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Attitudes to Sexuality Questionnaire (Individuals with an Intellectual

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Journal of Intellectual & Developmental Disability, September 2007; 32(3): 214–221

Attitudes to Sexuality Questionnaire (Individuals with an Intellectual

Disability): Scale development and community norms

MONICA CUSKELLY1 & LINDA GILMORE2

1
School of Education, The University of Queensland, Australia, and 2School of Learning and Professional Studies,
Queensland University of Technology, Australia

Abstract
Background Attitudes to the sexual expression of adults with an intellectual disability (ID) are one reflection of the
inclusiveness of a community. Our capacity to measure attitudes towards this important aspect of adult life is limited by the
lack of an appropriate instrument. The aim of this study was to continue the development of a recently published
questionnaire and to establish normative data.
Method The Attitudes to Sexuality Questionnaire (Individuals with an Intellectual Disability) (ASQ–ID: Cuskelly & Bryde,
2004) was modified slightly and questions about hypothesised stereotypical views of sexuality were added. A community
sample of 261 adults completed this modified questionnaire, as well as a shorter version of the questionnaire about attitudes
to sexual expression in typically developing adults.
Results Factor analysis revealed one general factor associated with sexual rights, plus three other factors related to parenting,
non-reproductive sexual behaviour, and self-control. There were few differences in attitudes towards male and female
sexuality, and attitudes were only slightly less positive for individuals with an ID than for those without a disability. Views
about parenting by people with an ID were more cautious than for other aspects of sexuality.
Conclusions The present study established the factor structure of an instrument for measuring attitudes towards the sexual
expression of adults with an ID and provided normative data. Community attitudes towards the sexual rights of adults with
an ID are generally quite positive.

Keywords: attitudes, sexuality, sexual behaviour, intellectual disability

Introduction one-third of the group consisted of university

Sexuality is an integral part of adult life. Until
recently, however, it has been relatively inaccessible
for adults with an intellectual disability (ID),
because of barriers such as lack of privacy in
institutional living situations, or because they have
been kept in ignorance (Servais, 2006). Attitudes of
parents and other carers are clearly central to the
amount and type of information made available to
individuals with an ID, and these attitudes will, in
turn, be informed by general community attitudes to
these issues. An important indicator of the inclu-
siveness of a community, therefore, is its attitude
towards the sexual rights of adults with an ID.
Cuskelly and Bryde (2004) developed a ques-
tionnaire to measure attitudes to the sexual expres-
sion of individuals with an ID. They compared the
attitudes of three groups: parents of an adult with an
ID, support staff working with adults with an ID,
and a general community sample. The community
sample was not particularly representative, as
students, who would be both younger and better
educated than the general community. Both age and
education have been found to be correlated with
attitudes to sexual expression of typically developing
individuals, with younger and better educated
individuals having more liberal attitudes than those
who are older and less well educated (Rollins, 1989).
Similar associations have been found between age
and educational level and attitudes to the sexual
behaviour of individuals with an ID (Cuskelly &
Bryde, 2004; Murray, MacDonald, & Levenson,
1999; Oliver, Anthony, Leimkuhl, & Skillman,
2002).
The instrument developed by Cuskelly and Bryde
(2004) to measure attitudes to sexuality (Attitudes to
Sexuality Questionnaire: ASQ) contained items
reflecting eight themes related to sexual expression:
sexual feelings, sex education, masturbation, perso-
nal relationships, sexual intercourse, sterilisation,
marriage, and parenthood. The authors suggested

Correspondence: Monica Cuskelly, PhD, School of Education, The University of Queensland, QLD 4072, Australia. E-mail: m.cuskelly@uq.edu.au
ISSN 1366-8250 print/ISSN 1469-9532 online # 2007 Australasian Society for the Study of Intellectual Disability Inc.
DOI: 10.1080/13668250701549450

