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All young people need sex education that prepares them the pleasures, pitfalls and realities of life, and those with SEN are no different, says Lynne Moxon

The process of building social relationships by making friends and beginning intimate relationships is a key developmental stage for all young adults. Education around sexual issues begins before puberty, and the onset of puberty can be difficult for any young person. However, there are still taboos around seeing people with disabilities and SEN as sexual beings, particularly in relation to the consequences of sex, including their vulnerability to abuse, sexually transmitted infections and the potential of some to abuse sexually because of their difficulties with understanding and empathy.

All young people have a right to develop relationships and everyone is entitled to sex and relationships education (SRE) at school, but SRE is more than a one-off biology lesson. Sexuality is about who we are, not just what we do with our bodies. It is life long and includes issues of our identity and self-esteem, social values and attitudes as well as specific sexual behaviours. It also involves a sense of gender identity and qualities such as respect and honesty.

Young people with SEN may also need time to process what they are being taught and to have the relevant information repeated on a number of occasions to help learning happen. Those with physical disabilities have the same rights as the able bodied but may need specialist help to understand the implications of their disability.

We need to recognise that sexual development and curiosity are normal developmental processes. A young adult showing interest in sex does not need medication or punishment; they need support and teaching. Even a young person with severe learning difficulties or autism will have more than just a sex drive. Many will have a drive for relationships and intimacy with others. Some young people will also be asexual, gay or lesbian and this also needs to be supported. All need to be taught that sex is not compulsory; just because you have turned sixteen does not mean you have to do it.

Why do we need SRE?

Sexual feelings are a normal part of adulthood and we do not need to “put ideas” into young people's heads. However, young adults with a developmental disability generally do not enter the adult community with the experiences and skills necessary to make informed decisions regarding their health, safety or lifestyles. Society encourages dependence and discourages the experiences necessary to develop decision-making skills.

How would you manage your sexuality if you had no sex education, could not ask anyone and did not have access to books or other written or visual material? It is our responsibility to teach the skills necessary to ensure that a young person has the capacity to make informed decisions around sex.

Teachers, parents and carers need to realise that children and young people should be made aware of body changes, privacy rules, and issues of personal space and distance, relationships and permission. Boundaries of body (private parts), of space (private places) and of topic (private subjects), which should have started with toilet training, need to be re-emphasised, and adult forms of affection and behaviour need to be developed. The proper use of social networking sites and other electronic media also needs to be included.

Research has found that young adults who have a learning disability have lower levels of sexual knowledge and experience in all areas except menstruation and body part identification, when compared to a typical student population. 50 per cent of these young women did not know how pregnancy happened. Some do not understand that sexual intercourse is “sex” because the TV is routinely re-tuned when a couple start hugging and kissing. Young women who experience sexual abuse often do not recognise the abuse; young men who experience sexual abuse often do not understand the sexual act.

Education is the way to support decision-making abilities and empower young people. Decision making skills will help them to make choices based on knowledge, and to act for the good of their health and wellbeing. Education not only contributes to reducing vulnerability, but also to decreasing inappropriate sexual expression. If you have a severe learning difficulty, there is no difference between scratching your head and touching your genitals, unless you have been taught to distinguish between them.

All young people are increasingly bombarded by sexual images and casual sex is on the  increase. Most of the incidents which lead to trouble for young people with autism or learning difficulties are boundary violations brought on by the impulse of a moment. Research notes that most learners with special needs receive sex education only after having engaged in sexual behavior that is considered inappropriate, offensive or potentially dangerous.  

Young people with learning difficulties can be kept in a permanent state of childhood and social restrictions can cause their sexual activity to be secretive and rushed. They can get in trouble for having sex in inappropriate places, but is anyone supporting them to have a sexual relationship in an appropriate place?

The laws around sex are complicated but are not a reason to avoid teaching SRE. Young people need to know about the law and consent. It is also our responsibility to continue SRE out of school and into the community. If we think that a young person's behaviour at the disco is going a step to far, we should intervene. How else will they know what is acceptable in society?

What is SRE?

Sex and relationship education is concerned with:

  • life-long learning about physical, moral and emotional development
  • an understanding of the importance of stable and loving relationships, respect, care and love
  • teaching about sexualities and sexual health
  • who we can have sex with, where and when.

