Sexual Identity/Curiosity is when individuals, through actions or words, display interest regarding their sexuality. This could include differences between themselves and others, body changes, sexual identity issues, cross dressing, etc.. Staff shall respond to individual's sexual questioning and concerns with sensitivity and dignity in a relaxed, mature, and professional manner, commensurate with each individual's chronological age and level of understanding. Questioning shall be considered a behavior which indicates readiness for sex education and training. Respond to the questions or actions in a non-judgmental manner, providing privacy and support. If an individual is non-verbal and expresses curiosity, anticipate questions and verbalize them for the individual appropriate to his/her level of understanding. If an answer is unknown, staff should refer questions to the individual's program manager. Document the behavior and action taken. Refer the incident to the program manager.
Question 1: If a person served asks you a question about their sexual identity, you should:
Sexually Explicit Material is any material such as books, photographs, movies, videos, that clearly depict behavior which is intended to cause sexual excitement. Adults have the right to possess sexually explicit material. Some persons served may be more susceptible to the impression received from viewing sexually explicit materials than others. Persons served, age 18 years and older, may possess sexually explicit material that is not clinically contraindicated or otherwise prohibited by law if kept in private. Sexually explicit material shall not be displayed on walls, in a common area, so that respect for the feelings and values of others is maintained. If sexually explicit material is found in the personal possession of an adult, the individual shall be allowed to keep it. If sexually explicit material is found in public areas, it shall be removed from the area. If pornographic materials are found, inform the client that the possession of such is illegal (Pornography is material depicting a sex act involving sadomasochistic abuse, excretory functions, bestiality, or a child.) If an individual 18 years of age or older shares his/her material with other individuals who are under the age of 18, staff are to interrupt the activity in a non-punitive manner. Volunteers/staff will not purchase or provide sexually explicit materials. Document the behavior and action taken.
Question 2: If you find sexually explicit material in the private bedroom of a person served:
Body Exploration/Touching is when two or more individuals are engaged in looking at, touching, or fondling each other's body for the purpose of curiosity. Body exploration and touching shall be considered a normal means of human sexual expression and may indicate readiness for sex education and training. It is permitted under appropriate circumstances. Inappropriate touching includes, but is not limited to: touching strangers; touching that causes discomfort or injury to the other person; touching that causes the person to be seen as immature, objectionable, and/or offensive, causing embarrassment to self and others. When appropriate, leave the individual(s) alone when the location and degree of body exploration/touching and degree of privacy are appropriate and he/she is not infringing on the rights of others. When inappropriate, interrupt the individual's behavior. Take advantage of the "teachable moment" and discuss the behavior with the individual utilizing appropriate sex education material. Document the behavior and action taken in the service documentation.
Question 3: Body exploration:
Masturbation is defined as sexual self-stimulation. Masturbation shall be considered a normal means of sexual expression. As with all explicit sexual behavior, it is appropriate to particular times and places and shall permitted under the appropriate circumstances: if the resident's behavior is not infringing on the rights of others; if conducted in private; if masturbating is not a health hazard, injurious, or interferes with training/programming. Excessive masturbation is when the act of masturbation consistently interferes with the individual's participation in his/her daily activities or becomes physically harmful. Staff should be aware that masturbation is not always purely sexually motivated. Other precipitating factors can include: boredom, attention seeking, frustration or agitation, ill-fitting clothes, genital infections or irritation, or social withdrawal. In addition, medication can result in sexual dysfunction, which may contribute to prolonged masturbation (i.e., inability or difficulty in achieving orgasm). These factors must be considered by the Interdisciplinary Team when developing programs. Consideration will be given to each individual's moral and religious convictions before any training program is recommended by the interdisciplinary team. When appropriate (the location and degree of privacy are appropriate and they are not infringing on the rights of others), leave the individual alone. When not permitted, interrupt the behavior. Discuss the issues of privacy and appropriateness with the individual in a non-punitive manner. If the individual is masturbating in public, tell him/her to stop and escort him/her to a private place for counseling on appropriate places for private acts. The staff member will give the individual the choice of returning to the public setting or going to a private place. The staff person should document the incident and the action taken.
Question 4: Is masturbation considered a natural means of sexual expression?
Nudity is the condition of being without clothing or other covering. Nudity shall be recognized as a normal occurrence of human behavior and shall be permitted only in preparation for or during showering, bathing, dressing, retiring, or any private activities. Upon discovering an individual who is inappropriately nude or attempting to be nude without the goal of showering, dressing, retiring, etc. staff should direct the individual to the appropriate area for dressing, showering, or toileting. Staff should ask the individual to dress himself/herself if he/she is capable of accomplishing the directive. If not, the individual shall be dressed by the staff. Staff should determine the extent of the individual's understanding of the behavior and discuss the inappropriateness of the behavior with them. Document the behavior and action(s) taken and report it to the program manager.
