Sexuality issues and the voices of adults with intellectual disabilities: A systematic review of the literature.
Adults with ID keep asking for clear sex ed and the right to choose—staff attitudes are the main wall, not their disability.
01Research in Context
What this study did
Davidovitch et al. (2018) read every paper they could find on what adults with intellectual disabilities say about sex and relationships. They pulled out 23 studies that let these adults speak for themselves.
The team then grouped the quotes into five big themes: wanting to decide for themselves, not knowing enough, having partners, needing help, and staying safe.
What they found
Across all papers, adults with ID kept saying the same thing: “Give us sex ed that we can understand and services that let us choose, but keep us safe.”
They felt staff and families saw them as either children or risks, not as adults who could love.
How this fits with other research
McGrath et al. (2025) later looked at 102 studies and agreed: low knowledge is real, but the bigger block is society treating adults with ID as forever kids.
McCann et al. (2016) zoomed in on LGBT adults with ID. They showed the target review’s themes get sharper when you add double stigma—staff often ignore same-sex wishes altogether.
Y-Chezan et al. (2019) tested a fix: train parents and staff. After the course, attitudes flipped from “they can’t” to “they can with support,” proving the barrier is attitude, not ability.
Why it matters
If you write behaviour plans, run social groups, or teach sex ed, start by asking the adult what they want—then check your own assumptions. Swap scare stories for skills: teach consent, privacy, and how to ask for help. One small move: add a “relationship goal” box to your next ISP and let the client fill it in first.
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02At a glance
03Original abstract
BACKGROUND: There is a growing and evolving research evidence base regarding sexuality issues and adults with intellectual disabilities. Individuals can face challenges, including the right to express their sexuality and to access necessary education and supports. AIMS: This systematic review explores sexuality experiences, the views and opinions of adults with intellectual disabilities and highlights areas for future practice developments. METHODS AND PROCEDURES: A comprehensive search of relevant databases from January 2006 to December 2016 was carried out. Included studies had to address specific criteria including: peer reviewed papers, the use of appropriate research methods, and focused exclusively on the individual views and opinions of people with an intellectual disability. The search of relevant databases yielded 230 hits. Following the application of explicit inclusion and exclusion criteria, 23 papers were deemed suitable for the review. OUTCOMES AND RESULTS: The data were analysed and key themes were identified that included: autonomy v's risk of harm, knowledge and sexuality, relationships and intimacy, self-determination and taking control, and encouragement and supports. CONCLUSIONS AND IMPLICATIONS: Adults with intellectual disabilities need education and support to express their sexuality and to meet individual needs.
Research in developmental disabilities, 2018 · doi:10.1016/j.ridd.2018.01.009