Mieke van Driel
Nicholas G Lennox
Anxiety, depression and relationship difficulties are common presentations in general practice and other healthcare settings. Many women with such difficulties report previous sexual abuse or previous or current abusive relationships.1 Sexual abuse is known to be very common in the community,2,3 and people with intellectual disability have been found to be at particularly high risk.4–8 People with intellectual disability experience difficulty in forming intimate relationships and are highly vulnerable to abuse in their relationships.9 Abuse may be difficult to detect in people with intellectual disability as they may lack the verbal skills to report the abuse, or may be assumed not to be sexually active.
Sexual abuse and abusive relationships
are known to be especially common
in people with intellectual disability.
This study explored how women with
intellectual disability understand sex,
relationships and sexual abuse, the
effects of sexual abuse on their lives, and
how successfully they protect themselves
Semistructured narrative interviews with
nine women with mild intellectual disability
in Queensland, Australia. Interviews were
audio recorded, transcribed, coded and
Major themes that emerged were: sexual
knowledge and sources of knowledge;
negotiating sexual relationships; declining
unwanted sexual contact; self protection
strategies; sexual abuse experiences; and
sequelae of sexual abuse.
Most participants reported unwanted
or abusive sexual experiences. They
described sequelae such as difficulties
with sex and relationships, and anxiety
and depression. They described
themselves as having inadequate self
protection skills and difficulty reporting
abuse and obtaining appropriate support.
Their understanding of sex was limited
and they lacked the literacy and other
skills to seek information independently. It
is important for general practitioners to be
aware of the possibility of sexual abuse
against women with intellectual disability,
and to offer appropriate interventions.
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