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de Wit W, Roeg D, Embregts PJCM. Using Concept Mapping to Explore the Perspectives of People with Mild to Borderline Intellectual DisabilitiesToward Sexual Health. SEXUALITY AND DISABILITY 2023; 41:1-15. [PMID: 37362799 PMCID: PMC10169136 DOI: 10.1007/s11195-023-09796-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2023] [Indexed: 06/28/2023]
Abstract
People with mild to borderline intellectual disabilities face many barriers toward their sexual health. To promote sexual health and overcome these barriers, they need individualized forms of sexuality support and education. To align sexuality support and education insight is needed on their understanding of sexual health. The current paper aims to provide greater insight in what sexual health consists of according to people with mild to borderline intellectual disabilities. Nine people with a mild to borderline intellectual disability participated in a concept mapping procedure, consisting of brainstorming, sorting, and ranking the statements. The resulting clusters and concept map were interpreted by an expert group. Analysis resulted in five clusters which participants considered important for their sexual health. According to people with mild to borderline intellectual disability cluster pertaining to romantic relationships and sexual socialization were the most important. These were followed by clusters on sexual health and lastly sexual selfhood. These results have implications for the development of sexuality support and education, as well as further research. Supplementary Information The online version contains supplementary material available at 10.1007/s11195-023-09796-w.
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Affiliation(s)
- Wouter de Wit
- Tilburg School of Social and Behavioral Sciences, Tilburg University, Postbus 90153, 5000 LE Tilburg, The Netherlands
- Zuidwester, Middelharnis, The Netherlands
| | - Diana Roeg
- Tilburg School of Social and Behavioral Sciences, Tilburg University, Postbus 90153, 5000 LE Tilburg, The Netherlands
- Kwintes Supported Housing, Zeist, The Netherlands
| | - Petri J. C. M. Embregts
- Tilburg School of Social and Behavioral Sciences, Tilburg University, Postbus 90153, 5000 LE Tilburg, The Netherlands
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Ćwirynkało K, Byra S, Fronek P. The lived experience of fathers with intellectual disabilities: An interpretative phenomenological analysis. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 131:104345. [PMID: 36174375 DOI: 10.1016/j.ridd.2022.104345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 08/07/2022] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
Fathers with mild to moderate intellectual disabilities (ID) are under-represented in research. This article explores the lived childhood experiences of fathers with ID using interpretive phenomenology to understand the meanings ascribed to these experiences and how this has shaped their understanding of self. Rich data was collected through in-depth interviewing of fathers in Poland. The analysis yielded thirteen constituent themes and four superordinate themes: traumatic experiences; resilience; the positive impact of significant others; and becoming a better parent. Many fathers focused on traumatic experiences associated with problematic parental practices (abuse, neglect, parental substance misuse) and discrimination in schools. Participants made meaning of adverse experiences especially resilience, strengths and a determination to be a better parent, which helped them cope with adverse situations. This study provides insights into the impact of lived childhood experiences of these fathers, which in many ways shapes their own parental practices.
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Affiliation(s)
- Katarzyna Ćwirynkało
- Depertment of Special Education and Social Rehabilitation, University of Warmia and Mazury in Olsztyn, Żołnierska 14, 10-561 Olsztyn, Poland.
| | - Stanisława Byra
- Department of Methodology of Pedagogical Sciences, Maria Curie-Skłodowska University, Głęboka 43, 20-612 Lublin, Poland.
| | - Patricia Fronek
- School of Health Sciences and Social Work, Griffith University, Gold Coast Campus, Parklands Drive, Building GO1, Queensland 4222, Australia; Law Futures Research Centre, Griffith University.
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A Pictorial Sexual Knowledge Scale for Male High School Students with Intellectual Disabilities in Taiwan. SEXUALITY AND DISABILITY 2022. [DOI: 10.1007/s11195-022-09750-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sexuality, Education and Support for People with Intellectual Disabilities: A Systematic Review of the Attitudes of Support Staff and Relatives. SEXUALITY AND DISABILITY 2022. [DOI: 10.1007/s11195-021-09724-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AbstractSupport staff and relatives are uncertain about multiple aspects of the sexuality of people with intellectual disabilities. Given that their attitudes embody positive and negative views, they can respectively support and restrict free sexual expression among people with intellectual disabilities and their potential for (intimate) relationships. A qualitative systematic literature review was conducted on the attitudes of support staff and relatives toward the sexuality of people with intellectual disabilities. A systematic search strategy was deployed across seven databases. The identified articles were screened on predetermined inclusion and exclusion criteria, and assessed on quality, which resulted in 31 included studies. A metasynthesis of these studies resulted in two major themes emerging, namely (a) attitudes toward the sexuality of people with intellectual disabilities, and (b) attitudes toward the sex education and support. Themes represented both positive and restrictive attitudes among support staff and relatives. The findings suggest that despite a general acceptance of the sexual rights of people with intellectual disabilities, certain forms of sexuality were approached more cautiously. Moreover, the sexual needs of some subgroups of people with intellectual disabilities received scarce attention. Those support staff and relatives holding rather restrictive attitudes appear to emphasize sexual risks. Finally, support staff and relatives stressed the importance of providing sex education and support for people with intellectual disabilities, while, simultaneously, expressing insecurity over the subject. The findings can help to improve the support provided to support staff and relatives to promote sexual health among people with intellectual disabilities.
