginning: neurodivergence does not change what consent is, and it does not cause abuse. At the same time, some neurodivergent people may be more vulnerable to coercion, confusing or mixed consent experiences, shutdown, going along to keep the peace, sexual victimisation, or unhealthy relationship dynamics. That is not a personal failing. It is one reason this conversation matters (Arrondo et al., 2023; Ohlsson Gotby et al., 2018).

Part of why I am writing this is because many people only find language for these patterns years later, often with a great deal of shame. Bringing them into the open is one way of reducing that shame and increasing safety.

If this article resonates and you would like a wider frame, you might also like “ADHD, Sex, Intimacy, and Relationships” and “ADHD and Sex: Why Your Brain May Be Running Your Sex Life.” They sit alongside this one in the same series.

Consent is more than a technical yes

Consent is not just the absence of a no. It is not going along with something because you feel awkward, afraid, frozen, guilty, pressured, or worried about disappointing someone. Consent needs to be active, ongoing, informed, freely given, and able to be withdrawn at any time.

That sounds simple on paper, but lived experience is often more complicated. A person can say yes while internally panicking. They can agree because they have learned that pleasing other people is safer than upsetting them. They can go blank and lose access to their words. They can only realise later that their body had already started shutting down. This can happen in long-term relationships, new connections, casual sex, and everything in between; it is not limited to strangers or first dates.

This is one of the reasons I think a trauma-informed lens is so important (Fava & Fortenberry, 2021). Sometimes the most helpful question is not, “Did you technically say yes?” but, “Did you have access to choice, safety, and your own body in that moment?”

Why this can feel complicated with ADHD

ADHD can affect far more than concentration. It can shape impulse control, emotional regulation, pacing, self-monitoring, body awareness, and the ability to notice what is happening internally while something is already unfolding. In sex and relationships, that can matter a great deal.

For some people, this looks like moving quickly and only realising afterwards that they were not comfortable. For others, it looks like intense attraction, urgency, fear of losing the moment, people-pleasing, delayed processing, or difficulty separating desire from overwhelm. Some people know exactly what they want when they are alone, but lose access to that clarity once another person is in front of them. For many, the body gives early warning signs—tightness, numbness, fogginess, a sense of checking out—that are easy to miss until afterwards.

None of this means neurodivergent people cannot consent. It means that consent may need to be understood as something embodied, relational, and paced rather than as a purely verbal or intellectual event (Bowers et al., 2024). It can also intersect with past trauma or controlling dynamics in ways that are hard to untangle at the time.

Trauma changes the picture

Trauma can affect how a person reads danger, how quickly the body goes into protection, and how easy it is to access voice, boundaries, or choice. When people hear the word trauma, they often think only of major events. But trauma can also include coercion, repeated pressure, relational instability, sexual shame, chronic invalidation, or years of learning that your discomfort does not matter, including in intimate partner or family relationships.

For some people, the nervous system goes into fight or flight. For others, it freezes, fawns, shuts down, or collapses. That means a person may look easy-going or willing on the outside while feeling numb, far away, or deeply unsafe on the inside. If you recognise yourself in that, it does not mean your body failed you. It may mean your body was trying to protect you in the only way it knew how.

This is also why the answer cannot be reduced to “just communicate better” (Fava & Fortenberry, 2021). Communication matters, but so do body cues, pacing, emotional safety, and whether the nervous system actually believes there is room for no.

When your body cannot keep up

One of the hardest things for many people to name is the difference between a real, grounded yes and what happens when their body can no longer say no. Sometimes people actively go along with something because they feel pressure, fear conflict, do not want to disappoint someone, or have learned that keeping the peace is safer than being honest. Other times, the body freezes or checks out so quickly that there is no real choice at all—on the outside they may look relaxed or willing, while on the inside they feel numb, far away, or on high alert.

This can make things complicated. Sometimes the other person genuinely does not realise how distressed or shut down you were, especially if discomfort is carefully masked or only shows up in subtle ways. Sometimes they may have checked in once, taken the first yes at face value, and not noticed that your body or voice had changed. Other times, they may not have checked in at all. Intention, awareness, and explicit communication all matter here.

In some situations there are obvious threats, pressure, or clear disregard for your discomfort. In others, the dynamics are much more subtle and confusing, and it may only be possible to see the pattern with distance and support. The fact that you did not recognise it at the time, or could not act differently, does not make the experience your fault.

