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Disability and Sexual Health

The sexual needs of people who live with disabilities are the same as everyone else’s but overcoming the stigma and gaining access to basic sexual-health-related information and services is much more challenging for them. Those with disabilities are still disproportionately underserved when it comes to sexual education and resources, both as adolescents and later in life. In this article, we discuss how to make information about sexual health more accessible for everyone, regardless of our physical or mental capabilities.

As much as 10% of the human population lives with some kind of disability and people who live with disabilities are often dissociated from their sexual needs. Their sexuality and reproductive health tend to be neglected, which makes it more challenging for them to advocate for these rights.

The impact of ableism

‘Ableism’ is conscious or unconscious discrimination against people with disabilities. If disability isn’t something that affects your life, you are probably unaware of how a simple thing you take for granted can be an insurmountable challenge for someone else if left unaddressed. Even well-meaning people can be ignorant of the experience of others and can easily fall into patterns of discrimination, unwittingly putting people with disabilities at a disadvantage. We can raise awareness to remedy this.


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Like everyone else, people with disabilities have sexual needs, desires, and fantasies they want to express and experience but when it comes to talking about them most non-disabled folk shrug and move on to another topic. It is still very common that teachers, doctors, and others who are potentially in a position to help ignore the importance of these basic human needs for a person living with a disability. This exacerbates the stigma and widens the disparity between those who live with disabilities and those who don’t.

People who live with disabilities face additional challenges to their sexual and reproductive health. Not only do many of us behave thoughtlessly, but the social and physical infrastructure of our world is built for the average person and does not take the wide variety of human experience into account without a reminder.

A lack of accessible information

Sexual education is a fundamental right. All young people should have the opportunity to learn about their anatomy, puberty and physical changes, sexual health, contraception, consent  and other vital information. Unfortunately, people with disabilities are often excluded from such conversations. Many of them are homeschooled for a variety of reasons and it is up to their parents to teach them basic sex ed on top of everything else. However, many parents avoid discussing sexuality with their children, disabled or not. Some parents are afraid of adolescence when their children cease being children and begin to feel a need for sex and for intimate relationships outside the family. Others dissociate their kids from sexuality because they have been taught to see this basic human need as a sin.

If a child with a disability does attend school, they might struggle to relate the information given about changing bodies as a diversity of body types are rarely represented.


Educational resources usually picture only average bodies, which excludes the many kids whose bodies aren’t reflected by the standard types presented.

Adolescents who don’t have others to talk with about their changing bodies and new experiences may be less confident about their sexuality and more susceptible to sexual violence, health problems, unplanned pregnancies, and sexually transmitted diseases.

Sexual and physical violence

People who live with disabilities are at a higher risk of experiencing sexual and physical violence compared to those who don’t.


People with disabilities are three times more likely to experience some kind of violence. People with developmental disabilities are the most vulnerable. In fact, 80% of women with developmental disabilities have suffered sexual abuse.

If a person doesn’t understand what’s happening to them, they are much less likely to call for help or flee from sexual abuse. Most abusers are close to their victims; they may be family members, caregivers, medical staff, or personal assistants. Those who live with disabilities and suffer abuse are often in a dependent relationship with their abuser and have no one to turn to, and even if they do reach out, the authorities tend to ignore their claims.

Read more about rebuilding intimacy after an abusive relationship.


Poor access

Many people who live with disabilities can’t access much-needed information about their reproductive and sexual health due to physical obstacles. Poorly designed, outdated, and dilapidated infrastructure, especially in rural areas, can pose insurmountable challenges to people with mobility issues. This increases the risk of untreated illnesses and complications related to sexual and reproductive health, such as STDs and unwanted pregnancies.

In some facilities, medical staff lacks the preparation and training to serve people with disabilities, so their needs may be ignored or not taken seriously. Some healthcare providers are prejudiced when it comes to providing sexual health resources to people with disabilities; they limit access to services or reject a young person’s dream of getting pregnant or raising children because they don’t see sexual behaviour as normal for someone whose body does not reflect the norm.