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Sandberg LJ, Rosqvist HB, Grigorovich A. Regulating, fostering and preserving: the production of sexual normates through cognitive ableism and cognitive othering. CULTURE, HEALTH & SEXUALITY 2021; 23:1421-1434. [PMID: 32772835 DOI: 10.1080/13691058.2020.1787519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 06/22/2020] [Indexed: 06/11/2023]
Abstract
People with cognitive disabilities are commonly positioned as risky sexual subjects. This article discusses the discursive production of sexual normates in the form of desirable and normative able-minded sexual subjects, in scientific research on the sexuality and cognitive disabilities of younger and older individuals (in particular those with dementia). We identify three interrelated discourses: regulating sexuality; fostering sexuality; and preserving sexuality. The first of these, regulation, pathologises sexuality of people with cognitive disabilities as faulty and in need of restriction. The second discourse, fostering, is more affirmative and argues for educating for a 'healthy' sexuality of people with cognitive disabilities, to mitigate risks of abuse. This discourse is more salient with younger people. The third discourse, preservation, in contrast, is more visible with older people with dementia and affirms sexuality so long as it is consistent with a 'genuine' or 'authentic' sexuality of the past. In conclusion, scientific research reinforces the cultural ideal of the rational and autonomous individual (and as such the mature/adult) capable of making independent decisions and engaging in healthy, good sex, based on stable sexual identities. Findings demonstrate how age intersects with cognitive ableism to intensify the cultural anxiety that exists around the sexualities of people with cognitive disabilities.
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Affiliation(s)
- Linn J Sandberg
- School of Culture and Education, Södertörn University, Huddinge, Sweden
| | | | - Alisa Grigorovich
- The Kite Research Institute-UHN, University of Toronto, Toronto, Canada
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Gil-Llario MD, Flores-Buils R, Elipe-Miravet M, Fernández-García O, Ballester-Arnal R. Development and psychometric properties of a self-report instrument for the assessment of sexual behaviour and concerns of people with mild intellectual disabilities (SEBECOMID-S). JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 35:134-142. [PMID: 34312946 DOI: 10.1111/jar.12924] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 05/24/2021] [Accepted: 06/13/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND This paper presents a description of the development and psychometric properties of a self-report instrument for the assessment of sexual behaviour and concerns of people with mild intellectual disabilities (SEBECOMID-S). METHODS AND PROCEDURES The study included 281 people with mild intellectual disabilities. The psychometric properties were examined through exploratory factorial analysis, descriptive statistics, and reliability indices. RESULTS The exploratory factor analyses offered a structure with three factors: concern about the appropriateness of their sexual behaviour, sexual practices performed, and safe sex practices. The model presents an excellent fit (χ2 /df = 1.10, RMSEA = 0.019, CFI = 0.997, TLI = 0.995, and SRMR = 0.065). General test reliability was good (α = 0.77, Ω = 0.76). CONCLUSIONS SEBECOMID-S is a valid and reliable tool to obtain objective information about the sexual behaviour and concerns of people with mild intellectual disabilities. The use of this instrument will make it possible to adjust their training to their real experiences, making it more effective.
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Affiliation(s)
| | - Raquel Flores-Buils
- Department of Developmental, Educational and Social Psychology and Methodology, Universitat Jaume I. Castellón, Castello de la Plana, Spain
| | - Marcel Elipe-Miravet
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I. Castellón, Castello de la Plana, Spain
| | - Olga Fernández-García
- Department of Developmental and Educational Psychology, University of Valencia, Valencia, Spain
| | - Rafael Ballester-Arnal
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I. Castellón, Castello de la Plana, Spain
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Deffew A, Coughlan B, Burke T, Rogers E. Staff member's views and attitudes to supporting people with an Intellectual Disability: A multi-method investigation of intimate relationships and sexuality. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 35:1049-1058. [PMID: 34009719 DOI: 10.1111/jar.12897] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/08/2021] [Accepted: 04/23/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Staff member's views and attitudes can have a significant impact on people with an intellectual disability. This study explores staff attitudes and experiences of people with an intellectual disability's expression of relationships and sexuality across service providers in Ireland. METHODS Staff (n = 86) from service providers (n = 5) completed the Attitudes to Sexuality Questionnaire-Individuals with an Intellectual Disability (ASQ-ID) and open-ended questions. RESULTS Multidirectional significant differences were noted on staff attitudes to sexuality based on demographic factors, that is, age, education, as well as non-demographics, for example, attendance at training, and active practising of religion. Qualitatively, three themes emerged: "Unsupported and Frustration"; "Taboo Subject Matter" and "Vulnerability and Access to Education". Staff reported a lack of service supports, dominant conservative cultures and people with an intellectual disability's vulnerability. CONCLUSION This study highlights the need for improved service practices and enhanced provisions for staff and the people with an intellectual disability that they support.
