Attitudes towards sexuality and related caregiver support of people with intellectual disabilities: A systematic review on the perspectives of people with intellectual disabilities

Abstract

Background: Sexual health remains at risk for people with an intellectual disability.Attitudes towards sexuality, its support and education have an important role in promoting sexual health. The current review aims to provide an overview of the current research on supportive and restrictive attitudes towards sexuality and its support of people with intellectual disabilities themselves.Method: A systematic review was conducted, searching across eight databases. The quality of the studies was assessed with the Mixed-Method Appraisal Tool.Results: Six themes emerged from the data: sexual behaviour, sexual identity, intimate relationships, barriers to sexual expression, sex education and support by caregivers. Supportive and restrictive attitudes were reported throughout.Conclusions: Attitudes regarding sexuality of people with intellectual disabilities are heterogeneous and people with intellectual disabilities seem to be able to express their sexual desires, needs and attitudes. Findings allow for improved individual support and in-depth research questions.

Using Concept Mapping to Explore the Perspectives of People with Mild to Borderline Intellectual Disabilities Toward Sexual Health

“…One potential reason why support and education went unmentioned in the present study is that some people with mild to borderline ID have learned to avoid sexuality-based support in order to prevent restrictions and punishment from support staff or relatives following their sexual endeavors [ 27 , 66 ]. However, previous research suggests that people with mild to borderline ID are more receptive to support and education when they have positive experiences with support staff or relatives who match their sexual and educational needs [ 28 ]. Hence, for support and sex education to be successful, they must be aligned with the individual needs of people with ID [ 12 , 28 ].…”

“…However, previous research suggests that people with mild to borderline ID are more receptive to support and education when they have positive experiences with support staff or relatives who match their sexual and educational needs [ 28 ]. Hence, for support and sex education to be successful, they must be aligned with the individual needs of people with ID [ 12 , 28 ]. The fact that people with mild to borderline ID prioritize dating and relationships, as shown in this and other studies [ 67 ], indicates that support and education should also prioritize these social dimensions.…”

“…To overcome these barriers toward sexual health, it is important that people with mild to borderline ID have access to individualized forms of support and education [ 28 , 29 ]. However, their sexual health has long been neglected in research and practice due to social stigma and paternalism [ 30 ], with most studies focussing on the perspectives of support staff and relatives rather than people with mild to borderline ID themselves [ 31 ].…”

Parental attitudes and beliefs about sexuality of individuals with intellectual disability: Insights from a Brazilian sample of parents of individuals with Williams syndrome

“…Studies have shown variations in the beliefs, perceptions and attitudes of parents and caregivers of adolescents with intellectual disabilities regarding their children's sexuality (de Wit et al, 2022). In this study, the parental responses indicated a low intention to interfere in their children's relationships and to offer young people a great deal of autonomy and freedom, which is not often found in the literature.…”

Sexual health in people with learning or intellectual disabilities

“…They are just as likely to be sexually active as peers without disability, but those with a mild to moderate LD/ID are more likely to experience sexual abuse or exploitation, have a higher risk of sexually transmitted infections (STIs), and are less likely to use contraception. They are also less likely to receive sexual health education, perhaps due to societal stigma, concern of carers, and possible infantilising attitudes towards people with an LD/ID (Brown et al., 2020; de Wit et al., 2022). There can also be issues with understanding when the education is not appropriately translated (Finlay et al., 2015).…”