PERSONS WITH DISABILITIES
Written by Geri Newton
Sexual awareness is normal. Sexual feelings are
normal, and there are many ways of expressing one's sexuality. If
a person has a disability, it does not change any of this. What
often changes is the socialization that provides the foundation
for sexual identity.
In America, people with disabilities are sometimes
oppressed and treated as less than someone without an identifiable
disability. This can have a profound impact on the individual's
self-identity. Often, people with developmental disabilities feel
they are bad or that something is wrong with them. By extension,
they can feel that their normal sexual feelings are also bad or
wrong. Humans' sexual drive is a primary drive; it is not optional.
We have a sexual drive as long as we have enough to eat, drink,
and sleep; and we are not under undue stress.
As parents, it is critical that we give our children
a loving understanding of human sexuality. If we give them the message
that their sexuality is precious and wonderful, then they will have
some information with which to balance the rather conflicting messages
they will likely receive from the dominant culture.
In the early years, we give children information
on being a boy or a girl. It is also helpful to give them correct
names for their body parts including penis, vagina and anus. These
terms should be taught using relaxed and open language.
Children will fondle themselves during early childhood.
Not responding to this behavior is fine in the early years. If this
behavior occurs during dinner or at Aunt Martha's birthday party,
then distracting them without drawing attention is certainly appropriate.
When they are old enough to be aware of others around them, saying
to them: "I know that feels good and it is supposed to feel
good, but it is also something that is special and private."
This type of explanation would help them understand their sexuality.
Whatever words you choose, they will best serve a child by imparting
the notion that sexual feelings are wonderful and very personal.
Bath time is also a good time to teach body awareness including
the need to treat one's body with respect. Based on my experience,
I believe this can be taught, regardless of the identified level
If we allow the child's disability to keep us
from teaching these concepts, then we will leave him/her vulnerable.
Just as children learn to eat, drink, sleep, and deal with fear,
they can learn to express their sexuality. In fact, children need
appropriate support to express themselves sexually; and this support
includes information about appropriate boundaries and various ways
to show regard for one's self.
Teenagers and Adults
By the time they move into their teens, they will
experience changes in their bodies that are reflected in their sexuality.
They will begin to experience orgasms. They will grow pubic and
underarm hair. Overall body hair will change. A young man's voice
will change. A young woman will begin to menstruate. Imagine going
through these changes without knowing the names of body parts, without
the preparation of anticipating change, and without the awareness
that someone trusted is available if he/she has any questions. This
type of information helps these individuals know that they are not
"falling apart" and that they can ask questions. It is
not enough to just wait and then tell someone "oh, by the way,
ask if you have questions."
Around this time, young men and women may begin
to masturbate. This activity can be engrossing after bringing oneself
to orgasm the first time. This is normal and should not cause undue
concern unless they are so engrossed that they are missing other
parts of his/her life. In that case, it would be helpful to assist
them in understanding balance in their activities. It may be as
simple as letting them know that evenings and bedtimes are good
times to masturbate, whereas daytimes are important to develop other
This is a good time to explain further the function
of body parts. For young men, explain to them why they cannot urinate
with an erection, how a penis works, etc. For a young woman, explain
to them where to find the clitoris and what it does, and why she
menstruates. If a person has autism and experiences tactile defensiveness,
masturbation may look different. The individual may rub harder or
with short rapid movements, more like a grinding motion. It is important
to determine if the person is still enjoying the sensation and not
causing harm to him-/herself. If he/she is causing abrasion to the
tissues, offering K-Y jelly or some other water-soluble lubricant
may be helpful.
After a young woman begins menstruation, she is
old enough for regular vaginal exams. Many will be terrified of
these exams. Women with disabilities often need training on how
to breath during an exam, how to relax the vaginal muscles, and
how to be assertive with the physician in order to go through exams
without being medicated. Women who do not speak can be taught to
use gestures to tell the doctor to "stop" or "wait."
