Representations of Sexuality among Persons with Intellectual Disability, as Perceived by Professionals in Specialized Institutions: A Systematic Review

Abstract

The objective of this systematic review is to make an inventory of the representations of the professionals of specialized institutions on the sexuality of persons with intellectual disabilities. The scientific studies were identified according to the PRISMA protocol using 18 databases, with keywords on sexuality and parenthood. Studies were reviewed through a methodological assessment and then a thematic analysis. Twenty-four studies were reviewed and three themes were identified: professionals’ representations of gender, sexuality, and consent; professionals’ perceptions of their role in supporting people’s sexual lives; and the ways in which professionals construct representations of people’s sexual lives. This corpus highlights deep paradoxes in the representations of professionals concerning the socio-affective needs and sexuality of people with intellectual disabilities, creating what we could define as a “system of incompatibility” and leading to difficulties in positioning. Support is still too random and subject to control logics in the name of protecting users, who are perceived as vulnerable. Training and new ways of teamwork appear to be central to supporting the evolution of the representations and practices of professionals. Future research anchored in practices and involving users as well as professionals is necessary to better understand the paradoxical aspects of professionals’ representations and to draw alternative ways of constructing these representations.

Social workers’ perceptions of intimate relationships of people with intellectual disabilities in residential settings

“…However, our findings also join recent studies in showing how professionals struggle to translate this abstract recognition into practice (e.g., Guenoun et al, 2022). Looking at intellectually disabled youths, Löfgren-Mårtenson (2004) describes these professionals as "an 'in the middle' generation," exposed on one hand to new reforms and discourses that, but on the other hand struggling to apply them in their practice, thereby becoming become the "new obstacles or institutional walls" (p. 206).…”

Atenção À Saúde Sexual De Mulheres Com Transtornos Mentais: Uma Revisão Integrativa

“…Por outro lado, experiências negativas anteriores os faziam não considerar seguro procurar apoio na equipe de saúde e/ou cuidadores por medo de represália, podendo fazer com que se exponham a comportamentos sexuais de risco. Guenoun et al (2022) demonstram que as práticas profissionais quanto à sexualidade das pessoas com deficiência intelectual ainda se restringem a uma visão limitada, estereotipada e de baixo suporte sujeito a uma lógica de controle com o intuito de proteger essa população devido a sua maior vulnerabilidade. Outro ponto levantado foi a visão binária referente ao tema que esses profissionais carregam, ora enxergando seus pacientes como assexuados, de forma mais angelical, ora enxergando-os como compulsivos e/ou doentes.…”

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

“…Hence, support staff and relatives often perceive sexual expressions as acts of friendship or self-exploratory behavior [ 16 – 18 ]. Alongside this, support staff and relatives may perceive people with mild to borderline ID as sexually vulnerable, either as a victim or a perpetrator of sexual abuse [ 4 , 19 , 20 ]. As a result of these stereotypes, support staff and relatives have been found to either ignore or limit the sexuality of people with mild to borderline ID [ 7 , 19 ].…”