that an examination of the factor structure of their
scale should be undertaken to ascertain whether
attitudes to the sexual expression of adults with an
ID were unidimensional or if a more complex
structure was apparent. They also suggested that
attitudes to the sexual expression of men and women
with an ID should be examined separately. This
latter suggestion is important as attitudes to the
sexual expression of men and women have tradi-
tionally been different. However, there is an extra
dimension to this issue when considering attitudes to
the sexual expression of individuals with an ID.
Earlier studies have revealed two conflicting and
stereotypical views of the sexual nature of adults with
an ID: the first is that they are asexual innocents who
should be protected (Blatt, 1987; DeLoach, 1994;
Morgenstern, 1973), while the second is that these
individuals have no control over their sexual
appetites and are likely to be promiscuous
(Antonak, Fiedler, & Mulick, 1989; Kempton,
Cavies, & Stiggall-Muccigrosso, cited in Ballan,
2001). It is possible that these two attitudes, if still
extant, will be applied differentially to the two sexes.
The present study, therefore, was designed (i) to
establish the factor structure of the scale, and (ii) to
undertake a separate examination of attitudes to the
sexual expression of men and women with an ID. It
also incorporates a comparison of attitudes to the
sexual expression of individuals with an ID with
attitudes to the sexual expression of typically
developing adults.
Method
Participants
A sample of 261 adults (135 females) from the
general community took part in the study. The
majority of respondents lived in the south-eastern
corner of the Australian state of Queensland.
Respondents’ ages were grouped into 10-year age
brackets: 53 (20.3%) individuals were aged 20–29
years; 66 (25.3%) were aged 30–39; 65 (24.9%)
were aged 40–49; 38 (14.6%) were 50–59; 24
(9.2%) were 60–69; and 14 (5.4%) were 70 years
or over. One person neglected to indicate his age.
The sample was reasonably representative of the
Australian population in relation to education,
although a higher proportion (32%) had tertiary
qualifications than in the general population
(20%: Australian Bureau of Statistics, 2005).
Approximately 27% had been awarded a certificate
or diploma (versus 31% in the wider Australian
population) and 41% stated that high school was
Attitudes to sexuality 215
their highest level of educational attainment (com-
pared to 49% in the general population).
Instruments
Attitudes to Sexuality Questionnaire (Individuals with
an Intellectual Disability: ASQ–ID). The ASQ–ID
(Cuskelly & Bryde, 2004) was used with some minor
modifications. The original questionnaire (available
as an Appendix to their article) was developed to
ascertain attitudes to sexuality in adults with an ID.
With two exceptions, the items did not specify either
men or women. The exceptions were the statements:
‘‘Sterilization is an undesirable practice for men [for
women] with intellectual disabilities’’. Since the
current study used a gender-specific version of the
questionnaire, this item was included only once for
each gender under consideration. Further, Item 7 in
the original version stated that ‘‘Sterilization should
be used as a means of inhibiting sexual desire
in adults with an intellectual disability’’. In the
current version, the term ‘‘sterilization’’ was
replaced with ‘‘medication’’. A question about
whether masturbation is morally wrong was
removed, as Cuskelly and Bryde found that it did
not assist with interpretation of their results. In
addition, three new questions were included: the
first (Item 5) was intended to tap into the idea that
individuals with an ID have little interest in sex (the
‘‘perpetual child’’ view), the second (Item 34)
addressed the stereotype that this group are unable
to control their sexual urges, and the third (Item 15)
asked about the capacity of individuals with an ID to
maintain an emotionally intimate relationship. One
question (Item 26 in the original and Item 27 in the
current version) was reworded, as it was felt that the
original question, which contained a negative, may
have led to some confusion. There was also some
reorganisation of items to give a better balance
across the questionnaire. Responses are scored on a
6-point Likert scale, with higher scores indicating
more positive or accepting attitudes. The revised
questionnaire is available in Table 1 (reverse scored
items are denoted in the first column by an (R)).
Attitudes to Sexuality Questionnaire (Individuals from
the General Population: ASQ–GP). A second
instrument, the ASQ–GP, was created to measure
attitudes towards sexual expression in adults without
an ID. This was an abridged version of the
questionnaire described above, as a number of the
original items were not applicable, such as those
related to sexual rights, which are not under
challenge for typically developing adults. This
second instrument is available in Table 2.
 216
Table 1. Factor analysis of combined data (for women and men) from the Attitudes to Sexuality Questionnaire (Individuals with an Intellectual Disability) (ASQ–ID)

