Sexuality in relation to people with learning disabilities

This assignment will analyse critically key ethical, attitudinal, political issues and historical development of sexuality in relation to people with learning disabilities and services.

This assignment will explore Task B, which is based on a young man with learning difficulties experience of sexual education or rather lack of sexual education at his school.The young man called Simon experienced exclusion from sexual education, his headmaster advised other pupils to speak to him about anything they were unsure of regarding sexual health; however when Simon approached him to discuss sexual health he advised him to speak to his support teacher called Mrs Hewitt. Mrs Hewitt advised him that he did not need the knowledge of condoms, Simon, who is gay wanted to speak to Mrs Hewitt about his sexuality who inadvisably replied he could not be gay "because it wasn't nice" (Carson, 2002; P207).In relation to task B this assignment will look at the headmaster Mr Bentley and Simon's support teacher Mrs Hewitt's approach to working with Simon.

It will also look at ethical implication of Mrs Hewitt's advice to Simon. The assignment will conclude by exploring philosophical and policy changes that is needed in mainstream schools to ensure that young people like Simon had a more inclusive experience of sexual education. Historical issues of sexualityMr Bentley and Mrs Hewitt have decided not to provide Simon with adequate sex education regarding his sexuality and sexual health. This approach they have taken can be due to many historical factors and issues about the way society views sexuality of individual with leaning difficulties.

Historically Society viewed individuals with learning difficulties as incomplete adults and literature review shows historically, people with learning difficulties's sexualities have been neglected (Gougeon, 2009).In Between 1880 to 1940 the eugenic movement led to mass sterilization and segregation of many vulnerable individuals in particular individuals with learning difficulties from the society (Greenspan, 2002). It could be argued that the eugenic movement was triggered by Jukes (1875) and Kallikaks (1912) study viewed people with learning disabilities and other sub groups to be linked to criminality (Lombardo, 2008).However according to Karellou (2007) Sterilisation is still common practice for women learning difficulties, in Canada as well as in many other developed countries (Karellou 2007). Historically society's views of individuals with learning disabilities were based on negative stereotypes, during the 19th century it was believed individuals with learning disabilities reproduced more rapidly compared to the rest of the society, the state feared rapid reproduction would overwhelm the population, therefore official checks needed to be placed to control this( Kempton and Kahn 1991).The governmental solution was to improve the human race by selective breeding and by enforcing eugenics; people with learning difficulties as well as other Vulnerable groups such a people with mental illness, young unmarried mothers were forcefully castrated or ovariectomiesed (Howard and Hendy, 2004)).

During 1940s little progress was made in relation to sexual education. Individuals with learning disabilities and other vulnerable groups were still institutionalised; intuitions kept men and women separate to stop sexual activities (Kempton and Kahn 1991).For those individual who were hidden away in parental home was viewed to be eternally innocent or sexless, they were seen to be "forever children" (Gougeon, 2009). This view has not changed to this date, looking at Simon's scenario there is clear indication that people with learning difficulties are still seen incapable of being a sexual being. Therefore perhaps the reason why Mr Bentley and Mrs Hewitt have denied Simon the change to learn about sexuality is due to the fact they still hold this view of people with learning difficulties being Asexual and not needing sexual education as it doesn't concern them.Also institutional discrimination and separation is still present at Simon's school due to the schools reluctance to provide him with same level of support as others.

In relation to Simon being homosexual, historically speaking the gay and the lesbian community suffered prejudice and discrimination and public attitude to homosexuality was very negative and during the eugenic movement individuals who practiced homosexual behaviour would have been ill treated and labelled as delinquents in the society just like individuals with learning difficulties ( Herek, 2007) .For Simon to be gay and have learning disabilities I believe it provides him with double negative labelling. Until early 1970's the medical model of disability would have viewed homosexuality as mental an illness (Mail, 2002). Homosexuality was originally classified as a mental illness in the American Psychiatric Association the Diagnostic and Statistical Manual (Sullivan, 2004). In relation to Mrs Hewitt's attitude to Homosexuality, there is clear distinctive homophobic language in her advice to Simon.

