Neurodivergent Hypersexuality: What Gets Misunderstood About ADHD, Autism, and Sex

Neurodivergent hypersexuality gets reduced to a punchline or a diagnosis nobody explains well. Ask most people what they know about ADHD or autism and sex, and the answer collapses into one of two stereotypes: the impulsive, hypersexual cliché or the flatly asexual one. Neither holds up against the research. The reality is a subject far more layered than headlines about “ADHD sex drive” or “autistic hypersexuality” suggest.

It touches neuroscience and gender bias in diagnosis, along with cultural stigma and a clinical history full of missteps. Underneath all of that sits a quieter opposite: the neurodivergent adults who feel little to no sexual desire at all, and who rarely see their experience discussed anywhere.

The reporting here draws from peer-reviewed research in journals like Archives of Sexual Behavior and Autism Research, along with Neuropsychiatric Disease and Treatment and clinical guidance from psychiatry and psychology sources. This is not a diagnosis. It is a map, because most people navigating this territory never got one.

A Note on Scope and Language

Neurodivergence covers dozens of neurotypes, from dyslexia to Tourette syndrome to sensory processing differences, and the term itself simply describes brains that process attention, sensation, and social information differently than the statistical majority. The sexuality research, however, has concentrated almost entirely on two of those neurotypes: attention-deficit/hyperactivity disorder and autism spectrum disorder, sometimes studied together as co-occurring traits. That is where the evidence lives, so that is where the focus stays here. Other neurotypes are not unrelated to sexuality. The data on them simply has not caught up yet.

On terminology: this coverage uses identity-first language, “autistic adult” rather than “adult with autism,” reflecting a preference expressed by a majority of autistic self-advocates in survey research. For ADHD, both “person with ADHD” and “ADHD adult” appear in circulation without a comparable consensus, so both show up here interchangeably. None of this terminology makes a clinical claim beyond what the cited research actually supports.

This subject also sits at the intersection of two topics people are taught not to discuss openly: mental health and sex. That silence has a cost. Adults spend years quietly wondering whether their sexual patterns mean something is wrong with them, without anyone ever pointing them toward the research that already exists. Consider this a starting point for that conversation, not the final word on it.

Where the Stereotypes Came From

Before getting into the research, it helps to understand why this topic feels so loaded in the first place. Popular media has spent decades attaching sexuality stereotypes to neurodivergence in ways that rarely reflect lived reality, and neurodivergent hypersexuality is one of the least accurately portrayed. Autistic characters on screen are often portrayed as either entirely asexual, treated as childlike regardless of adult age, or written with an odd, hypersexual social cluelessness played for comedy. ADHD gets the opposite treatment more often, framed as a personality trait synonymous with impulsive, chaotic romantic behavior rather than a medical condition with a specific neurological basis.

Both portrayals do real damage. The infantilizing autism stereotype has contributed directly to the sex education gaps documented throughout this coverage, since educators and parents who view autistic people as inherently non-sexual see less reason to provide adapted, comprehensive sex education at all. The chaotic ADHD stereotype does the opposite kind of harm, turning a genuine neurological pattern into a punchline that discourages people from seeking an accurate diagnosis or real clinical support.

Clinical researchers writing in this space explicitly push back against both narratives. The consistent message across the literature reviewed here is that neurodivergent sexuality is neither absent nor excessive as a rule. It is simply different, shaped by a nervous system that processes sensation, reward, and social information differently than the neurotypical baseline most cultural narratives assume.

What Hypersexuality Actually Means, Clinically

The word gets thrown around loosely. In casual use, “hypersexuality” can describe anyone with a high sex drive. Clinically, it means something narrower and more specific.

The World Health Organization added compulsive sexual behavior disorder to the ICD-11 in 2019, classifying it as an impulse control condition rather than an addiction or a sexual health disorder. The diagnostic picture centers on control, not appetite. A person meets the threshold when sexual behavior becomes the central focus of their life, when repeated attempts to reduce that behavior fail, and when the pattern continues despite real consequences to health, relationships, or work. The pattern has to last six months or longer and cause genuine distress or impairment.

That last part matters enormously. Wanting sex often, or thinking about it often, is not by itself a disorder. Distress and dysfunction are the deciding factors. A high libido that brings someone joy and does not disrupt their life sits outside the clinical definition entirely, no matter how it compares to a statistical average.

A Contested Diagnostic History

The path to a formal hypersexuality diagnosis was neither quick nor smooth. Researchers proposed criteria for a condition called hypersexual disorder ahead of the DSM-5’s 2013 publication, and the American Psychiatric Association rejected it, citing insufficient evidence and concern about pathologizing normal sexual variation. The ICD-11’s 2019 adoption of compulsive sexual behavior disorder, placed among impulse control conditions rather than addictions, effectively settled a debate the American system had left open.

That history carries real weight for neurodivergent adults specifically, because it means the clinical tools available today are still relatively new, and researchers are still refining them. A condition this recently formalized has not yet been fully tested against neurodivergent populations, which helps explain why so much current guidance leans on smaller studies and clinical observation rather than the large-scale, long-term data available for more established diagnoses.

ADHD and the Dopamine Chase

Attention-deficit/hyperactivity disorder rarely gets discussed as a sexual health condition, yet a growing body of research treats neurodivergent hypersexuality as exactly that. A 2023 anonymous online survey published in the International Journal of Environmental Research and Public Health, titled “Let’s Talk about Sex… and ADHD,” set out specifically to map that gap.

The mechanism researchers point to is dopamine. ADHD brains show altered dopamine signaling in the reward pathways that govern motivation and pleasure, including how the brain responds to novelty. Sex offers one of the most reliable, fastest-acting dopamine spikes available. For someone whose baseline dopamine runs low, sex can function less like desire and more like self-medication.

This is the same underlying mechanism that connects ADHD to other behavioral patterns clinicians describe as dopamine-seeking, including compulsive shopping and gambling, along with substance use. Sex sits alongside those behaviors in the clinical literature rather than existing as an isolated phenomenon, and treatment models increasingly borrow directly from behavioral addiction frameworks when addressing ADHD-linked hypersexuality specifically. That framing helps remove some of the moral weight patients often carry into treatment, replacing shame with a concrete, treatable neurological explanation.