This is also the time when parents may begin to
worry about pregnancy. In Oregon, we have a strict law regarding
sterilization. This law came about because many women and men with
disabilities were abused. It is nearly impossible now to sterilize
a person with a disability. Good self-care and an understanding
of one's sexual needs and responsibilities can keep a person as
safe as possible under normal circumstances, but there will be times
when concerns about pregnancy and/or sexual behaviors will result
in the need for oral or other forms of contraception. As a result,
many people have used chemicals to prevent pregnancy. Self-management
may also be useful when teaching appropriate sexual behavior.
Another important consideration is sexual abuse.
Women are abused sexually at alarming rates. Women who have a disability
appear to be abused even more. While accurate statistics are difficult
to obtain, it is certain that all women and men with disabilities
need to be aware of their healthy sexual options; and they need
to know what to do if faced with sexual abuse or sexual contact
that makes them uncomfortable.
It is important for people to understand that
nothing they do makes someone abuse them. It is the perpetrator
who makes the decision to sexual abuse. Therefore, when teaching
people about how to say "No" to unwanted sexual contact,
we must be sure to avoid giving the impression that they are responsible
if they are abused. Nothing could be further from the truth.
In order to teach assertiveness, like saying "No,"
we have to stop teaching command compliance. We should teach negotiation,
compromise, etc., but not compliance. We can also teach them to
discriminate between reasonable and unreasonable requests, how to
be assertive, and how to find an appropriate sexual partner. If
we tell people that they cannot have sex, then we increase the risk
that they will respond to their sexual feelings and not tell us.
If they are abused, we may not know it unless we can spot the indicators.
It is important to help adults understand that
if someone is trying to talk them into something without respecting
their feelings or wishes, then the safest answer is "No."
Sexual abuse is not about sex. Sexual abuse is about power. If we
support people to define their own style of personal power, they
are in a better position to understand someone who is trying to
control them. A person who listens to the wants and needs of others
is more likely a safe partner. We can teach this using role playing.
Many of my clients have told me that having sex
with someone is the only time they feel normal. They have a job
that they know a "normal" person would not have. They
cannot drive. They are not free to go where they want, when they
want. They always have to tell someone where they are and who they
are with. They feel like they are treated like a child. Yet when
they are sexual with someone, they are just like everyone else -
a grown-up. I have received this same message from people with identified
IQ's from 30 to 70, verbal and nonverbal.
Unfortunately, some people are victimized sexually
because they value the feeling of sexual activity. If we can recognize
the power of an abusive relationship because of one’s sexual feelings,
we will be better able to support people in developing ways to discriminate
respectful relationships that can grow and benefit both people.
It is important to teach the context for a sexual
relationship. This starts to develop during the early teachings
of how and where to masturbate; how to enjoy sexual expression;
valuing self; showing respect for others and expecting respect towards
self; learning to express emotions such as anger, sadness, and joy
in ways that other people can understand; and developing a sense
Adult men and women who have disabilities may
or may not be aware of their own attractiveness and how they present
themselves to others. Women who have a disability may want to shave
their legs in the summer. Men may want to experiment with hairstyles.
Both may want to decide what looks best on them. This may seem trivial,
but it is important; it allows them to deal with the world.
Some individuals with autism
may need specific instructions about social expectations. Some manners,
ways of conversing, or sexual mores may not have meaning for them
in the same way a person without autism might experience them. For
these individuals, it is important to provide them with ample information
about social rituals and boundaries. Role playing, discreet reminders
when in public, and lots of practice are helpful.
People are sexual beings. It is not a choice or
an option. It is a truth. The best sex education is a full awareness
of social skills, boundaries, sexual expression, and expectations.
Geri Newton is a consultant in ethics, sexuality
and therapeutic interventions. If you would like to contact Ms.
Newton, her office number is: (503) 363-6347, and her mail is: email@example.com
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