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Quaderni di Psicoterapia Cognitiva - Open Access

La sessualità in psicoterapia cognitivo-comportamentale

No. 57 (2025)

Neurodivergence and Sexuality: Clinical Complexities and CognitiveBehavioral Approaches to Psychotherapeutic Intervention

DOI
https://doi.org/10.3280/qpc57-2025oa23134
Submitted
giugno 24, 2026
Published
2026-07-16

Abstract

The growing recognition of neurodivergence as an expression of the natural variability of human neurocognitive functioning has significant implications for the understanding of sexuality and for psychotherapeutic practice. Neurodivergent individuals frequently experience nonlinear developmental trajectories in the affective and sexual domains, influenced by specificities in emotional and sensory regulation, in communicative processes, and by exposure to specific forms of minority stress. These factors influence identity development, the experience of sexual response, and the ways in which intimacy is expressed, often within social and clinical contexts that remain strongly normative.

The contribution proposes an integrated framework combining neurodiversityaffirming perspective with evidencebased cognitivebehavioral models, with the aim of offering a clinically useful framework for psychotherapeutic work with neurodivergent individuals who bring sexualityrelated concerns into therapy. Key concepts are discussed, including the Double Empathy Problem, masking, minority stress, and the adoption of a cultural humility stance, highlighting their implications for the therapeutic setting, the therapeutic alliance, and clinical language.

The article further explores the intersections between neurodivergence and sexual identity. The implications related to late diagnoses and disclosure processes are also discussed, emphasizing the role of psychotherapy as a space for the coconstruction of affirmative and depathologizing meanings. In conclusion, drawing on the presentation of a clinical case, several clinical principles are outlined for a neurodivergenceinformed cognitivebehavioral psychotherapy, capable of integrating methodological rigor and attention to subjectivity, promoting wellbeing, agency, and authenticity in affective and sexual experiences.

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