(((((hugs)))))
I know how hard this is. been there done that and never wanted a t shirt!
My son had some of the same diagnosis and was incredibly violent with us, esp with his younger sister. We had 4 mos of residential therapy after I found him choking his little sister in the middle of the night. I took her to her doctor (also his pediatrician so she knew all the issues) and asked her to call and report abuse for us. I knew she had to report abuse and that we had no complicity in his violence. We never left him alone with his younger siblings, not even long enough to go to the bathroom. I took my daughter to the bathroom when I had to go and my husband took my son in with him when he had to go. THe kids stood in the shower with the curtain closed, which is what a therapist and the pediatrician had both advised in writing. We did that to avoid any hint of abuse because it was not safe to leave the kids alone for even 30 seconds.
With the focus on sex, is there a possibility that he could be bipolar? Hypersexuality is a symptom of bipolar, but I don't know how it figures in with tourettes. That is the diagnosis that we didn't have. My son is one of the rare people with depression who is not actually bipolar. Many kids with a first depression diagnosis end up with bipolar diagnosis instead. The focus on sex could be puberty and a lack of understanding of social rules from the Aspergers though. Esp with the lack of filters from the Tourettes.
I had to spend a couple of days on the phone to find help when my son spun out of control 2 yrs after he came home from residential. By calling a couple of pastors/reverends and asking if they knew of programs or knew anyone who might know of a program, I got a few numbers and just kept calling until I found a few programs. I had just gotten my son a tentative approval to a boy's home here that is just incredible when my father decided he needed a retirement project and my son would do just fine. A few years before a psychiatrist we really liked and trusted said that what my son needed was to be an only child. I was pregnant with my 3rd child at the time, so that was not going to happen as my husband and I had zero plans to divorce. But my dad had just retired as a jr high teacher, my son was in jr high, and my folks put enough pressure on me that we agreed to let them try it. I have zero idea of what my parents did, other than be there and annoy him into behaving (my mom just speaks quietly at you until you agree with her, and it can be incredibly annoying in the best Mom way, Know what I mean??) and with no little siblings to get in his way, well, something changed and he turned out pretty good. He is now almost 25, in his first apartment, with a full time job, and he is doing well.
But your son likely needs residential. As much as my son LOATHED the hospital, it really helped long term. At the time he would deny it helped anything, but years later he admitted he learned a lot there and he needed it. He still wishes we hadn't done it, but eh understands that he needed it.
I cannot recommend that you do a Parent Report strongly enough. If you follow the link in my signature or on the top of the general forum page, you will find a post with instructions. A PR is a report that you write about your son. You keep records of everything in it, and it goes to every appointment with you. It was the most powerful tool I had to keep the 'professionals' on the right course and to get them to see what is going on.
I also recommend you or your husband video a few of your son's tantrums/outbursts and look at them later. Show them to the professionals too. Often they think they know what is going on but seeing video of it can shock them. Cell phones make taking videos easy and unobtrusive, so your son won't necessarily know what is going on. I used a cell phone video to get the sheriff's deputies to stop blowing off reports of what my son had done when we had to call them. They thought I was blowing it out of proportion when I said my son choked his sister or hurt me. Then one deputy I went to high school with watched a video and it blew his mind. It also blew my son's psychiatrist's mind - he thought I was exaggerating and learned I was understating things because no one would believe what actually happened. Keep a flash drive of videos with your parent report if you can. just don't put the videos online - your son doesn't need that - what is posted online is public forever.
I am sorry things are so tough. I really hope you get some help soon. One thing I said really stuck with me and with a few therapists we had: I will not sacrifice my younger children on the altar of my oldest child's mental illness. The little ones need to be a focus too. Our therapists often focused only on my oldest and ignored the effects on my other kids. That wasn't right or how life was going to be in our family. Just something to think about.