Looking at historical attitudes towards homosexuality, it is clear that often homophobia is often driven from individual's religious or cultural background (Adamczyk, 2009). Unfortunately the scenario does not state Mrs Hewitt's background so we cannot make a clear judgment on her attitude, however we could say the approach she used with Simon in relation to his homosexuality could be due to personal attitude to homosexuality (Fish, 2009), and to clarify Mrs.Hewitt insisted Simon could not be gay because it wasn't "nice". Homophobia is greatly experienced by people with learning difficulties, Abbott and Howarth (2007) found many individuals with learning difficulties faced emotional and physical abuse due to their sexuality. Historically homophobia has also been major issue in the gay community, although reflecting on the literature compared to 50, 60s, 70s and so on homophobic bullying is not overt as it use to be (Mail, 2002).Abbott and Howarth (2007) identified that issue of sexuality specially homosexuality were not introduced to groups in care environment, the authors state this could be due to lack of educational training given to staff concerning these issues.

Perhaps Mrs. Hewitt and Mr. Bentley do not have right training to provide such intimate discussion. During the 1950s, real progress on sexual education for individuals with learning difficulties was made.Group of parents from the United States formed "association for retarded children (ARC) in 1950s, they lobbied the government for funding, parental education and professionals training programme and for the first time special education classes in mainstream schools (Kempton and Kahn 1991). However, looking at Simon's experience of sex education in school, it seems that sex education in mainstream school for children and young people with learning disabilities has not really been embraced by schools.

But perhaps this is to do with other social factors such as individual attributed of advice givers and poor school policies on sex education for individuals with learning difficulties (Grieve et al, 2009). During the 60s, disability movements got stronger Normalisation was introduces , Nirje ( 1980) stated that normalisation purposed the opportunity for people with learning difficulties to experience sexual love with both sexes.Normalisation opened up the opportunities for people with learning difficulties to receive sexual and health education (Nirje 1980), the main goal of this would have been to equip individuals with skills and knowledge to protect themselves from sexually related illness and abuse, although this type of education is not effectively enforced in schools even to this date (Hollomotz, 2007), this has been clearly identified in Simon's scenarios. Normalisation has influenced public policies for people with learning difficulties to have rights to sexual relationship and the duty of services to support them (Yacoub and Hall 2008).This would mean schools now days have a duty to educate people on sexuality. Quick glance at the 70s and 80s revel stronger attributes to support individuals to receive sex education, the enforcement of social model of disability enforced the need for inclusive treatment of people with learning difficulties (Walmsley, 2001).

Although historically speaking even during the 70' and onward people with learning difficulties were seen as asexual therefore society did not see the need to teach people adequately about sexuality (Murphy, 2003).In fact according to Rohlder and Swartz (2009) providing individual with sex education were seen to be dangerous, in fact this view is still held to this date. In relation to Simon's scenario, his teachers and headmasters attitude of reluctance to teach him about sex show that individual attitudes to sex education has not improve. Although the scenario does not describe the age of the two teachers, perhaps due to the ere these to teachers grew up in they still hold a conservative view towards sex education for individual with learning difficulties, perhaps time and polices have changed but lack of attitudinal change still remains.Another reason for the way these two professionals have taken the ignorance approach is perhaps to do with wanting to protect Simon from gaining sexual knowledge, perhaps they feared he might be abused or over sexed. Historically speaking people used to believe people with learning difficulties were over sexed and could not control their sexual drive (Mclimens and Combes, 2010) Ethical Implications of Mrs Hewitt's adviceWhen Simon approached Mrs Hewitt to have a sexual educational discussion: "she said I didn't need to know about condoms, about because I didn't need them, only other boys in the class would need them, and she said that I couldn't be gay either because it wasn't nice! " (Carson, 2002; P 207)".

In relation to this quote the assignment will explore ethical and legal implication of Mrs Hewitt's advice. Firstly a person with learning difficulties who has no or very little knowledge of sexual conduct and sexual behaviour can lack the capacity consent to sexual behaviour (Foundation for people with learning disabilities, 2001).Legally the Mental capacity act (2005) expects the service providers to provide individuals with range of accessible information so they can make an informed decision (Hollomotz, 2007). Since Simon had very little knowledge on sexuality and sexual health he did not have the capacity to make an informed decision as he did not know the full fact of what he was consenting to and the consequence of his action (Keywood, 2003).

Ethically speaking without the full knowledge of sex and its consequences Simon's sexual health and wellbeing could be placed in great danger (Harris and Tough 2004).Individuals with learning difficulties who do not have prior knowledge on sex may not be able to exercise resistance to the act, as they might not be aware of what they are embarking upon (Hollomotz, 2007). According to the Sexual Offence Act (2003) a sexual experience is unwanted if the person did not consent, however in order to consent the person would need full knowledge of the situation, this links into the mental capacity act (2005) (Home Office, 2003). However, could there be a possibility that Mrs Hewitt's denial to provide sex education to Simon was based on false stereotypical judgement?Heywood (2003) states there is an issue of over protecting people with learning difficulties which can limit their chances to form meaningful relationships (Heywood, 2003). Overprotecting vulnerable people is due to stereotypical view of individual, society views them to be uncompleted adults who are not self sufficient therefore need protection (Evans and Rodgers, 2000).