Novelty, Impulsivity, and Hyperfocus

Novelty plays a particularly important role in this mechanism. ADHD brains respond more strongly to new stimuli than to familiar ones, a pattern researchers have documented extensively in attention and motivation studies. Applied to sexuality, this can translate into a stronger pull toward new partners, new scenarios, or new forms of stimulation than toward the kind of steady, familiar intimacy long-term relationships often settle into. That pattern does not doom ADHD adults to unstable relationships, but it does explain why novelty-seeking within a committed relationship is a recurring theme in clinical conversations about ADHD and sexuality.

Impulsivity compounds the pattern. The same difficulty pausing before action that shows up in ADHD as interrupting conversations or overspending can show up sexually as decisions made in the moment, without the usual pause for risk assessment. Hyperfocus adds another layer. When an ADHD brain locks onto something, be it a person, a fantasy, or a new relationship, it can crowd out nearly everything else for a stretch of time.

What the Data Shows

A 2020 study in the journal Psychiatry Research found a meaningful association between ADHD symptoms and both hypersexuality and paraphilic interests, though researchers were careful to note the relationship is not universal. Not everyone with ADHD experiences elevated sexual behavior. Some experience the opposite, covered later in this piece.

A separate meta-analysis examining ADHD prevalence specifically among patients already diagnosed with hypersexuality and paraphilic disorders found rates substantially elevated compared to the general population, reinforcing that this is not a one-off finding from a single research group but a pattern replicating across independent samples. Researchers describe the relationship as bidirectional in clinical practice: ADHD raises the likelihood of hypersexual patterns, and clinics treating hypersexuality are seeing higher rates of undiagnosed ADHD walk through their doors than population base rates would predict.

Risky sexual behavior tracks alongside this pattern too. Adults with ADHD report higher rates of unprotected sex, more sexual partners on average, and earlier sexual debut compared to neurotypical peers in multiple survey-based studies. Researchers frame this as a downstream consequence of impulsivity and planning difficulty rather than evidence of anything resembling moral failure, a distinction that matters for how clinicians talk to patients about it.

Escapism, Not Just Chemistry

Clinicians increasingly describe ADHD-linked hypersexuality as an escape valve as much as a chemical one. Emotional dysregulation, a core but underrecognized ADHD trait, leaves many adults without effective tools for processing anxiety, boredom, or shame in the moment. Sex becomes a fast, accessible way to regulate an overwhelmed nervous system.

This same escapism pattern shows up in other ADHD-linked behaviors, and researchers increasingly study them as a cluster rather than in isolation. A 2025 qualitative study of neurodivergent adults with bulimic-spectrum eating disorders described binge eating functioning as a strategy for managing overwhelming emotion in much the same way hypersexual behavior does, both offering fast, reliable relief for a brain that struggles to regulate itself through slower means. Clinicians treating any one of these behaviors in isolation risk missing that the underlying driver, dopamine-seeking paired with poor emotional regulation, runs across several presenting problems at once.

That framing changes how treatment gets approached. Rather than only targeting the behavior, clinicians working with ADHD patients often focus on building broader emotional regulation skills and identifying triggers. Many also treat the underlying attention condition itself, sometimes with stimulant medication that can, counterintuitively, reduce impulsive sexual behavior by improving overall impulse control.

Porn, Apps, and the Digital Amplifier

Modern sexuality does not happen in a vacuum, and for ADHD brains specifically, the digital environment supplies an almost perfectly engineered trigger. Dating apps and pornography platforms run on novelty and instant reward, backed by an endless supply of new stimuli, the exact combination that an under-stimulated dopamine system finds hardest to resist.

Clinicians who treat ADHD and compulsive sexual behavior together frequently point to compulsive pornography use and app-based dating cycles as the most common presenting complaints, more so than in-person sexual behavior itself. The pattern often mirrors other ADHD-linked compulsions, like doomscrolling or online shopping. It is less about sex specifically and more about a brain that struggles to disengage once a reward loop starts, regardless of which app is delivering it.

Treatment approaches here overlap closely with behavioral addiction models. Structuring access, building in friction before impulsive decisions, and treating the underlying ADHD tend to outperform approaches that target the sexual behavior in isolation, according to clinicians writing on ADHD-linked behavioral addictions.

New Relationship Energy and the Hyperfocus Effect

ADHD hyperfocus deserves a section of its own within the sexuality conversation, because it explains a pattern many ADHD adults recognize instantly once they name it. Early in a new relationship, an ADHD brain can lock onto a partner with an intensity that feels less like ordinary infatuation and more like total absorption, mirroring the same hyperfocus that shows up around a new hobby or special interest.

That intensity often produces a period of elevated sexual and romantic energy that can look, from the outside, indistinguishable from hypersexuality. Clinicians draw a sharp line between this phase, tied specifically to novelty and typically settling over time, and a more persistent pattern that continues regardless of relationship stage. The distinction matters for treatment, since a temporary hyperfocus phase rarely needs intervention on its own, while a pattern that never settles may point toward the dopamine-driven dynamic discussed earlier in this section.

Partners of ADHD adults sometimes describe a difficult transition once that initial hyperfocus phase fades, since the same intensity that once felt like being the center of someone’s universe eventually redistributes toward whatever the ADHD brain fixates on next. Framing this honestly early in a relationship, rather than letting a partner assume the intensity is a permanent baseline, tends to prevent a great deal of confusion and hurt down the line.

Autism, Sensory Regulation, and Unconventional Interest Patterns

Autistic sexuality research tells a more complicated story than a single “more” or “less” narrative, and the same nuance applies to autistic hypersexuality specifically. A 2023 systematic review in Neuropsychiatric Disease and Treatment examined seventeen autism studies and nineteen ADHD studies on psychosexual functioning. Across both groups, researchers found poorer overall psychosexual functioning compared to neurotypical peers, including higher rates of dissatisfaction and dysfunction, along with elevated vulnerability to sexual victimization. That pattern showed up more strongly in autistic women.

Within that broader picture, some autistic adults do report elevated hypersexual behaviors and fantasies, particularly autistic men. A 2025 literature review noted higher rates of paraphilic fantasies, including sadistic and masochistic interests, among both autistic men and women compared to neurotypical samples. Researchers link this partly to intense, focused interests, a defining autistic trait, occasionally attaching to sexual content the same way it might attach to trains, history, or a favorite band.

Sensory Input and Fantasy

Sensory processing plays a documented role too. Some autistic adults describe sex and masturbation as a way to regulate an overwhelmed or understimulated nervous system, similar to stimming. For a brain seeking intense sensory input to feel regulated, sexual activity can supply exactly that.

