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

There are a few local services that exist to support sexual health for individuals in addition to local GP surgeries. There is a Sexual Health Clinic in Nuneaton that offers contraception, emergency contraception, pregnancy testing, chlamydia screening and general advice and information about sexual health. They also offer C-Cards, which allow the holders to get free condoms (although this is only available to young people). There is a Contraceptive Service, which provides contraception and pregnancy testing. Finally, there is also a GUM clinic at the hospital which offers full STI testing.

Like all other facets of an individual’s health, sexual health should be assessed and planned. Information about sexual health should be readily available to individuals and it should be in a form that they can understand.

Support plans should be put in place to provide the necessary information. This should be done in alliance with other health and social care professionals such as doctors, psychologists and care workers.

The Department of Health provides a Health Action Plan for all individuals with learning disabilities. Two copies are made; one for the individual and the other for their GP. They can be obtained by asking a doctor or nurse and are filled in jointly by the individual and a health professional. As well as containing information about eating healthily and exercise there will also me information about sexual health as it pertains to the individual.

Plans can include doing research about sexual health, going to workshops or classes or obtaining information from a health professional.

There are several sexual health issues that only affect one gender or affect genders differently. It is important for individuals to understand the sexual issues that affect their own bodies but it is also important to understand the issues of the opposite gender.

Females experience the menstrual cycle each month and in later life will experience the menopause. Many contraceptives affect only a female’s body such as the pill, injection, diaphragm and implants whereas condoms fit on a male’s penis.

Males experience erections and can suffer from impotence and premature ejaculation. During puberty, many males will have wet dreams.

Both males and females will usually masturbate at some point in their lives, however the technique is different between genders. Likewise, both genders experience orgasms but the feeling is different for the different sexes.

Sex drive can peak and trough during the lives of both men and women although females are more likely to experience a much-reduced sex drive when they hit menopause.

Sexual health is a state of physical, mental, social and emotional well-being related to sexuality. This not only means the absence of sexually transmitted diseases but also having mutually beneficial relationships with both partners respecting one another, physical intimacy and safe sexual experiences free from coercion, discrimination and violence.

An individual’s sexual health and well-being can contribute to their overall health and well-being because they will be happier and have increased self-esteem and self-confidence. They will not suffer from sexual frustration and having somebody to talk to often relieves stress. And, of course, being in a strong relationship provides emotional stability to an individual’s life.

Mental capacity can have a direct influence on sexual development, sexual experience, sexual expression and sexual health, however it should be remembered that under the Mental Capacity Act all individuals should be treated as being able to make their own decisions until it is shown that they are not able to do so.

Having said that, the Sexual Offences Act states that a person can only consent to sexual relations if they have the mental capacity to make that choice and that they only have the capacity if they understand the nature of the act and the reasonably foreseeable consequences.

Therefore it is essential that support workers and other health and social care professionals provide individuals with the education and information they need to make informed decisions. This can include topics such as sex education, an openness to talking frankly about sexual subjects and the importance of protection.

Mental capacity can influence sexual development if an individual can not understand sexually mature behaviours and attitudes. It can affect sexual experience if an individual is unable to comprehend the possible after-effects of unprotected sex. It can affect sexual expression if the individual can not understand what is socially acceptable. And it can affect sexual health if an individual is unable to understand the health risks of sexual intercourse.

However, in all these cases, mental capacity should not be confused with a lack of education.