Supported Loving is a nationwide network dedicated to advancing best practices in sexuality and intimate relationships, primarily for individuals with learning disabilities. The most common request we receive, as network leader, is for training and guidance related to sexual activity and mental capacity. We provide training to various professionals, including social workers, nurses and support staff. Attendees often express concerns about sexual activity or physical contact with the people they support right from the start.

Chapter 1 by Sandland, ‘Historical Perspectives on Law, Sexual Intimacy and Capacity’, offers insight into the evolution of the law concerning sexuality and mental capacity. Initially, legal developments aimed to protect women with cognitive or intellectual disabilities who could not provide consent to sexual acts, via the looming threat of prosecution. The Mental Deficiency Act 1913 marked a moral shift, underpinned by the eugenic ideology regulating the reproductive choices of individuals categorised as ‘mental defectives’, often depriving women of the right to a sexual relationship. It was not until the 2003 review of the Sexual Offence Act that the law refocused on an individual's ability to consent to sexual activity, rather than their diagnosis. The Mental Capacity Act 2005(MCA) was envisioned as a progressive piece of legislation, enshrining our rights to make decisions in law if we possess the requisite cognitive capacity. However, practitioners in training sessions do not uniformly view the MCA in this way. It is not uncommon to encounter the belief that all individuals with cognitive or intellectual disabilities must ‘pass’ a capacity assessment before being permitted to engage in a sexual relationship. This view of the MCA as a standard prerequisite suggests a prevailing adherence to the historical views described in Chapter 1, challenging their enduring influence on current practices.

Historical biases affecting the sexual autonomy of people with cognitive or intellectual disabilities still influence practice. Paternalistic attitudes, particularly towards women, persist, as seen in Bates et al (2020), McCarthy et al (2022) and practical experiences, like those shared by Supported Loving. Unfortunately, this group faces restrictions in developing and maintaining sexual relationships.