The relationship between autism and paraphilic interest deserves careful framing, since it is one of the more sensitive findings in this research area. Researchers stress that an elevated rate of unconventional fantasy or interest does not equal elevated risk of harmful behavior, and most autistic adults with atypical sexual interests never act on them in ways that violate consent or law. What the data does show is a wider range of reported fantasy content, which several researchers connect back to the same intense, narrow-focus interest pattern that shows up across every other domain of autistic cognition, from special interests to routines.

Executive function differences shape autistic sexuality in more mundane but equally significant ways. Difficulty transitioning between tasks, planning ahead, or reading a partner’s nonverbal timing cues can make initiating or maintaining sexual encounters genuinely harder, independent of desire level. Several autistic adults describe wanting intimacy but struggling with the sequential, socially timed choreography that sex often requires, a friction point rarely discussed outside of specialized therapy settings.

Masking and Delayed Sexual Development

Masking, the exhausting practice of suppressing autistic traits to appear neurotypical, complicates the picture further. Many autistic adults spend years or decades not understanding their own bodies, desires, or sensory experiences because early life taught them to override their instincts in every other domain. When that internal disconnect finally loosens, sometimes after a late diagnosis, some adults describe a period of intense sexual exploration as they catch up on self-knowledge that earlier life never offered them.

Communication differences add another layer of risk. Difficulty reading social cues, understanding indirect refusal, or recognizing manipulation leaves some autistic adults more vulnerable to exploitative partners, a pattern the 2023 systematic review flagged as a serious public health concern requiring further study. Recognizing neurodivergent hypersexuality accurately, rather than assuming either predation or promiscuity, matters directly for how clinicians and partners respond to it.

Vulnerability, Victimization, and the Consent Gap

This is one of the more urgent findings across the research gathered for this coverage, and it deserves direct attention rather than a passing mention. The 2023 systematic review covering both autism and ADHD found elevated rates of sexual victimization across both conditions, with the pattern appearing more pronounced among women. Researchers attribute this partly to social vulnerability, meaning difficulty recognizing manipulation or coercion in real time, and partly to a lack of adequate sex education that leaves many neurodivergent adults without a clear framework for identifying and asserting boundaries.

Girls with autism in the 2021 exploratory sexuality study reported negative sexual experiences at nearly double the rate of typically developing peers, roughly half describing at least one unwanted encounter. Researchers were careful to note this reflects a protective and educational failure, not anything inherent to autism itself.

A More Encouraging Data Point

Comprehensive, adapted sex education that explicitly covers consent, boundary-setting, and recognizing manipulation shows measurable benefit in the limited intervention studies available, though access to that kind of programming remains inconsistent even in well-resourced school systems.

The same vulnerability dynamic applies, with different mechanics, to ADHD. Impulsivity and difficulty pausing before a decision can make it harder to exit a situation that is becoming unsafe, and emotional dysregulation can make it harder to hold a boundary under social pressure. None of this places responsibility on the neurodivergent adult for someone else’s exploitative behavior. It does mean that clinicians, educators, and partners all have a role in building the kind of explicit, direct communication structures that reduce risk without restricting anyone’s actual sexual agency.

The picture is not uniformly grim. The large 2021 Autism Research survey found autistic and non-autistic adults did not differ meaningfully in age of first sexual activity or in rates of sexually transmitted infection, despite the elevated victimization risk found elsewhere in the literature. Researchers read that as evidence that targeted education and protective planning, rather than broad restriction, are the more effective and more respectful path forward for supporting neurodivergent adults around sexual health.

Sexual Orientation Diversity

Autistic adults report significantly higher rates of non-heterosexual orientation compared to the general population, a finding that has replicated across multiple independent studies. A 2021 survey of nearly 2,400 adults found autistic participants were less likely to identify as heterosexual and more likely to report an “other” sexuality category entirely, one that did not map cleanly onto existing labels.

Researchers offer a compelling explanation rooted not in biology but in social conditioning. Autistic adults frequently describe feeling less pressure to perform social expectations that do not fit them, partly because masking already demands so much energy that conforming to additional expectations around orientation or gender presentation becomes unsustainable. Reduced susceptibility to social conformity, in other words, may free some autistic people to recognize and express identities that neurotypical peers suppress under similar internal circumstances.

Romantic Attraction Is Not the Same as Sexual Attraction

One distinction that gets lost in most public conversation about autistic sexuality is the difference between wanting a romantic partner and wanting a sexual one. Research on the autism and asexuality overlap treats these as separate axes rather than a single sliding scale, and autistic adults report more varied combinations of the two than neurotypical samples typically show.

An autistic adult can desire deep romantic partnership while experiencing little or no sexual attraction, a combination researchers label as aromantic-adjacent or simply romantic without a sexual component. Another autistic adult can want physical intimacy without any interest in the emotional infrastructure of a traditional romantic relationship. Neither combination is unique to autism, but autistic adults report both patterns at rates notably higher than the general population, which researchers suggest reflects the same reduced pressure toward social conformity discussed above.

How Gender Reshapes the Picture

Almost every study in this space returns the same finding in different words: gender changes everything, and neurodivergent hypersexuality looks meaningfully different depending on who is experiencing it. That starts with diagnosis itself. Clinicians diagnose boys with ADHD at roughly 2.4 times the rate of girls in childhood, and women with ADHD receive their diagnosis an average of four years later than men, according to a 2025 systematic review on ADHD and sex hormones. Researchers built diagnostic criteria largely around how the condition presents in boys, meaning quieter or internalized presentations in girls and women get missed for years.

That diagnostic gap shapes the sexuality research too, since most historical samples skewed male. Within the data that exists, ADHD in women shows a stronger connection to impulsivity linked to mood and anxiety, while in men impulsivity connects more closely to sociability and activity level, according to research on gender differences in ADHD and impulsivity. Clinicians at the Sachs Center, who specialize in adult ADHD and autism assessment, note that women with ADHD frequently experience both ends of the spectrum, cycling between hypersexual periods and stretches of low desire tied to executive dysfunction, sensory sensitivity, or medication side effects.

Hormonal fluctuation adds a layer unique to women and some nonbinary people. A 2025 narrative review found emerging evidence that menstrual cycle phases interact with ADHD symptom severity, with several small studies pointing to worse executive functioning and mood regulation in the luteal phase. Researchers caution the findings remain preliminary, but the pattern lines up with what many women with ADHD report anecdotally about fluctuating libido across the month.

