Equality and human rights commission guidance
Supported Loving toolkit
Sexual rights
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Sexual rights are human rights related to sexuality. These rights are often an under-acknowledged area of sexuality and relationship support, but are very important.
This toolkit page focuses on one of the most important and often overlooked areas of sexuality and relationship support - rights! Sexual rights are human rights related to sexuality. As professionals we would never intentionally breach someone’s human rights, but in reality, breaches happen more often than we think, sometimes unknowingly and occasionally following professional advice.
It’s vital that we understand everyone’s human rights in this area so they can advocate for the people they support and challenge decisions when needed. Organisations (including social care providers) have a legal obligation to protect human rights and rights in the Act are enforceable by law. If someone’s rights are breached, they can take the organisation to court, something that has happened, although not often enough to prevent breaches from continuing. Breaching sexual rights can lead to legal consequences, as individuals have successfully taken legal action for violations of privacy or sexual autonomy. Organisations must be aware that these breaches have real-world implications, not just theoretical ones
Several articles in the Human Rights Act relate to sexuality and relationships:
Article 8 - Respect for your private and family life, home and correspondence
This protects our sexual autonomy, including the right to live together and enjoy each other’s company, the right to develop relationships as free from interference as possible and the right to have information about our sexuality and relationships kept private.
Article 10 - Freedom of expression and the right to receive information
Includes the right to receive and share information about sexuality and relationships.
Article 12 - The right to marry and to start a family
Protects the right to marry and have children, provided the individual is of marriageable age and able to consent.
Article 14 - The right to be free from discrimination
Ensures all the above rights are enjoyed equally, without discrimination.
The rights above could potentially be interfered with (unlike absolute rights like freedom from torture) if there a specific lawful reason (eg to prevent a crime).
The World Health Organisation (WHO) working definition of sexual rights includes the right of all persons, free of coercion, discrimination and violence, to:
- the highest attainable standard of sexual health, including access to sexual and reproductive health care services
- seek, receive and impart information related to sexuality
- sexuality education
- respect for bodily integrity
- choose their partner
- decide to be sexually active or not
- consensual sexual relations
- consensual marriage
- decide whether or not, and when, to have children; and
- pursue a satisfying, safe and pleasurable sexual life.
What are the most common challenges faced by people in this area and how best to support people to overcome the issues?
Denial of sexuality – Perhaps the most common issue faced by many people who access support (such as people with a learning disability, autistic people and older people) is the denial of their sexuality and/or their need for intimate relationships. For older people relationships and sex can be seen as something that it is no longer important to them. Autistic people, it is often assumed, are uninterested in sex or relationships. Similarly, for people with a learning disability, staff may assume they are not interested or lack capacity. Everyone needs to be aware that all humans are sexual beings, how this is expressed may differ, but it is a fundamental aspect of being human. Sexuality and relationship needs should be treated as any other support need and included in support planning, assessments, provision of double beds as standard etc. Organisations should monitor staff practices through audits and ensure there are clear systems for reporting and addressing rights violations. Staff must be held accountable for respecting sexual rights to prevent breaches and foster a culture of respect.
Privacy - A lack of privacy is a common issue where people receive 24-hour support. Research across social care groups shows people are often afforded no privacy with a partner. People have told us they have been told to leave their bedroom door open and that they are not allowed to have a partner stay overnight in their room. Supported accommodation often provide single beds, so it would not be possible to have an overnight guest. People may be unable to go out unsupported so have staff present on dates. Organisations need to explore how they can give people privacy to allow space for intimate relationships to develop/be maintained. If there are concerns regarding a person’s capacity (see page on capacity) regarding sexual relations and being alone with a partner, this must be addressed ASAP. However, if there are no concerns, people MUST be allowed privacy in their home. To ensure privacy, supported accommodation spaces should be redesigned to include private areas. Staff routines can be adjusted to respect personal space, and privacy signals can be used. Staff should be trained to facilitate privacy without intrusion.
Access to education and support - Under the Human Rights Act people have the right to receive information, in a way they understand, to be able to make decisions regarding their sexuality and relationships. The WHO’s definition also incorporates the right to Relationships and Sex Education (RSE). Many people with learning disabilities and/or autistic people have not received RSE or had it provided in a way they understood. In England, the Care Quality Commission (CQC) support this by stating that providers must make sure people have access to education and information to help them develop and maintain relationships and express their sexuality.
