Children with intellectual disabilities (IDs) are at an increased risk for experiencing sexual abuse, as compared with their typically developing peers (Mahoney and Poling in J Dev Phys Disabil 23(4):369–376, 2011). One of the most frequently cited populations of sexual offenders against this population are other individuals with IDs. This may be due to skill deficits in areas including social development, cognitive abilities, emotion regulation and awareness, and communication in both expressive and receptive areas. Delays in each of these areas can impact an individual’s ability to navigate healthy sexuality and relationships, partnered or with oneself. Whereas education and intervention can support building capacity for healthy sexuality across the lifespan, there presents a unique opportunity to address both risk-reduction (i.e., addresses the potential victim) and prevention (i.e., addresses the potential perpetrator) by educating one population, that is, all individuals with IDs. Challenges such as the duality of simultaneously being victim and perpetrator, the potential need for education/support and direct consequences, and the balancing act of supporting a potential perpetrator whilst protecting potential victims will be examined in this literature review (Thompson in Health Risk Saf 2(1):33–46, 2000; Fyson in Br J Learn Disabil 35:181–186, 2007).