The aim of this study is to examine how the responsibilities of organizations, services and professionals are described in relation to enabling sexual health and self-determination for people with disabilities in Sweden. The study focuses on which measures, approaches and competencies are emphasized as necessary to support the right to sexuality, as well as how these issues are addressed within the scope of social work related welfare services. Particular attention is paid to the tension between care and protection of individual autonomy.

The study is based on qualitative analysis of secondary data in the form of media material and previous scientific research. The material is thematically analyzed through a norm-critical and rights-based perspective, with crip theory and sexual ableism as an analytical framework to try to explain and challenge prevailing norms surrounding sexuality norms.

The findings in this study indicate that the lack of clear guidelines, policies and structural governance contributes to professional uncertainty and passivity in work related to sexuality and persons with disabilities. In practice, this often results in the avoidance of sexual health issues or reliance on individual professionals' personal values rather than shared ethical and organizational frameworks. The study further demonstrates that professional practice is shaped by ableist norms and a dominant risk-oriented perspective, in which sexuality is frequently associated with danger rather than pleasure, intimacy and self-determination.

At the same time, the material reveals perspectives that challenge these assumptions by emphasizing sexuality as a fundamental aspect of a good life and as a matter of equality and human rights, although these perspectives remain largely parallel rather than dominant in practice. A comparison between Swedish and Danish approaches shows that clearer guidelines and educational initiatives in Denmark contribute to a more active and enabling approach to sexual health, while Sweden is characterized to a greater extent by uncertainty and passivity.

Overall, the study demonstrates that responsibility for sexual health and self-determination is often shifted from a structural level to the individual professional, resulting in unequal conditions for persons with disabilities to have their sexual rights fulfilled. The findings highlight the need for clearer governance, shared guidelines, and increased knowledge to strengthen professionals' ability to work in a rights-based manner with individual autonomy at the center.