Contraception and children - Research (McCarthy 2009; Ledger et al. 2016) shows that people with learning disabilities are often excluded from decisions regarding contraception choices and there is a preference for long-acting contraception to avoid pregnancy. People also take contraception for period management without knowing the impact on their fertility. Everyone’s right to start a family (if they choose) is enshrined in law, there is a long-standing prejudice about certain groups of people becoming parents. If a person wanted a child and those around sought to restrict this, such a contentious issue would need to be referred to the Court of Protection. We need to empower people to make informed choices surrounding contraception, using accessible information and education.
Watch Professor Claire De Than’s presentation on supporting the human right to have fun - how sex, relationships, intimacy, loving and the law fit together.
Do...
- educate yourself on what people’s rights are regarding sexuality and relationships
- make sure people are aware of their own rights and receive education if needed
- respect people’s right to make decisions in this area, even if you don’t agree
- provide training for staff to confidently support people’s sexuality and relationship rights (eg legal knowledge and practical skills).
Don't...
- see rights in this area as different to any other area – they are important human rights
- over-emphasise safeguarding at the expense of human rights
- allow human rights breaches to go unexamined – you must raise concerns if you feel this is happening without there being a reason prescribed in law
Case study
Tanisha is a 25-year-old autistic woman with a mild learning disability. She recently moved from her family home to live with her friend Evie. They receive 24-hour support from a local provider organisation. Tanisha wants her boyfriend Jaylen to visit. Staff are worried about Tanisha getting pregnant and are not sure what she knows about sex. They decided to make sure the couple leave the bedroom door open and they keep a regular check. Tanisha gets upset as they have no privacy. Staff are worried about mentioning sex to Tanisha in case it puts ideas in her head.
A new manager, Gloria starts at the company and explains that staff are potentially breaching Tanisha’s human rights. They are restricting her right to develop relationships as free from interference as possible, and the right to have information about her relationships, kept private by sharing with her parents.
Gloria meets with Tanisha, and they talk about her relationship with Jaylen, how it is going, what support she thinks she might need from staff, and Gloria asks her if she has ever received any relationships and sex education. Tanisha covered this topic in college and knows quite a lot about it! She says the couple would like a sexual relationship. Gloria looks at the criteria for capacity for sexual relations (see toolkit page) and feels confident Tanisha can consent. However, she might need some help deciding what contraception to use. Gloria books an appointment with the local sexual health clinic to discuss. Tanisha, with support from her team and nurse, chooses an implant, and as they both have no previous sexual partners and are in a monogamous relationship, they do not need to use condoms. Staff are told to make sure they knock before entering her bedroom and wait for a response to enter.
Top tips
- Treat people’s relationships the same as you would your own - if you would not put up with something – why should they?!
- Make sure human rights are respected and reflected throughout your organisation. This is not an ‘add on.’
- Think about how someone's environment may limits their relationships eg only having a single bed or single chairs (no space for cuddles).
- If, due to capacity/other issues, people’s rights need to be restricted, how can we make the most of what they are able to do? Eg if a person lacks capacity for sex, how do we still support their relationship to continue in other ways?
The views expressed in the Supported Loving toolkit are not necessarily those of Choice Support.
Resources
Information on the Human Rights Act (HRA)
Sexual rights of young people with learning disabilities
Manual for sensitizing intermediaries on sexual rights of young people with learning disabilities.
Sexual and reproductive health - World Health Organisation
World Health Organisation's (WHO) working definition on sexual and reproductive rights
Sexuality and Relationships - My Rights Charter
My Life My Choice, the Supported Loving network, the National Development Team for Inclusion (NDTi), and the Tizard Centre at the University of Kent developed the charter based on the findings of two academic research projects on relationships.
British Institute of Human Rights - Easy Read
Easy read information on human rights
You are a sexual citizen
As sexual citizens, we need to be aware of our sexual health rights and responsibilities. But how many of us are? Gillian Leno addresses the things we make take for granted in our sex and relationships, and why some people are being left out of the conversation.- watch it here
Supported Loving toolkit
The Supported Loving network has produced a series of guides to help support people with issues surrounding sexuality and relationships.
Read more
What is Supported Loving?
For some people finding love is often more than just chemistry – it can come down to getting the right support
Read more
Supported Loving network
Supported Loving is not a formal membership organisation. Anyone can take part, it is free.
Read more