Intimate Relations (sex) and the Intellectually Disabled

Face it social and intimate relationships are difficult for everyone. Intimate relations can be particularly difficult for Intellectually Disabled adults. The law says that Intellectually Disabled individuals have all the same rights as everyone else. The law also says that that in general whatever two consenting adult’s choice to do with each other in private is permissible. Resident Rights in facilities specifically address the residents’ right to social relationships of their choice. Resident Rights also address the persons’ right to privacy. Evan an adult who is conserved usually maintains these rights legally. Specifically the law comes right out and says that Intellectually Disabled adults (over 18 years old) can have friends, intimate relations (including sex) whenever and with whoever they want to. Should be a “hands down” issue, but for many individuals, it’s not.

Just because a person is biologically an adult it infers that the person can give informed consent for sex. It implies that both individuals involved in the relationship have the ability to give informed consent. Informed consent means that the person is aware not just of their rights but also their responsibilities. Both parties are expected to fully understand how women get pregnant, methods of birth control, sexually transmitted diseases, how to use a condom, be able to define sexual abuse, and can say “No” appropriately and effectively. For some individual’s Relationship/Social skills training and Sex Education are enough. For some, additional counseling also helps. For others, particularly for lower cognitively functioning individuals some of these areas of understanding are just not possible.

Where a person lives can make a great difference in what to do or not to do. For those individuals who are independent living arrangements there are larger risks of abuse that naturally come with independence. For those who live with family members are provided with more social protections and varying levels of independence.

Facilities are structural completely different for the residents who live there and their families. In governmental licensed facilities the regulations are clear: Residents have rights and these rights are enforced by agencies like Licensing and Regional Center. The staff are trained on orientation and at least annually about the residents rights. The staff are also given training to prevent physical, sexual or any kind of abuse between staff and residents. There are however, resident protections from physical abuse between residents. But to be absolutely clear: There are No legal provisions for residents regarding potential sexual abuse between residents.

Sex and the need for close relationships is a normal and natural part of being human.
Appropriate hugging, holding hands, even sitting next to someone you like and feel comfortable is pretty much acceptable in facilities. Masturbation is also pretty much acceptable as long as it is in private areas. Open masturbation in public rooms and exposure to nudity of private parts is not. Pornography is also acceptable, but again in private places only. Privacy in facilities is very important to insure resident protections. In many facilities the rooms are semi-private so privacy curtains are often used between residents. Bathroom and bedroom doors are often kept closed and staff need to knock before entering.

I have worked in many individual facilities over the years and can only say that the “grey areas” between resident rights of privacy, intimate relationships and protecting the residents from sexual abuse between each other are handled differently depending on the facility.

Starting just before the community based facilities were first defined and developed following the closing of the large developmental centers issues of free sex emerged. Those residents who could physically and cognitively have sex, did. If was a fairly open policy. Men and women could freely go from room to room. Many of the women were as a matter of course put on some form of birth control. In the smaller facilities out in the community social skills and relationship training became prominent and important. All resident were assessed for sexual interests and desires. Residents who could understand any sex educational material were given training. As time went on birth control pills, shots and implants were used more on a case by case basis. Access to religious services and faith based facilities increased greatly focusing on Social and moral values.

There were ongoing problems when people of varying cognitive abilities get together. How does a person of higher cognitive abilities and understanding wants to engage in an intimate relationship with someone with more limited understanding. The greatest protection against this came when Licensing and Regional Center decided that an appropriate peers group was of upmost importance. By simply matching individuals in facilities with others who had similar cognitive abilities or social/behavioral issues some of the problems are relieved to a degree.

Eventually became clear that the only way to balance between the regulations, social/moral conduct, and prevention of potential sexual abuse was to treat each case individually. Yes, problems still occur, but as usual in any situation where people live together there will always be issues.