Ask the expert about sex and relationships - starting on 14 February

[Brad_relationships]

Hi

My name is Brad English and I am a Clinical Psychologist that specialises in working with people with learning disabilities. My area of special interest is the romantic relationships and sexual expression of people with learning disabilities.

I have done research into how Clinical Psychologists can best support care staff to enable healthy relationships and sexual expression in those they support, and into people with learning disabilities’ views and experiences of intimate relationships. I also frequently engage in work around these issues in my clinical work.

Sex and relationships can be a very confusing, uncomfortable, and often nerve-wrecking topic for parents, families and friends (I have a sister with learning disabilities myself). However, everyone has the right to love and feel loved in this way (should they want to), and I therefore whole-heartedly feel it is important that we are having conversations about how we can support this, while still keeping people safe.

To celebrate Valentine’s day I am here to answer any questions you have about love, romance, sex, intimacy, lust (the list goes on!), and how they can be safely supported. Don’t be shy!

Many thanks
Brad

[SarahL]

Hello everyone

Brad is here from Thursday 14 February for one week to answer any questions you have about love, romance, sex, intimacy, lust and how they can be safely supported.

Please feel free to post your questions before then and Brad will get back to you after the 14th.

Many thanks
Sarah

[SarahL]

[frances_is_a_sibling]

Great topic @Brad_relationships! I’d be really interested in hearing real-life success stories around this. Do you have any case studies that you can share with us of when someone has been supported to have a relationship?

[Joe24]

Hello Brad

Sorry I am a bit early with this post.

My brother Jacob is 20 and has a LD. He is keen on finding a girlfriend and know there is a girl he likes (I am not sure what she thinks about him ). He is very open with me – a perk of being a big brother I guess.

However, it is my parents’ reaction to the thought of him having a partner that worries me most. They have always been protective and they find it hard to think of him having an independent life, including a girlfriend. They don’t accept that he needs a girlfriend at all as they are there for him all the time.

Have you any advice about how I could help him and how I can help my parents cope/accept this?

I feel a bit of responsibility to talk to him about any (potential) relationship. I don’t think he has had much sex education. I’d love my parents to step up with this too – but I think it is unlikely.

I’d also really love to hear what other siblings have done to help their brothers/sisters out with this sort of thing.

Thanks

[Brad_relationships]

Hi Joe24, great question and such a common issue.

I think the most important thing to acknowledge – which I have seen time and again in both my research and my clinical work – is that attempts to try and reduce risk by trying to distract or deter someone from finding/starting a romantic and/or sexual relationship when they want one generally tends to put the person at a greater level of risk. This is particularly the case when someone has not received adequate sex and relationships education (which sadly is so often the case for people with learning disabilities). The heart wants what it wants! And barriers to finding love and having relationships can lead people with learning disabilities to act in secret, often engaging in behaviours and acts that they have not been sufficiently supported to understand, and in places where they believe they will not be seen or ‘caught’, inevitably making them more vulnerable and actually increasing risk.

The alternative of course is that a person resigns themselves to the idea they will never be able (or ‘allowed’) to love or feel love in that way, which is equally as sad and poses different risks in terms of the mental health difficulties that such levels of loneliness and longing might well be associated with.

So, it may be worthwhile sharing this different perspective with your parents. However, also really important to remember that your parents have dedicated their life to keeping your brother safe, so letting their guard down on that is probably a terrifying prospect!

It sounds like you are someone for your brother to turn to about these matters, so perhaps have some discussions about what exactly he is looking for and what he does understand in terms of sex and relationships. If you do feel there is a gap in his knowledge there, but he is expecting to embark on a relationship, you might consider seeking further education on this front for him through a community learning disability nurse (this can generally be requested through GPs), but also my friends at Mencap have put together some wonderful resource lists and information around sex and relationships that is being launched this week. I call on you Jenny, Ellen, and Richard!.. where can this be found?

And I agree – let’s hear from other siblings about how you are dealing with this situation, as I know Joe24 is not alone in this!

[Brad_relationships]

Thanks francis_is_a_sibling! I have been involved in a number of success stories on this front. The crucial parts of most of these have been firstly helping care staff and families to understand that people with learning disabilities have a right and generally a desire to have intimate relationships, and secondly to ensure people have the opportunities to meet people and to spend time with one another.

