Supporting People With ID/DD Through Sex, Sexuality, and Bodily Development: Overcoming Our Fears and Doing Better
For many parents and providers, few topics feel more intimidating than talking about sex, sexuality, and bodily development with individuals who have intellectual or developmental disabilities (ID/DD). Anxiety often shows up as silence, overprotection, or avoidance—but these responses can unintentionally create risk, confusion, and vulnerability for the very people we’re trying to protect.
The truth is this: people with ID/DD have the same bodies, desires, rights, and developmental experiences as anyone else, and they deserve access to clear, healthy, shame-free education and support.
Why This Topic Feels So Hard—for Everyone
Many caregivers feel caught between two fears:
1. Fear of giving “too much” information
Some worry that providing sexual education will increase sexual behavior. Research consistently shows the opposite: comprehensive sexuality education reduces risk, increases safety, and improves communication for people with ID/DD (Sexuality Information and Education Council of the United States (SIECUS)).
2. Fear of exploitation
This is a deeply understandable concern. People with ID/DD are at disproportionate risk for sexual abuse, but experts emphasize that lack of education is a major contributor to this vulnerability. When individuals don’t know the language of their bodies, consent, or boundaries, they’re less able to advocate for themselves or identify unsafe situations (The Arc — “Sexual Violence and People With IDD”).
3. Fear of doing it wrong
Parents and providers often feel unprepared, uncomfortable, or unsure of what is “appropriate.” But perfection isn't required—presence, honesty, and respect matter more.
Recognizing these fears is the first step toward reducing their hold on you.
Start With Yourself: Managing Your Own Discomfort
Supporting someone else begins with self-reflection. Consider:
What messages did I receive about sex growing up?
Where does my discomfort come from—culture, trauma, religious beliefs, fear of judgment?
How do those feelings show up in the way I speak (or stay silent)?
Your emotions are valid, but they shouldn’t prevent a person with ID/DD from receiving safe, evidence-based education. You can still model calmness, respect, and openness even while working through your own anxieties.
If you want a structured starting point, here are two valuable resources:
the Planned Parenthood Sexuality Education Resources offer accessible, factual grounding for adults and educators:
Sex Education Resources (Planned Parenthood)Among Friends, LLC has a program to help you build your confidence and competence: Sexual Self-Determination Certification and Train-the-Trainer Program , particularly Tier 1: FOUNDATIONS
Use a Framework of Best Practice
People with ID/DD need sexuality education tailored to their cognitive and chronological, development. This includes:
Concrete language
Avoid metaphors. Use accurate anatomical terms (recommended by the American Academy of Pediatrics).
Visual supports
Charts, pictures, role-play scripts, and social stories enhance comprehension for many learners.
Repetition & consistency
Like any skill, healthy sexual behavior is learned over time—not in a single conversation.
Skill-building focus
Instead of “don’t,” prioritize teaching:
Consent
Privacy
Safe vs. unsafe touch
How to say “no,” “stop,” or “I need help”
Recognizing bodily changes
Healthy vs. unhealthy relationships
The UCSF Office of Developmental Primary Care offers excellent, accessible guides.
Normalize Sexuality as Part of the Human Experience
Every person—disabled or not—experiences:
Puberty
Attraction
Curiosity
Desire for connection
Boundaries
People with ID/DD deserve a message that frames sexuality as normal, healthy, and theirs, not shameful or dangerous.
Try using statements like:
“Everyone’s body grows and changes.”
“It’s okay to have feelings or to be curious.”
“You deserve to know how to keep yourself safe.”
When sexuality is treated as taboo, individuals often internalize shame or seek information from unsafe or inaccurate sources.
The Right to Make Mistakes and Live Without Constant Surveillance
This is one of the most important—and most overlooked—rights for people with ID/DD.
Organizations including The Arc, The Autistic Self Advocacy Network (ASAN), and the UN Convention on the Rights of Persons with Disabilities affirm that people with disabilities have the right to autonomy, privacy, and self-determination, including in matters of sex and relationships.
Links:
Why this matters
Overprotection can unintentionally:
Increase isolation
Prevent learning healthy boundaries
Reduce ability to recognize exploitation
Create shame & secrecy
Limit opportunities for real relationships
Letting people make mistakes is part of dignity
Everyone learns by trying, failing, regrouping, and trying again. People with ID/DD are no different. Supporting autonomy might look like:
Allowing private time for masturbation
Not hovering during conversations, online time, or dating interactions
Letting a person have friendships and relationships you don’t fully control
Teaching skills instead of enforcing surveillance
This does not mean abandoning safety. It means shifting from control to coaching, and from preventing all risk to building skills to navigate risk.
Practical Strategies to Support Healthy, Safe Sexual Development
Here are ways parents and providers can take action:
1. Communicate early and often
Normalize these conversations long before puberty starts. Short, calm discussions work better than long lectures.
2. Establish clear, consistent rules about privacy
Use visuals or scripts to teach:
“Private parts”
“Private spaces”
“Public behaviors vs. private behaviors”
3. Teach consent explicitly
Practice scripts:
“Is this okay?”
“I don’t like that.”
“Stop now.”
“I want to be alone.”
Role-play these skills regularly.
4. Address technology and online safety
Include:
What photos are never okay to send
What to do if someone asks for sexual content
How to block or report
The National Domestic Violence Hotline & Love Is Respect offer disability-inclusive guidance.
5. Build a circle of support
No one adult can do this alone. Involve:
Clinicians
Therapists
Direct support staff
Teachers
Behavior specialists
Trusted family & friends
6. Use high-quality curricula
Evidence-based sexuality education models for people with ID/DD include:
These reduce caregiver anxiety and ensure the learner receives accurate, well-designed material.
Final Thoughts: Courage, Not Perfection
Supporting someone through their sexual development isn’t about having all the answers—it’s about showing up with openness, honesty, respect, and the willingness to learn alongside them.
Your comfort will grow with time. More importantly, the confidence, safety, and self-advocacy of the person you support will grow too.