Sex and intellectual disability – dealing with sexual health issues.

Sexual health is a vital but often neglected aspect of healthcare for people with intellectual disability, to quote one of the abstracts below. These appear on what appears to be a special focus issue of the Australian Family Physician on intellectual disabilities. The two papers on sexuality are short but broach a subject that doesn’t come up very much: sexuality amongst the intellectually disabled.

I’ll admit it, whenever I hear someone say that an adult “…is developmentally at about 5 years old” or something to that effect, I cringe a bit. Physically, they are developmentally adults. Adults most often have a drive to seek sex. Beyond that, sex is not always consensual and the intellectually disabled are all to often targets.

I’m not going to go into details about these papers other than to point out that they are out there and I’m glad there is some ongoing dialogue. And, to highlight the concluding paragraph of the first abstract:

Most participants reported unwanted or abusive sexual experiences. They described sequelae such as difficulties with sex and relationships, and anxiety and depression. They described themselves as having inadequate self protection skills and difficulty reporting abuse and obtaining appropriate support. Their understanding of sex was limited and they lacked the literacy and other skills to seek information independently. It is important for general practitioners to be aware of the possibility of sexual abuse against women with intellectual disability, and to offer appropriate interventions.

Here are the two papers (pdf’s online):

Women with intellectual disabilities – a study of sexuality, sexual abuse and protection skills

Sex and intellectual disability – dealing with sexual health issues

and the abstracts:

. Aust Fam Physician. 2011 Apr;40(4):226-30.
Women with intellectual disabilities – a study of sexuality, sexual abuse and protection skills.
Eastgate G, Van Driel ML, Lennox NG, Scheermeyer E.
Source

MBBS, FRACGP, is Senior Lecturer, Queensland Centre for Intellectual and Developmental Disability, School of Medicine, The University of Queensland, Mater Hospitals, Brisbane, Queensland.
Abstract
BACKGROUND:

Sexual abuse and abusive relationships are known to be especially common in people with intellectual disability. This study explored how women with intellectual disability understand sex, relationships and sexual abuse, the effects of sexual abuse on their lives, and how successfully they protect themselves from abuse.
METHODS:

Semistructured narrative interviews with nine women with mild intellectual disability in Queensland, Australia. Interviews were audio recorded, transcribed, coded and analysed qualitatively.
RESULTS:

Major themes that emerged were: sexual knowledge and sources of knowledge; negotiating sexual relationships; declining unwanted sexual contact; self protection strategies; sexual abuse experiences; and sequelae of sexual abuse.
DISCUSSION:

Most participants reported unwanted or abusive sexual experiences. They described sequelae such as difficulties with sex and relationships, and anxiety and depression. They described themselves as having inadequate self protection skills and difficulty reporting abuse and obtaining appropriate support. Their understanding of sex was limited and they lacked the literacy and other skills to seek information independently. It is important for general practitioners to be aware of the possibility of sexual abuse against women with intellectual disability, and to offer appropriate interventions.

Sex and intellectual disability – dealing with sexual health issues.
Eastgate G.
Source

MBBS, FRACGP, is Senior Lecturer, Queensland Centre for Intellectual and Developmental Disability, School of Medicine, The University of Queensland, Mater Hospitals, Brisbane, Queensland.
Abstract
BACKGROUND:

Sexual health is a vital but often neglected aspect of healthcare for people with intellectual disability. It may initially be difficult for the general practitioner to raise sexuality issues with patients with intellectual disability, but there is potential for simple interventions that offer great benefit.
OBJECTIVE:

This article describes ways in which the GP may be able to assist people with an intellectual disability with their sexual health needs.
DISCUSSION:

It is important to engage the person with intellectual disability directly, preferably alone. A person with intellectual disability is likely to have the same range of sexual and relationship needs as other adults. However, there may be multiple barriers to forming healthy, equal sexual relationships. Sexual abuse is widespread. Reporting abuse may be difficult for a person with limited verbal skills, and prevention and support services are limited. The GP is well placed to offer sexual health services such as information, contraception and cervical and sexually transmissible infection screening, and to discourage inappropriate treatments such as sterilisation for social rather than medical reasons, and androgen suppression.