A shift to person-centered ideologies has allowed for the identification of the right to establish intimate relationships, with the users of such intellectual disability services being allowed to identify the desire they hold to form different relationships. Nevertheless, the service providers and caregivers have always faced a great challenge in enhancing sexual autonomy in individuals with intellectual disabilities. Such challenges emanate from the existing culture of paternalism and conservatism and the ethical and legal uncertainty concerning the responsibilities and rights of the service users, caregivers, and the service providers.
As much as one cannot provide clear answers to any questions that may arise concerning the issue of sexuality and relationships, there is need for all the stakeholders including the caregivers, the service users, clinicians, service providers, policymakers, and the researchers, among others, to acknowledge, discuss, and explore such an issue. This paper reviews some of the areas concerning sexuality and relationship among intellectually disabled individuals that have experienced intensive research. As much as relationship and sexuality education programs currently occur in abundance, there is a need for more systematic and rigorous evaluation of such programs in terms of their effectiveness in knowledge enhancement, and primarily to examine how such education impacts decision-making capacity and behavior. It is important to note that the lives of individuals with intellectual disability occur within various social systems that interact, including peer systems, work systems, family systems, school systems, legal systems, and community systems.
Thus, it is vital to understand the mores and norms that may influence sexual identity development of such individuals through providing them with or mitigating opportunities for such development. According to Dukes and McGuire, the attitudes that the surrounding individuals may have in relation to the sexual expression of individuals with intellectual disability is a measure of inclusiveness and openness of the community to such individuals
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