Sexual health, neurodiversity and capacity to consent to sex

Abstract

Purpose -The purpose of this paper is to clarify: the law on capacity to consent to sex; ethical and legal factors in assessing decision-making capacity of those on the autism (ASD) and neurodiverse (ND) spectrums; and the legal obligations to promote sexual health devolving to local authorities from April 2013. We make proposals to ensure socio-sexual competence by providing appropriate sex and relationship education (SRE).Design/methodology/approach -Critical legal analysis of case law and legislation on the capacity of the vulnerable to consent to sex, in the context of those diagnosed on the autism and neurodiverse spectrums.Findings -Consent to sex cannot be regarded as informed, autonomous, valid and lawful without socio-sexual competence. Sex and relationships education should be provided to ensure socio-sexual competence, in keeping with international conventions and national laws and policies. Research limitations/implications -There is an urgent need for research into the needs and experiences of people with ASD/ND and their families/carers with regard to the efficacy and tailoring of SRE strategies. This research should feed into SRE family intervention programmes (SREFIPs), developed in partnership with people with ASD/ND, their families/carers and professionals.Originality/value -This article seeks to resolve many of the existing legal uncertainties surrounding the capacity to consent to sex and to propose novel solutions to ensure the socio-sexual competence of those diagnosed on the ASD or ND spectrums in relation to their rights to sexual expression.

Review of Sociosexuality Curricular Content for Individuals With Developmental Disabilities

“…The concept area of sexual health centered primarily on information related to STDs (2.6/3), contraception (2.2/3), and reproductive health (2.1/3). It is important for curriculums to include the legal aspects that accompany engagement in sexual activity such as age of consent (Mackenzie & Watts, 2013). Alcohol and drugs should be addressed in sexual health as well as covered in other topical concept areas such as personal skills (decision making), given that the use of drugs and alcohol can lead to the impairment of decision making and engagement in risky behaviors (Blanchett & Wolfe, 2002).…”

Capacity to consent to sex reframed: IM, TZ (no 2), the need for an evidence-based model of sexual decision-making and socio-sexual competence

“…4241/12, ECHR 20 May 2014. A solution more in keeping with local authorities' responsibilities for sexual health services would be to provide tailored SRE routinely for all those diagnosed as LD/ASD/ND (Mackenzie & Watts, 2013). This could be integrated with the revised SRE programmes which young people are currently demanding (Parker, 2014).…”

“…To ensure the sexual health, promote the right to sexual expression and redress inequalities pertaining to those diagnosed as having an autism spectrum disorder or otherwise neurodiverse [ASD/ND], and their families/carers, we advocated evidence-based SRE which addresses the individual differences and requirements of those with ASD/ND. We argued SRE incorporating family intervention [SREFIPs] should be developed to foster socio-sexual competence from childhood, to provide vulnerable children, young people, and adults with the requisite information and skills to exercise autonomy and avoid exploitation in their sexual decisions and practices (Mackenzie & Watts, 2013). To anchor these conclusions, we assessed recent English cases focused on the test for the capacity to consent to sex, and concluded that these revealed a regrettable confusion.…”

“…For instance, TZ, the subject of two of the cases we discuss below, was diagnosed with mild learning disabilities, atypical autism and hyperactivity disorder. While a significant body of research concerns the lawful sexual expression of the learning disabled (Curtsy and Kelson, 2011;McGuire, 2011;Richards et al, 2009), there is a paucity of studies focused on those diagnosed with ASD/ND (Mackenzie & Watts, 2013). This means that the prominent judicial concern to find a workable and manageable test for consent to sex evident in these cases risks privileging administrative convenience over the need for a test which is sensitive to current sexual practices, as well as to the sexual rights and vulnerabilities of those diagnosed with LD/ASD/ND whose capacity is in question.…”

Clinician Perspectives of Adult High-Functioning Autism Support Groups’ Use of Neurodiversity Concept

“…Resolutions of specific clinical deficits are essential for people with HFA, and clinicians can use support groups to help persons with HFA learn how to make and keep friends [19,20]. The incorporation of these support groups by clinicians can even help these individuals meet romantic partners [21].…”