Everyone has the right to information about gender and sexuality and to get good support to express themselves.
This is why it is so important to actively encourage people to explore their identity. Find out who they are and find ways to express this. We all have a role to play in this!
Everyone is different and unique. Identity means who we are, how we feel, and how the world sees us. Our vision is a future where everyone’s sexual identity, and personal and sexual relationships are recognised, accepted, and respected. Everyone has the right to information about gender and sexuality, and to get good support to express themselves.
People with a disability, including people with a learning disability and autistic people, express a range of sexual orientations and gender identities including, but not limited to, those who identify as lesbian, gay, bisexual and transgender (LGBTQ+). Sexual identities are more varied among autistic people than in the general population (Warrier et al. 2020.) This intersectionality can result in ‘double discrimination,’ with a person's sexual rights denied because of their disability, as well as their sexual orientation or gender identity. Research has found that many LGBTQ+ people with a disability face discrimination and abuse because of their sexuality or gender, including from those paid to support them. This can impact on their decision of whether to disclose their sexuality to paid staff (School for Social Care Research, 2017.) Some LGBTQ+ people with a learning disability are bullied or harassed. In addition, their family members or service staff might not acknowledge their identities or relationships (LGBTQ HIP and Lewis, 2015; Harflett & Turner, 2016.) Evidence suggests some LGBTQ+ people with a learning disability have concealed their sexuality to avoid expected negativity (Rushbrooke et al. 2014.)
LGBTQ+ people with learning disabilities experience additional discrimination from the broader LGBTQ+ community who are not always welcoming, with some members holding negative stereotypes (Stauffer-Kruse, 2007.) Despite the issues experienced, many LGBTQ+ people with a learning disability can feel proud of their identity, but some may need additional support to achieve this through having a safe space to explore their identity with their peers (Tallentire et al., 2016.)
This is why it is so important to actively encourage people to explore their identity, find out who they are, and to find ways to express this. We all have a role to play in this!
What are the most common challenges faced by people in this area?
We know that many people with a learning disability and autistic people struggle to access good quality accessible relationships and sex education (RSE). Even where RSE is offered, there are very few educational materials and images that reflect a diverse range of identities and/or relationships. As a result, people can often hold incomplete or inaccurate knowledge of relationships (including LGBTQ+ relationships), sexual health and the legal and emotional aspects of sex (Jahoda & Pownall, 2014; Sinclair et al, 2015; Whittle & Butler, 2018.) Consequently, they are at higher risk of negative sexual experiences, contracting sexually transmitted infections or unwanted pregnancies (Baines et al., 2018.) Service providers often make assumptions that the people they work with are heterosexual, and there is little discussion or exploration of identity and sexuality.
The social care sector is currently not proactively supporting people to explore their identity. For example, support plans or person-centered reviews may not adequately ask about gender identity, expression or sexual orientation, if at all. Some staff may assume a person’s sexuality or gender without asking them about this or opening up a conversation. There are often no guidelines or frameworks to ensure meaningful conversations are had about identity and the support people might want or need. This is further reinforced by accessible sex education tools that can be heteronormative.
Following a nationwide survey in 2017, the Government Office for Equality identified a need for better support for older people, people in care, people with disabilities and long-term conditions who identify as LGBTQ+. People with a learning disability were highlighted in their action plan: “We will take action to improve the support for LGBTQ+ people with learning disabilities. The Department of Health and Social Care will review, collate and disseminate existing best practice guidance and advice regarding LGBTQ+ issues and learning disability; and will also ensure that training requirements for support staff and advocates includes advice regarding LGBTQ+ people.”
We know it is extremely important for LGBTQ+ people to be able to connect with LGBTQ+ communities and spaces, for a sense of connection, belonging, and to feel their authentic self, free from fear of judgment. However, the LGBTQ+ community is not always the most welcoming or accessible for people with a learning disability, and this puts people at risk of experiencing further isolation. From our existing work, Mencap are aware that there are few support groups for people with a learning disability who are LGBTQ+. Attendance at these groups can be poor as people often lack the confidence or support to access them.
How best to support people to overcome the issues listed above
Some people you work with will identify as lesbian, gay, bisexual and/or transgender (LGBTQ+) just like anybody else, or they might be questioning their sexual orientation or gender. You can best support people by giving them opportunities and prompts to explore their identity, and by talking to them about being LGBTQ+. You can offer reassurance that it is okay to be LGBTQ+, that we are all different, and our individuality is something to be celebrated. Our resources listed below can help to support some of these conversations, and our animated film explains some of the concepts in an accessible way.
