Sexual Behaviour in Individuals with Intellectual Disability and Caregivers’ Attitudes Towards It: A Cross-sectional Study

Introduction: The gap between cognitive-psychosocial development and physical-sexual maturity in children with intellectual disability (ID) can result in inappropriate sexual behaviours, leading to negative social and legal consequences. Parents are unaware of such behaviours and may resort to punishment or feel guilty of these behaviours. While sex education has been proposed as a solution, no studies in India have thoroughly examined sexual behaviours in individuals with ID or caregiver attitudes toward these behaviours. Aims and Objectives: To assess the types and frequency of sexual behaviours in individuals with ID and caregiver attitudes towards them. Methods and Materials: It was a cross-sectional study conducted after approval from the Institutional Ethics Committee, which included 100 patients with ID and their caregivers. Sociodemographic details of caregivers and individuals with ID were collected. Two questionnaires were administered: one assessed sexual behaviours, and the other explored caregiver attitudes on topics like sexual education, concerns about sexual abuse, dating and intimacy. Data was analysed using mean, standard deviation and frequency, as required. Results: Masturbation was the most frequent behaviour (37%), followed by consumption of pornography (33%) and undressing in public (33%). Inappropriate touching (13%), voyeurism (14%) and explicit conversation (9%) were less frequently reported. Our study found that only 40% of caregivers believed sex education was important, while over half felt discussing sexuality might encourage inappropriate behaviour. Just 26% of caregivers had discussed sexuality with their ward, and 64% believed dating and intimacy should not be allowed. Conclusions: Inappropriate sexual behaviours are prevalent among individuals with ID, and caregiver attitudes reveal a lack of acceptance and reluctance to address sexual education, exacerbated by cultural taboos in India. The study’s findings can guide the development of tailored intervention programmes to address sexual behaviour in individuals with ID in the Indian context.