Factor

M. Cuskelly & L. Gilmore

Item 1 2 3 4 5 6 7
26. Advice on contraception should be fully available to women# with ID* whose level of development 2.770 .081 .153 2.078 2.071 .128 .130
makes sexual activity possible
16. Sex education for women with ID has a valuable role in safeguarding them from sexual exploitation 2.731 .101 .027 2.181 2.143 .220 .225
5. Women with ID have less interest in sex than do other women (R) .725 .020 2.164 .063 .365 2.053 .113
13. Women with ID typically have fewer sexual interests than other women (R) .723 .103 2.272 .027 .252 .154 .026
32. Marriage should not be encouraged as a future option for women with ID (R) .715 .357 2.231 .124 2.003 2.015 .029
15. Women with ID are unable to develop and maintain an emotionally intimate relationship with a partner (R) .689 .183 2.175 .147 .119 .017 .008
2. Provided no unwanted children are born and no-one is harmed, consenting adult women with an ID should 2.861 2.085 .393 2.142 .016 .071 .144
be allowed to live in a heterosexual relationship
18. Sexual intercourse should be permitted between consenting adults with ID 2.630 2.271 .409 2.060 2.008 2.025 .113
22. Women with ID have the right to marry 2.628 2.395 .245 2.187 .085 .181 .230
28. Marriage between adults with ID does not present society with too many problems 2.625 2.386 .095 .008 .138 .028 .053
1. With the right support, women with ID can rear well adjusted children 2.610 2.520 .057 .081 2.097 .076 .051
29. Sterilisation is a desirable practice for women with ID (R) .583 .521 2.048 .238 2.018 .034 .087
23. It is a good idea to ensure privacy at home for women with ID who wish to masturbate 2.567 .081 .439 2.104 2.053 .305 .047
17. In general, sexual behaviour is a major problem area in management and caring for women with ID (R) .438 .350 2.033 .242 2.166 .415 2.128
19. Group homes or hostels for adults with an intellectual disability should be either all male or all female, .433 .408 2.273 .352 .085 .178 2.034
not mixed (R)
10. Discussions on sexual intercourse promote promiscuity in women with ID (R) .409 .293 2.265 .332 .308 .165 2.314
20. Care staff and parents should discourage women with ID from having children (R) .095 .824 2.107 .110 2.013 .051 2.088
33. Women with ID should be permitted to have children within marriage 2.048 2.800 2.016 .021 .006 .261 2.100
11. Women with ID should only be permitted to marry if either they or their partners have been sterilised (R) .288 .778 2.102 .135 .102 2.090 2.027
6. If women with ID marry, they should be forbidden by law to have children (R) .143 .757 2.053 .063 .097 2.310 .087
14. Generally women with ID are able to make distinctions between sexual thoughts and sexual actions .164 2.640 .188 2.162 2.133 2.260 2.148
25. Sexual intercourse should be discouraged for women with an intellectual disability (R) .243 .589 2.325 .151 .224 .045 .017
12. Masturbation in private for women with ID is an acceptable form of sexual expression 2.360 2.172 .815 2.064 .015 .023 2.091
31. Masturbation should be taught to women with ID as an acceptable form of sexual expression in 2.176 2.021 .749 2.000 2.084 .089 .094
sex education courses
9. Masturbation should be discouraged for women with ID (R) .406 .107 2.718 .146 .068 .036 .044
3. Consenting adult women with ID should be allowed to live in a homosexual relationship if they so desire 2.092 2.460 .639 2.095 2.218 .130 .107
27. Women with ID are more easily stimulated sexually than people without ID (R) .024 .224 2.102 .828 .035 2.095 2.061
34. Women with ID have stronger sexual feelings than other women (R) .456 2.055 2.011 .722 .027 2.129 .252
8. Medication should be used as a means of inhibiting sexual desires in women with ID (R) .313 .340 2.252 .419 .126 .061 2.215
4. It is best to wait for a girl or woman with ID to raise questions about sexuality before discussing the topic with her (R) .014 .108 2.087 .052 .788 2.175 2.159
21. It is best not to discuss issues of sexuality with girls with ID until they reach puberty (R) .461 .194 2.134 .036 .632 .091 .010
24. Whenever possible, women with ID should be involved in the decision about their being sterilised 2.292 2.344 .069 2.106 2.056 .538 .006
7. Women with ID should be allowed to engage in non-sexual romantic relationships 2.078 2.312 .292 2.196 2.102 .473 .052
30. Sex education for women with ID should be compulsory 2.156 .142 .035 .031 2.129 .015 .861

