Support workers’ understanding of their role supporting the sexuality of people with learning disabilities

Abstract

Accessible Summary We asked support workers what they thought about their role supporting sexuality. They said they want to try to support sexuality and relationships but also have to keep people safe. They said they have lots of things to consider which makes it difficult. We think support workers need more training and advice to help them talk about some of their worries and difficulties supporting sexuality. Abstract BackgroundDespite positive attitudes amongst support staff towards sexuality, adults with learning disabilities report being dissatisfied with the support they receive. This research aimed to explore support workers’ understanding of their role supporting the sexuality of adults with learning disabilities. MethodSix support workers from supported living services were interviewed about their role. Data were analysed using interpretative phenomenological analysis. ResultsThree themes emerged which were understood as suggesting that support workers held conflicting beliefs and emotions about their role supporting sexuality. This was interpreted as creating an ambivalence that could result in support workers distancing themselves from an active role in supporting sexuality. ConclusionThis study concluded that support workers may inadvertently express an understanding of their role that may be consistent with negative and limiting discourses about the sexuality of adults with learning disabilities. The findings suggest a continuing need for sexuality training with a focus on reflective practice.

“Always trying to walk a bit of a tightrope”: The role of social care staff in supporting adults with intellectual and developmental disabilities to develop and maintain loving relationships

“…Staff felt that social isolation, combined with limited support hours, made both men and women vulnerable to abuse. Our participants shared the views of Maguire et al (2019) that support was often a complex juggling act of balancing help for people to meet their aspirations and protection from abuse. As in the Maguire et al (2019) study, our participants found this “walking the tightrope” particularly challenging when they had little or no training and no knowledge of organisational policy.…”

“…Staff have been shown to hold gendered attitudes, typically viewing women with intellectual and developmental disabilities as sexually innocent, vulnerable to abuse and requiring protection, while seeing men with intellectual and developmental disabilities as more sexually driven and liable to engage in problematic and predatory sexual behaviour (Young, Gore, & McCarthy, 2012). The juggling act staff feel they perform between helping people regarding sex and relationships (such as finding a partner) and protecting them from harm is commonly reported in the literature (Maguire, Gleeson, & Holmes, 2019). Feely (2016) acknowledges the conflict faced by staff who limit privacy through observation, record keeping and reporting potential safeguarding concerns, but also uphold a commitment to supporting sexual rights.…”

“…Maguire et al (2019) argue that decisions made regarding support for a person's sexuality and relationships are rooted in staff's personal beliefs, their work experience and their own morals and religion. This often results in staff responding reactively, rather than proactively, and the importance of sexuality for people with intellectual and developmental disabilities being minimalised.…”

Supporting people with learning disabilities who identify as LGBT to express their sexual and gender identities

“…Adults with learning disabilities present with the full range of gender identities and sexual identities which occur in the general population (Parkes et al, 2009;Bates, 2018). Regarding adults with learning disabilities who identify as lesbian, gay, bisexual and transgender (LGBT), there is both historic and recent evidence of negative attitudes and stigma surrounding them (Abbott & Howarth, 2006;Cambridge, 2013;Bates et al, 2016;Bates, 2018;Maguire et al, 2019), with services responding inappropriately to their needs and many services considering sexual choice and sexuality to be a taboo topic (Wilkinson et al, 2014;Bates, 2018). In 2018 the Government Equalities Office (GEO) released its LGBT Action Plan; this follows a national survey of LGBT people, open to anyone who identified as having a minority sexual orientation, gender identity or those with variations in sex characteristics (GEO, 2018).…”

“…When discussing risk aversive practices alongside this legalisation it is important to distinguish that the person is not being treated as unable to decide merely because decision could be considered unwise. Allowing a person with a learning disability, who may be vulnerable, to make decisions regarding their sexual expression and relationships, can be testing for services and providers (Bates, 2018;Maguire et al, 2019). However, this complexity ought not preclude the person of their right to choose and to learn from the decision.…”