This chapter provides an overview of the main trends in Sweden for people with intellectual disability since deinstitutionalisation was completed in 2003. The country’s rights-based disability legislation applies in all 290 municipalities, yet different interpretations of the law and its application result in people receiving very different levels and quality of support. This, together with general trends towards individualisation and marketisation in society, has resulted in what can be described as negotiated welfare. A parallel trend, which started in the 1990s and continues today, is the increasing categorisation of children and young people as disabled. An additional and growing phenomenon is self-advocacy. Here, adults with intellectual disability who share the experience of being categorised by society, come together and support each other in taking a greater role in their own lives and in influencing society for greater inclusion and accessibility. This chapter examines some of the important developments that have characterised the lives of people with intellectual disability and their families in recent decades. There is particular focus on self-advocacy and the increasing disparities in support and services.