There is something of a paradox around people with learning disabilities (PWLD) and sexual health and relationships.
On one hand, they can be unprotected to an extent – if they don’t receive education around consent and sexual decision-making, they can be vulnerable to abuse or more likely to display inappropriate behaviour.
On the other hand, PWLD can be overprotected by parents, carers and support workers, and denied the opportunity to explore their sexuality, leading to frustration and isolation. They may be treated like children, even into adulthood, and natural sexual behaviours like masturbation can be actively discouraged. Life can be especially difficult for people who are also lesbian, gay, bisexual or transgender.
All people are sexual beings, regardless of learning, or other kinds of disabilities, and we all need support to make informed and safe choices in life.
How we can help
FPA works directly with PWLD in schools and other settings such as supported living accommodation and day centres. We also facilitate workshops for family carers and training and consultancy for professionals and frontline staff.
Our new website FPA Pleasure is an inclusive online shop and hub for articles and blog posts about sexual enjoyment and wellbeing, including picking a sex toy if you have a disability. When we select toys for the site we think about how easy they are to use and enjoy if you have a disability, and add extra information to the product descriptions to help make a decision.
Support for professionals
Some PWLD will have previous negative experiences in medical settings, but with some simple measures you can help to create a more positive environment for patients to feel comfortable discussing their sexual health needs.
PWLD are more likely to face discrimination in other parts of their life and avoiding conversations about their sexuality and relationships can contribute to this. You’re in a unique position to help remove barriers and improve people’s quality of life by empowering them to make their own decisions in a safe way.
Tips for working with people with learning disabilities
- Don’t make assumptions about your patients’ sexuality, gender identity or relationships based on learning disabilities. Remain open-minded and remember all people are sexual beings.
- Talk in a clear and straightforward way and use accessible resources to support what you are saying; FPA has publications which can help.
- If the patient is accompanied by a parent, carer or support worker don’t just talk to the support worker and ignore the person with LD. Ask them questions and give them information directly.
- You don’t have to know everything and work in isolation; link in with other local services that have more resources for people with LD, and who can help you.
- If you are not sure about someone’s capacity to understand the information that you are giving about sexuality, relationships and sex, make sure you know of local services who work with PWLD and who will be able gauge the person’s understanding and offer a programme of support.
- While it is important to be aware of current legislation and guidance around working with vulnerable people and capability to consent, and know how to refer issues on, don’t let legal worries stop you from having conversations. It is illegal for people to be involved in sexual activity with people who will never be able to consent, but it is always OK to educate people.
- Offering patients double appointments will give time to go through information in a clear and digestible way, and also leave more time for questions.
- Empowering someone to make choices about their sexuality isn’t just about penetrative sex. PWLD may be looking for support in their friendships or relationships which involve other forms of sexual activity. Any information you give should be based around mutual respect and consent in relationships.
Our range of training has a number of courses to support professionals working with people with learning disabilities.