"Good services will help people with learning difficulties develop opportunities to form relationships, including ones of a physical and sexual nature. It is important that people can receive accessible sex education and information about relationships and contraception."

This statement from Valuing People, the government white paper on learning difficulties, represents an important challenge to services. Policy documents in Wales, Scotland and Northern Ireland contain similar messages.

Lesbian, gay and bisexual (LGB) people with learning difficulties may have additional needs or face particular barriers in this area of their lives, including prejudice and discrimination in wider society, as well as from staff, services, family and friends. But until recently the stories and experiences of LGB people with learning difficulties have been largely hidden. Finding out more about their lives represents a crucial step in working out how best to offer support, services and information.

Researchers at the Norah Fry Research Centre, University of Bristol, worked in partnership with Terrence Higgins Trust and Regard, the national organisation of gay, lesbian and bisexual disabled people. A three-year study, funded by the Big Lottery Fund, aimed to find out more about the experiences of gay, lesbian and bisexual men and women with learning difficulties.

The research involved interviewing 71 staff in 20 learning difficulties services across the UK about their views and experiences of working with people with learning difficulties who were, or may have been, gay, lesbian or bisexual; and interviewing 20 women and men with learning difficulties who were having, or wanted to have, a same-sex relationship.

The people we interviewed told us a lot of distressing messages. Much of it reflected the experiences of non-disabled LGB people but some differed. For example, in relation to "coming out", people's fears of rejection from friends and family were strong, but among people with learning difficulties it was exacerbated by their concern abut "coming out" to staff and services. They were worried that if they did so, services would be taken away, or even that they would be asked to leave the places where they lived.

Mark talked about why he did not want people at his day centre to know he was gay: "They might start being funny with you, saying, 'Well, you shouldn't be that, you know, you're not that, you're just being silly'. They might even say, 'If that's the way you're going to start acting then you're not coming to this organisation any more'. You might even get dropped from the centre."

Unfortunately, the fears that people had about coming out to staff were sometimes well-founded. Interviews with staff showed that most services were reluctant to engage with gay, lesbian or bisexual people. Some of this was homophobia; sometimes a fear of doing work in the area without the support of policies, training or management. But often it was because only a few staff did things that sent a message to others that it was all right to be lesbian, gay or bisexual.

This quote from a worker in a day service speaks volumes: "The local day centre found a couple of men having sex in the shed and guess what they did to deal with the problem? They took down the shed. I think that says it all."

However, a few services that we visited as part of the research were doing thoughtful and effective work. This was often no more than putting up pictures of same-sex couples on the walls of offices and services. In two services where this had been done, gay men with learning difficulties had said it made them think that it would be safe to come out. Paul said the pictures made him feel that it was "all right to have anybody you love", while Jim said the pictures that were around at his advocacy service made him think "everyone's equal here so I'll come out".

A report by gay equality organisation Stonewall in 1996 found that LGB people experienced high levels of verbal and physical abuse. In our group of 20 people, 19 said that they had been bullied, called names or assaulted. Much of the verbal abuse came from close family members. Four people told of serious discrimination and harassment in their places of work. Half of the people we interviewed had been physically or verbally abused by strangers on the street or on public transport. Christine told us about children in her neighbourhood who had called her names for being a lesbian.

"Some of them do call and spit at us and stuff, and I hate that. They are not as bad now, they lay off a bit. But when I first moved they used to call over and hit the ball at the door and chuck stones and stuff."

Finally, the people we spoke to had a lot to say about love. People wanted boyfriends and girlfriends to fall in love with, do day-to-day things with and to have sex with. A few people were in relationships but most were not. They told us about some of the barriers they faced - prejudice, difficulties in meeting other people, hostility when they used gay pubs and clubs.

Ann spoke at length about her isolation and depression - a theme common to almost all of the interviewees. She longed to meet another lesbian and was on medication to suppress her sexual feelings: "My mum had to get me tablets to calm me down." But two young women, Angelique and Sarah, who had met each other through a magazine, spoke at length about how much in love they were.

LGB people with learning difficulties were clear about what they wanted from staff in services. They wanted staff to be supportive and non-judgmental about their sexuality. They wanted practical help to achieve important goals such as going to places where they might meet other LGB people. People wanted help and information to think about the emotional aspects of relationships, and clear information about sex which makes them feel like adults and not children.

Stephen offered an eloquent and robust challenge to ambivalent staff: "It's actually taken me a while for staff to understand I am who I am and let's get on with it. It's all right in my life, it is me that's dealing with the issues, and all you do is support me with my issues. And that's been hard work. Just say it. If you're not happy with who I am, just say it. I'm not going to change who I am to please you. Tough luck! Get on and like me for who I am, or go and find a different job."

This research has uncovered much of what was previously hidden in the lives and experiences of people with learning difficulties. What we can keep with us as we move forward are the words of one man, simply and clearly expressed:

"I suppose my ultimate dream is to be with someone who I'm going to be with for the rest of my life."

Don't we all have similar goals for our lives? 

Training and learning
The author has provided questions about this article to guide discussion in teams. These can be viewed at www.communitycare.co.uk/prtl and individuals' learning from the discussion can be registered on a free, password-protected training log held on the site. This is a service from Community Care for all GSCC-registered professionals.

Abstract
This article reports on research into the problems and prejudices lesbian, gay and bisexual people with learning difficulties face when they come out to professionals, family and friends.

Further information
D Abbott and J Howarth, Secret Loves, Hidden Lives? Exploring Issues for People with Learning Difficulties who are Gay, Lesbian or Bisexual, Policy Press, 2005. Available from Marston Book Services on tel 01235 465500; fax 01235 465556; e-mail direct.orders@marston.co.uk.
A summary of research findings and information about resources for people with learning difficulties and for staff is available on the Norah Fry website: www.bris.ac.uk/Depts/NorahFry

Contact the author
By e-mail: David Abbott at d.abbott@bristol.ac.uk
Joyce Howarth at joyce.howarth@bristol.ac.uk 

David Abbott is a research fellow at the Norah Fry Research Centre, University of Bristol. He has worked for the past three years with co-researcher
Joyce Howarth, exploring issues for lesbian, gay and bisexual people with learning difficulties.