Supporting People with Intellectual Disabilities: Difficult Conversations

Last night, as I was flipping through the channels I happened to catch an episode of “Law and Order: SVU” that dealt with intellectual disabilities. I’m always interested to see how the media portrays people with disabilities, so I decided to watch.

People with Intellectual Disabilities and Sexual Assault

“Law and Order: SVU” is always interesting, but it’s rarely easy to watch. Some episodes are easier for me to handle without wanting to burst into tears than others, but it’s the only show on television that makes me consistently ask myself, “Can I really handle this?” Last night was no exception; the show was about a young woman with Down’s Syndrome who was pregnant as a result of a rape, and the numerous issues that come out of that particular situation.

People with disabilities (in general, not just intellectual disabilities) are, unfortunately at much higher risk of sexual assault. The California Coalition Against Sexual Assault reported in 2001 that 15 000 to 19 000 people with developmental disabilities were raped per year (California Coalition Against Sexual Assault, “Serving Survivors of Sexual Assault with Disabilities”, 2001). I couldn’t find more current statistics, but I shudder to think what they are now.

The Importance of Having the Difficult Conversations

The statistics I quoted above scare me, but they also strengthen my resolve not to avoid difficult conversations. I’m not a mother, but I’ve had enough conversations about sex with people with intellectual disabilities, people operating at a teenage mentality or lower, to know that it’s not fun for anyone involved. It’s not comfortable to have to ask people if they know what sex is (and to sometimes have to explain) or ask if they’ve thought about birth control. But damn it, it’s necessary. The people I support may be, mentally, in their teens or younger. But they’ve got adult bodies, complete with adult sex drives. They need to be prepared for the possibility that they may choose at some point to have consensual sex.

They need to also be aware that not all sexual contact is good. They need to know the difference between “good” and “bad” touch, and what they need to do if someone ever touches them in a “bad” way. Because, as much as we’d like to be able to protect people with intellectual disabilities from all the bad that’s out there in the world, it’s just not possible to do so, or responsible to believe that it can be done forever. The harsh reality is that eventually the parents of these adults with disabilities aren’t going to be there to protect their kids. And while that doesn’t mean that the adult with disabilities is necessarily going to be out on the street, having as many skills and as much knowledge as possible – including at least a basic awareness of issues around sexuality and sexual safety – is going to make the transition to whatever comes next all that much easier.

It’s much easier to have these difficult conversations than to have to hear, as the mother on the SVU episode did, that your daughter with intellectual disabilities is pregnant as a result of a rape. In the name of their safety, people with intellectual disabilities need education appropriate to their developmental level (not just once, but again and again) about sexual safety just as much as people without disabilities do.

I’m not going to even get into right now some of the other issues that the “SVU” episode raised: competency and capacity assessment, the debate about whether people with intellectual disabilities can raise children, who should get to decide what when it comes to individuals with intellectual disabilities…but you can bet that I’ll revisit these things at a later date.

Please remember, though, that I don’t claim to have all the answers…when you get into questions like these, nothing is black and white and sometimes it seems like the “right” answers change by the day. If there’s ever anything that you’d like me to talk about in a more in-depth manner, or do more investigation into yourself, let me know; I’ll either do some more research myself or point you to resources where you can find out more.