376: Principles of supporting individuals with a learning disability regarding sexuality and sexual health (LD 307)

Individuals can be supported to keep safe sexually by being provided with relevant information and education. This can include guidance on safe sex, contraception, appropriate sexual behaviour and what is lawful and unlawful. It is also paramount to teach individuals that nobody has the right to touch their genitals or any other part of their body without consent. Building up a trusting professional relationship with an individual and installing a core value of ‘no secrets’ and talking openly about sexual subjects can be very useful in preventing sexual abuse, as can explaining the importance of gentleness in intimacy. In some cases, specialist assistance may be needed from other health and social care professionals such as psychologists and social workers.

In addition, it is paramount to remember that an individual with learning disabilities has the same rights as everybody else in their sexual expression and has the freedom to make their own choices providing it is lawful and there is not a safeguarding issue (a copy of my company’s Safeguarding Policy has been attached to this document as evidence).

There are several ways that an individual can express themselves sexually. Of course, having sexual intercourse is the most obvious but other intimate actions such as kissing, hugging and stroking can also be methods of sexual expression. There is also the use of sex aids and legal pornogography, masturbation and the way an individual dresses (including their underwear) can be a form of sexual expression.

It is important for a support worker to be able to support an individual in their sexual expression and respect the choices that they make without judgement, whilst also providing guidance on what is lawful and socially acceptable. This could mean dealing with sensitive subjects and doing things that some people may find uncomfortable with (for example, supporting an individual to buy products from an adult store).

The development of a meaningful relationship is often important to the development of an individual’s sexuality because it allows them to develop intimacy and share experiences with another person without sexual intercourse.

As the relationship between the individuals develops there will be opportunities for them to learn about each other and their likes and dislikes, including their sexual preferences. It will also allow them to try out new things with each other and develop closeness, understanding and empathy.

It is important that a support workers own values, belief systems and experiences do not influence the support they provide for individuals with learning disability. All individuals beliefs and choices should be respected whether you agree with them or not. For example, I do not believe in a God, however I have worked with clients that are deeply religious and I respect that. I don’t force my own opinions on others although I’m happy to discuss them if asked. I’ve also worked with clients that are racist and even though I have great difficulty understanding why people can be bigoted I do not let it affect my work (however I may formally explain to the individual that their views are discriminatory and not socially acceptable). I am addicted to cigarettes and I worked with a client who hated the smell of tobacco so I had to respect this and refrain from smoking when I was on shift with him so he didn’t become upset.

Some people with learning disability can become frustrated and stressed if they interact with people that do not their share their views about topics they feel strongly about, so in most cases, it is best not to get into a debate about it. In addition,some individuals are easily influenced by the views of others.

Legislation relating to sexuality and sexual health includes:

• The Equality Act & Human Rights Act – Individuals should not be discriminated against because of disability and should be free to make the same choices as anybody else, including those relating to sexuality
• The Mental Capacity Act – Until proven otherwise, an individual should be considered capable of the capacity to make their own choices
• Sexual Offences Act – Outlines what is considered a sexual offence
• Genital Mutilation Act – makes genital mutilation unlawful
• Abortion Act – legislation regarding abortions

Legislation sets out what is lawful and unlawful as well as making it clear that everyone has the basic freedom of free choice. However, in practice, it can be confusing for people with learning disabilities to understand what is legal and what is appropriate behaviour, so it is up to support workers and other health and social care professionals to provide information, education and guidance in this regard.