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Affiliation(s)
- Andrew Deffew
- Department of Psychology, University of Limerick, Limerick, Ireland
| | - Barry Coughlan
- Department of Psychology, University of Limerick, Limerick, Ireland.,Brothers of Charity Services, Limerick, Ireland
| | - Tom Burke
- Department of Psychology, University College Dublin, Dublin, Ireland
| | - Elaine Rogers
- Department of Psychology, University of Limerick, Limerick, Ireland
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Oloidi EO, Northway R, Prince J. 'People with intellectual disabilities living in the communities is bad enough let alone…having sex': Exploring societal influence on social care workers' attitudes, beliefs and behaviours towards support for personal and sexual relationship needs. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 35:1037-1048. [PMID: 33314466 DOI: 10.1111/jar.12839] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 11/02/2020] [Accepted: 11/10/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND Services have a duty to uphold the personal and sexual relationship (P&SR) rights of adults with intellectual disability. However, little is known about how social care workers' (SCWs) perceptions of public views of intellectual disability and sexuality might affect their attitudes, believes and behaviours towards supporting P&SR needs. This exploratory study addresses this gap in knowledge. MATERIALS AND METHODS Qualitative interviews using critical incident technique were conducted with 18 SCWs. Data were transcribed and thematically analysed. RESULTS Four dominant themes were identified; socio-cultural, practice-policy gaps, fear and safety needs. These highlights how perceptions of public attitudes impact on SCWs' attitudes towards supporting development of P&SR both directly and through perceptions of organisational policies. This leads to prioritisation of safety needs over support for P&SR. CONCLUSIONS Public expectations strongly influenced SCWs' interpretation of organisational policy, emphasising a need for practice-based support to manage public expectations and reduce fear.
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Affiliation(s)
- Edward Olayinka Oloidi
- School of Care Sciences, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
| | - Ruth Northway
- School of Care Sciences, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
| | - Jane Prince
- School of Psychology and a Therapeutic Studies, University of South Wales, Pontypridd, UK
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Parental Support for Sexuality Education and Expression Among Adults with an Intellectual Disability. SEXUALITY AND DISABILITY 2020. [DOI: 10.1007/s11195-020-09659-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Oakes LR, Thorpe S. The Sexual Health Needs and Perspectives of College Students with Intellectual and/or Developmental Disabilities and Their Support Staff: A Brief Report. SEXUALITY AND DISABILITY 2019. [DOI: 10.1007/s11195-019-09602-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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English B, Tickle A, das Nair R, Moore K. Consensus-based good practice guidelines for clinical psychologists to support care staff in enabling sexual expression in people with intellectual disabilities-A Delphi study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2019; 33:268-282. [PMID: 31578807 DOI: 10.1111/jar.12671] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 07/16/2019] [Accepted: 08/28/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Care staff supporting people with intellectual disabilities (PWID) report accepting views on PWID's sexual expression, but people with intellectual disabilities report their sexual expression is restricted by care staff. METHODS We recruited a panel of 17 UK clinical psychologists experienced in helping care staff support PWID's sexual expression. We used the Delphi Method to develop consensus-based practice guidelines for UK clinical psychologists supporting care staff in this way. RESULTS Having proposed three guidelines each in Round One, panel members reached consensus (≥90% agreement) that 12 were important, falling under four themes: "Addressing staff attitudes," "Addressing uncertainty about rights and responsibilities of people with intellectual disabilities," "Locating the problem, being part of the solution," and "Supporting care staff to understand and reflect upon their role." CONCLUSIONS Clinical psychologists help care staff support PWID's sexual expression by normalizing care staff concerns, encouraging reflection, clarifying PWID's rights, and prompting those at managerial and service level to support care staff.
