Sex education for people with intellectual disability has been characterised by neglect. This was evidenced at the time of the HIV/AIDS epidemic, when people with intellectual disability found themselves in a vulnerable position because they possessed no education about protection from this disease.
The incentive to counteract this epidemic saw the onset of sex education work among people with intellectual disability, including HIV prevention work in places such as the UK, Australia, Canada and the US.
The pioneering work of educators in the field focused on taking issues to do with sexuality closer to people with intellectual disability. However, today there is still only a limited amount of direct sex education on offer as this is often not part of the holistic education provided to people with intellectual disability.
Lack of knowledge in a number of key areas, including pregnancy, masturbation, contraception, sexually transmitted infections, types of sexual relationships, as well as the legal aspects of sex is typical of people with intellectual disability.
The reasons for such low levels of sexual knowledge are numerous. Among them are less informal sex education, such as from parents, friends and media sources and ultimately fewer sexual experiences and relationships when compared to non-disabled people. Consequently, people with intellectual disability often have fewer opportunities to observe, develop and practice appropriate social and sexual behaviour.
The influence of Catholic doctrine on both social policy and curricular aspects of sexuality has been notable throughout Maltese history
Apart from receiving only limited information about sexuality, sex education is often marred by issues of morality and the content is often at the discretion of educators and parents. Information provided is frequently revised in accordance with what the latter deem the recipient could understand and use.
As a result, the model of education that people with intellectual disability are often exposed to is factual and biological, but also rules based. Notwithstanding that the WHO’s definition of sexual health includes “the possibility of having pleasurable and safe sexual experiences”, protection and prevention are often the focus of sex education for people with intellectual disability. This approach is known to leave them with more questions than answers and lacunas of information.
Moreover, a predominantly reactive teaching approach to sex education, rather than a proactive one, is often adopted as a result of a real or perceived problem related to sexual behaviour or reproduction. The rationalisation for this varies from stereotypical beliefs of asexuality to overprotection and cultural taboos regarding sexuality.
Sex education in Malta
Tom Shakespeare, who visited Malta in 2017, asserts that barriers to the sexual expression of disabled people are primarily linked with the society in which they live in and “not the bodies with which they are endowed”.
Socio-cultural beliefs surrounding sexuality and disability have a strong and direct influence on the sexuality of people with intellectual disability and their opportunity to receive sex education.
Consequently, cultural scripts associated with restrictive religious views regarding sexuality have further impacted the lives of people with intellectual disability.
Malta is heavily influenced by Catholicism and associated family values that exert a powerful influence on our culture. In the Maltese context, a common representation of people with intellectual disability is an image of innocence embodying the phenomena of the eternal child. The state of innocence is assumed to be a result of an undeveloped intellect accompanied by a sheltered life with no exposure to sexual experiences.
The angelic image of people with intellectual disability contrasts strongly with yet another early Christian belief that stereotypically portrayed people with intellectual disability as possessed by the devil, therefore rendering them dangerous and unable to control themselves.
These two portraits contributed to the fact that people with intellectual disability, in this context, were hidden from society from early childhood, either to be protected from society itself or to save the family from embarrassment.
The influence of Catholic doctrine on both social policy and curricular aspects of sexuality has been notable throughout Maltese history.
Currently, research carried out locally claims that the majority of parents of people with intellectual disability resist the idea that their sons and daughters have a sexual identity and that they could have intimate relationships. Some parents are also reported to lack sex education themselves, apart from disapproving of it, because they find it difficult to accept that their children are exposed to and are interested in these matters.
In this context, discourse on sexuality and disability has only recently been brought to national attention. As a result, in the past years, local service providers, NGOs and DPOs have been proactive in their approach to sexuality and have sought training in sex education. This was eventually reflected in the availability of sex education for people with intellectual disability and their parents, while others used alternative forms of sexual expression through mediums such as the arts, such as Lou Ghirlando and Diana Cauchi’s Sex-Able project and more recent video productions by Opening Doors.
While proactivity, rather than the outdated reactive model, is encouraged, sex education should be approached by striving to find the necessary balance between empowerment through knowledge and sexual autonomy based on the right to sexual expression.
Claire Azzopardi Lane is deputy dean of the Faculty for Social Wellbeing and heads the Department of Disability Studies and the Department of Gender and Sexualities. Specialising in the field of disability and sexuality, Azzopardi Lane has worked in various sectors, including education and social care. Her doctoral research concerned elements of sexuality in people with intellectual disability in a Maltese context. She is also a board member of the Women’s Rights Foundation.