A lot of my work on this matter as a Psychologist is to work not only with the individual with learning disabilities to help ensure they have the best understanding of sex and relationships that can be expected of them (given their level of ability), but also to ensure the system around them understands that having a safe and healthy intimate relationship can provide so many benefits for people, in terms of mental health, feelings of self-worth and quality of life. Also, and perhaps most importantly, I often need to help people acknowledge that an intimate relationship does not necessarily mean a sexual relationship. It is all to easy to think one is protecting a person with a learning disability from potential pregnancy or STIs, when all they wanted was to kiss, cuddle, hold hands with, or even just sit next to the person they have a connection with. Jumping to conclusions can so easily deny someone the chance at a happy and fulfilling romance!

In terms of opportunities for meeting people and spending time together, I often try and signpost individuals I work with and those caring for them to different social events. My personal favourite is one I volunteer at in Mansfield called ‘TenFifty’ – a nightclub night for people with learning disabilities. With on average 150 people attending, dance-floor filling music, the bar open to business, and generally a really wonderful atmosphere, numerous people have found love at this event, and either see each other at the event each month, or make plans outside of it.

The ‘supported loving’ network provides information on events like this and more going on across the country, and I am proud to be a part of it. Check out the website for more information: https://www.choicesupport.org.uk/about-us/how-we-support-you/supported-loving Perhaps one my favourite success stories is also well documented by supported loving. Have a look at this youtube clip of a piece channel 4 did on our meetings… I’m sure you will find it truly inspirational! https://www.youtube.com/watch?v=8eIKYKWU-VE

[tech-friend]

Hi @Brad_relationships this is such a difficult subject, I am a brother to an older sister and can relate to the stories being written here.

My Sister text’s boys and wants a relationship but my parents do not, it is a much more complicated story with her friends pushing and encouraging along with history of the boys in question getting pregnant other girls etc.

While I try and be a bridge between my sister and parents on some of these matters, I can understand the concerns and issues my parents have with the non support, lack of understanding the unique situation with my sister and the lack of understanding/constituency after numerous chats about what has happened with them and others in the area.

Happy to have more information and learn on how to improve…

[Angeli]

Hi Brad, my son is 14 and in full blown teenage mode with hormones exploding. He is seeking out pictures of women to take to his room to have ‘private time’ and getting increasing frustrated as we don’t have any and has been searching for images on the internet - which we have now stopped. But how do I support him best? I want him to have access to suitable materials- his older siblings are simple able to access what they want, but because he has an LD he’s being prevented. But I am a bit stuck. Thanks!

[Brad_relationships]

Hi tech_friend,

As for ‘learning how to improve’, I think you are doing a great job already… you are acknowledging that your sister wants a relationship, and you are seeking out ways to support that – don’t underestimate what a great brother you are being just for getting that far!

The idea that your sister wants a relationship is really illustrative of the fact that research suggests just about the same percentage of the learning disability population want a relationship as do the general population. Your comment about texting boys however, raises a separate point. The level of desire for a relationship does not differ greatly between the learning disability population and general population. But what does differ greatly is the amount of opportunity people with learning disabilities get to meet people that could potentially become a suitable partner.

As with the population more generally, I think we need to try to move away from the getting to know people via social media and messaging here. The use of technology in this way makes it all the more easy for impressionable people to be deceived and also puts the older generation (such as parents) on edge as it is often quite an unknown world for them, and therefore feels quite dangerous.

If at all possible, traditional dates might be the way to go. The dating scene is complicated whoever you are, but thankfully there are numerous dating and friendship projects for people with learning disabilities popping up across the country. This can provide the opportunity for people like your sister to find people that are better matches for her and to explore potential relationships while being supported to do so, and in a way that your parents might feel more comfortable with. The only thing is not all areas have projects like this (but see love4life (Hampshire) https://www.fitzroy.org/love4life/ and happily (London) https://www.happilydating.co.uk for excellent examples). If your area is not covered, it might be down to you to provide some of that support, or at least to discuss with your sister how exciting and romantic traditional dates can be if done in a safe way.

All too often people with learning disabilities are only told about what they should not be doing and what to avoid because it’s dangerous, and not taught about what good romantic experiences and relationships are like! Therefore they may not be aware that something they are getting into is a bad or one-sided relationship – they have no frame of reference to call upon.

[Brad_relationships]

Hi Angeli,

I definitely hear you on this one… such a confusing area!

