Affective and Sexual Citizenship in Mental Disability. Voices, Practices, and Psycho-Educational Interventions for Young Adults with Intellectual Disabilities, Autism, and Severe Mental Illness

This doctoral dissertation investigates the intersection between mental disability—including intellectual disability, autism spectrum conditions, and severe psychiatric disorders—and the right to affective and sexual citizenship. Although sexuality is widely recognized as a constitutive dimension of both health and citizenship, it often remains a neglected “gap” within care pathways for young adults, who are frequently trapped in the paradox of the “eternal child.” Using a qualitative, multi-method research design informed by Participatory Action Research (PAR), the study involved 13 young adults aged 18–40 in semi-structured interviews and 10 primary caregivers in six focus groups. Data were analyzed through Braun and Clarke’s Reflexive Thematic Analysis (RTA), revealing a profound tension between young people’s desire for autonomy and the dynamics of control, infantilization, and educational reticence exercised within familial and institutional microsystems. The research also included the development, implementation, and evaluation of a modular psycho-educational intervention grounded in the principles of Comprehensive Sexuality Education (UNESCO). Results from the pilot project showed a significant increase in participants’ knowledge and awareness (average +30%), particularly regarding the management of personal boundaries (the Circles Model), privacy, and autonomy in body care. The original contribution of this work lies in the proposal of an Integrated Ecological Model for Mental Disability, which expands Bronfenbrenner’s framework by introducing concepts such as the “Defensive Mesosystem” and the “Permeability of the Exosystem” as conditioned by social capital. In conclusion, the dissertation argues for the necessity of Relational Justice, calling for a paradigm shift from a logic of “risk containment” to one of “enabling subjectivity,” in which affective inclusion is recognized not as rhetoric, but as an everyday practice of rights recognition.