None of this means your experience is less real if someone else did not understand it at the time. And it does not mean that everything is your responsibility to prevent. A softer and more accurate response is often this: perhaps some part of you did know, but your nervous system did not catch up in real time, and you did not yet have the safety, language, or support to act on that knowing in the moment (Fava & Fortenberry, 2021). For some neurodivergent people, this can also be shaped by interoceptive and emotional processing differences, where body signals and emotional meaning do not always arrive clearly or quickly enough in the moment, and sometimes only make sense afterwards (Brewer et al., 2016; Kis et al., 2020; Shah et al., 2016). At the same time, we can ask more of partners, communities, and education so that consent conversations become clearer, ongoing, and more attuned to body cues—not just words.

Sometimes it can help to imagine a friend telling you this story and quietly ask yourself: “Would I hear a solid yes, or someone going along so things don’t get rocked?”.

Interoceptive awareness during intimacy

For some neurodivergent people, one of the difficulties is not just what happens in the moment, but noticing clearly enough what is happening in the body while it is unfolding. Some people only realise later that they felt tense, numb, flooded, disconnected, or not fully there. Others struggle to tell the difference between desire, urgency, anxiety, sensory overload, and shutdown in real time.

Interoception is our internal sense of what is happening inside the body—things like heartbeat, breathing, muscle tension, temperature, hunger, fullness, nausea, or the felt sense of being settled or braced. It plays an important role in emotional awareness and self-regulation, and differences in interoception have been described in both ADHD and autism research (Brewer et al., 2016; Murphy et al., 2023). This does not mean neurodivergent people are disconnected from themselves; it means the signals may be harder to notice, interpret, or trust quickly enough while something is already unfolding.

Interoceptive awareness can be strengthened gently. That might mean pausing before or during intimacy to notice breathing, muscle tension, temperature, heartbeat, or whether the body feels open, braced, foggy, or far away. It can help to use simple prompts such as: “What am I feeling in my body right now?”, “Do I feel more open or more contracted?”, “Am I moving toward this, or just not stopping it?” Practices like breath awareness, body scans, movement, progressive muscle relaxation, and guided noticing can all help build this skill over time.

For some people, it also helps to build structure around this rather than relying on spontaneous awareness. That might mean using agreed pause points with a partner, checking in before things escalate, having words for “slow down” or “I need a moment,” or noticing patterns afterwards through brief reflection or journalling. Visual body maps, sensation lists, and checking in outside sexual situations can also make it easier to recognise cues earlier over time. This is not about making sex clinical or awkward. It is about making it safer, clearer, and more mutual.

What the recent research adds

The research in this area is still growing, but it is clear enough that this conversation should not be treated as fringe. A 2023 review found that adults with ADHD were more likely to be involved in intimate partner and sexual violence, including as victims, and called for better tailored prevention and support (Arrondo et al., 2023). A 2018 study also found higher rates of coercive sexual victimisation among young people with some neurodevelopmental conditions, especially girls and women (Ohlsson Gotby et al., 2018).

More recent work suggests similar concerns for autistic people: one study found higher odds of unwanted or distressing sexual experiences in autistic young adults, and another reported substantial rates of dating violence in autistic youth, both pointing toward the need for clearer consent communication and neurodiversity-informed dating violence prevention (Bowers et al., 2024; Cusano et al., 2025).

This research should never be used to paint neurodivergent people as helpless, dangerous, unchangeable, or destined for harm. What it really underscores is that safety, consent education, pacing, trauma-informed care, and neurodiversity-affirming support matter deeply.

Why vulnerability can increase

There is rarely just one reason. Vulnerability can grow when several things overlap: difficulty reading cues, delayed processing, fear of rejection, low self-worth, trauma history, sensory overwhelm, dependency, past abuse, isolation, or a lifetime of being told you are “too much” or “too sensitive” (Arrondo et al., 2023; Cusano et al., 2025).

Some people are also more likely to second-guess themselves, minimise discomfort, or assume they are the problem when something feels off. Others may have become very good at masking and accommodating, which can make it harder to notice the moment when accommodation tips into self-abandonment.

This is why the answer is not simply “be more assertive.” For most of us, the deeper work is learning how to notice ourselves again, trust our bodies and their cues, tolerate disappointing others, and experience moments of safety without overriding our own signals. On the page this can sound straightforward; in real life it is often hard work for many people, and there can be many extra layers of difficulty for neurodivergent nervous systems.

What trauma-informed support can look like

Trauma-informed, neurodiversity-affirming therapy does not begin by trying to force a person into a more “normal” version of sex or relationship behaviour. It begins with safety.

That might mean slowing everything down. It might mean learning what your body feels like before you are overwhelmed rather than after. It might mean noticing the difference between desire, urgency, fear, shutdown, and numbness. It might mean building language for boundaries or helping partners understand pacing, sensory needs, repair, and the reality that consent is ongoing.