Note. # Separate, but otherwise identical questionnaires were used to collect data with respect to men and women. *The term ‘‘ID’’ is used here to save space, however, the questionnaire uses
the expression ‘‘women/men with an intellectual disability’’. (R)5Reverse scored items.
 Attitudes to sexuality 217

Table 2. Factor analysis of combined data (for women and men) from the Attitudes to Sexuality Questionnaire (Individuals
from the General Population) (ASQ–GP)

Factor

Item 1 2

9. Masturbation in private is an acceptable form of sexual expression for women# .860 2.078
2. Girls should be discouraged from masturbating (R) 2.804 .010
5. Consenting female adults should be allowed to live in a homosexual relationship if they so desire .764 2.152
8. Sex education for girls should be compulsory .657 2.173
4. Sex education for girls has a valuable role in safeguarding them from sexual exploitation .622 2.177
3. Discussions on sexual intercourse promote promiscuity in girls (R) 2.536 .423
7. Advice on contraception should be fully available to young women .496 2.408
6. It is best not to discuss issues of sexuality with girls until they reach puberty (R) 2.013 .873
1. It is best to wait for a girl to raise questions about sexuality before discussing the topic with her (R) 2.222 .705

Note. # Separate, but otherwise identical questionnaires were used to collect data with respect to men and women. (R)5Reverse scored items.

Procedure Seven factors were extracted with eigenvalues

The study was approved by the Ethical Approvals
Committee of the Queensland University of
Technology. Data were collected by students under-
taking a course in human development who chose to
research this topic from a selection of topics
provided by the course coordinator. Each student
asked approximately 8 people who were known to
him/her to complete the two questionnaires (focus-
ing on individuals with an ID and on the general
community respectively). Only data where both
respondent and student gave consent for the
responses to be added to the group data pool were
included in the study. All respondents were given an
information sheet explaining the nature of the study
and providing details of data handling procedures,
including their right to refuse to participate or to
withdraw at any time. Each person completed both
questionnaires either for men with and without ID,
or for women with and without ID. Approximately
half the sample (124) completed both questionnaires
on attitudes towards sexual expression of males, and
the remainder (137) completed both questionnaires
on attitudes towards sexual expression of females. A
similar number of respondents (122) completed the
questionnaire on individuals with an ID first, while
the remainder (139) completed the questionnaire on
typically developing individuals first. Data were
checked for completion by the second author and
then entered into SPSS.
Results
Factor analysis of the ASQ–ID
A factor analysis using principal components with
a varimax rotation was undertaken using the
combined data for women and men (see Table 1).
greater than 1 and accounting for 66% of the
variance. The first factor was labelled ‘‘Sexual
rights’’ and initially comprised 16 items, however
consideration of the best fit of items eventually
resulted in this subscale comprising 13 items (Items
2, 5, 10, 13, 15, 16, 17, 18, 19, 22, 26, 28, 32). The
second factor was labelled ‘‘Parenting’’. This label
reflected the content of the items contributing to this
subscale with the exception of Item 14 (which was
discarded). There were a number of additional items
that we had anticipated would contribute to a
‘‘Parenting’’ subscale (Items 1, 28, 29, and 32),
however these loaded most highly on Factor 1. Items
1 and 29 both had almost equivalent loadings on the
second factor and so the decision was taken to
include these on the ‘‘Parenting’’ subscale. The
‘‘Parenting’’ subscale thus comprised 7 items (Items
1, 6, 11, 20, 25, 29, 33). The third factor resulting
from the factor analysis consisted of 4 items. Item 23
also loaded substantially on this factor, was related
to the content of the majority of items on this
subscale, and so was added to this subscale.
Somewhat surprisingly, the item about the accept-
ability of homosexual relationships also loaded on
this factor. The third factor was therefore labelled
‘‘Non-reproductive sexual behaviour’’ and con-
tained 5 items (Items 3, 9, 12, 23, 31). The fourth
factor consisted of 3 items and was labelled ‘‘Self-
control’’, as all items were related to the strength and
control of sexual feelings (Items 8, 27, 34). The fifth
factor included 2 items, both related to when sexual
information should be presented, and was labelled
‘‘Preparation’’ (Items 4, 21). The sixth factor,
labelled ‘‘Responsibility’’, comprised 2 items
(Items 7, 24), and the final factor contained only 1
item related to sex education (Item 30). This item
was discarded. At the end of this process we had 6
subscales, we had discarded Items 14 and 30, and
218 M. Cuskelly & L. Gilmore