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Affiliation(s)
- Brad English
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - Anna Tickle
- Trent Doctorate in Clinical Psychology, University of Nottingham, Nottingham, UK
| | - Roshan das Nair
- Trent Doctorate in Clinical Psychology, University of Nottingham, Nottingham, UK
| | - Kate Moore
- Nottingham University Hospitals NHS Trust, Nottingham, UK
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Pariseau-Legault P, Holmes D. [Sexual health and intellectual disability: a narrative literature review and its implications for nursing practice.]. Rech Soins Infirm 2017; 130:12-30. [PMID: 29192460 DOI: 10.3917/rsi.130.0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Issues associated with affectivity and sexuality in the context of intellectual disability have recently been the subject of various interdisciplinary discussions in academia. In nursing, interventions in sexual health are supported with hesitation and those issues constitute a marginal field of nursing research. A narrative literature review was realized in order to establish a portrait of the knowledge produced on this topic in the last decade. This paper illustrates three specific research areas recently developed, namely issues related to sexual autonomy, contextual factors positively or negatively contributing to emotional and sexual life, and the experiences of people identified as having an intellectual disability in this regard. On the basis of these results, different issues related to sexuality and intellectual disability are discussed, including those associated with the negotiation process of affective and sexual life, parenthood as a mediator of emotional and sexual expression, and the inclusiveness issues of sexual diversity in health interventions. Implications for nursing are finally discussed in light of the recent development of its role in sexual health.
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Kramers-Olen A. Sexuality, intellectual disability, and human rights legislation. SOUTH AFRICAN JOURNAL OF PSYCHOLOGY 2016. [DOI: 10.1177/0081246316678154] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Sexuality constitutes a central feature of what it is to be human, yet health practitioners, families, and caregivers frequently perceive romantic and sexually intimate relationships among persons with intellectual disabilities to be inappropriate tending to regard such individuals as either ‘asexual’ or ‘hyper-sexed’. A number of myths, stereotypes, and prejudices intersect in a manner that has deleterious consequences for persons with intellectual disabilities. This article reviews the literature on sexuality and barriers to sexual expression among persons with intellectual disabilities. Relevant legislative frameworks and human rights issues, in particular, the tensions between protecting persons with intellectual disabilities from exploitation, and the promotion of sexual autonomy also receive consideration. In addition, the article explores issues relating to competency to consent to sexual acts and concludes with a synthesis of the current knowledge.
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Affiliation(s)
- Anne Kramers-Olen
- Department of Behavioural Medicine, University of KwaZulu-Natal, South Africa
- Fort Napier Hospital, South Africa
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Saxe A, Flanagan T. Unprepared: An Appeal for Sex Education Training for Support Workers of Adults with Developmental Disabilities. SEXUALITY AND DISABILITY 2016. [DOI: 10.1007/s11195-016-9449-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Rushbrooke E, Murray CD, Townsend S. What difficulties are experienced by caregivers in relation to the sexuality of people with intellectual disabilities? A qualitative meta-synthesis. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:871-886. [PMID: 24508295 DOI: 10.1016/j.ridd.2014.01.012] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 01/09/2014] [Accepted: 01/09/2014] [Indexed: 06/03/2023]
Abstract
The aim of the meta-synthesis was to determine any difficulties experienced by caregivers relating to the sexuality of people with intellectual disabilities and how they address those difficulties. A qualitative meta-synthesis was used to integrate the findings from 17 papers about these topics. The synthesis produced five concepts: 'Fear and Uncertainty', 'Impact of Perceptions of Sexuality', 'The Same and Different', 'Balancing the Roles of Protector and Facilitator' and 'Conditional Sexuality: Conditional Support'. The findings suggest key issues for caregivers in relation to addressing the sexual needs of people with intellectual disabilities and highlight the possible implications of caregivers own views on their practice. These issues are discussed and in conclusion the review offers explanations about what the difficulties for caregivers are and how they might be addressed, as well as recommendations for future research.
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Affiliation(s)
| | - Craig D Murray
- School of Health and Medicine, Lancaster University, Lancaster, United Kingdom.
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Factors That Impact Support Workers’ Perceptions of the Sexuality of Adults with Developmental Disabilities: A Quantitative Analysis. SEXUALITY AND DISABILITY 2013. [DOI: 10.1007/s11195-013-9314-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Wilson NJ, Parmenter TR, Stancliffe RJ, Shuttleworth RP. From diminished men to conditionally masculine: sexuality and Australian men and adolescent boys with intellectual disability. CULTURE, HEALTH & SEXUALITY 2013; 15:738-751. [PMID: 23656632 DOI: 10.1080/13691058.2013.780262] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Men and boys with intellectual disability represent a unique group who have hitherto been overlooked by researchers and theorists exploring men and masculinities. Qualitative data from an Australian ethnographic study focused on the sexual health needs of men and adolescent boys with moderate to profound intellectual disability. Findings suggest that masculinity for this group of men is more a biopsychosocial phenomenon than a social construct organised around heteronormative ideals. The conditional masculinity of the men participating in the study was based instead on a number of intrinsic and external factors, which are described in detail.
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Affiliation(s)
- Nathan J Wilson
- Faculty of Health Sciences Centre for Disability Research and Policy, The University of Sydney, Sydney, Australia.
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