Firstly, I would say, it is not necessarily the use of pictures of women in this situation that is problematic, but the type of pictures. As so many 14-year-old boys do, it sounds like your son is seeking out pornographic material, right? I am going to presume so and talk about that – please feel free to correct me if I am off the mark.

For people with learning disabilities, pornographic material not only serves as an aid to sexual arousal or stimulation, but also has educational implications, particularly since sex education for people with learning disabilities has historically been minimal and insufficient to develop a sound understanding. Therefore, it is important to ensure the nature of the material carries as respectful of a tone as possible, e.g. not depicting people being mistreated or disrespected.

Generally, providing access to magazines offers a little more control over this factor, as an individual can be supported to purchase an appropriate magazine for their private use. The danger with supporting the use of internet pornography is that someone can continue to search for more and more material, and can easily become exposed to pornography that is aggressive, inappropriate, or even illegal, very easily. So, I think you have made a good call on that front.

Regardless, it can be argued that all pornography is degrading of the people it depicts. But there is legal pornography that exists in the public domain and therefore people with a learning disability, like everyone else, have the right to view it if they wish to do so… and more often than not, a 14-year-old will be looking to explore it. People with learning with disabilities will sometimes however need help in understanding why something is demeaning, and also that the way people act in these magazines and films is not generally how people act in real life. This is the crucial part of how we support people on this issue.

It is worth considering whether your son’s older siblings would be willing to support him in going to purchase a magazine, maybe at a news agent or a sex shop, with all that I have mentioned above in mind. Though uncomfortable, frank conversations with your son from either you or his siblings about how realistic the things depicted in the magazine are, and why it is essential that there is mutual respect within any sexual act, would be really important, as we know that is not always portrayed in such magazines.

As mentioned in one of my posts above, completely denying someone something they are very keen on exploring like this runs the risk of forcing them to do it covertly, with little prior knowledge and understanding, and nobody there to provide clarification. Doing what we think is protecting someone can therefore make them more vulnerable in the long run, so it is worth having that in mind.

I have to say though Angeli, what a great topic to bring up! You are saying what a lot of people are thinking (and worrying about). So, thank you for putting yourself out there!

[emma.walker]

Hello Brad

My daughter is dating someone she met through a day service and I am very fond of him. I have always been supportive of their relationship because it makes her happy, but it has had its challenges. It has been fairly innocent, they mainly see each other at the day service. I know she wants more than that though.

I feel that her partner needs more support than she does and I am unsure whether he has capacity to consent to consent to a sexual relationship. I don’t know how to explain this to her. I don’t know how to bring this up with his family and the day service either.

Thanks

[Brad_relationships]

Hi Emma,

I bet you have completely mixed feelings on this one… fantastic that your daughter found someone she likes and that makes her happy, but as the relationship progresses it becomes more of a worry for you as a parent.

I guess the place to start is to establish how much ‘more’ your daughter wants. I did some research on the views and experiences of intimate relationships in people with learning disabilities (https://link.springer.com/article/10.1007/s11195-017-9502-z) and found that though most people wanted intimate relationships, not all wanted to develop fully sexual relationships. So, finding out for sure how far your daughter wishes to go will be important. Most people feel squeamish asking someone about their sexual needs and desires, particularly when it is a family member, and even more so here in Britain! But, it is a totally natural thing to talk about, and in fact a very healthy thing to talk about if you feel it is something that may cause confusion for your daughter in her relationship. It is easy to overlook the fact that in not talking openly about sex we make those who have not yet been supported to understand many of the issues involved (such as consent, pleasure, respect) more vulnerable than they need to be. Then when they have sexual urges and feelings (as most of us do!) it is inevitably a struggle for some to know how to act and what is ok.

The next thing you will be needed to consider is whether your daughter’s partner wants a sexual relationship or not. Issues of capacity would not need considering if he states he does not want one, as this must be respected. Ideally, this would be something your daughter could ask her partner, but again, this would only be relevant if it had been established that she is looking to take the relationship to that next level. It would be interesting to find out whether the day centre has provided any training or courses around sex and relationships for those that attend, particularly as I assume they are accepting of people developing romantic relationships. If they have not done anything along these lines, or it has not been done for a while, it would be perfectly reasonable for you to request that they do. This may be helpful in starting the conversation between your daughter and her partner, and maybe even you and the parents.

