Global Comment

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The capacity for consent in learning disabled adults

Two people on a dock

A young autistic woman has made the news because the agency responsible for her care had been allowing her to have indiscriminate sex, apparently sometimes with strangers. A court approved a trial period of two months, during which she was allowed to have sex with men who visited her at home during the day time. Care workers also did not intervene if she approached a man to have sex with him in public, which resulted in her having sex in a taxi and at a bowling alley, amongst other places.

Last month, the court brought an end to this trial period, with a psychiatrist warning that allowing it to carry on was exposing her to a high level of risk that could lead to abuse, trafficking, violence or injury.

It is vital to protect her, as a learning disabled woman, from situations that could be dangerous to her. She also has a history of difficult behaviour, such as running away a lot as a child, and being “subjected to sexual activity with men”, including “sexual violation and rapes”.

Like many autistic people, this woman has an obsessional interest. Hers is men, especially those from different ethnic or cultural backgrounds. It was predominantly Asian men who targeted her as a child, the court reports, and it is often Asian men who she is attracted to now, and who she approaches for sexual activity or to give her phone number to.

Safeguarding vulnerable adults is an essential part of a social worker’s job, and that role extends to care workers. If there are any questions about a person’s capacity or safeguarding, it could end up in court, as it has in this woman’s case. In the past, in 2015, a court ruled that this woman was incapable of consenting to sex, which sounds like it is a definitive ruling, but later, she was permitted to get married (with the implication that she can consent to sex with her husband).

She had 24-hour support, and part of the role of the support workers was to protect her from harm, including the potential danger she could get into having indiscriminate sex with strangers. Last year, her behaviours escalated, such as sending nude photographs and having naked video chats with men she had given her phone number to. This led to the decision that allowed the ‘experiment’ of allowing her to have sex within the parameters the court allowed.

As The Times reports, “According to court documents, the local authority told the court that a psychologist employed by the company believed that giving her “unsupervised contact with men” was in her best interests. A safety net would mean that she could contact her carers by phone if necessary. The council opposed the plan, arguing that to withdraw support in the community would “inevitably expose her to a very significant risk of sexual harm, violence, abuse and trafficking”.

“In June, however, Judge Jonathan Butler gave Engage Support permission to leave the woman alone at home “to have sexual relations with others during daytime hours [10am to 4pm]”. If she sought sex in public, carers were “not expected to intervene physically”, nor to “remain present during such acts”. She had promised the judge that she would no longer have sex in public. Over the next few weeks, she had sex with at least six men in her bedroom and continued to seek sex in public. On one July night alone, she left home and had sex with three men before police brought her back at 4.30am.”

Complexity, consent and capacity

With cases like this, it is of the utmost importance that a person’s ability to consent to sex is assessed. Whether this woman has the capacity to understand what consent means, and to understand the repercussions of sex or not makes all the difference to whether her freedom should be restricted (and her ability to interact sexually with others is reduced), or whether it should be respected that she has a desire for sex with lots of men, in risky situations.

Other adults have kinks and desires that don’t fit conventional society’s limited rules on what sex should look like, so why shouldn’t she? Should her impairment mean that sex with her husband is considered to be ok but sex with a taxi driver isn’t?

If so, we are looking at moral judgements, not judgements about capacity or consent.

If she has the capacity to consent to sex with her husband, then we need to look at why that capacity may not extend to other types of sex, with other types of men, and whether assumptions about women’s desires, as well as a healthy dose of disablism, are contributing to the decisions people are making about her life.

If I want to have sex with a stranger, and I understand the risks and know how to mitigate them, nobody stops me from doing so. This woman is learning disabled and autistic but if she, too, understands the risks and how to mitigate them, why are we stopping her?

She is an adult, living in an adult’s body, with sexual desires – like most adults.

The decision that her caregivers and the courts must make depends on her capacity to consent, which is impossible for me, a stranger, to judge. But society’s judgements about acceptable female sexuality, and the acceptable sexuality of disabled and autistic people, are undoubtedly having an impact on what she is being allowed to do, and what courts and social services are limiting.

Photo: Wyatt Fisher