had moved Items 1 and 29 from the ‘‘Sexual rights’’
subscale to the ‘‘Parenting’’ subscale, and Item 23
was included on the ‘‘Non-reproductive sexual
behaviour’’ subscale.
Internal consistency for each of the 6 subscales
was established using Cronbach’s alpha. The
‘‘Sexual rights’’, ‘‘Parenting’’, and ‘‘Non-reproduc-
tive sexual behaviour’’ subscales all had excellent
internal consistency (alpha5.93, .88, and .84,
respectively). The ‘‘Self-control’’ subscale had an
acceptable level of internal consistency (alpha5.67),
however the other subscales were not internally
consistent (‘‘Preparation’’5.58, ‘‘Responsibility’’
5.33), and so were not used in any further analyses.
The final 4-factor structure and the items included
in each factor are shown in Table 3.
For the combined male and female data sets, the
mean for the ‘‘Sexual rights’’ subscale was 58.87
(SD510.98) with a possible range of 13–78; the
‘‘Parenting’’ subscale had a mean of 30.59
(SD56.75) with a possible range of 7–42; the
‘‘Non-reproductive sexual behaviour’’ subscale had
a mean of 15.00 (SD53.77) with a possible range of
5–30; and the ‘‘Self-control’’ subscale had a mean of
13.51 (SD52.65) with a possible range of 3–18.
Correlational analysis showed that all 4 factors were
significantly correlated, at p,.001 (range5.43–.66).
An examination of the impact of age on attitudes
indicated that all other age groups differed signifi-
cantly from the two oldest age bands (60–69 years
and 70+ years). For ease of reporting, participants
were divided into two groups: those younger than 60
years (n5222) and those 60 years and older (n538).
As mentioned above, one individual did not answer
the question regarding age and so was omitted from
this analysis. A MANOVA with age group as the
independent variable and subscale scores of the
ASQ–ID as the dependent variables was conducted.

Table 3. Final 4-factor structure of the ASQ–ID

Factor Item

Factor 1: 2. Provided no unwanted children are born and no-one is harmed, consenting adult women with an ID should
Sexual rights be allowed to live in a heterosexual relationship
5. Women with ID have less interest in sex than do other women (R)
10. Discussions on sexual intercourse promote promiscuity in women with ID (R)
13. Women with ID typically have fewer sexual interests than other women (R)
15. Women with ID are unable to develop and maintain an emotionally intimate relationship with a partner (R)
16. Sex education for women with ID has a valuable role in safeguarding them from sexual exploitation
17. In general, sexual behaviour is a major problem area in management and caring for women with ID (R)
18. Sexual intercourse should be permitted between consenting adults with ID
19. Group homes or hostels for adults with an intellectual disability should be either all male or all female,
not mixed (R)
22. Women with ID have the right to marry
26. Advice on contraception should be fully available to women# with ID* whose level of development
makes sexual activity possible
28. Marriage between adults with ID does not present society with too many problems
32. Marriage should not be encouraged as a future option for women with ID (R)
Factor 2: 1. With the right support women with ID can rear well adjusted children
Parenting 6. If women with ID marry, they should be forbidden by law to have children (R)
11. Women with ID should only be permitted to marry if either they or their partners have been sterilised (R)
20. Care staff and parents should discourage women with ID from having children (R)
25. Sexual intercourse should be discouraged for women with an intellectual disability (R)
29. Sterilisation is a desirable practice for women with ID (R)
33. Women with ID should be permitted to have children within marriage
Factor 3: 3. Consenting adult women with ID should be allowed to live in a homosexual relationship if they so desire
Non-reproductive 9. Masturbation should be discouraged for women with ID (R)
sexual behaviour 12. Masturbation in private for women with ID is an acceptable form of sexual expression
23. It is a good idea to ensure privacy at home for women with ID who wish to masturbate
31. Masturbation should be taught to women with ID as an acceptable form of sexual expression in
sex education courses

