Relationships are very important to people with a learning disability

Although some people with a learning disability may not be able to consent to having sex or a relationship, this is the minority.

Generally, if they are given sufficient social support and accessible sex and relationships education, many people with a learning disability are able to engage in safe, healthy and happy personal and sexual relationships (Darragh et al., 2017; Black & Kammes, 2019). 

Many people with a learning disability have the same aspirations for loving relationships as those without a learning disability (Lane et al., 2019). The companionship that a partner provides is important to people with a learning disability (Bates et al., 2017a; 2017c; Retzik et al, 2021).

However, there are various barriers to people with a learning disability having the relationships they want. Many people with a learning disability are not given appropriate support needed to engage in loving and sexual relationships with others. (NIHR, 2020).

A man and woman with downs syndrome smiling at the camera

The role of caregivers and their support

Support workers and family members can play a large role in supporting or preventing people with a learning disability in developing and sustaining relationships (Azzopardi-Lane, 2017; Charitou et al., 2020; Oloidi et al., 2020).

For example, support workers are often a key source of advice as well as emotional and practical support for people with learning disabilities. (NIHR, 2020).

In some cases, support staff have reportedly been instrumental in helping the development of relationships, especially for those with higher support needs (Bates et al., 2017a).

However, evidence suggests some support workers see their role as limited and report a lack of guidance on what they can and cannot do or say in regard to supporting sexuality (Sitter et al., 2019).

This issue is further exacerbated by tensions between trying to enable positive relationships and trying to protect the person with a learning disability from abuse or exploitation (Bates et al., 2017b; Maguire et al., 2019).

People with a learning disability can be lesbian, gay, bisexual and transgender (LGBT), just like anyone else

It is important to recognise that people with a learning disability can be lesbian, gay, bisexual and transgender.

As such, sex education resources and campaigns for people with a learning disability should be designed with the specific needs of lesbian, gay or bisexual people in mind, rather than assuming that all people with a learning disability are straight (heterosexual) (Wilson et al., 2016; Stoffelen et al., 2018).

Research has found that LGBTQ people with a learning disability face ‘double discrimination’ because of their sexuality or gender (Snell, 2018).

For example, some LGBTQ people with a learning disability are bullied or harassed. In addition, their family members or service staff might not acknowledge their identities or relationships (Dinwoodie et al., 2016; Toft et al., 2019).

Evidence suggests some LGBTQ people with a learning disability have concealed their sexuality to avoid expected negativity (Miller et al., 2019; Bates 2020).

Relationships and Sex Education (RSE)

Information and support to help people with a learning disability to understand their sexuality and have relationships is lacking within many learning disabilities services.

If information and support is given, it may be provided in an unplanned way, be insufficient or inappropriate for people with a learning disability (Reynolds, 2019; Sala et al., 2019).

As a result, people with a learning disability often hold incomplete or inaccurate knowledge of relationships (including LGBTQ relationships), sexual health and the legal and emotional aspects of sex (Whittle & Butler, 2018; Ferrante & Oak; 2020; Spyropoulou, 2020).

Consequently, they are at higher risk of negative sexual experiences, contracting sexually transmitted infections or unwanted pregnancies (Baines et al., 2018).

RSE serves as a way to increase the autonomy of people with a learning disability by equipping them with the tools of knowledge around sex and relationships (Daly et al., 2019).

To do this, RSE must be provided in an appropriate and accessible way. RSE programmes should be designed and developed with people with a learning disability to ensure content is appropriate and accessible (Frawley & O’Shea, 2019).

A young man and woman are sat at a table in a community centre smiling at the camera

References

Azzopardi-Lane, C. (2017). Intimate relationships and person with learning disability. Tizard Learning Disability Review, 22(1), 24-27.

Baines, S., Emerson, E., Robertson, J., & Hatton, C. (2018). Sexual activity and sexual health among young adults with and without mild/moderate intellectual disability. BMC Public Health, 18(1), 667.

Bates, C., Terry, L., & Popple, K. (2017a). The importance of romantic love to people with learning disabilities. British Journal of Learning Disabilities, 45(1), 64-72.

Bates, C., Terry L., & Popple, K. (2017b). Supporting people with learning disabilities to make and maintain intimate relationships. Tizard Learning Disability Review, 22(1), 16-23.

Bates, C., Terry, L., & Popple, K. (2017c). Partner selection for people with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities, 30(4), 602-611.

Bates, C. (2020). “It's Nothing to be Ashamed of, I'm Like, I'm Bisexual and I Love Women, I Like Men” - Being a Bisexual Person with an Intellectual Disability. Journal of Bisexuality, 20(4), 493-513.

Black, R., & Kammes, R. (2019). Restrictions, Power, Companionship, and Intimacy: A Metasynthesis of People With Intellectual Disability Speaking About Sex and Relationships. Intellectual and Developmental Disabilities, 57(3), 212-233.