Question 5: Nudity is a normal occurrence if a person is:
Body exposure is the exposing of one's body to provoke, excite, or stimulate the individual or others. Body exposure shall
not be considered a socially acceptable behavior. Upon discovering an individual who is exposing his/her body, ask the individual to dress himself/herself if capable of accomplishing the directive. If not, the individual shall be dressed by the staff. Discuss the behavior with the individual. Topics to cover might include: acceptable areas for being undressed (i.e., own room with curtains and door shut, bathroom with door shut and no one else in the room); laws against public exposure. Document the behavior and action taken on an Incident Report and service documentation. Report the behavior to the program manager.
Question 6: Body exposure is
Dating is a social engagement between two individuals where both have expressed a desire to be in the company of each other. Dating shall be recognized as an acceptable socializing experience in human social and sexual development. Staff should provide supervision as indicated by the Individual Support Plan and document behavior and action taken. The Interdisciplinary Team shall determine the level of supervision necessary in consultation with the individuals. This decision will be based on their ability to interact in a socially appropriate manner, follow rules and use good judgment, understand and manage one's sexual
desires, and comprehend and utilize training in human sexuality.
Question 7: Dating:
Petting is defined as any kissing or caressing of the arms, neck or facial areas, legs, buttocks, genitals, or breasts for the purpose of sexual arousal. Petting shall be recognized as a normal means of human sexual expression between two consenting adults and is permitted under appropriate circumstances. Petting shall be considered appropriate under the following circumstances: the behavior does not infringe upon the rights of others; the individuals have demonstrated an understanding of and responsibility for their sexual behavior; the individuals are establishing a personal relationship; the location and degree of privacy is appropriate; the behavior is not excessive and does not interfere with other designated learning activities; the behavior is not injurious; the individuals know appropriate social behavior, including an understanding of discretion and privacy; the individuals know how and when to say yes or no, either verbally or behaviorally. When permitted, allow individuals to continue petting. At the appropriate time, discuss with the individuals their feelings and understanding of the behavior and the accompanying responsibility. Document the behavior and action taken. When not permitted, interrupt the behavior. Discuss with the individuals the feelings and understandings of the behavior. Document the behavior and actions taken in the service documentation. Report the behavior to the Program Manager.
Question 8: Petting is appropriate if:
Sexual intercourse is sexual relations between consenting adults. Sexual intercourse will be recognized as a normal means of sexual expression between consenting adults. Sexual intercourse between unmarried individuals will not be promoted. Individuals are urged to participate in the sex education training. Individuals that are sexually active are encouraged to have routine screenings as recommended by their personal physician. Sexual intercourse will not knowingly be permitted at
inappropriate times and places, but will be permitted under the appropriate circumstances.
Sexual Intercourse is appropriate under the following conditions:
a. Individuals are consenting adults.
b. Individuals have been provided information about birth control and show an understanding of birth control information.
c. Individuals have demonstrated an understanding of and responsibility for their sexual behavior.
d. The location and degree of privacy is appropriate.
Sexual intercourse is not appropriate under the following conditions:
a. The individuals' behavior infringes upon the rights of others or is coercive or abusive.
b. The behavior is conducted in public.
c. One or both individuals are under 18 years of age.
d. Individuals have not demonstrated an understanding of and responsibility for their sexual behavior
e. Individuals have not been provided with birth control information or show an understanding of birth control information.
f. If sexual intercourse is limited in the Individual's Support Plan.
g. The behavior interferes with other designated learning activities.
If appropriate circumstances, allow individuals to continue the sexual activity uninterrupted. At an appropriate time, discuss with the individuals their feelings and understanding of the behavior and the accompanying responsibility.
If not appropriate circumstances, stop the behavior in a non-punitive manner. At an appropriate time, discuss with the individuals their feelings and understanding of the behavior and the accompanying responsibilities. Document the behavior and action taken in an Incident Report. Refer the individuals for medical examination to assess for possible injury, abuse, disease, or pregnancy when considered appropriate by the team. Report the behavior to the Program Manager and document the behavior and action taken.
Question 9: When shall sexual intercourse be considered inappropriate?
Birth control, for the purpose of this policy, includes abstinence and contraceptive devices such as birth control pills, IUD's, diaphragms, condoms, etc. Sterilization is a medical procedure, which may render an individual sterile. This procedure should be performed only after the consultation with a physician and the informed consent of the individual and/or guardian with specific court approval. Education and information on birth control shall be available to individuals. Notice of the availability of birth control information shall be conveyed to each individual in a method they can understand. Individuals shall be informed that any decisions they make regarding birth control shall not influence their receipt of services. When appropriate, staff shall refer individuals to the interdisciplinary team for discussion of possible contraceptive needs. The individual's physician shall have primary authority for prescribing and dispensing oral contraceptives, intrauterine devices (IUD), and diaphragms upon request from individual and/or consent of guardian. Because of the potentially significant implication for persons served and others, decision-making in the area of birth control must include special efforts to insure informed consent and due consideration of the ability of the individual to take responsibility for the consequences of his or her actions. Sterilization will not be initiated by this agency. Individuals will be responsible for their own non-prescription birth control devices. Documentation shall identify which individuals were given birth control information.
