Sexuality, Education and Support for People with Intellectual Disabilities: A Systematic Review of the Attitudes of Support Staff and Relatives

Abstract

Support staff and relatives are uncertain about multiple aspects of the sexuality of people with intellectual disabilities. Given that their attitudes embody positive and negative views, they can respectively support and restrict free sexual expression among people with intellectual disabilities and their potential for (intimate) relationships. A qualitative systematic literature review was conducted on the attitudes of support staff and relatives toward the sexuality of people with intellectual disabilities. A systematic search strategy was deployed across seven databases. The identified articles were screened on predetermined inclusion and exclusion criteria, and assessed on quality, which resulted in 31 included studies. A metasynthesis of these studies resulted in two major themes emerging, namely (a) attitudes toward the sexuality of people with intellectual disabilities, and (b) attitudes toward the sex education and support. Themes represented both positive and restrictive attitudes among support staff and relatives. The findings suggest that despite a general acceptance of the sexual rights of people with intellectual disabilities, certain forms of sexuality were approached more cautiously. Moreover, the sexual needs of some subgroups of people with intellectual disabilities received scarce attention. Those support staff and relatives holding rather restrictive attitudes appear to emphasize sexual risks. Finally, support staff and relatives stressed the importance of providing sex education and support for people with intellectual disabilities, while, simultaneously, expressing insecurity over the subject. The findings can help to improve the support provided to support staff and relatives to promote sexual health among people with intellectual disabilities.

Sexual experiences and knowledge of people with moderate intellectual disability

“…It could be due to common myths about sexual needs, even among the general population, which perpetuate the misconception that men have greater sexual needs and desires than women (de Wit et al . 2022).…”

Adaptation and Validation of the Indonesian Version of Attitudes toward Sexuality Questionnaire in Individuals with Intellectual Disability (ASQ-ID)

“…That is pointed out training has a positive effect on attitudes toward sexuality. Support staff and family members have to provide sexual education for a person with intellectual disabilities [20,22,23]. Sexuality is relevant to the work of health professionals.…”

“…In general, there is reproduction in the medical curriculum but not sexual attitudes [24]. Thus, the attitude towards sex should be included as a specific subject of sexual education or part of reproduction [23,24].…”

Discapacidad intelectual y derechos sexuales: revisión narrativa de la literatura

“…Otra barrera consiste en la falta de capacitación a los cuidadores para brindar a las personas con DI el apoyo sensible al que tienen derecho (50). Un punto de gran relevancia y que genera conflictividad es que no se suele reconocer la identidad y la diversidad sexual de las personas con DI, porque existen prejuicios que limitan esa posibilidad, lo que afecta decididamente sus derechos sexuales (21,26,51).…”

“…Debido al proteccionismo de profesionales y familiares, se restringen los derechos de las personas con DI (52). Se identifica una tensión comúnmente expresada entre el personal de apoyo y los familiares respecto a permitir y apoyar la expresión y las relaciones sexuales y, al mismo tiempo, mantener a las personas con DI a salvo de los riesgos sexuales (51).…”