Autism, Gender, and the Desire Gap

Autism research shows a strikingly consistent gender split. The same 2021 study of nearly 2,400 adults found autistic men reported a stronger desire for sexual and romantic relationships than autistic women, while autistic women reported lower sexual desire overall yet were more likely than autistic men to be in committed relationships.

Earlier foundational research by Bejerot and Eriksson, frequently cited across this field, first documented that autistic women report reduced sexual desire and libido compared to both autistic men and neurotypical women, a finding that subsequent studies have replicated consistently across different countries and survey methods. That consistency across independent research teams is part of why clinicians increasingly treat the pattern as a genuine feature of autistic female sexuality rather than an artifact of any single study’s methodology.

The higher relationship-commitment rate among autistic women despite lower reported desire deserves its own scrutiny. Possible explanations include that autistic women may place relatively more value on the emotional and routine-based stability a committed relationship provides compared to the sexual component specifically, and that societal pressure to partner may push some autistic women toward relationships regardless of desire level. Neither explanation has been definitively confirmed, and researchers flag this as an area needing more qualitative, first-person research rather than survey data alone.

Autistic women and nonbinary people also report higher rates of both asexuality and non-heterosexual orientation compared to autistic men and to neurotypical samples of any gender. Researchers studying the autism and asexuality overlap suggest sensory sensitivity, alexithymia, and difficulty interpreting internal bodily signals may explain part of the pattern, since several of these traits appear more pronounced or differently expressed in autistic women.

Intersectionality: Race, Disability, and Compounding Bias

Gender is not the only identity layer that shapes how neurodivergent sexuality gets recognized, diagnosed, or dismissed. Race and ethnicity influence diagnostic timing significantly, particularly in the United States and United Kingdom, where clinicians diagnose Black and Hispanic children with autism later than white peers on average, often after initially misdiagnosing them with a behavioral or conduct disorder instead. That same bias tends to follow people into adulthood, shaping which adults get access to accurate diagnosis and, by extension, accurate information about their own sexual patterns.

Adults with co-occurring physical or intellectual disabilities face an additional layer of erasure specific to sexuality. Caregivers and clinicians, along with family members, frequently assume disabled adults, including those with intellectual disabilities alongside autism or ADHD, are either asexual by default or incapable of consenting to any sexual relationship at all. Disability advocates have pushed back on this assumption for decades, arguing that presumed asexuality functions as a form of erasure rather than protection, and that appropriate support looks like accessible sex education and consent training, not blanket exclusion from the conversation entirely.

Socioeconomic status compounds all of the above. Specialized clinicians who understand both neurodivergence and sexual health charge accordingly, and insurance coverage for either category of care remains inconsistent across most health systems. Adults without financial access to specialized care must rely on general practitioners who, as noted earlier, typically receive minimal training in either subject.

Nonbinary and transgender neurodivergent adults remain the most underresearched group in this entire field. What data exists suggests gender-diverse autistic and ADHD adults report higher rates of nonheterosexual identity and more fluid relationships to sexuality overall, though sample sizes in nearly every available study are too small for firm conclusions.

The Trans and Nonbinary Overlap

A separate and growing body of research has documented an elevated rate of autism diagnoses among transgender and gender-diverse adults, independent of the sexuality question entirely. Clinics specializing in gender identity have reported autism rates in their patient populations well above general estimates for years, prompting researchers to investigate whether the two experiences share underlying cognitive or social mechanisms.

What this means for the hypersexuality conversation specifically is still unclear, and that uncertainty is itself worth stating plainly. Existing hypersexuality and hyposexuality research rarely disaggregates gender-diverse participants as their own analysis group, folding them instead into broader “other” categories or excluding them from binary-coded survey instruments altogether. Advocates and clinicians increasingly call this a research gap that needs direct attention, not an assumption that trans and nonbinary neurodivergent adults simply mirror whichever binary group they are closest to demographically.

The Diagnoses Neurodivergent Hypersexuality Gets Mistaken For

Here is where things get genuinely dangerous for patients. Hypersexuality is not exclusive to ADHD or autism. It shows up as a symptom across several unrelated conditions, and clinicians without training in neurodivergence sometimes reach for the wrong label entirely.

Bipolar Disorder

This is the misdiagnosis clinicians warn about most. Hypersexuality is a recognized criterion of manic and hypomanic episodes in bipolar disorder, and it almost never appears in ADHD on its own, according to clinical guidance published in Psychiatric Times. The distinguishing features are episodic mood, grandiosity, racing thoughts, and a sharply reduced need for sleep, all arriving together in a defined stretch of time.

ADHD hypersexuality, by contrast, tends to be a stable trait rather than an episode. It does not arrive and vanish with mood cycles. A person can carry it consistently for years, tied more to impulsivity and dopamine regulation than to a discrete manic phase. Because ADHD and bipolar disorder share so many surface symptoms, including impulsivity and restlessness, misdiagnosis runs in both directions. Some research puts bipolar misdiagnosis rates as high as 40 percent across all presentations, most often confused with depression, but the ADHD crossover remains a well-documented clinical trap.

Obsessive-Compulsive Disorder

OCD produces something that can look like hypersexuality from the outside but functions almost oppositely on the inside. Sexual OCD involves intrusive, unwanted sexual thoughts that clash with a person’s actual values and cause acute distress, not pleasure. Someone with sexual OCD might compulsively masturbate not for gratification but to “cancel out” a disturbing intrusive thought, according to clinical descriptions from the OCD treatment platform NOCD.

That distinction, between behavior driven by pleasure-seeking and behavior driven by anxiety-neutralizing, is the clearest line clinicians use to tell the two apart. A 2019 study found rates of hypersexuality in people with OCD track closely with the general population, suggesting true hypersexuality and OCD-driven sexual intrusive thoughts function as separate phenomena that simply get confused. Given how frequently autism and undiagnosed OCD co-occur, this confusion has real consequences for neurodivergent patients specifically.

The stigma around sexual intrusive thoughts compounds this diagnostic confusion further. People experiencing them often fear that voicing the thought means something dark about their character, so they stay silent rather than describe the symptom accurately to a clinician. That silence makes it far more likely a clinician defaults to a hypersexuality or paraphilia framework based on incomplete information, rather than recognizing the anxiety-driven OCD pattern underneath. Specialists in this area consistently point to exposure and response prevention therapy as the most effective treatment once a clinician reaches the correct diagnosis, a markedly different approach than anything used to treat genuine hypersexuality.

