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Background. Sexual health is frequently overlooked for people with intellectual disability (ID). Recently there have been increased expectations that disability service providers will address this issue. An important part of so doing concerns the sexual knowledge of people with ID. Several ID-specific tools have been developed to assess sexual knowledge. This thesis examines the barriers to sexual health provision for people with ID, how clinicians use these tools, and their perspective on the tools’ usefulness and usability. Methods. This research used constructivist grounded theory. It was conducted in two concurrent phases. Phase One involved semi-structured phone interviews with disability service managers. Phase Two involved face-to-face semi-structured interviews with clinicians working in sexual health provision for people with ID. Analysis occurred during data collection. Sampling continued until theoretical saturation was reached and no new themes emerged. Findings and Discussion. Qualitative analysis identified 16 barriers to sexual health service provision including; lack of funding, lack of appropriate sexual knowledge assessment tools, minimal staff training, attitudes of others and the reactive nature of sexual health service provision. Sexual knowledge assessment was not routine and was typically only assessed following problematic sexualised behaviour, usually seen to be displayed by males. If a person with ID did not have their sexual knowledge assessed then they generally did not receive any sexual health provision. Clinicians said that they need the tools to support their work on sexual health. They also reported that the tools have gaps and are not fully meeting their needs or those of people with ID. Areas of concern identified for these tools included; missing important sexual health topics, complex wording of questions and not enough pictures.