1. Examining Attitudes Toward the Sexuality of People with Intellectual Disability: An Analysis of Medical, Mental Health, and Developmental Disability Providers
Hannah Ginn, M.S.W., Canyon Hardesty, M.S., CHES, Anna-Margaret Goldman, Ph.D., Kendra Lystad, M.D., Stacey Titus, M.S.W., Wayne Trice, M.S.W., Elizabeth Ferguson, M.S.
Methods
Measures
The Attitudes to Sexuality Questionnaire (Individuals with an Intellectual Disability) (ASQ-ID) was developed by Australian researchers
Only validated measure assessing attitudes toward the sexuality of males and females with intellectual disability (ID) (Sankhla & Theodore, 2015).
Demonstrated high reliability and internal consistency (Cuskelly & Gilmore, 2007).
A demographic survey was developed to assess participant demographics as well as characteristics that may affect attitudes.
Procedure
IRB approval received January 2017
Survey distributed electronically to medical, mental health, and disability providers in Wyoming, Utah, Montana, and Idaho via announcement
These participants were contacted through:
Medical and human services agencies
Professional organizations and licensing boards
Snowball sampling
Initial distribution of the survey: February 14 and March 16, 2017
Participants
653 respondents from:
Idaho (12%)
Montana (18%)
Utah (26%)
Wyoming (44%)
Provider groups:
Developmental disability providers: 33%
Mental health providers: 27%
Medical providers made up 12%
Other (uncategorized to date): 27%
Participant characteristics:
A majority female (77%)
Median age: 41 years old
Practiced for a median of 10 years in their indicated field
Background and Need
Widely-held attitudes regarding the sexuality of people with intellectual disabilities (ID), rooted in the eugenics movement of the previous century, have limited the sexual choices, opportunities, and expression of people with ID (Gomez, 2012).
These attitudes have affected the provision and access to services for those with ID (Anderson, 2015). People with ID have expressed their desire for romantic relationships and to receive more information about sexual health, yet access to and the content of such education has often been constrained by restrictive attitudes toward their sexuality (Frawley & Wilson, 2016). Attitudes can negatively impact the self-identity and sexual self-concept of those with ID, leaving them vulnerable to sexual abuse and interpersonal violence (Fitzgerald & Withers, 2013). While research on attitudes regarding the sexuality of those with ID is fairly robust outside the U.S., there have been a limited number examining domestic attitudes since the 1990s (Scior, 2011).
Results
Additional participant descriptors:
Comfort with discussing sexuality with clients:
A majority (71%) expressed some degree of comfort discussing sexuality with clients
Frequency of interaction with clients with ID:
A majority (69%) interact with clients who have ID everyday or a few times a week. A third (30%) interact with them a few times a month or a few times per year
Religiosity:
Over 50% indicated they are religious, while 37% said they are not.
Nearly 60% attend religious services and 40% do not attend
Participants were generally highly educated:
Half had Masters or Doctoral degrees (53%); a third (30%) had Bachelors degrees
ASQ-ID Results
Statistical tests used included T-tests and ANOVAs
The overall mean ASQ score was 4.01 (out of 5).
Each factor had the following mean score:
Non-reproductive Sexual Behavior: 4.11
Sexual Rights: 4.08
Self-control: 3.87
Parenting: 3.87
Respondents from Utah had less supportive attitudes than all other states, with Wyoming as the second least supportive
Religious attendance and consideration of self as religious was negatively correlated with supportive attitudes
Future Research & Inquiry
Considerations for future ASQ studies :
Allowing for qualitative responses to allow for further clarification
Increasing response rates from providers with diverse educational backgrounds
Randomly assigning ASQ-ID scale and ASQ-GP (attitudes toward general population) for cross-comparison of attitudes
Future policy-related considerations:
Advocating for policies within developmental disability provider contexts that support the sexual rights of those with ID
Ensuring access to educational opportunities and resources for developmental disability, medical, mental health providers about how to support client sexuality.
The states included in this study were Montana, Idaho, Wyoming, and Utah
Project Overview
The Utah Regional Leadership Education in Neurodevelopmental and Related Disabilities (URLEND) is a five state leadership development program funded under Title V of the Maternal and Child Health grant, administered by the Health Resources & Services Administration (HRSA).
URLEND provides training to a diverse range of professionals in the health and human services fields so they may best serve children and adolescents with special health care needs and their families (URLEND, 2017).
During the URLEND academic year, the disability and sexuality leadership team of five trainees conducted a study to assess the attitudes of health care, mental health, and developmental disability providers toward the sexuality of people with intellectual disabilities in the Rocky Mountain Region.
References
Anderson, S. (2015). Sex education programs focused on "protection" and "prevention" with little attention given to supporting people to develop healthy, positive sexual relationships. Research and Practice in Intellectual and Developmental Disabilities, 2(1), doi: /
Cuskelly, M., & Gilmore, L. (2007). Attitudes to sexuality questionnaire (individuals with an intellectual disability): Scale development and community norms. Journal of Intellectual and Developmental Disability, 32(3), doi: /
Fitzgerald, C., & Withers, P. (2013). 'I don't know what a proper woman means': What women with intellectual disabilities think about sex, sexuality and themselves. British Journal of Learning Disabilities, 41(1), doi: /j x
Frawley, P., & Wilson, N. J. (2016). Young people with intellectual disability talking about sexuality education and information. Sexuality and Disability, 34(4), doi: /s x
Gomez, M. T. (2012). The S words: Sexuality, sensuality, sexual expression and people with intellectual disability. Sexuality and Disability, 30(2), doi: /s
Sankhla, D., & Theodore, K. (2015). British attitudes towards sexuality in men and women with intellectual disabilities: A comparison between white westerners and south Asians. Sexuality and Disability, 33(4), doi: /s
Scior, K. (2011). Public awareness, attitudes and beliefs regarding intellectual disability: A systematic review. Research in Developmental Disabilities, 32(6), doi: /j.ridd
URLEND. (2017). Welcome to the URLEND program. Utah Regional Leadership Education in Neurodevelopmental Disabilities. Retrieved from