Adults with intellectual disabilities (ID) face multiple health disparities and challenges to accessing health care. Little is known about sexual health care of this population and about how to optimize women’s reproductive health care for women with intellectual disabilities. Women with ID face important barriers to care, including lack of provider training and experience, hesitancy to broach the topic of sexual health, a lack of sexual knowledge and limited opportunities for sex education, disability-related barriers, higher prevalence of sexual abuse and assault, often underreported, lack of dialogue around this population’s human right to consensual sexual expression, undertreatment of menstrual disorders, and legal and systemic barriers. We conducted a limited literature review related to six aspects of sexual health care of women with ID, including barriers to sexual health care, sex education, sexual abuse and consensual sexuality, contraception, screening for sexually transmitted infections and cervical cancer, and pregnancy and parenting. After providing background information about each topic, we suggest practice recommendations for primary care clinicians, using a rights-based framework. 1. Introduction Intellectual disability (ID, formerly mental retardation) is characterized by significant limitations in intellectual functioning (generally measured as IQ of 70–75 or less) and in adaptive behavior, including conceptual, social, and practical skills, that originates before the age of 18 [1]. Adults with intellectual disability (ID) face significant health disparities [2], including disparities in primary health care access [3, 4] cancer screenings and preventive health care access [5–9], health education uptake [10], mental health care and substance abuse treatment access [11, 12], and oral health [13–15]. There are also significant disparities in research participation [16, 17], which contributes to important gaps in knowledge about the health of this population. Reproductive and sexual health of women with ID is especially overlooked and understudied. The literature that does exist is often from the perspective of support workers and family members [18–23]. Recently, there has been limited scholarship focused on the perspectives and preferences of adults with ID [24–27]; however, important gaps in the literature remain. Though many adults with ID receive health care from primary care physicians [3, 28, 29], there is also a specific lack of primary care-focused research and practice guidelines for the sexual health care of adult women with
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