Sexuality in the lives of people with intellectual disabilities: A meta-ethnographic synthesis of qualitative studies

Background: The normalisation movement calls for more recognition of the sexual rights of people with intellectual disabilities to challenge classically paradoxical cultural beliefs: 'hypersexual' versus 'asexual'. Aims: This meta-ethnographic qualitative synthesis aimed to explore the voices of people with intellectual disabilities in regards to their experiences and perceptions of sexuality using a Coordinated Management of Meaning framework to derive new conceptual understandings of how their sexuality exists within multiple contexts. Methods and procedures: A systematic literature search and quality assessment yielded 16 studies that met the inclusion criteria and were synthesised following the method of meta-ethnography. Outcomes and results: Four core themes were identified; 'Sociocultural Norms'; 'Under Others Power'; 'Sexual Identity' and 'Sexual Experience'. Conclusions and implications: Application of the hierarchical Coordinated Management of Meaning model suggested caregivers contextual beliefs about people with intellectual disabilities' sexuality inhibited or facilitated positive expressions of sexuality over and above individual needs and desires. Rights-based cultural messages provided the only context that led to positive sexuality outcomes and research that explores sexuality within this context is much needed. The Coordinated Management of Meaning model identified by this research may act as a framework to support the reflective-practice of caregivers.