Between a rock and a hard place: The Problems and Practices of Professionals and Care Workers supporting autistic people with regards to their sexual autonomy, capacity and decision making

This article presents findings from a research project which examined the problems of professionals and care workers working with autistic people in dealing with issues of sex and sexuality in their day to day work with service users. The research explored what professionals and support workers feel they can or should do when providing support for people whose intellectual disability or mental condition makes their sexual consent - being informed, competent and free from coercion - legally unreliable. As desexualising prejudices about people with disabilities recede, staff and their organisations are left with no guidance as to how to support service users with regards to the realisation of their sexual desires and the expression of the sexual identities. The law is unhelpful in that the 2003 Sexual Offences Act and the 2005 Mental Capacity Act make contradictory demands of settings in terms of the criteria for consent and its absence. Despite contradictions in the law and the absence of national guidelines, the overarching finding from the data is that staff are sensitive to the needs and desires of their service users and have developed an inclusive ethos and display positive attitudes in supporting the people they work with regarding to their sexuality. However, the contradictory demands of the SOA (2003) and MCA (2005) presented staff with a dilemma, One the one hand, staff and the organisation they work for have statutory duties to safeguard the people they support but, at the same time, they also work in a strengths focused way to support individuals to live a full and fulfilled life, which includes a recognition of their sexual desires, orientations and identities. At the core of staff concerns are judgements of the competence and comprehension of the service user, complicated by the difficulty of assessing competence, and recognising that competence is neither easily measured nor consistent amongst service users.