Charitou, M., Qualye, E., & Sutherland, A. (2020). Supporting Adults with Intellectual Disabilities with Relationships and Sex: A Systematic Review and Thematic Synthesis of Qualitative Research with Staff. Sexuality and Disability, 39(1), 113-146.

Daly, A., Heah, R., & Liddiard, H. (2019). Vulnerable subjects and autonomous actors: The right to sexuality education for disabled under-18s, Global Studies of Childhood, 9(3), 235-248.

Darragh, J., Reynolds, L., Ellison, C., & Bellon, M. (2017). Let’s talk about sex: How people with intellectual disability in Australia engage with online social media and intimate relationships. Journal of Psychological Research on Cyberspace, 11(1), 44-51.

Dinwoodie, R., Greenhill, B., & Cookson, A. (2016). ‘Them Two Things are What Collide Together’: Understanding the Sexual Identity Experiences of Lesbian, Gay, Bisexual and Trans People Labelled with Intellectual Disability. Journal of Applied Research in Intellectual Disabilities, 33(1), 3-16.

Ferrante, C., & Oak, E. (2020). ‘No sex please!’ We have been labelled intellectually disabled. Sex Education, 20(4), 383-397.

Frawley & O’Shea (2019). ‘Nothing about us without us’: sex education by and for people with intellectual disability in Australia. Sex Education, 20(4), 519-539.

Lane, C., Cambridge, P., & Murphy, G. (2019). Muted voices: The unexplored sexuality of young persons with learning disability in Malta, British Journal of Learning Disabilities, 47(3), 156-164.

Maguire, K., Gleeson, K., & Holmes, N. (2019). Support workers’ understanding of their role supporting the sexuality of people with learning disabilities.British Journal of Learning Disabilities,47(1), 59-65.

Miller, R., Wynn, R., & Webb, K. (2019). “This really interesting juggling act”: How university students manage disability/queer identity disclosure and visibility. Journal of Diversity in Higher Education, 12(4), 307-318.

National Institute for Health Research (NIHR) (2020). Exploring support for adults with learning disabilities to find loving relationships. (Accessed 14/05/21).

Oloidi, E., Northway, R., & Prince, J. (2020). ‘People with intellectual disabilities living in the communities is bad enough let alone…having sex’: Exploring societal influence on social care workers' attitudes, beliefs and behaviours towards support for personal and sexual relationship needs. Journal of Applied Research in Intellectual Disabilities, 1(2), 122-167.

Retznik, L., Wienholz, S., Höltermann, A., Conrad, I & Riedel-Heller, S. (2021). “It tingled as if we had gone through an anthill.” Young People with Intellectual Disability and Their Experiences with Relationship, Sexuality and Contraception, Sexuality and Disabilty, 39(2), 421-438.

Reynolds, K. (2019). Relationships and sexuality education for children with special educational needs and disabilities. Journal of Health Visiting, 7(2), 233-255.

Sala, G., Hooley, M., Attwood, T., Mesibov, G., & Stokes, M. (2019). Autism and Intellectual Disability: A Systematic Review of Sexuality and Relationship Education, Sexuality and Disability, 27(2), 353-382.

Sitter, K., Burke, A., Ladhani, S., & Mallay, N. (2019). Supporting positive sexual health for persons with developmental disabilities: Stories about the right to love. British Journal of Learning Disabilities, 47(4), 255-263.

Snell, J. (2018). Ending bigotry faced by LGBT people with learning disabilities. Learning Disability Practice 21(1), 8-11.

Spyropoulou, K. (2020). Sex and relationships education: How can children with a learning disability be a part of it?. European Journal of Special Education Research, 6(4), 117-138.

Stoffelen, J., Schaafsma, D., Kok, G., & Curfs, L. (2018). Women Who Love: An Explorative Study on Experiences of Lesbian and Bisexual Women with a Mild Intellectual Disability in The Netherlands. Sexuality and Disability, 36(2), 249-264.

Toft, A., Franklin, A., & Langley, E. (2019). ‘You're not sure that you are gay yet’: The perpetuation of the ‘phase’ in the lives of young disabled LGBT+people. Sexualities, 23(4), 516-529.

Whittle, C., & Butler, C. (2018). Sexuality in the lives of people with intellectual disabilities: A meta-ethnographic synthesis of qualitative studies. Research in developmental disabilities, 75(2), 68-81.

Wilson, N., Macdonald, J., Hayman, B., Bright, A., Frawley, P., & Gallego, G. (2016). A narrative review of the literature about people with intellectual disability who identify as lesbian, gay, bisexual, transgender, intersex or questioning. Journal of Intellectual Disabilities, 22(2), 171-196.