This work is often very gentle. We are not trying to shame the parts of you that freeze, fawn, go along, disconnect, or chase intensity. We are trying to understand what those responses have been protecting, and what they may need now in order to feel safer and more connected.

Drawing on trauma-informed sex-positive work, safety does not have to mean fear-based avoidance. It can also mean creating the conditions where pleasure, agency, and real choice become possible again (Fava & Fortenberry, 2021).

If this feels personal

If this article feels close to home, please know that confusion around sex, safety, and consent does not mean you are broken. It may mean your body has been carrying more than anyone realised. It may mean you learned to survive in ways that made sense then, but no longer feel good now.

It is also common to feel conflicted about the other person—to care about them, minimise what happened, or worry about making a fuss, even when part of you knows something was not okay. That ambivalence does not cancel your experience; it is a normal response to complex situations. If your situation involves current partner violence, control, or ongoing fear, part of the work may also include looking at practical safety and support options alongside the emotional pieces.

You do not need to have the perfect language before seeking support. You do not need to prove that something “bad enough” happened. And you do not need to sort all of this out on your own. In my work, I support people to make sense of sex, trauma, consent, intensity, shutdown, shame, and relational confusion with care and without judgement. The goal is not to make you smaller or easier for other people. It is to help you feel safer, clearer, and more able to stay with yourself.

Take the first step

If sex, safety, consent, or relationship intensity has felt confusing, painful, or hard to name, therapy can help you explore it gently and at your pace.

I offer sessions in person at my practice in Goodwood, Adelaide, and online for clients across South Australia, interstate, and internationally. If you would like support in making sense of your relationship with consent, intimacy, trauma, and safety, you are welcome here.

Book your first session here.

This article is for general information and is not a substitute for personalised therapeutic advice. If you are experiencing distress, please connect with a mental health professional or your GP.

For immediate crisis support in Australia, contact Lifeline on 13 11 14 or text 0477 13 11 14. For LGBTQIA+‑specific peer support, you can contact Rainbow Door on 1800 729 367 (10am–5pm) or QLife on 1800 184 527 (3pm–midnight). If your mental health emergency is life‑threatening, call (000).

References

Arrondo, G., Goodwin, G. M., D’Agostino, A., & Fazel, S. (2023). Attention-deficit/hyperactivity disorder as a risk factor for intimate partner violence and sexual violence: A systematic review and meta-analysis. *Epidemiology and Psychiatric Sciences, 32*, e64. https://doi.org/10.1017/S2045796023000774

Bowers, H., Qu, Y., Gassner, S. L., Schrenker, R. A., Tu, K. M., Shumway, S., Butler, E. A., Wang, Y., Dax, J., & White, S. W. (2024). Perceptions and use of explicit verbal sexual consent in young adults entering college. *Archives of Sexual Behavior*. https://pmc.ncbi.nlm.nih.gov/articles/PMC11662084/

Brewer, R., Cook, R., & Bird, G. (2016). Alexithymia: A general deficit of interoception. *Royal Society Open Science, 3*(10), 150664. https://pmc.ncbi.nlm.nih.gov/articles/PMC5098957/

Cusano, J., Graham Holmes, L., Caplan, R., & Rothman, E. F. (2025). Prevalence and correlates of dating violence victimization among a U.S.-based sample of autistic youth. *Journal of Interpersonal Violence, 40*(11–12), 2676–2699. https://doi.org/10.1177/08862605241275997

Fava, N. M., & Fortenberry, J. D. (2021). Trauma-informed sex positive approaches to sexual pleasure. *International Journal of Sexual Health, 33*(4), 537–549. https://doi.org/10.1080/19317611.2021.1961965

Kis, B., Gyorffy, Z., Simor, P., et al. (2020). Alexithymia, emotion processing and social anxiety in adults with ADHD. *Journal of Attention Disorders*. [Please check your final preferred APA formatting/source details if you are using a different record.]

Murphy, J., Brewer, R., Plans, D., Khoury, B., & Bird, G. (2023). Emotional dysfunction and interoceptive challenges in adults with autism spectrum disorder. *Frontiers in Psychiatry*. https://pmc.ncbi.nlm.nih.gov/articles/PMC10136046/

Ohlsson Gotby, V., Lichtenstein, P., Långström, N., & Pettersson, E. (2018). Childhood neurodevelopmental disorders and risk of coercive sexual victimization in childhood and adolescence: A population-based prospective twin study. *Journal of Child Psychology and Psychiatry, 59*(9), 957–965. https://doi.org/10.1111/jcpp.12884

Shah, P., Hall, R., Catmur, C., & Bird, G. (2016). Alexithymia, not autism, is associated with impaired interoception. *Cortex, 81*, 215–220.