Question 10: Birth control information should
Sexual abuse is any sex act between persons when prior consent is not provided or resulting in harm or injury to either party or in violation of state law. All persons have the right to be free from sexual abuse and exploitation. Sexual abuse has been defined when:
* The act is done by force or against the will of another.
* If the consent is procured by threats of violence toward any person
* If the act is done while the other is under the influence of a drug inducing sleep or is unconscious.
* Such other participant lacks the mental capacity to know the right and wrong conduct in sexual matters.
* Such other participant is a minor.
Any sexual activity between staff (paid or volunteer) and a person served shall be considered abuse. Any sexual act committed by an adult with a child is a criminal act. The occurrence of sexual abuse or exploitation may indicate a need for professional social-sexual education, training, and counseling. The reporting of sexual abuse or exploitation will be done on the basis of state law. If you become aware of sexual abuse you should stop the behavior in a non-punitive manner, if possible, and separate the individuals immediately. Notify medical staff, program managers, and house managers. Look for any signs or evidence of sexual abuse. Preserve all evidence in the room by making sure that nothing in the room is touched or moved. Follow mandatory reporting procedures and/or contact local law enforcement when justified. Document the behavior and action taken and file a written incident report.
Question 11: It is considered sexual abuse if:
Marriage is a union of two consenting adults, the institution whereby individuals are joined in a special kind of social and legal bond. Marriage will be recognized as an acceptable and normal part of the human social and sexual developmental process between two consenting individuals. The Iowa Code prohibits issuing a license for marriage for "mentally ill or retarded, a mental retardate, or under guardianship as an incompetent." This law has not received a recent court challenge. In any event, common law marriages are, under certain conditions, legal and recognized in Iowa. The Interdisciplinary Team should identify whether or not the individuals are their own guardians. If guardianship is in place, the couple should secure the approval of guardians. The team should help locate suitable housing, identify supports needed and provide counseling/recommendations for marriage. This decision will be based on the individual's ability to interact in a socially appropriate manner, demonstrate good judgment, understand and manage one's sexual desires, or have completed and utilized training in human sexuality. If there is reason to believe that a genetically transmitted condition exists, appropriate genetic counseling should be encouraged. If individuals who marry have children and are incapable of rearing those children, the same legal and professional procedures concerning parenthood that apply to all parents will apply to them also. Finances/budgeting should be carefully considered.
Question 12: Marriage is all of the following EXCEPT:
Pregnancy is the development of an embryo/fetus in the uterus following the fertilization of an egg. Adults have the right to choose to have a child or children. If there is reason to suspect that an individual has become pregnant, refer the individual to the program manager so that appropriate medical treatment can be accessed. If persons served by Progress Industries are considering pregnancy, the following should be encouraged:
* Individuals are consenting adults.
* Individuals understand the responsibility involved in child rearing, nurturing, financial obligations, and genetic counseling.
* Use of birth control is practiced until pregnancy is desired.
* Individuals would be encouraged to be married.
* Individuals have consulted with their physician and have had genetic counseling, if appropriate.
Pregnancy would not be encouraged if
* Individuals are not consenting adults.
* Individuals are not married.
* Individuals do not demonstrate an understanding of sexuality and parenting responsibilities.
* Individuals have not consulted with a physician or the physician has determined that a pregnancy would be a risk to them.
If there is reason to suspect that an individual has become pregnant, appropriate medical tests will be performed immediately. If the medical tests confirm a pregnancy, this issue shall be addressed by the Interdisciplinary Team in a timely manner. The individuals shall be encouraged to discuss the situation and the options, privately, with the physician of their choice and shall be assisted in locating pregnancy counseling. The Interdisciplinary Team will facilitate the identification and accessing of pertinent educational and medical resources through the pregnancy counseling agency or the community. If they are deemed unable to make responsible decisions, the Interdisciplinary Teams shall assist them. Any decision regarding termination of pregnancy will be the responsibility of the physician, the individual, and the guardian, if appropriate.
Question 13: Which of the following is NOT an accurate statement?
Sexually transmitted diseases are any diseases which occur as the result of a sexual act or relationship. All individuals have the right to protect themselves against sexually transmitted diseases. Individuals have the right to be educated regarding the transmission and protection against such diseases. When an individual is suspected to have a sexually transmitted disease or there is reason to believe a sexually transmitted disease may have been contracted, staff should report the situation to the Program Manager and document the situation and action taken in the individual's records. The individual should be observed for signs and symptoms of sexually transmitted diseases and advised to schedule medical tests to verify whether a disease is present. The individual should be encouraged to notify sexual partner(s).
Question 14: Persons served by Progress Industries should be encouraged to
Sexual harassment is communication and/or physical touch of a sexual nature, which the person finds offensive. Progress Industries believes that all persons served have the right to living and working environments that are free from sexual harassment. If staff witness or become aware of possible sexual harassment, they should interrupt the behavior, discuss with the individuals their feelings and understanding of the behavior, document the behavior and actions taken in the service documentation, and report the behavior to the Program Manager.
Question 15: If staff become aware of sexual harassment they should do all of the following EXCEPT: