Support worker’s understanding of the sexual and reproductive health and rights of women with intellectual disability : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Psychology (Endorsement in Health Psychology) at Massey University, Auckland, Aotearoa New Zealand

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Women with intellectual disabilities (ID) face significant challenges to their sexual and reproductive health and rights (SRHR). Sexual ableism and gendered assumptions limit their sexual agency and access to education and services. They also contribute to high levels of physical and sexual abuse in this population. Support workers caring for women with ID under in residential disability services play a key role in supporting, or further obstructing, the SRHR of these women. However, there is little research on this topic internationally and almost none in Aotearoa New Zealand. Therefore, the purpose of this research is to explore support workers’ understanding of this topic. Framed within a feminist constructionist approach, a reflexive thematic analysis was used to explore patterns in language use: constructions of women with ID’s sexuality and needs, the support worker role, and how support workers position themselves and others in their accounts. I considered the wider implications of these constructions for the agency of women with ID and their SRHR. I developed four main themes: (1) “a working relationship like no other”; (2) “powerless and invisible women”; (3) “what if it gets complicated”; and (4) “in the absence of guidance”. The findings highlight a tension between managing potential risks to the women in care, while enabling their sexual expression, as discourses of victimisation, human rights, gender, and ableism intersect in various ways. Based on the findings, I suggest opportunities for developing training and policies to help support workers empower women with ID and discuss future directions for research in Aotearoa New Zealand.