It is not about the promotion or restriction of any sexual orientation or activity. Contraception and homosexuality, for example, are legal in the UK, so information should be disseminated.

Mere exposure to appropriate social situations does not help a young person with a developmental disability improve their social skills, or there would not be a problem in the first place. Developmental delay which is sufficient to cause major learning problems at school is also sufficient to cause major learning problems in non-academic areas as well. This can result in:

  • difficulties interpreting social events, rules and subsequent interpersonal actions
  • awareness of being different from peers and siblings, particularly if associated with poor self-esteem. This can have a major impact on an individual's emotional development
  • young people with special needs being more vulnerable to abuse, rejection, scapegoating and exclusion from social settings.

Emotional needs and mental health promotion are often less important to the family and other networks because they are more concerned with overcoming intellectual difficulties and other health problems. While many parents and professionals may acknowledge the sexuality of individuals with disabilities and SEN, they tend to focus more on issues relating to safety and sex, rather than on the need for SRE. Young adults with developmental disabilities, though, tend to identify as their major concerns relationship development and the development of skills for responsible sexual activity.

What are the differences between a man and a woman? What is the difference between sex and rape? How do you use a condom? How do you stay with just one person? These are the same concerns that exist for any young person. In the first instance, learning how to make friends is key to understanding social relationships and should be the foundation of SRE from early childhood.

The influence and impact of pornography on young people

Just because a young person has special needs does not mean they do not have access to pornography. When porn was kept on the top shelf, it was clearly fantasy, removed from real relationships. But when it can be accessed easily from your computer, TV or phone, it suddenly seems normal and acceptable. This is often highly explicit adult material. Young people are naive, inexperienced and highly impressionable and should come to intimacy in their own time and in their own way, not through exposure to uncensored and unrestricted sexualised imagery.

The most common ways of distributing sexually explicit material are via Bluetooth, by uploading it on to a personal website or social networking site, or by e-mailing and texting it to individuals. 70 per cent of young people aged fifteen to seventeen report unintended exposure to pornography and 58 per cent of teenagers view porn regularly. The average age that males start to access porn is ten. Girls use porn to measure their sexual performance (oral sex is in the repertoire of many sixteen-year-olds and full waxing is common because it is “expected” by a boyfriend). Porn has been found to influence young men’s ideas of what should be included in sexual activities and disappointment when expectations created are not met.

Many young people are not aware that sending indecent images of children and other pornographic images via mobile phone is illegal. For example, fifteen-year-old Katy takes a sexual photo of herself on her camera-phone and sends it to her boyfriend, Jason, who is also fifteen. Katy is now potentially guilty of distributing child pornography and Jason of possession of child pornography. Katy dumps Jason who then sends the photo to his friends to get back at her. Jason is now also guilty of distributing, and his friends of possession of, child pornography. Katy is embarrassed as her photo passes round school.

Despite our best efforts, people with learning disabilities are victims of sexual abuse and exploitation at a rate much higher than that in the wider population. Many young people do not realise that the picture of the nice young man who wants to meet them on the social networking site is really a front for a sex offender who is online grooming them. However, only seventeen per cent of sexual abuse cases are committed by strangers; the majority are by family, friends or someone else the victim already knows. It is crucial, therefore, that we teach adult assertive responses to activities that the young person does not like, rather than continuing to encourage a “you must do what the grown up says” mentality.

Sex and relationship education should focus on dignity and respect, providing information on safe sex and making it possible for young adults with SEN to safely experience what millions of other young people take for granted. SRE gives people confidence, the ability to make choices and greater protection from exploitation. We all have a right to understand our bodies and feelings and to know what is appropriate. The opportunity to develop loving sexual relationships is an important and valued part of adult life.

Further information

Lynne Moxon teaches SRE at a special college, is a senior lecturer at Northumbria University and is a consultant psychologist for Education and Services for People with Autism:
www.espa.org.uk

www.fpa.org.ukFPA provides materials and training for teachers and youth workers on disability and sexuality:
www.fpa.org.uk

This article was first published in issue 47 (July/August 2010) of SEN Magazine.


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