Sexuality and Disability
In approaching the topic of sexuality and disability, it is hard to develop a framework on where to start. There are so many different types of disabilities and varying levels of functionality within each of those categories, that identifying all of them is way beyond the scope of one blog. However, we are going to simplify this topic into a few main categories in order to talk about how the concepts and realities of “disability” impact sexuality elements.
categories of disabilities:
- Physical (e.g., needing a spine brace, blindness, hard of hearing, etc.)
- Developmental (e.g., autism, Down Syndrome, intellectual disabilities)
- Mental/Emotional (e.g., bipolar, major depression, schizophrenia, etc.)
It should be noted that some disabilities may fall into more than one category and that people can have multiple disabilities. For example, some people with Down Syndrome can have both physical and developmental delays or someone struggling with fibromyalgia may also find themselves dealing with depression as a result. People with disabilities are just that, people. And they have the same wants and desires as typical-functioning or able-bodied people. They want to lead happy fulfilled lives and desire to have relationships, like most other people do.
Sexuality can be a tough and uncomfortable subject, but when disability is layered on top, it is even more so. Parents and teachers may not know exactly how to bring up the subject, when to bring it up, or what information is appropriate for what age. They may not think they are adequately prepared to have these conversations and may let discomfort prevent them from discussing sexuality with young people or people with disabilities in their lives. Sex and sexual development are not reserved for the “able” community and the importance of starting conversations on this subject is vital for everyone.
Why Talking Disability and Sexuality Matters
Young people primarily get their information about sexuality from their parents, teachers, peers, and media. The age when they are figuring out who they are, what they like, and how they are going to express themselves, is a critically important time of development. The World Health Organization identifies sexuality as an integral part of being human. They note that the opportunity to be able to express sexuality is a human right. So the flipside of that is if you deny a person the opportunity to express their sexuality and create meaningful relationships, you are denying them an important part of being human. It is, of course, difficult to approach these conversations, and many times the whole concept is overlooked or ignored for a variety of reasons. Many people assume that disabled individuals won’t understand or that talking about it will make the person more interested or active in the sexual realm. Don’t be afraid to ask for help in having these conversations. Counselors can help and are often used to helping to navigate difficult conversations so that the important information does not get lost.
The unfortunate reality is that those with disabilities are at a much higher risk of being the VICTIM of sexual assault than the general population. This risk underscores the need for talking about body autonomy, safe touches, and appropriate versus inappropriate expressions of sexuality, among many other related topics.
How this becomes an issue?
As an example, imagine a young man of 19 with Down Syndrome. His aids, caretakers, and parents treat him like a child, because he does not act as though he is 19. They hug him and encourage him to hug them back, but never talk about appropriate versus inappropriate hugging. One day they are at Target, he sees a pretty girl, and goes up to hug her and it is not received well by the girl. Uh oh, what now? For individuals who may not be able to discern differences between situations, it is the responsibility of those around them to help these individuals to develop that discernment, so that they don’t find themselves in problem situations.
Sexuality Doesn’t Just Mean Intercourse
Humans are social creatures, they crave intimacy. However, this doesn’t always have to mean sexual intercourse. Humans also require emotional intimacy, or the reciprocity of a deep connection that brings about fulfillment. This can understandably bring up some fears for parents and caretakers of those with disabilities:
What happens if they want alone time with a person?
What if they get taken advantage of?
What if they end up wanting to have sex?
Well-intentioned family members, friends, and caretakers may have some of these fears (and more!). These can be addressed by having honest conversations. The delivery and content of the conversation depends on the functioning level of the individual, but the discussion as a whole can be immensely helpful when discussing how to get needs met in a healthy and safe way.
Myths About Sexuality and Disability
- People with disabilities are dangerous
- People with disabilities will never have sex
- People with disabilities don’t want to have sex
- People with disabilities don’t need to learn about sex because they are asexual
- People with disabilities wouldn’t understand the information anyway
Stigma, Shame, and Risk
There is already so much stigma and shame associated with having a disability that if the sexual expression of such a person is stifled or shamed, it can really influence their mental health. They may not know how their own body functions, or how to protect themselves from unwanted pregnancies or STDs. Not to mention, if they are taught to shut off that part of themselves (the sexual part), they may be more at risk for not only developing mental health issues, but also being taken advantage of in relationships. This could include having trouble saying “no” when they want to say no, feeling as though their wants and needs don’t matter, or wanting to please other people to the point of their own detriment.
Honest and open conversations about sexuality are needed for young people and people with disabilities at any age, and for anyone who wants support for that matter. It’s normal for people with disabilities to be curious about their own bodies and the bodies of others, and we are doing a disservice to our differently abled comrades if we deny this part of their identity. If you are looking for support regarding a sexuality related issue, or need assistance with these types of tough conversations, counseling is a great resource. You can access local counselors through your insurance carrier, Psychology Today, or by asking friends and family who they have seen. When you contact a counselor, ask about their experience and comfort level in approaching these topics. Don’t be afraid to shop around until you find someone that not only you would be comfortable with, but that your loved one would be with as well.
At Angelus Therapeutic Services, we have several therapists who have extensive experience in helping families explore these issues and set up healthy and safe boundaries around topics of sexuality. If you are in the western PA region, explore our therapist bios and see if one of our clinicians may be the right fit for you and your situation.
Blog Credit: Natalie Drozda, MA, LPC is a PH.D student in Counseling Education and Supervision at Duquesne University & therapist at Angelus Therapeutic Services