If the partner stated that he does want to have sex, then you may need to consider whether he has the capacity to make the decision, particularly if you feel he has more difficulty understanding things than your daughter. Contrary to popular belief, the bar is not set terribly high in terms of the essential information one must understand in order to meet the criteria to have the capacity to consent to sex. You have to know the basic mechanics of the act, that there are health risks such as STDs, that penile-vaginal sexual intercourse can result in pregnancy, and that both parties must consent to the act – each having the right to say no. Furthermore, just because someone does not know this information at one point in time, it does not mean that it cannot be learnt and retained. Therefore, a person can develop the capacity to consent to sex, given appropriate education/discussion/training.

I suppose this all only becomes an issue when the relationship starts moving in that direction, for example, when your daughter and her partner start to request to spend time in privacy alone together, or to sleep over at one another’s house. The only reason this should ever be prevented is if one or both the individuals lack the capacity to consent to sex, and you believe they will have sex in these situations and that there is an identifiable risk in this. But, people must always be presumed to have capacity unless it is established otherwise. Therefore, should things move in that direction and you or the other parents did have concerns about the partner’s understanding, then you would need to seek an assessment of the partners capacity by a professional (such as a nurse, GP, clinical psychologist, psychiatrist).

A final point, that is not necessarily aimed at your situation Emma, but would be a good one to raise for the wider audience, would be that when people want to be intimate or have sexual needs and are restricted from the opportunity of an outlet for these it can force them to seek out opportunities covertly. One of the most common things I come across in my research into the sexual expression of people with learning disabilities is what I call the ‘lack of privacy leads to a need for secrecy’ effect – denied the opportunity to be alone with themselves or another person, people with learning disabilities all too often have to resort to getting physically intimate with others or themselves in a place or time where those that care for them will not know about it (public toilets and parks are common ones!). Paired with insufficient understanding of what they are doing (owing to inadequate sex education) and a reduced appreciation of risk, this can leave people with learning disabilities unnecessarily vulnerable.

Thank you for your question Emma, I feel like it raised a number of important issues, and I wish your daughter and her partner every happiness!

[BettyBoo]

Hi. What advice do you have for parents who have a child with more complex needs? My daughter is 13 and needs a lot of physical and personal support, most of which is carried out by me. I do want her to understand what changes are happening to her body but feel at a loss of how to do this?

[frances_is_a_sibling]

Hi @Joe24 thanks so much for sharing this. I’m a sibling myself and several of my sibling friends have had similar experiences to you. You are not alone - siblings and parents often see things differently as their brother/Son with learning disabilities grows up. I completely echo what @Brad_relationships has said. Sibs (the UK charity for brothers and sisters of disabled children and adults) has some great advice for communicating with parents. Get in touch with them here https://www.sibs.org.uk/contact/

[frances_is_a_sibling]

Hi @Brad_relationships thanks so much for your response. It’s great to hear that you have been involved with so many success stories, and yes, I can imagine that one of the key parts of this is helping care staff and families to understand that people with learning disabilities want to have relationships and have a right to do so. It’s really helpful to point out that a person may just want to kiss, cuddle, sit next to someone and that a relationship doesn’t necessarily mean a sexual relationship. The video link you shared made me smile - some beautiful stories. The Supported Loving network are doing some great work in this area, what a useful resource - thanks. I will share this with other siblings I meet. Thanks for running this topic on the family hub, it’s a really important discussion.

[frances_is_a_sibling]

@Brad_relationships That’s a really good point about giving people a point of reference to know what a healthy and positive relationship looks like

[frances_is_a_sibling]

Hi @tech-friend you are right, this is a really difficult subject, and it’s really common for siblings and parents to have different points of view. It sounds like you are doing everything you can to support your sister and to empathise with your parents. You can always get in touch with Sibs (https://www.sibs.org.uk/contact/) for 1:1 advice on communicating with parents - you’re not alone, and this is something many siblings experience.

[SarahL]

[Jenny_Mencap]

H Brad and Joe. Brilliant post. Getting the right advice and information is so important, but it can be hard to know where to begin. We have put together a list of recommended relationships and sex education resources for people with a learning disability, their families and supporters. You can find it here https://www.mencap.org.uk/advice-and-support/relationships-and-sex/sexuality-and-relationships-faqs Hope that helps.