Institutions for persons with disabilities also have a higher risk of becoming a victim of sexual violence even if to a lesser extent than women. Easily accessible internal and external sex education offers and counselling opportunities should therefore be available. Sex support must be possible The freedoms mentioned also include the opportunity to avail of external sex support as is specially offered by some associations for persons with disabilities. Availing of paid sex services must be accessible for persons with disabilities – regardless of whether they live inside or outside of institutions and facilities – within the legally permissible framework. It must be considered in this context that many persons have difficulty in masturbating due to their intellectual and motoric impairments. When sexual needs cannot be fulfilled, helplessness can turn into anger and aggression that are directed towards the self or third parties. Denial of the sexuality of persons with disabilities, a lack of sex concepts in facilities or the categorical exclusion of all support services is not compatible with human rights standards. The rights of transgender, homosexual or bisexual persons should be given special emphasis here. Inspection of the underlying conditions will be a focal point of NPM preventive monitoring and control work in the future. It should be mentioned in this context that there are existing examples of good practice and several institutions and facilities are pursuing this topic with great commitment. For example, Commission 3 reported about a facility in which the topic of sexuality was communicated openly. Together with a sex therapist, a concept was drafted involving the residents and sex education kits provided. Commission 5 reported about seminars on sexuality that were also offered outside the facility. Commission 6 visited a facility in which support from a sex pedagogue is offered and all residents have sufficient privacy to enable them to lead a selfdetermined sex life. The Commission also reported about a residential group that set up a couple-support circle. Other institutions introduced mandatory participation in further training on this topic for the staff. XX  Sex concepts should be mandatorily created and implemented by all operators of institutions. XX  Persons with disabilities must be guaranteed sufficient privacy in all facilities. XX  Persons with disabilities should have the opportunity to receive sex education and information in institutions. XX  Operators of facilities should remove legal uncertainties on the part of the staff through training and guidelines. 92