Children with intellectual disabilities at the intersection of adolescence and sexuality: A qualitative study on mothers' experiences regarding care, protection, and sexual education.

PURPOSE: This study explores the experiences of mothers of adolescents with intellectual disabilities regarding care, protection, and sexual education. The study focuses on the impact of increasing physical and behavioral changes during adolescence, intensive caregiving burden, safety concerns, and challenges related to providing sexual education. DESIGN AND METHODS: This study was conducted using a qualitative descriptive design. Semi-structured interviews were conducted with 15 mothers selected through purposive sampling from special education centers in Zonguldak, Türkiye. The data were analyzed using Braun and Clarke's thematic analysis approach. RESULTS: Four main themes were identified: care burden and managing the adolescence process; hygiene and privacy management; sexual behaviors and protection; and perceptions regarding sexual education. Mothers' daily lives were shaped around a completely child-centered routine requiring intensive physical and emotional effort, particularly in managing menstruation, body cleanliness, and aggressive behaviors. While cultural concepts such as "shame" and "sin" were frequently reflected in privacy education, fear of abuse, especially for daughters, emerged as the primary source of anxiety. CONCLUSIONS: Although mothers believed in the necessity of sexual education, they experienced feelings of inadequacy and helplessness due to their children's cognitive limitations. The findings emphasize that sexual education should not be left solely to mothers' individual efforts. IMPLICATIONS FOR PRACTICE: Pediatric healthcare teams should provide family-centered guidance on sexual education, privacy, hygiene, and protection for adolescents with intellectual disabilities. Structured educational interventions and professional support may help reduce mothers' caregiving burden and improve the safety and well-being of adolescents with intellectual disabilities.