Disclaimer: Names and details have been changed to protect the confidentiality and dignity of service users.
I am a Learning Disability Support Worker in the UK, and I have to deal with the issues under discussion on a day-to-day basis.
Reading through the thread of discussion, I am saddened to see so many damaging assumptions being made about learning disabled people. Saddened, but not surprised: I encounter them all the time.
My present employers (and I do consider them as my employers... read on and you'll find out why) are a group of severely / profoundly learning disabled middle-aged men who share a household in a rural community. Here are some examples of what they can and can't do. Most of them are non-verbal, and the rest can only manage a few simple utterances (e.g. "Hungry" or "Go-for-walk"). They can all operate a lever-type door-handle, about half of them understand the function of toilets, one of them can do up his flies, and none of them know how to operate a simple bolt lock.
But they ARE NOT passive recipients of care. Far from it... they all have decades of experience at getting the most from their care workers! They can laugh with you, or laugh at you. They can participate, or refuse to play ball. They can smile, frown, shout, scratch, hug, push or self-injure.
My favourite example of this involves John. I consider John to be the most disabled, and also the most easy-going of the people I work for. The only vocalisations he can manage are grunts and groans. He's getting on in years and has limited mobility. His favourite activities include sunbathing and hugging people.
John once sacked somebody.
The person he sacked was a new guy sent by the agency as temporary cover. As soon as John saw him he took his hand, marched him straight to the front door, and left him there. He kept doing this for about half-an-hour, until the rest of us got the hint: John didn't want this man in his house. We sent him back to the agency.
Now you know why I consider John to be one of my employers.
Nobody knows why John acted this way, and John can't tell us. Perhaps this man had abused John in the past? Perhaps John just didn't like his aftershave?
Another possibility (unlikely, but impossible to discount) is that we misinterpreted John's wishes. Discovering the preferences of the people I work for is one of the most important and difficult aspects of my job. Sometimes it's impossible, but over time much can be achieved. One man likes country walks, whereas another prefers going to town and watching the world go by. One man likes jogging trousers and sweatshirts, whereas another prefers jeans and printed T-shirts. One man likes dance music, whereas another likes the Beatles. Etc.
Since the men moved out of institutional care in the early nineties, their lives have been transformed. Although it was a good institution, everything was "one size fits all. Now, they have staff who can learn exactly what their preferences are and adjust their environment accordingly. The results are impressive... people who knew these men from a decade ago are astounded at how much happier and more settled they are.
So what about sexuality? At the risk of sounding platitudinous, I believe that sexuality is part of the richness of human experience, and this applies just as much to people with learning disabilities as it does to a Mathematics graduate like myself. (If I tried to pretend otherwise, my employers have ways of letting me know that I'm wrong....)
So far as I can see, the biggest problem with offering more "hands on" services is the issue of INFORMED choice. Speaking for myself, if the only kind of sexual relationship I was aware of was the one offered by Nina de Vries, then I'd probably be a regular customer at the local massage parlour. But I know that there are alternatives, and I prefer to hold-out for a real girlfriend. How can I explain these options to my employers?