Introduction

We examined the breadth of research on sex, sexuality, and sexual and reproductive health and rights with young people with intellectual disability in the past two decades.

Methods

An inclusive scoping approach focused on agency and resilience was used to review studies in English-speaking, high-income countries (2000–2019).

Results

In the 68 studies included, we found positive examples of sexual and reproductive agency across five key domains: 1) sexual development including sexual desire, identities, relationships, and menstruation, 2) sexual knowledge including sexuality education and sexual self-advocacy, 3) sexual activity and contraceptive use, 4) access to HPV immunization and cervical cancer screening, and 5) pregnancy, childbirth, and parenthood. The strongest factors in enabling agency were social support and sexuality education. However, several barriers including paternalist attitudes and infantilization of young people with intellectual disability affected all aspects of sexual expression, leading to the persistence of unfair and avoidable health inequities over the past two decades.

Conclusions

Ensuring young people with intellectual disability have a voice on all matters affecting their bodies, even if they have high support needs, is essential to promoting sexual and reproductive health and rights for all.

Policy Implications

Anti-ableist policies in sexual and reproduction health (e.g., education curriculum, service delivery) are key to moving forward.

中文翻译：

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智障青年的性与生殖健康与权利：范围审查

介绍

在过去的二十年中，我们研究了与智障青年有关性，性，性与生殖健康和权利的研究广度。

方法

采用了一种针对机构和抵御力的包容性范围界定方法来审查英语高收入国家（2000-2019年）的研究。

结果

在包括在内的68项研究中，我们发现了跨越五个关键领域的性和生殖能力的正面例子：1）性发展，包括性欲，身份，人际关系和月经； 2）性知识，包括性教育和性自我倡导，3）性活动和使用避孕药具； 4）接受HPV免疫和宫颈癌筛查； 5）怀孕，分娩和生育。促成代理机构的最重要因素是社会支持和性教育。但是，家长式的态度和智障青年的婴儿化等一些障碍影响了性表达的各个方面，导致过去二十年来持续存在不公平和可避免的健康不平等现象。

结论

即使有很高的支持需求，也要确保智障青年在影响其身体的所有问题上都有发言权，这对于促进所有人的性健康和生殖健康以及权利至关重要。

政策含义

性健康和生殖健康方面的反歧视政策（例如，教育课程，服务提供）是前进的关键。