Sex Selling and Autism Spectrum Disorder: Impaired Capacity, Free Enterprise, or Sexual Victimization?

Sexual behavior is a complex phenomenon. While appetitive and linked to reproduction, it also has a strong hedonic component to it. Like other human behaviors, it is dimensional and, although it may fall along a continuum of normality, it may also deviate in a variety of directions. Selling and buying sex is one of said deviations. We report the case of a young man with an autism spectrum disorder who began to sell himself in exchange for money in a country where sex selling, or prostitution, is not in and of itself illegal. The case is noteworthy as it explores issues of freedom of will, capacity to consent to sexual relations in an individual with a clinically diagnosed psychiatric condition at risk for victimization, exploitation of the disabled, and medico-legal responsibility. We likewise underscore the clinical complexity of assessing the relationship between moral understanding, cognitive skills, and sanctionable and risky behaviors.