Sexual Self-Determination of Individuals with Intellectual Disabilities—A Possible Philosophical Conceptualization and Resulting Practical Challenges
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Conceptualization of “Self-Determination”
3.2. What Is Sexuality?
3.3. Proposed Conceptualization of Sexual Self-Determination
4. Discussion
4.1. Implications of the Proposed Conceptualization of Sexual Self-Determination for IID
4.2. Challenges Regarding Sexual Self-Determination of IID in the Here-Proposed Sense
- (1)
- Sexual self-determination, in the sense proposed here, requires that IID can discover themselves and their desires as free from influence as possible. However, influence might arise from the attitudes of staff members caring for IID, which not infrequently are rather conservative about sexuality [44]. Moreover, sexual acts by IID often result in negative, prohibitive, and regulatory responses from parents, service providers, and staff [45,46]. Society predominantly views adult IID as “eternal children” [47]. Such attitudes may present significant barriers to IID sexual development [48]. In dealing with IID, one must refrain from overprotective attitudes and suppression of their natural sexuality [49,50]. Anything else would be an inappropriately paternalistic approach [51]. To enable the sexual self-determination of IID, such negative and derogatory attitudes among parents and professionals must be dismantled. This should be done carefully, because often the negative attitudes regarding IID sexuality are embedded in an overall tabooing attitude of society towards sexuality in general [51].
- (2)
- Sexual self-determination, in the way presented here, presupposes that an at least minimal cognitive process precedes the sexual act. This should not be denied to IID from the outset. However, it can be very time-consuming to determine which action or which form of sexuality is experienced by IID as self-determined. This certainly places high demands on parents and staff who care for IID.
- (3)
- To be sexually self-determined in the proposed sense, IID need to be informed about their sexuality and the various dimensions associated with it. However, far too few IID receive adequate sexuality education [52], which is why there is a need to focus much more on sexuality education for IID. Sex education is necessary in order to be able to perform the described process of gaining self-knowledge regarding the dimensions of sexuality. Individualized sex education of IID has already been shown to be positive in helping IID make independent decisions regarding their sexuality and become sexually self-determined [53,54]. Furthermore, appropriate sex education requires exploring in advance what knowledge and experience IID already have regarding their sexuality [55]. Specialized tools have already been developed in this regard [56].
- (4)
- Adequate sex education requires that professionals receive appropriate and sufficient information about sexuality in general and the specific aspects of IID sexuality. Unfortunately, few professionals receive adequate and sufficient education regarding the sexuality of IID [23,57], although this could reduce prejudice and promote the sexual self-determination of IID [45]. There is a high need to provide parents and professionals with opportunities to learn about IID’s sexuality.
- (5)
- Sexual self-determination involves dealing with people who identify as non-heterosexual or transgender. However, gay and transgender IID are highly marginalized [58], and professionals still need to become more responsive to the needs of these groups of IID [59]. Evidence suggests that professionals do not feel confident working with IID who are non-heterosexual or transgender [60]. Hence, there is a high need for training and education of patients and professionals in this area.
- (6)
- If IID are to be supported in their sexual self-determination, this also means that they are granted sexual self-determination. This means that regarding IID as “eternal children” [47] or their sexuality as immature [16] must rigorously be challenged. This will certainly require long and detailed processes of education and transformation not only on the part of parents and professionals, but ultimately on the part of society as a whole.
4.3. Limitations
5. Conclusions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Dimensions | Functions | ||||||
---|---|---|---|---|---|---|---|
biological sex | gender identity | orientation/preference | sexual desire | sexual action | relationship | reproduction | orientation |
sex | gender identity | sexual orientation | eroticism, pleasure, thoughts, fantasies, desires | roles, behaviors, practices | intimacy, relationship | reproduction | beliefs, attitudes, values |
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Skuban-Eiseler, T. Sexual Self-Determination of Individuals with Intellectual Disabilities—A Possible Philosophical Conceptualization and Resulting Practical Challenges. Int. J. Environ. Res. Public Health 2022, 19, 12595. https://doi.org/10.3390/ijerph191912595
Skuban-Eiseler T. Sexual Self-Determination of Individuals with Intellectual Disabilities—A Possible Philosophical Conceptualization and Resulting Practical Challenges. International Journal of Environmental Research and Public Health. 2022; 19(19):12595. https://doi.org/10.3390/ijerph191912595
Chicago/Turabian StyleSkuban-Eiseler, Tobias. 2022. "Sexual Self-Determination of Individuals with Intellectual Disabilities—A Possible Philosophical Conceptualization and Resulting Practical Challenges" International Journal of Environmental Research and Public Health 19, no. 19: 12595. https://doi.org/10.3390/ijerph191912595