Factor 4: 8. Medication should be used as a means of inhibiting sexual desires in women with ID (R)
Self-control 27. Women with ID are more easily stimulated sexually than people without ID (R)
34. Women with ID have stronger sexual feelings than other women (R)

Note. (R)5Reverse scored items.


There was a significant effect for age: F(4,
220)59.27, p,.001. Univariate analysis showed
that the older respondents had less accepting views
of the sexual rights of individuals with an ID: F(1,
233)519.55, p,.001 (Older M551.33, SD513.03;
Younger M560.09, SD59.94), and were more
negative about parenthood for this group: F(1,
233)512.24, p,.001 (Older M527.08, SD56.42;
Younger M531.12, SD56.51). They also had lower
scores on the ‘‘Non-reproductive sexual behaviour’’
subscale: F(1, 233)531.63, p,.001 (Older M518.65,
SD54.35; Younger M523.49, SD55.56), and
believed that individuals with an ID were less able to
control their sexual urges than individuals without a
disability: F(1, 233)514.22, p,.001 (Older M512.14,
SD53.08; Younger M513.79, SD52.45). Since the
older group contained only a small number of
participants (n538), their data were removed from
subsequent analyses.
Effect of respondent gender and gender of focus of the
ASQ–ID
A 2 (gender of respondent)62 (gender of person
with an ID) MANOVA was used to examine the
effect of respondent gender on responses, and to
ascertain whether attitudes differed towards males
and females with an ID. The 4 subscales of the
ASQ–ID were the dependent variables. There was a
main effect for gender of the person with an ID: F(4,
194)53.34, p,.01, but no effect for respondent
gender and no interaction. Follow-up univariate
testing revealed a significant effect for the ‘‘Self-
control’’ subscale only, with males with an ID seen
to have greater difficulty in controlling their sexual
desire than females with an ID: F(1, 201)54.71,
p,.05 (Males M513.34, SD52.50; Females
M514.22, SD52.34).
A repeated measures MANOVA with planned
contrasts compared mean values for the 4 subscales,
and found a significant difference between respon-
dents’ views: F(3, 198)53.74, p,.01. The only
significant differences were between the ‘‘Parenting’’
subscale and the other 3 subscales. In all instances,
respondents were less positive about parenthood for
individuals with an ID than about other aspects of
sexuality (‘‘Parenting’’ vs. ‘‘Sexual rights’’: F(1,
200)59.26, p,.01; ‘‘Parenting’’ vs. ‘‘Non-repro-
ductive sexual behaviour’’: F(1, 200)56.42, p,.01;
‘‘Parenting’’ vs. ‘‘Self-control’’: F(1, 200)53.49,
p,.05). Mean scores for the 4 subscales were as
follows: ‘‘Sexual rights’’54.62 (SD50.77);
‘‘Parenting’’54.45 (SD50.93); ‘‘Non-reproductive
sexual behaviour’’54.70 (SD50.87); and ‘‘Self-
control’’54.60 (SD50.82).
Attitudes to sexuality 219
Factor analysis of the ASQ–GP
A principal components factor analysis with varimax
rotation was undertaken using the 9 items on the
scale for the general population (see Table 2). Two
factors were identified: the first was labelled ‘‘Sexual
openness’’ and the second ‘‘Timing’’ (since the
items were concerned with when information about
sexual matters should be presented). Internal con-
sistency for the first factor (containing 7 items) was
high at .84. The second factor had only 2 items
(Items 1 & 6) and was not used in further analyses.
Effect of respondent gender and gender of focus of the
ASQ–GP
Using only the data from the respondents who were
under 60 years of age, a 262 ANOVA was
conducted, with the sum of the ‘‘Sexual openness’’
factor as the dependent variable and respondent
gender and gender of the focus of the questionnaire
as the independent variables. There was a main
effect for respondent gender: F(1, 217)53.99,
p,.05, but no effect for gender of the focus of the
questionnaire and no significant interaction. Women
were slightly more positive about sexual openness
than men (Female M536.06, SD55.11; Male
M534.74, SD54.57).
Comparison of attitudes towards the sexuality of
individuals with an ID and typically developing
individuals
Initially, a subscale comprising the items of the
‘‘Sexual openness’’ subscale for typically developing
individuals was created for individuals with an ID
from the items of the ASQ–ID (Cronbach’s
alpha5.72). A paired-samples t-test was then used
to establish whether there was a difference between
respondents’ views on the level of sexual freedom
that should be allowed to those with an ID and the
level of freedom that should be allowed to typically
developing individuals. A significant difference
emerged: t(247)513.59, p,.001, with more free-
dom seen as acceptable for those who were devel-
oping typically than for individuals with an ID
(Intellectual disability M531.42, SD54.85;
Typically developing M534.62, SD55.76).
Respondents’ attitudes to the sexual expression of
individuals with an ID were significantly correlated
with their attitudes towards the sexual expression of
those who were developing typically. Responses to
questions on the ‘‘Sexual openness’’ subscale were
highly correlated with the sum of the same items for
