Bathroom male and female signs

Sexuality and People With IDD

Table of Contents

Introduction

What comes to mind when you think about the people you serve choosing to engage in sexual activity? For many parents and providers, the first thought is Nooooo!

Realistically, we know that sex is natural and healthy for consenting adults.  It can satisfy legitimate physical and emotional needs and is an activity most people enjoy and find meaningful (even if they perceive meaning in different ways). However with regards to sex and sexuality among vulnerable populations there are many other aspects to consider.  

Don't Bury Your Head In The Sand!

Don't be an ostrich - discuss sex and people with IDD

Sex and sexuality can be difficult and contentious topics to discuss in any setting, but perhaps especially so for the family members and service providers of people with IDD. Discussion, however uncomfortable, is essential in order to assist people served to make good (meaning responsible – let’s save the moral judgment for a different discussion) choices.  Simply discussing sex does NOT condone engaging in dangerous activity any more than burying one’s head in the sand makes the issue go away! So don’t be an ostrich, read on and we’ll give you the facts and practical help you need to protect your clients while addressing this vital issue in a responsible way.

Inherent Sexual Rights

First it is important to remember that people with Intellectual or Developmental Disabilities, like all people, have inherent sexual rights that should be recognized and responsibly and respectfully addressed with the person. The presence of an intellectual or developmental disability, regardless of severity, does not, in itself, justify the dismissal of people’s rights related to sexuality. Of course there are situations where sexual activity cannot be legitimately consented to by specific clients and appropriate action must be taken by the provider to protect such persons. However the unilateral restriction of sexual activity for all people with IDD is not advocated.

Shaming people with IDD for a natural interest in sexual activity is likely to cause them to 

engage in hidden sexual activity for all the wrong reasons. 

The Very Real Dangers Of Avoiding 'The Talk'

There are still some who labor under the misguided belief that people with special needs are (or at least should be) asexual and do not deserve the same privacy rights/confidentiality considerations afforded others. This has resulted in far too many situations in which people with IDD are made to feel inappropriate shame for a natural and healthy interest in an activity that is essential to human health and well-being.  Shaming and denial are more likely to cause people to engage in sexual activity for all the wrong reasons.  Open discussion and education are necessary to prevent sexual activity based on manipulation, loneliness or physical force. 

In fact, people with Intellectual Disabilities are seven times more likely to be victims of sexual assault and females with IDD experience heightened rates of pregnancy compared to their non-disabled peers. 

People with Intellectual Disabilities are 7 times more likely to be victims of sexual assault and females with IDD experience heightened rates of pregnancy compared to their non-disabled peers.

Practical Help

So… how do we approach sex-related discussions and objectively focus on supporting responsible decisions?

1.  Be open:  Use appropriate words for body parts and sexual activities.  When people don’t know appropriate words, make that education the starting point.  Don’t allow embarrassment to curtail frank, open discussion to ensure understanding.  One practice that supports this openness is the designation of one or two members of the team to be “Sex SMEs (Subject Matter Experts).”  Use the strengths of the most open, verbal, and vocal members of your team to explore sensitive subject in a matter-of-fact, unembarrassed way.   

2.  Be honest:  Don’t try to hide the fact that sex can (and is supposed to be) enjoyable.  Clearly communicate the pros and cons of engaging in different types of sexual activity, the rights and responsibilities involved in sex with a partner, the importance of personal protection, potential consequences and the importance of consent. 

3.  Be proactive:  Less than 12% of Medicaid HCBS waivers (including HCS and TxHmL) include any kind of sexuality services, and those services provided are predominantly reactive.  Don’t wait.  Make open, nonjudgmental discussions about sex (education and activity) part of every person’s planning processes BEFORE they have negative experiences or are victimized.

4.  Be empathetic:  Realize that many of the people you serve have already been exposed to sexual activity – opening the topic may support people to address negative previous experiences and overcome past trauma.

Finally........

There’s no “easy way” to talk about sex with the people you serve or your families, but it really doesn’t have to be the elephant in the room.  Address the topic head-on, with compassion, empathy, and understanding.  We’re all more alike than we’re different.

Nick Winges-Yanez of the Texas Sibling Network (a community of adult siblings of people with IDD) said it well:  “Simply put, we need to make sex education for people with intellectual disabilities a priority to empower them, not shield them in harmful silence.”

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Focused Blog List

2019 (18)
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  • June 30 | Problem Solving For LTSS Providers (IDD Business Management, Intellectual or Developmental Disability – Character and Wellness)
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  • May 5 | Workflow Process Improvement for Long Term Care (Uncategorized)
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  • March 24 | IDD Service Workflow Optimization (IDD Business Management)
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  • March 10 | Sexual Harassment in the IDD Workplace (IDD Regulatory)
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  • February 24 | The Art Of Compromise In The IDD Workplace (IDD Business Management)
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  • February 10 | Lessons From A(nother) Government Shutdown (IDD Business Management)
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  • February 3 | Strategic Marketing For IDD Service Providers (IDD Business Management)
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  • January 27 | Setting Marketing Goals For Success (IDD Business Management)
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  • January 20 | Developing Marketing Plans For IDD Companies (IDD Business Management)
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  • January 13 | The ONE Step To SURE Success Launching Your EHR (IDD Business Management)
    There is just ONE step you can take TODAY that will almost certainly guarantee the successful implementation of an EHR in your IDD service business. This is the fastest way to guarantee rollout possible. Read our blog to find out what it is!
  • January 6 | Sex, Sexuality and People with IDD (Intellectual or Developmental Disability – Character and Wellness)
    Sex and sexuality can be difficult topics to discuss. However it is essential to assist people served to make wise choices. Here we give you practical help in addressing this vital issue while protecting your clients.
2018 (41)
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  • November 18 | Giving Thanks For IDD Service Vendors (IDD Business Management)
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  • June 1 | Culture of Change In IDD/Special Needs (IDD Business Management)
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  • May 18 | Legacy and the IDD Professional (Intellectual or Developmental Disability – Character and Wellness)
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  • May 13 | IDD Providers Busy-ness and Business (IDD Business Management)
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  • May 6 | The Natural Born Leader Myth in IDD Services (IDD Business Management)
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  • April 30 | Strategic Acquisitions among IDD Service Companies (IDD Business Management)
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  • April 10 | Integrity and the IDD Professional (Intellectual or Developmental Disability – Character and Wellness)
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