Stereotypes

In many societies, people with disabilities aren’t seen as sexual beings. That makes it more challenging for them to find partners, have healthy relationships, and engage in satisfying sexual experiences. This prejudice strips people who must live with such challenges of their fundamental human rights and freedoms. Stereotypes divide people into groups without any interest in nuance or circumstance. We use shortcut thinking for all sorts of reasons every day but should think twice when it comes to questions of human dignity.

Exclusion of people with disabilities from the decision-making process

People with disabilities are often left out of decisions that directly influence their rights and wellbeing. Many still see them as those who receive services rather than people who can actively participate in solving their own problems, present their point of view, and suggest potential solutions. By excluding perhaps, the most relevant source of information, helpers cannot transform their good intentions into useful solutions.

Lack of support

Another all-too-common stereotype is that people with disabilities cannot be good parents. When people with special needs decide to become parents, they are often ridiculed and denied the support commonly given to others. In fact, most women with disabilities—even intellectual impairment—can take excellent care of their babies. While they might need some modified apparatus and other adaptations, they can manage to create families and raise children. However, they are at a much higher risk of losing their parental rights. Even without proof, social services are more likely to remove children from such families because of the deeply rooted prejudice that remains in the medical community.

The journey through pregnancy, childbirth, and the postpartum period can be challenging for any woman, let alone a woman who must also cope with a disability. Poor access to resources and clinics also means a greater risk of complications due to delayed medical attention.

Solutions to make sexual and reproductive health more accessible

The sexual and reproductive health of people who live with disabilities isn’t currently receiving the attention it needs. Here are a few suggestions for how we can make their experience more positive.

Raise awareness

When 10% of our population lives with some sort of disability, and many more are directly affected by their experience, our society is foolish not to address these issues. Educating people about what living with different disabilities entails and raising awareness about the fact that most people can live happy and healthy lives despite their challenges is essential to breaking the stigma.

Training the medical community about the social aspects of living with a disability is another way of making information and other resources more accessible to people with limited capabilities.

Diversify the decision-making process

Inclusive decision-making means ensuring that everyone’s experiences are taken into account. People with disabilities tend to be seen as incapable of advocating for themselves and so are often left out of decisions that directly affect their lives. Ideally, decisions should be made by those who must live with them, bringing in specialist advice when necessary; this way we can transform nice words into appreciated actions.

Education

Most reproductive and sex education programs have been designed for the averagely abled, so young people with special needs often find it hard to relate. Representing people with limited mobility, health conditions, and intellectual disabilities in the educational curriculum will help them feel seen and give everyone a better understanding of how sexuality and reproduction work in diverse circumstances.

Representation matters. Without information, people tend to get scared and make assumptions. Diversifying the information presented to include a greater variety of bodies and experiences will help us all relate to each other’s problems and break the stigma.

Better infrastructure and access to facilities

Specialized transport, inclusive infrastructure, and community openness are crucial to creating an experience of dignity and equality for people living with disabilities. Hospitals and medical clinics, public and commercial buildings should provide wheelchair ramps and lifts to ensure access for people with mobility issues.

Affordability is also an important factor in ensuring equal care. As many people with disabilities live in poverty, it’s necessary to provide specialised transport services or compensate for travel to ensure that everyone has equal access.

Whether disability affects you or not, improving the accessibility of services in your community improves life for everyone who lives there. We won’t achieve equality as long as the needs of people who live with disabilities are ignored. Let’s make the world a better place for all of us.

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http://www.nln.org/professional-development-programs/teaching-resources/ace-d/additional-resources/pregnancy-in-women-with-disabilities
https://www.oregon.gov/oha/PH/HEALTHYPEOPLEFAMILIES/YOUTH/YOUTHSEXUALHEALTH/Documents/SexualHealthDisparities-DevelopmentalDisabilities.pdf
http://apps.who.int/iris/bitstream/handle/10665/44207/9789241598682_eng.pdf;jsessionid=573696B2E273B840AC0132EE7CAC28FC?sequence=1
https://www.betterhealth.vic.gov.au/health/ServicesAndSupport/disability-and-sexuality
https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/intellectual-disability-and-sexuality
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