those with an ID (r5.71, p,.001) and with the
220 M. Cuskelly & L. Gilmore
‘‘Sexual rights’’ subscale (r5.77, p,.001).
Responses to questions on the ‘‘Sexual openness’’
subscale were significantly positively correlated with
the ‘‘Parenting’’ subscale, although the correlation
was quite low (r5.35, p,.001). There was a high
correlation with the ‘‘Non-reproductive sexual
behaviour’’ subscale (r5.72, p,.001), and a mod-
erate correlation with the ‘‘Self-control’’ subscale
(r5.41, p,.001).
Attitudes to homosexual behaviour
A paired-samples t-test revealed that the community
was as accepting of homosexual relationships in the
population of adults with an ID as they were of
heterosexual relationships for this group:
t(256)5.05, p5ns (Homosexual item M54.64,
SD51.18; Heterosexual item M54.64; SD51.10).
However there was a significant difference when
attitudes to homosexual relationships within the
general population were compared to homosexual
relationships for individuals with an ID:
t(260)52.06, p,.05 (Intellectual disability
M54.64, SD51.10; General population M54.79;
SD51.18).
Discussion
This paper has reported the further development of a
questionnaire for measuring attitudes towards the
sexuality of people with an ID. The study examined
the factorial structure of the questionnaire, which
had been modified to include questions directly
addressing two hypothesised stereotypical views of
people with an ID (i.e., an inability to control sexual
behaviours and asexuality). In addition, a larger and
more normative community sample was included to
provide a more robust indication of community
attitudes than that available from Cuskelly and
Bryde’s (2004) study. Data were gathered on
attitudes to the sexuality of both males and females
with an ID to ascertain whether these were viewed
differently in the community. Finally, the inclusion
of questions about sexuality in typically developing
males and females enabled comparisons of attitudes
across the four groups.
The results of the factor analysis did not reflect the
eight themes used by Cuskelly and Bryde (2004) as
the basis for their item development. Instead, it
produced one general factor associated with sexual
rights, plus three other factors related to parenting,
non-reproductive sexual behaviour and self-control.
This suggests that the community recognises the
multifaceted nature of sexual behaviour, which
should contribute to more sophisticated future
discussions of sexual rights and responsibilities,
and their implications for individuals with ID. The
availability of a questionnaire that taps these multi-
ple components will facilitate further research of
these interrelated aspects of sexuality.
The two hypothesised stereotypical views of
individuals with an ID were not supported.
Further, despite previous suggestions that attitudes
on sexual rights for people with an ID might differ
for males and females, views in our community
sample for both genders were quite similar, with the
only difference being that males were seen to have
more difficulty controlling their sexual urges.
Our results suggest that community attitudes
towards the sexual rights of people with an ID are
generally quite positive. With the exception of those
over 60 years of age (whose views were less
accepting), attitudes of this community sample were
only slightly less positive for people with an ID than
for those without a disability. Respondents were,
however, somewhat less accepting of homosexuality
for those with an ID than for the general population.
Male and female respondents displayed similar
attitudes.
Community views about parenting by people with
an ID were more cautious than for other aspects of
sexuality, suggesting that respondents recognised
this area to be more complex and to perhaps have
implications beyond the rights of the individuals
concerned. Nevertheless, the mean score for the
‘‘Parenting’’ subscale indicated that respondents
generally held quite positive views about parenting
by individuals with an ID.
The limitations of this study relate to the sample.
The fact that respondents were known personally to
their student interviewers may have biased their
responses towards more positive or socially accep-
table views. In addition, it is likely that participants
who agreed to be interviewed on this sensitive topic
felt more comfortable discussing sexuality, and
perhaps, therefore, held more accepting attitudes.
In addition, only a small number of older people
took part in this study. For this reason, and because
their views were different from those of the rest of
the sample, their data were excluded from some of
the analyses, which limits our capacity to understand
the concerns of this group. Further, the majority of
respondents lived in or close to a large city, so their
views are unlikely to reflect the views of the entire
community; however, this is an empirical question to
be investigated by future research. Finally, the ethnic
background of the respondents is unknown, and this
may also have had some influence on attitudes to the
issues addressed by this study.