It is best practice for support staff to be proactive in ensuring that the support and information they provide around sex and relationships is LGBTQ+ inclusive. You can make sure that LGBTQ+ role models, support groups, and events are visible to the person. Sharing books and videos with LGBTQ+ characters will also create a more inclusive environment. Sex education resources and campaigns for people with a learning disability should be designed with the specific needs of lesbian, gay or bisexual people in mind, rather than assuming that all people with a learning disability are straight (heterosexual) (Abbott and Howarth, 2007.)
Changes may start to be seen within social care in England, as the Care Quality Commission (CQC) guidance states: "Providers have a duty to promote equality, diversity and human rights in their service, including for their staff. Providers need to promote LGBTQ+ inclusive practices. LGBTQ+ people need to be proactively supported by staff who understand the need to adequately balance risk and responsibility toward the individual concerned. This will help LGBTQ+ people to form and maintain personal, loving, intimate and sexual relationships." CQC also states that providers should ask people about their sexuality needs and this should form part of support planning.
Watch this video from Mencap, which is part of a workshop resource called You Being You about gender identity, gender expression, sexuality and celebrating you being you.
Watch Claire Bates, Supported Loving Leader, talk about her research exploring the experiences of bisexual people with a learning disability and/or autism, and how the findings can be used to help organisations to be more LGBTQ+ inclusive. Christian Buchan, from Choice Support, and Charlotte Johnson, the founders of 2buWakefield share how they set up and run with virtually no funding, a social group for LGBTQ+ people with disabilities.
Do...
provide opportunities for the people you support to explore their identity and self-expression in a way that is right for them
celebrate everybody as individuals and encourage people to express themselves in the way they want to
help people to access support groups/networks if they wish, and develop a strong circle of support
think about how everyone can be part of this, for example, celebrating Pride is a great way to bring people together.
Don't...
make assumptions about people’s identity or preferences without asking them
omit information about different expressions of gender and sexuality from any RSE activity
allow prejudice or discrimination to exist amongst staff or people you support
ignore this right to explore identity and self-expression, as it is a human right we all share.
Case study
Esther is a young woman with a mild learning disability who has recently told her support staff that she may be bisexual. She had a boyfriend previously, but she has recently met a woman in her gym class who she is sexually attracted to. Esther wants to talk about how she feels with someone who understands, but she feels very isolated as there are no other women, that she knows of, who feel like her. Her support worker suggests finding a local social group for women who identify as gay or bisexual. When they go to the group, none of the other women have a learning disability and Esther feels uncomfortable bringing her support worker along. The group members also speak outside of meetings, online in a Facebook group, but Esther has trouble joining in as she cannot read very well and does not want to ask her staff to write posts for her as its very personal.
Esther shares how she is feeling with her key worker, Erica. Erica understands and thinks about the ways she might be able to help.
Staff help Esther to get a program for her computer (like a screen reader) to help 'read' text on her social media. It also dictates her voice into text, so she can join in the chat.
Erica finds a volunteer, Amy, who identifies as a lesbian and is closer in age to Esther, to go with her to the group instead of bringing support staff each month.
Erica and Esther look online for a LGBTQ+ group for people with a learning disability, but there are none locally. Erica asks the social care organisation if they can help set one up in the local area. The organisation gives them a room on a Thursday, tea/coffee and biscuits, and help send out flyers. Esther, Erica, and her volunteer Amy host their first social club event for LBGTQ+ people with a learning disability and four people join! They plan to meet in a local LGBTQ+ pub for a pint next month!
Esther and Amy continue to go to the first LGBTQ+ group, (you can never have too many social groups and friends,) even after they set up their own group as Esther has made friends there.
Top tips
Everyone has the right to understand their sexuality and be themselves.
It is a wonderful thing to be yourself.
Let’s celebrate you being you!
Rachel Ashcroft, Senior Development Manager at Mencap
The views expressed in the Supported Loving toolkit are not necessarily those of Choice Support.
Resources
You Being You
Mencap have created an animated video and some resources about gender identity, gender expression, sexuality and celebrating you being you. They did this with the help of Gendered Intelligence.
The Rainbow Support Group Guidebook for LGBTQ+ & Intellectual Disabilities
Written by LGBTQ+ self-advocates leaders based on interviews with LGBTQ+ adults with intellectual and developmental disabilities from across the United States. The guidebook includes: Information about gender and sexuality, quotes and personal stories, advice on how to support, a statement of human rights, tips for sex educators, letter to families and friends and resources and handouts
The Autistic Trans Guide to Life - This essential survival guide gives autistic trans and/or non-binary adults all the tools and strategies they need to live as their very best self.
LGBTQI+ Disabled People using Self-Directed Support
LGBTQI+ Disabled People using Self-Directed Support by SCIE
Read more
Supported Loving toolkit
The Supported Loving network has produced a series of guides to help support people with issues surrounding sexuality and relationships.