Problem sexual behaviour

Problem sexual behaviour may be related to the person not understanding concepts of public, private or acceptable behaviour. For problem sexual behaviour that does not pose a risk to others, see Inappropriate sexual behaviour in a person with developmental disability.

Problem sexual behaviour can be a response to abuse; for advice on recognising, asking about and reporting suspected abuse, see Abuse, trauma and supporting people with developmental disability. Refer people with developmental disability exhibiting problem sexual behaviour for positive behaviour support. Appropriate interventions may include sex education, psychological and behavioural therapies.

Antilibidinal medication has limited evidence for efficacy in treating problem sexual behaviour, particularly in people with intellectual disability. The use of medication to inhibit sexualised behaviour is contraindicated on the basis of potential adverse effects, and raises serious legal implications in every state. It is governed by both state and federal regulation of ‘chemical restraint’, and should only be considered when there are significant risks (eg sexual offending) and other interventions have been trialled and found to be ineffective. Use of antilibidinal medication in people with developmental disability requires special authorisation; see Restrictive practices, the law, and the responsibility of the doctor.

Antilibidinal medications include hormonal and psychotropic (ie antipsychotic, antidepressant) drugs. Hormonal drugs can have serious long-term adverse effects, including osteoporosis and hepatotoxicity, and requires regular monitoring with blood tests. If antilibidinal medication is considered, refer to a psychiatrist with experience in developmental disability.