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The Sexual and Reproductive Health and Rights of Young People with Intellectual Disability: A Scoping Review

Abstract

Introduction

We examined the breadth of research on sex, sexuality, and sexual and reproductive health and rights with young people with intellectual disability in the past two decades.

Methods

An inclusive scoping approach focused on agency and resilience was used to review studies in English-speaking, high-income countries (2000–2019).

Results

In the 68 studies included, we found positive examples of sexual and reproductive agency across five key domains: 1) sexual development including sexual desire, identities, relationships, and menstruation, 2) sexual knowledge including sexuality education and sexual self-advocacy, 3) sexual activity and contraceptive use, 4) access to HPV immunization and cervical cancer screening, and 5) pregnancy, childbirth, and parenthood. The strongest factors in enabling agency were social support and sexuality education. However, several barriers including paternalist attitudes and infantilization of young people with intellectual disability affected all aspects of sexual expression, leading to the persistence of unfair and avoidable health inequities over the past two decades.

Conclusions

Ensuring young people with intellectual disability have a voice on all matters affecting their bodies, even if they have high support needs, is essential to promoting sexual and reproductive health and rights for all.

Policy Implications

Anti-ableist policies in sexual and reproduction health (e.g., education curriculum, service delivery) are key to moving forward.

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Funding

This review was funded through an Emerging Investigator Award from UNSW Sydney.

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All authors contributed to the conception of this paper. Database searching and data extraction were conducted by AC and CW. AC, ISW, and CW drafted the initial manuscript; AC, ISW, and JL discussed and revised the draft, using an easy-read version; all the authors provided critical feedback. All the authors have critically reviewed and approved the final manuscript, gave approval for publication, and acted as guarantors of the work.

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Correspondence to Allison Carter.

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Carter, A., Strnadová, I., Watfern, C. et al. The Sexual and Reproductive Health and Rights of Young People with Intellectual Disability: A Scoping Review. Sex Res Soc Policy (2021). https://doi.org/10.1007/s13178-021-00549-y

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Keywords

  • Young people
  • Intellectual disability
  • Sexual and reproductive health and rights
  • Inclusive research