Conclusions
This investigation found that members of the general
community accept that individuals with an ID are
sexual beings, and are generally comfortable with
these individuals expressing their sexuality. There
were few differences in their level of acceptance of
those with an ID compared to those who are
developing typically. Female and male respondents
were very similar in their level of acceptance, and
acceptance did not differ significantly for sexual
behaviour in females and males with an ID. It is
possible that attitudes may differ depending upon
the level of disability, however this was not examined
in the current study. Further investigation of the
specific concerns held by members of the commu-
nity about parenting by individuals with an ID
would be useful, in concert with a consideration of
the effect of level of disability on attitudes towards
sexual expression for this group.
Author note
A version of this paper was presented at the 1st Asia
Pacific IASSID Conference, held in Taipei in June,
2005. The authors would like to thank the tutors and
students who helped with the data collection. No
financial assistance was received for this project and
the authors have no financial or other conflict of
interest.
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Attitudes to sexuality 221
References
Antonak, R. F., Fiedler, C. R., & Mulick, J. A. (1989).
Misconceptions relating to mental retardation. Mental
Retardation, 27, 91–97.
Australian Bureau of Statistics. (2005). Year Book Australia,
(No. 1301.0). Canberra: ABA.
Ballan, M. (2001). Parents as sexuality educators for children with
developmental disabilities. SIECUS Report, 29, 14–19.
Blatt, B. (1987). The conquest of mental retardation. Austin TX:
Pro-Ed.
Cuskelly, M., & Bryde, R. (2004). Attitudes towards the sexuality
of adults with an intellectual disability: Parents, support staff,
and a community sample. Journal of Intellectual &
Developmental Disability, 29, 255–264.
DeLoach, C. P. (1994). Attitudes toward disability: Impact on
sexual development and forging of intimate relationships.
Journal of Applied Rehabilitation Counselling, 25, 18–25.
Morgenstern, M. (1973). The psychosexual development of the
retarded. In F. F. de la Cruz, & G. D. LaVeck (Eds.), Human
sexuality and the mentally retarded (pp. 15–28). Oxford:
Brunner/Mazel.
Murray, J. L., MacDonald, R. A. R., & Levenson, V. L. (1999).
Staff attitudes towards the sexuality of individuals with
learning disabilities: A service-related study of organisational
policies. British Journal of Learning Disabilities, 27, 141–145.
Oliver, M. N., Anthony, A., Leimkuhl, T. T., & Skillman, G. D.
(2002). Attitudes toward acceptable socio-sexual behaviors for
persons with mental retardation: Implications for normal-
ization and community integration. Education and Training in
Mental Retardation and Developmental Disabilities, 37, 193–201.
Rollins, B. (1989). Sexual attitudes and behaviours: A review of the
literature. Melbourne: Australian Institute of Family Studies.
Servais, L. (2006). Sexual health care in persons with intellectual
disabilities. Mental Retardation and Developmental Disabilities
Research Reviews, 12, 48–56.