Compulsive Sexual Behavior Disorder, On Its Own Terms

CSBD deserves its own mention because it can exist entirely independent of neurodivergence, and lumping every hypersexual ADHD or autistic adult into a CSBD framework risks pathologizing normal variation. The ICD-11 explicitly separates CSBD from paraphilic disorders and sexual dysfunctions, positioning it instead among impulse control conditions. Researchers have tested a validated screening tool, the CSBD-19, in the United States as well as in Hungary and Germany, giving clinicians a consistent, cross-cultural way to assess it. Notably, the validation study behind that tool found men scored higher on average than women across all three countries, a gender gap that holds steady regardless of language or cultural context and that researchers say warrants further investigation into whether it reflects a true prevalence difference or a reporting gap shaped by differing social expectations around female sexuality. Treatment overlaps heavily with ADHD-informed approaches, including cognitive behavioral therapy and, in some cases, SSRIs.

Borderline Personality Disorder and the Impulsivity Overlap

Borderline personality disorder shares a striking amount of clinical territory with ADHD, including impulsivity and emotional volatility, along with a pattern of unstable relationships. Hypersexuality is not a core diagnostic criterion of BPD, but clinicians report it appears often enough in practice to warrant real attention, usually connected to a need for connection or a way of regulating overwhelming emotion rather than pleasure-seeking on its own.

The overlap runs deeper than symptoms. Research on adults with severe BPD has found ADHD prevalence rates as high as 60 percent within that population, far above general estimates. Both conditions also show strong associations with childhood trauma, though the type of trauma differs somewhat between them, with BPD histories more frequently involving emotional and sexual abuse. Clinicians increasingly argue that trauma-informed evaluation should be standard practice whenever hypersexuality shows up alongside ADHD or BPD symptoms, since untreated trauma can drive sexual behavior patterns that neither an ADHD nor a personality disorder framework fully explains on its own.

Post-Traumatic Stress and Trauma Responses

Trauma deserves its own line here because it can produce hypersexual behavior through an entirely different mechanism than any neurodevelopmental condition. For some trauma survivors, sexual behavior becomes a way of regaining a sense of control after an experience defined by powerlessness. For others, it functions as dissociation, a way of leaving the body during moments that otherwise feel unbearable.

Because neurodivergent adults, particularly those with ADHD, report elevated rates of childhood trauma tied to neglect and misunderstanding, along with repeated punishment for traits they could not control, trauma and neurodivergence frequently arrive at a clinician’s office tangled together. Separating which factor is driving a given sexual pattern requires a careful history, not a checklist, and researchers studying ADHD-trauma overlap explicitly warn that trauma-informed care has not yet become standard in most ADHD evaluations.

The line between “high libido” and “clinical hypersexuality” was never about how much sex someone wants. It is about whether the person still feels in control of the wanting.

Culture, Geography, and the Diagnostic Blind Spot

Nearly everything discussed so far comes from research conducted in the United States and Western Europe, including the United Kingdom. That is not an accident. The DSM-5 and ICD-11, the two diagnostic frameworks clinicians use globally, draw heavily on Western research populations, and both autism and ADHD diagnostic tools reflect that history.

A 2019 comparative study of college students in Lebanon and the United States found autism stigma measured significantly higher in Lebanon than in the U.S., though the researchers found collectivism itself was not the driver. Instead, autism knowledge, quality of personal contact with autistic people, and openness to experience predicted lower stigma far more reliably than any single cultural value.

Diagnostic tools built for Western social norms do not always translate cleanly elsewhere. Researchers studying autism assessment across cultures point out that behaviors clinicians treat as red flags in Western settings, like muted emotional expression in groups or a strong preference for structured social interaction, register as culturally expected or even valued in many collectivist societies. That mismatch means autistic traits get missed in some regions and, in specific clinical contexts, overattributed in others. A study of Japanese medical professionals found clinicians were more likely to attribute a child’s behavioral difficulties to autism relative to other conditions, compared to typical Western diagnostic patterns.

How That Bias Reaches Sexuality Research

This same instrument bias extends directly into research on neurodivergent hypersexuality, since researchers developed and validated nearly every survey tool that measures hypersexuality, hyposexuality, or sexual orientation diversity on Western populations. A questionnaire built around assumptions of individual autonomy in romantic choice, for instance, may not translate meaningfully into a cultural context where family involvement in partner selection is standard practice, regardless of how accurately it measures desire or behavior on its own terms. Researchers studying cross-cultural mental health assessment increasingly call for locally developed and validated instruments rather than simple translation of existing Western tools, though funding for that kind of work remains scarce outside high-income countries.

Sexuality research compounds the gap even further. Discussing hypersexuality openly requires a cultural environment where sex itself is discussable, and in many regions of the world it simply is not, at least not in clinical research. What limited cross-cultural sexuality data exists tends to come from countries with established sexual health research infrastructure, meaning most of the global neurodivergent population remains almost entirely unstudied on this specific question.

Family structure shapes outcomes too. In cultures where extended family involvement in medical decisions is the norm, a neurodivergent adult’s sexuality can become a matter of family reputation rather than individual health, according to researchers studying autism stigma across non-Western communities. That dynamic can delay diagnosis, delay treatment, and push people toward silence regardless of what they are actually experiencing.

A Continent-by-Continent Snapshot

Africa illustrates the diagnostic gap clearly. A 2023 review found autism prevalence across African countries likely sits close to global estimates once researchers use proper screening, yet confirmed diagnoses lag far behind risk indicators, largely due to a shortage of specialists and the absence of assessment tools built for local languages and cultural contexts. ADHD shows a similar pattern, with a continent-wide meta-analysis estimating prevalence near 7.5 percent among children, using a boy-to-girl ratio close to global figures, but adult diagnosis infrastructure remains limited across much of the region.

The Middle East and North Africa report consistently lower autism prevalence than Western countries, which researchers attribute primarily to stigma, limited diagnostic access, and a lack of culturally validated screening instruments rather than an actual difference in underlying rates. Studies from Saudi Arabia and Oman describe families delaying evaluation for years out of concern for how a diagnosis might affect a child’s or an adult’s social and marital prospects, a dynamic with direct downstream effects on how openly sexuality gets discussed in clinical settings.

