Introduction Sexuality relates to how people express themselves as men and women. This is culturally defined and influenced by family, peers, religion, the law, customs, knowledge and economics. Development of sexual maturity is a biological process which happens to almost everyone, including people with a learning disability (the exceptions include people with syndromes that affect sexual maturation). Heshusius (1987) reviewed the literature on perceptions of sexuality by people with learning disabilities and found that 'at least for the most part, sex is desirable, an essential part of life, pleasurable and adding warmth and excitement to living - not unlike the meaning it carries for most people'. In this chapter we shall examine how society has responded to people with learning disabilities expressing their sexuality, and the particular issues which face them in the areas of sex education, abuse, contraception and parenthood.