“More Than Protection — Recognition”: What Adults with ID/DD Say About Sexuality, Gender, and Their Own Identities
For decades, conversations about people with intellectual and developmental disabilities (ID/DD) have centered on risk avoidance, caregiving needs, or clinical concerns. But when adults with ID/DD are invited to speak about their own lived experiences — especially around sexuality, gender identity, and selfhood — a powerful and affirming narrative emerges: one grounded in agency, desire, and the basic human need for connection.
Sexuality as an Integral Part of Identity
Adults with ID/DD consistently describe sexuality as a fundamental aspect of their lives and identities, not an optional or problematic add-on. A 2021 scoping review found that sexuality includes intimate relationships, personal identity, and emotional experiences — themes that adults with ID/DD themselves identified as central to their lived experience. (PubMed)
Importantly, these studies reveal that barriers to sexual expression are often external — rooted in stigma, lack of opportunities, and limited access to supportive education — more so than internal lack of desire. (PubMed) Rather than being asexual or disinterested, many adults with ID/DD express the same range of desires, romantic hopes, and relational needs as adults without disabilities.
Barriers Rooted in Attitudes and Support Structures
One of the strongest themes across the research is that others’ attitudes profoundly shape supported people’s sexual and relational lives. Adults with ID/DD often report that family members, support staff, or social systems prioritize safety and risk avoidance — sometimes at the expense of autonomy, pleasure, and agency. (Springer Link)
A systematic review of attitudes toward the sexuality of adults with intellectual disabilities found that while some community attitudes are moderately positive, stereotypes and preferences for low intimacy or strictly platonic relationships persist. These attitudes influence whether adults with ID/DD feel empowered to pursue meaningful intimate relationships. (Springer Link)
Research also highlights that limited sexual knowledge — often a consequence of inadequate sex education — affects adults’ confidence and capacity to navigate relationships safely and confidently. (Springer Link)
Autonomy, Self-Determination, and Gender Identity
When discussions turn to gender identity and LGBTQ+ experiences, adults with ID/DD provide powerful insights into how identity intersects with disability and societal expectations.
Inclusive research conducted in the United States with LGBTQ+ adults with ID/DD found that participants connected gender and sexual self-determination — having control over how they express their gender and sexuality — directly to their sense of self. These individuals described both barriers and supports to that self-determination, emphasizing how acceptance, validation, access to information, and community connections shaped their experiences. (PubMed)
A systematic review focused on adults with intellectual disabilities who identify as lesbian, gay, bisexual, or transgender also underscores that dual stigma — from ableism and heteronormativity — can undermine the development of a positively evaluated sense of self. It points to the need for greater awareness and acceptance in policies and daily life. (PubMed)
Sexuality, Identity, and Life Satisfaction
Beyond attraction, sexual activity, or gender, adults with ID/DD talk about sexuality as deeply tied to identity and self-esteem. Sexual expression, relationship experiences, and the ability to explore intimacy contribute to personal meaning, not just risk categories.
Research repeatedly highlights that opportunities for reciprocal relationships — not just supervision or guardianship — are central to well-being. Even where participants are not currently sexually active, the desire for relationships, closeness, and emotional connection is clear. (PubMed)
The Challenge of Dual Stigmas
Adults with ID/DD — especially those who identify as LGBTQ+ — often face dual stigmas:
Ableism that frames them as sexually innocent or childlike.
Heteronormative or cisnormative expectations that minimize diverse gender or sexual identities.
These intersecting pressures can limit self-expression, opportunities to form relationships, or access to affirming community spaces. (PubMed)
What Adults with ID/DD Say They Want
Across studies, adults with ID/DD consistently express the need for:
Sex education that respects how they learn — tailored, accessible, and strengths-based. (PubMed)
Supportive environments that balance safety with autonomy, allowing people to make choices about intimacy and self-expression. (Springer Link)
Recognition of gender and sexual diversity, rather than assumptions based on stereotypes or normative frameworks. (PubMed)
Opportunities for connection — spaces where relationships can be initiated, nurtured, and maintained. (PubMed)
Conclusion: From Protection to Recognition
The voices of adults with ID/DD challenge outdated assumptions that frame them as less sexual, less desirous, or less capable of self-authorship. Instead, their perspectives reframe sexuality and gender as intrinsic parts of identity, deserving of respect, support, and affirmation.
To build truly inclusive communities, we must listen to these voices directly, elevate their lived experiences in research and policy, and recognize that sexuality, gender, and self-identity are human rights — not luxuries.