ADHD, Autism & Sex: Why Sex Feels So Hard, with Dr. Bowen Marshall

For many neurodivergent people, sex becomes draining or disconnected over time, even when there’s desire and care underneath it all.

Sex can start to feel like something you’re being evaluated on — rather than something you get to enjoy.

In this episode, I talk with licensed counsellor Bowen Marshall about how ADHD, Autism, masking, and performance expectations affect our sex lives — and why so many people end up feeling like they need to "get sex right", instead of actually feeling pleasure.

We specifically talk about:

• Attachment patterns and sex
• Why sex can start to feel like performance rather than pleasure
• How masking and self-monitoring undermine sexual connection and pleasure
• The role dopamine plays in desire, arousal, and motivation
• Why many people don’t know what they enjoy — and why that’s not a failure
• How expectations around sex create pressure and anxiety
• What it can look like to shift focus from “doing it right” to what actually feels good

Chapters:

1:48 - Introducing Bowen Marshall 4:02 - Bowen's Journey into Specializing in Neurodivergence 9:54 - Understanding Masking & Attachment Theory 17:57 - How Masking Shows Up in Relationships 22:42 - The Hot Stove Analogy: Understanding ADHD Challenges 28:55 - Sexual Challenges with ADHD & Autism 33:34 - Performance vs. Connection: When Sex Becomes a Test 38:08 - Dopamine, Motivation & the ADHD Brain 42:41 - Sex, Dopamine & Competing Sources of Pleasure 47:57 - P*rn vs. Partnered Sex: The McDonald's vs. Michelin Analogy 52:43 - Using Kink Language for Better Communication 57:11 - Final Advice: Finding What Feels Good 59:37 - Where to Follow Bowen Marshall 1:00:03 - A Sex Therapist's Reflections: Expectations & Presence 1:05:45 - Closing & Resources

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