Sexuality in Fetal Alcohol Spectrum Disorder: A Topical Review Primer for Clinicians and Researchers

Challenges related to sexual behavior represent an area of concern for some individuals with fetal alcohol spectrum disorder (FASD). Although such difficulties have been highlighted within diagnostic guidelines, general review papers, and a small number of studies, the empirical and clinical literatures focused on sexuality in FASD remain in the early stages. This topical review aims to increase awareness and understanding of FASD and sexuality among clinicians and researchers to improve assessment, conceptualization, and intervention practices. We first review the circumscribed nature of the extant literature and current understanding of sexuality for people with FASD from a lifespan perspective. Second, we consider biopsychosocial and bioecological factors that can inform a more comprehensive understanding of sexuality in FASD. Third, we provide an overview of current clinical approaches to supporting and managing sexuality, including sexual health promotion, caregiver and service provider focused programming, as well as clinical and correctional/forensic screening, assessment, case conceptualization, and intervention practices. Fourth, we conclude by offering specific recommendations for future research and practice for supporting individuals with FASD in developing and maintaining healthy sexual development. Clinicians and researchers are encouraged to become FASD-informed as well as knowledgeable in understanding sexuality in this population. Early identification and intervention are important in facilitating healthy sexual development and expression in individuals with FASD.