East Asia and Latin America

East Asian contexts add a different wrinkle. Research comparing Japanese clinicians to Western diagnostic norms found a tendency to attribute a broader range of behavioral difficulties specifically to autism, suggesting cultural expectations around social conformity may shift which behaviors read as clinically significant in the first place. Korean-American families, meanwhile, conceal autism diagnoses within their communities out of fear of judgment in documented cases, a pattern that likely applies just as strongly, if not more so, to any conversation about sexuality layered on top of it.

Latin America shows the underdiagnosis pattern in a slightly different form. Reported autism and ADHD prevalence across much of the region trails high-income countries, and researchers attribute the gap primarily to limited specialist access and a shortage of screening infrastructure rather than any true divergence in how common these conditions actually are. Machismo-influenced cultural norms around masculinity and sexuality, documented across several Latin American countries in broader sexual health research, add a further layer of complexity specific to how openly men in particular might discuss either hypersexual or hyposexual patterns with a clinician, though dedicated studies connecting that cultural dynamic directly to neurodivergent sexuality remain essentially nonexistent.

Across nearly every region outside North America and Western Europe, one theme repeats: local systems never built the tools there, specialists remain scarce, and sexuality research trails even further behind basic diagnostic access. Global neurodivergent adults are not experiencing less complexity around hypersexuality and hyposexuality. Clinicians and researchers simply ask them about it far less often.

The Overlooked Opposite: Hyposexuality and Asexuality

For every headline about neurodivergent hypersexuality, there is a quieter, less discussed reality on the other end of the spectrum. Hyposexuality, meaning consistently low or absent sexual interest, and asexuality, a stable orientation involving little to no sexual attraction, both appear at elevated rates among neurodivergent adults, particularly autistic adults.

A 2025 study published in Archives of Sexual Behavior analyzed a global sample of over 10,000 people on the asexual spectrum and found autism prevalence within that group sat at 6.9 percent, notably higher than general population estimates. Autistic individuals in the sample also identified more strongly with their sexual orientation and were more likely to be in relationships with other asexual or aromantic partners.

The mechanisms researchers point to differ meaningfully from the hypersexuality side of the equation. Alexithymia, a difficulty identifying and naming internal emotional and physical states, is common among autistic adults and can make sexual desire genuinely hard to notice or interpret even when a person wants a romantic relationship. Sensory sensitivities that make touch, sound, or smell overwhelming can turn physical intimacy into an unpleasant experience rather than a desired one. One study of 230 autistic adults found 30 percent described their sexual experiences as unpleasant.

Community, Belonging, and What the Data Does Not Mean

Community connection appears to buffer some of this difficulty. The 2025 asexual-spectrum study found autistic participants were more likely than non-autistic asexual peers to partner with someone also on the asexual or aromantic spectrum, and more likely to engage with online LGBTQIA+ communities generally. Researchers suggest that finding language and community for an experience that once felt confusing or isolating appears to meaningfully improve wellbeing, independent of whether the underlying desire pattern itself ever changes.

It is worth stating plainly that asexuality and hyposexuality are not medical problems requiring correction. Autism does not cause asexuality, and being asexual does not require an autism diagnosis to be valid. What the research shows is a statistical overlap worth understanding, not a causal chain implying either condition is a deficient version of the other.

Autistic burnout adds another layer specific to this population. Adults navigating chronic overload from masking, sensory demands, or executive dysfunction frequently report their libido dropping sharply during burnout periods and returning, sometimes, once the burnout eases. Clinicians increasingly frame this as a nervous system response rather than a relationship problem, a distinction that matters enormously for partners trying to understand what is happening.

Recovery and the Return of Desire

What happens after burnout deserves more attention than it typically gets, since the recovery period itself can be confusing for both the neurodivergent adult and any partner involved. Desire does not usually return on a predictable schedule. Some adults describe it flooding back once masking demands ease, sensory input becomes more manageable, or a major stressor resolves. Others describe a much slower, patchier return that never fully matches their pre-burnout baseline.

Occupational therapists and autism-informed sex therapists increasingly recommend treating the recovery of desire as a byproduct of broader nervous system recovery rather than a goal to pursue directly. Reducing sensory load, protecting recovery time after socially demanding events, and rebuilding a sense of safety in the body tend to matter more than any intervention aimed narrowly at libido itself. For many autistic adults, that reframe alone relieves a significant amount of pressure, since it replaces a fixation on “fixing” desire with a broader, more sustainable focus on wellbeing.

Medication and the ADHD Libido Paradox

ADHD tells a more paradoxical story. The same population shown to experience elevated hypersexuality also reports high rates of low libido, often as a side effect of stimulant medication rather than the condition itself. Executive dysfunction can also suppress sexual initiation entirely, since planning, initiating, and following through on intimacy requires exactly the executive functions ADHD impairs. For some adults, hypersexuality and hyposexuality are not opposite poles but the same underlying dysregulation showing up differently depending on the day, the stress level, or the medication dose.

This is why clinicians increasingly resist framing ADHD sexuality as a single fixed trait. A person can experience a hypersexual period during an unmedicated, high-stress stretch of life and a hyposexual period once treatment stabilizes their mood but flattens their libido as a side effect. Both experiences trace back to the same underlying condition, which is exactly why treatment plans built around one static assumption tend to fail.

When Low Desire Gets Mistaken for a Relationship Problem

Partners of hyposexual neurodivergent adults often internalize the mismatch as a personal rejection, and neurodivergent adults themselves frequently absorb the same message from partners who do not understand what is driving the pattern. Sex therapists working with neurodivergent clients increasingly emphasize separating the nervous system explanation from the relationship narrative, since conflating the two tends to deepen shame on one side and hurt on the other without addressing what is actually happening physiologically.

Age and the Shifting Terrain of Desire

Age reshapes nearly every pattern discussed here, and clinicians warn against applying findings from one life stage to another.

In children and early adolescents, clinicians apply far more caution around hypersexual behavior than they do with adults, since age-inappropriate sexualized behavior in a child points toward possible abuse, overstimulation, or a bipolar phenotype far more often than toward ADHD or autism alone. Pediatric guidelines explicitly require ruling out abuse before any neurodevelopmental explanation enters the picture.