Perhaps this was the case with Simon, although Mrs Hewitt's advice and attitude towards Simon proved to be breaking the ethical code of conduct on service delivery.Local and governmental policies often link leaning difficulties with Vulnerability, therefore because these individuals are in danger of being mistreated and abused providing them with self defence skills such as knowledge of sexual activities, appropriate behaviour, sexually transmitted diseases and contraception is vital self defence tool (Hollomotz, 2007). Therefore the consequence of Simon's school being reluctant to teach him about sexuality proves to infringing health and social care code of conduct such as valuing people (2001).Mrs Hewitt advice holds ethical and legal implication, the Human rights act (1998) states that individuals with learning difficulties have the right to sexual life, and the valuing people (2001) paper states that support should be given to help individual to form meaningful relationships (HMSO, 1998; DoH, 2001).

By denying Simon the advice he sought Mrs Hewitt and the school are not respecting Simons Identity and dignity (Ward and Stewart, 2008). Mrs Hewitt has also clearly infringed the Disability discrimination act and equal opportunity policy by implying due to his disability he did not need to know about sex.In fact often it's not just people with learning difficulties whose human right to have safe sexual relationships are placed in jeopardy. A study in North America and Europe found that deaf individuals lacked access to health education, these individual were deprived of the knowledge of HIV, AIDS and other sexually transmitted diseases and consequences (Yousafzai et al, 2003).Simon states he did not acquire the knowledge of sexually transmitted during his school years, which makes one under could he have learnt about these consequences after he came in contact with it. nd perhaps the misfortunate things of all is if school took responsibility in teaching about these consequences then sexually transmitted diseases could have been avoided.

In fact 2007 family planning found that 63 percent of people with learning disabilities wanted to know more about sex (Hollomotz, 2007). What's astonishing is the fact that schools such as Simons take a very dim view of individuals with learning difficulties wellbeing.Mrs Hewitt explained to Simon he did not need to know about condom, to this Simon could have interpreted that having unprotected sex was ok for him, this false view could lead to serious of consequences. According to research since 1950s there has been a trend of young people being exposed to sexual activities under the age of 16, therefore they face high risk of coming to contact with HIV and other sexually transmitted infections and unplanned pregnancies, as wells physical and emotional implications (Tripp and Viner, 2005).The revised version of Working Together to Safeguard Children (HM Government, 2006) provides guidance on working with sexually active young people (HM Government, 2006).

Mrs Hewitt's attitudes towards Simons sexuality is also an issue, she seems to hold a negative view of homosexuality. Simon's sexuality is part of his identity, and when Mrs Hewitt made a negative connotation towards his sexuality this would have affected his self-esteem and self confidence (Falomir-Pichastor and Mugny, 2009). Young homosexual individuals often face prejudice and discrimination due to their sexuality.They are often bullied and mistreated which can affect their outcome of the life chances. According to Mail (2002) schools often fail to provide a safe space for lesbians, gays and transvestites' youth to socialise and to create social ties (Mail, 2002). Simons scenario reflect schools negative attitudes towards homosexuality, this was displayed by Mrs Hewitt.

In fact Mail (2002) cited an American study which showed that young homosexual individuals reportedly faced higher rate of bullying compared to heterosexual groups (Mail, 2002).In fact the Section 28 of the Local Government Act 1988 prohibits expenditure, except for the purpose of treating or preventing disease, for the promotion of homosexuality (HMSO 1998). In fact according to Ellis and High (2004) due to this law schools and teachers are reluctant to talk about same sex relationship, perhaps this explains schools reluctance to discuss homosexual issues. However section 28 of the local government law has been scrutinised, and as of 2006 policies were reinforced to minimise these types of discrimination within services (Fish, 2009).However, the Sex, Relationship and Education Policy (2008) expects the national curriculum key stage 4 to educate children on homosexuality, although it doesn't provide an indication on what level and how much education on same sex relationship should be given (Dep of Ed and skills, 2008) . Simons scenarios indicates clear lack of policies on dealing with sexuality and sexual health in relation to individuals with learning difficulties, therefore for the next part of this assignment it important to look at and recommend philosophical and policy change for the school.