Sexual rights, mental disorder and intellectual disability: principles and law

People with mental disorder and intellectual disability have the same rights to sexual expression as other people, albeit that in some cases a lack of capacity may require curtailment of those rights and regard must be had to protecting the vulnerable. Furthermore, the formation or maintenance of sexual relations, or the attainment of sexual fulfilment, may assist in the maintenance or restoration of mental health or well-being. This article demonstrates how the courts in England and Wales, applying statute law and judicial precedent, are largely supportive of the rights of people with mental disorder or intellectual disability to make decisions about sexual expression, sexual relationships and related matters, notwithstanding some societal and staff attitudes that act to prevent them fulfilling their sexual needs and making decisions about sexual and reproductive matters

Investigating Reproductive Coercion and Violence Towards Women with Disabilities

4 Executive summary Background: the issue For centuries, women with disabilities (WWD) have been subject to multiple and intersecting forms of violence (Abbas, 2022). Much of the literature has focused on intimate partner violence towards WWD (i.e. Campbell et al., 2022; Meyer et al., 2022). Reproductive violence towards WWD has received less attention, despite the long history of reproductive injustice within Canadian and international contexts. This particular form of violence towards WWD is a violation of human rights and has multiple and pervasive impacts on social, emotional, and physical health (Björnsdóttir et al., 2017; Grace & Anderson, 2018; McConnell & Phelan, 2022; Powell, 2021). The Senate of Canada Committee on Human Rights (2022), recently published a report indicating the prevalence of reproductive coercion on intersecting and marginalized communities, calling to action the government and health and social service sectors. Despite the recognition of the issues and rights of WWD within their reproductive journey, there is scant literature in the field. Objectives The objective of this project was to conduct a scoping review investigating and synthesizing the research literature related to reproductive violence against WWD within Canadian and international contexts. Results Following a rigorous research strategy, 48 publications were included in this scoping review. Although heterogeneous, this review provides an overview of the meaning and types of reproductive violence towards WWD. The results of this scoping review are centered on legal analysis and most of the publications are related to women with intellectual disabilities. Within the legal disciplines, questions related to the ‘best interests’ of WWD and informed consent were widely examined in the selected international publications. Key messages • Stereotypes within society, such as WWD being identified as asexual, dependent, and unfit for motherhood prevail. Within the legal studies, it was evidenced that these ideologies underpinned many decisions that were taken in court applications for sterilization. • WWD lack access to information and services related to sexual and reproductive health and rights. 5 • WWD are often coerced into long-term and/or irreversible contraception methods. • Managing menstrual issues is one of the main arguments in the application of sterilization towards WWD. The other important issues are related to protecting against sexual abuse and preventing unexpected pregnancies. • There is a gap in research-knowledge related to sterilization that occurs outside institutions. • There is a need for more empirical studies related to reproductive violence including the exploration of the experiences of WWD. Methods (search methods, selection criteria, data collection and analysis) In this project, we conducted a scoping review, following the six steps recommended by Arksey and O’Malley (2005) in their framework for conducting scoping reviews (updated by Levac et al., 2010). The inclusion and exclusion criteria were related to gender (had to be oriented towards women), disabilities (had to be disability focused) and reproductive violence (had to refer specifically to reproductive violence). We excluded all publications related to HIV/AIDS and mental health issues. Another important exclusion criterion was related to the accessibility of the publication

Caregiver awareness of reproductive health issues for women with intellectual disabilities

<p>Abstract</p> <p>Background</p> <p>Limited attention has been paid to the issue of reproductive health as it affects women with intellectual disabilities, despite reproductive health being a vital issue in public health policy for women in the general population. This paper describes caregiver awareness of reproductive health issues relative to women with intellectual disabilities who are being cared for in welfare institutions in Taiwan.</p> <p>Methods</p> <p>The study employed a cross-sectional, questionnaire-based study which recruited 1,152 caregivers (response rate = 71.87%) from 32 registered disability welfare institutions in Taiwan. We classified their understanding/awareness of reproductive health issues into four domains: menstrual (1) and menopause (2) issues, sex education (3), and reproductive health services (4). Each domain had five associated yes/no questions and the total score for the four domains was out of a maximum of 20. Data were analyzed using SPSS 15.0 software.</p> <p>Results</p> <p>We found that most of the caregivers were familiar with matters concerning sex education, menopause, and reproductive health services, but they lacked adequate understanding of issues associated with menstruation in women with ID. Many aspects of reproductive health such as "menstrual pain", "age at menarche", "masturbation", "diet during perimenopause", and "publicly available reproductive health services" were issues in which caregivers lacked adequate knowledge and required further instruction. Logistic regression analysis revealed that female caregivers with a university degree, and those who had experience assisting with reproductive health care were more inclined to have higher reproductive health awareness scores than their counterparts.</p> <p>Conclusions</p> <p>This study highlights that service providers should offer appropriate reproductive health education to institutional caregivers, and that more attention be focused on the personal experiences and concerns of intellectually disabled women in future research.</p

The sexual lives of people with disabilities within low- and middle-income countries: A scoping study of studies published in English

Although approximately 80% of the global population of people with disabilities reside in low- and middle-income countries, very little is known about their sexual lives due to a lack of empirical data. The purpose of this scoping review is to provide a data-driven overview of low- and middle-income countries concerning what topics in disability and sexuality have been investigated, where this research has been carried out, and how this research has been conducted. It is concluded that: a) disability and sexuality research in African countries focuses predominantly on contexts of vulnerability, b) the sexuality of people with disabilities within many low- and middle-income countries has received little or no empirical investigation, c) and there have been very few experimental studies on disability and sexuality conducted in low- and middle-income countries in general. Recommendations for future research are discussed

Identificación de criterios que permiten definir el tipo de las primeras claras en las masas de Pinus nigra subsp. Laricio en el País Vasco (España)

The main objective of this study was to identify the best thinning treatment for young Pinus nigra ssp. laricio Arn. stands in the Basque Country. Felling selection criteria qould be based on individual tree attributes and vertical stratification. Data collected in the field indicate that the stands to do not show a tendency to vertical stratification. Individual tree characteristics are not distinctive enough to support felling decisions. Consequently, only operational aspects should be considered when planning treatments in young stands. Low thinning should be preferred over selective thinning at this stage of development in the stands.Se pretende definir el tipo de clara más conveniente en las masas de latizal de Pinus nigra Arn. subsp. laricio (Poir) del País Vasco, a partir de la caracterización obtenida a través de ciertos atributos individuales de los árboles y de su estratificación vertical. Se desprende que los individuos no ofrecen rasgos distintivos destacables y suficientes sobre los que sustentar los criterios de elección de los árboles a apear en las claras, así como que tampoco muestran tendencia hacia la estratificación vertical. Desde este análisis, se apunta como necesario primar aspectos de sencillez y operatividad práctica en la fase de señalamiento de la intervención selvícola, optándose, en consecuencia, por las claras por lo bajo y posponiéndose para más adelante las selectivas