Research comparing prepubertal bipolar disorder to ADHD found hypersexuality occurred almost exclusively within the bipolar group rather than the ADHD group, a distinction clinicians treat as diagnostically significant precisely because the two conditions overlap so heavily on nearly every other symptom. That research emphasizes direct observation and separate interviews with children and parents, since researchers consider self-report alone insufficient at this age for a symptom this sensitive.

Adolescence Through Later Life

In autistic adolescents and young adults, a 2021 exploratory study found overall similarities to neurotypical peers in romantic desires, but significant gaps in sexual knowledge and experience, with autistic girls reporting notably higher rates of negative early sexual encounters. That finding underscores how limited sex education access, not desire itself, shapes much of the disparity researchers observe at this age.

Midlife brings hormonal transitions that intersect with neurodivergence in ways research has barely begun to map. Menopause and perimenopause affect ADHD symptom severity in women, and clinicians increasingly suspect the same hormonal shifts affect sexual desire patterns in autistic women, though dedicated studies remain scarce. Older neurodivergent adults, particularly those diagnosed later in life after decades of masking, sometimes describe reevaluating their entire relationship to sexuality once they finally understand why their patterns never matched the people around them.

Late diagnosis deserves particular attention here, since the number of adults receiving autism and ADHD diagnoses well into adulthood, from their thirties through their sixties and beyond, has climbed sharply over the past decade. For many of these adults, an entire sexual history suddenly reads differently once neurodivergence enters the picture. A pattern once interpreted as promiscuity, coldness, or a personal failing gets reframed as a nervous system doing exactly what its wiring intends, sometimes decades after the shame around it had already taken root.

Relationships Caught in the Middle

Every pattern described so far plays out inside relationships, not in isolation, and partners of neurodivergent adults are rarely given any framework for understanding what they are experiencing. Neurodivergent hypersexuality and its quieter opposite both show up as relationship strain long before either partner has language for what is actually happening. A partner living with an ADHD adult’s hypersexual period may feel overwhelmed or suspicious of infidelity. A partner living with an autistic adult’s hyposexual stretch may feel unwanted or unloved. Both reactions make sense on their own terms, and both frequently miss what is actually happening physiologically.

Couples therapists who specialize in neurodivergent relationships describe a recurring pattern: once both partners understand the mechanism, whether that is dopamine-seeking, sensory overload, alexithymia, or trauma response, the emotional temperature of the conflict tends to drop substantially, even before any behavior actually changes. Understanding does not resolve every practical challenge a mismatched libido creates, but it reliably reduces the sense of personal betrayal driving much of the initial conflict.

Mixed-neurotype relationships, where one partner is neurodivergent and the other is not, face a particular version of this challenge, since neither partner has an intuitive map for the other’s internal experience. Clinicians increasingly recommend explicit, direct communication about sensory needs, regulation strategies, and desire patterns rather than relying on the indirect cues most relationship advice assumes both partners can read.

Disclosure Without Shame

Many neurodivergent adults describe the disclosure conversation itself, telling a partner about a hypersexual or hyposexual pattern, as harder than managing the pattern day to day. Fear that a partner will see them as broken, dangerous, or uninterested keeps some adults silent well past the point where silence starts costing the relationship something real.

Therapists working with neurodivergent couples generally recommend framing these conversations around mechanism rather than blame. Describing a pattern as something the nervous system does, rather than something a person chooses, tends to land very differently for a listening partner. It shifts the conversation from a verdict on character to a shared problem two people can work through together, which is closer to what the research actually supports in the first place.

Shame, Self-Stigma, and the Cost of Silence

Nearly every clinician and researcher cited in this coverage touches on the same undercurrent: shame does more damage than the underlying pattern itself in many cases. Adults who grow up believing their sexual desires, whether elevated or nearly absent, mean something is fundamentally wrong with them often carry that belief quietly for years before ever hearing an alternative explanation.

That silence tends to compound. A person ashamed of a hypersexual pattern is less likely to seek treatment early, which allows the pattern more room to cause real consequences before anyone intervenes. A person ashamed of a hyposexual pattern is less likely to voice it to a partner, which allows misunderstanding to calcify into resentment on both sides. Neither outcome reflects anything about the person’s worth. Both reflect a healthcare and cultural environment that has historically offered very little accurate language for either experience.

Self-diagnosis communities, particularly online spaces built by and for neurodivergent adults, have done meaningful work filling that gap in recent years, offering language and validation long before formal clinical resources caught up. Clinicians generally view this development positively, while also emphasizing that community-sourced information works best as a starting point for a real evaluation, not a replacement for one, particularly given how much this specific topic overlaps with several distinct and easily confused diagnoses.

What This Means for Diagnosis and Care

The throughline across all of this research is not “neurodivergent people want more sex” or “neurodivergent people want less sex.” It is that neurodivergent sexuality follows different rules than the ones most clinical training builds around, and clinicians without specialized knowledge routinely reach for the nearest familiar label instead of the accurate one.

A comprehensive assessment for hypersexuality or hyposexuality in a neurodivergent adult should account for the underlying neurodevelopmental condition, screen for common co-occurring conditions like OCD and mood disorders, and ask directly about sensory experience, masking history, and medication effects rather than relying on behavior checklists built for neurotypical populations. Several of the researchers cited here specifically call for more inclusive study design, including larger samples of women, nonbinary adults, and participants from outside North America and Western Europe.

For neurodivergent adults trying to make sense of their own experience, the most consistent advice across clinical sources is the same: the goal is not matching some external average. It is understanding your own pattern, distinguishing distress from difference, and finding a clinician who treats neurodivergence as context rather than a footnote.

What Treatment Actually Looks Like

Treatment approaches differ substantially depending on what is actually driving a given pattern, which is why an accurate underlying diagnosis matters so much before any intervention begins. For ADHD-linked hypersexuality, first-line approaches typically combine stimulant or non-stimulant medication for the underlying attention condition with cognitive behavioral therapy focused specifically on impulse control and trigger identification. Some patients also benefit from structured coaching that targets the practical, day-to-day skills ADHD impairs, including planning ahead and recognizing early warning signs before an impulsive decision occurs.

When the Overlap Requires a Blended Approach

For adults whose hypersexuality traces back to overlapping conditions, ADHD alongside BPD, or ADHD alongside unresolved trauma, treatment tends to work better when it addresses both threads at once rather than picking one diagnosis to prioritize. Dialectical behavior therapy, originally developed for BPD, has shown growing use with ADHD patients specifically because it targets the emotional regulation skills both conditions share a deficit in.

