Sexuality of People with Learning Disabilities

Implications for Staff: Sexuality of People with Learning Disabilities Like everyone else people with learning disabilities have sexual feelings and a right to express them (Brown and Benson 1995). Carers will be closely involved with people’s relationships, providing protection from abuse and exploitation. This presentation will look at the laws and ethical/moral implications for practice.

Here is a brief historical overview of how the sexuality of people with learning disabilities has become an ethical and legal headache for staff. Segregation into large long stay hospitals and colonies was seen as away to prevent learning disabled people from having children through close supervision. Another motive was the belief that the public had the right to be protected from inappropriate sexual behaviours committed by those who could not act responsibly (Robbins 1990).

Since the implementation of the NHS and Community Care Act 1990 the issue of the sexuality of people with a learning disability has come to the attention of care workers and the general public. In addition, there is an awareness, through concepts such as normalisation and empowerment that people with a learning disability have a right to express their sexuality. Craft (1994) comments this right should not be at the mercy of the individual sexual attitudes of different care givers.

It is now recognised that in moving away from ‘overprotecting’ people with a learning disability through empowerment, issues of risk-taking and protection have had to be considered. Because of these associated ‘risks’ and attitudes of staff, sexuality and sexual health has become a neglected subject in nursing (Aylott 2000). Because of this the RCN in April 2000 launched new guidelines aimed at improving nurses’ understanding of the sexual health needs of patients/clients (RCN 2000).

These guidelines have included, the provision of professional, ethical and legal guidance on best practice and assistance to nurses who want to explore practical ways to make a difference, by examining why each area of nursing practice should have a sexuality policy and what conditions and treatments may impact on a person’s sexuality and sexual health. How does this relate to the care of people with learning disabilities? Fairbairn (2002) argues that a consideration of the legal and ethical problems sexuality raises in relation to people with learning disabilities is central to practice.

There has been some outcry in the nursing press about professionals assisting learning disabled clients to express their sexuality in an appropriate fashion, claims have been made that imply if a nurse assists a client towards expression of natural sexuality that the nurse is little more than a masturbatory aide or a prostitute (Nursing Times 1998). The legal position relating to sexual behaviour of people with learning disabilities is a key area of uncertainty. There are eleven acts of parliament relevant to the sexual behaviour of people with learning disabilities (Gunn 1996).

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