Trauma-informed care adds another essential layer whenever a childhood trauma history sits underneath the presenting pattern. Clinicians who skip this step, treating only the ADHD or only the sexual behavior, risk leaving the actual driver of the pattern completely unaddressed. A comprehensive intake that asks directly about trauma history, rather than waiting for a patient to volunteer it, catches far more of these overlapping cases than a narrower, symptom-only evaluation.

Autism-Specific Approaches

Autism-linked patterns, whether hypersexual or hyposexual, generally respond better to approaches centered on sensory regulation and self-understanding than to behavior-suppression models borrowed from neurotypical sex therapy. Occupational therapy focused on sensory processing, structured psychoeducation about the autistic nervous system, and therapy that treats masking fatigue as a legitimate clinical factor all show promise in early clinical literature, though large randomized trials remain scarce for this population specifically.

Affirming clinicians increasingly emphasize a starting principle that shapes everything downstream: autistic sexuality is not inherently something to correct. Treatment becomes appropriate only when the pattern causes genuine distress, either to the individual or within a relationship, not simply because it deviates from a neurotypical average.

Where the Systems Still Fall Short

Access remains the single largest barrier across every category discussed here. Clinicians trained in both neurodivergence and sexual health are rare, and most general practitioners receive minimal training in either subject during standard medical or psychological education. Adults frequently report seeing multiple providers before finding one equipped to address both halves of their experience at once, rather than treating them as unrelated issues requiring separate appointments with separate specialists who never communicate with each other.

Sex education itself remains a documented gap specific to this population. Multiple studies cited throughout this coverage found autistic adults reporting significantly lower confidence in their own sexual knowledge compared to neurotypical peers, often tracing back to sex education programs that were never adapted for different learning and communication styles. Closing that gap earlier, during adolescence rather than well into adulthood, is one of the more consistently cited recommendations across the research gathered here.

Insurance and cost create a separate but related barrier. Specialized evaluations for adult ADHD or autism can run into the thousands of dollars in the United States when insurance coverage is limited, and sexual health specialists who also understand neurodivergence charge similarly. For adults already managing the practical costs neurodivergence can bring, from workplace accommodations to executive function support tools, an accurate diagnosis in this specific area often sits far down a very long and expensive list.

Telehealth has narrowed some of this gap in recent years, particularly for adults in rural areas or countries with few specialists in either field. Several clinics now offer combined evaluations covering ADHD and autism alongside sexual health through virtual platforms, though availability still concentrates heavily in higher-income countries and English-speaking regions, echoing the broader research gap discussed earlier.

Common Questions, Answered Directly

Does ADHD medication cause hypersexuality or reduce it?

Clinicians report both effects, and the difference often comes down to which is driving the behavior. Stimulant medication that improves impulse control tends to reduce impulsive sexual decision-making for many patients. For others, the same medication reduces libido as a side effect, sometimes significantly. Clinicians recommend tracking changes closely after starting or adjusting medication rather than assuming either outcome in advance.

Is hypersexuality more common in autistic men or autistic women?

Research points toward autistic men reporting stronger overall desire for sexual and romantic relationships, while some studies find elevated hypersexual fantasy content in both autistic men and women compared to neurotypical peers. Autistic women show a stronger overall lean toward reduced desire and higher rates of asexuality. The pattern is not uniform, and individual variation within each gender remains substantial.

Can someone be both hypersexual and hyposexual?

Yes, and it is common enough that clinicians treat it as an expected pattern rather than a contradiction. Neurodivergent hypersexuality and hyposexuality often describe the same underlying dysregulation at two different moments, not two separate diagnoses. Cyclical shifts tied to burnout, medication changes, stress, or hormonal fluctuation mean many neurodivergent adults move between both states over the course of months or years, rather than sitting permanently at one end of the spectrum.

Should every neurodivergent adult with a high sex drive assume something is wrong?

No. A high libido that does not cause distress or interfere with someone’s life falls entirely outside the clinical definition of hypersexuality. The relevant question is never how much desire someone experiences compared to an average. It is whether the person feels in control of their own choices and whether the pattern is causing them or someone else genuine harm.

Where should someone start if they suspect a misdiagnosis?

A comprehensive evaluation from a clinician trained in adult ADHD or autism assessment is the most reliable starting point, ideally one who also asks directly about mood history, trauma background, and sexual patterns rather than treating those as separate conversations. Bringing a written history of symptoms, including when patterns started and how they have changed, tends to make that evaluation considerably more accurate.

The Bigger Picture

Research on neurodivergent hypersexuality, and its quieter opposite, is still a young field, built on samples that are too small and too Western, and too often skewed toward men diagnosed in childhood. What exists already overturns the flattened stereotypes that dominate public conversation. Neither “hypersexual” nor “asexual” describes neurodivergence as a whole, because neurodivergence itself is not one experience. It is dozens of overlapping traits, expressed differently across gender and culture, shaped further by age and the specific wiring of an individual brain.

The adults living this reality deserve more than a punchline or a stereotype. They deserve research that reflects the full range of what their bodies and minds are actually doing, and clinicians equipped to tell a symptom apart from a side effect, and both apart from simply who someone is.

What Researchers Say Comes Next

Nearly every study cited in this coverage ends with some version of the same call for more research, and the specifics of that call are worth naming directly. Researchers want larger samples that include women, nonbinary and transgender adults, and participants recruited outside North America and Western Europe in proportions that actually reflect the global population. They also want longitudinal studies that track individuals across years rather than single-point surveys, since so much of what adults describe only shows up over time: cycling between hypersexual and hyposexual periods, burnout dulling desire, medication reshaping libido along the way.

They also want assessment tools built and validated specifically for neurodivergent populations rather than borrowed from general sexuality research, and training programs that require clinicians to understand both neurodevelopmental conditions and sexual health rather than treating the two as unrelated specialties. None of that exists yet at scale. Until it does, the adults navigating this territory must keep doing what readers here have likely already been doing for years: piecing together an understanding of their own experience from scattered research, clinical anecdotes, and the hard-won knowledge of other neurodivergent adults willing to talk about it openly.

That willingness to talk, more than any single study, is probably what moves this field forward fastest. Every adult who describes their actual experience to a clinician, a partner, or a researcher chips away at decades of stereotype in both directions, the desexualized autistic adult and the chaotic ADHD one, replacing both with something closer to the truth. That truth turns out to be far more varied, and far more human, than either caricature ever allowed.