by Maggie Rudnicki
Sex education is an incredibly important part of any child’s education and will shape their beliefs and experiences going into sexual maturity. The urge to reproduce is one of our most basic biological imperatives that goes back to Darwinian evolution – we are driven to survive and reproduce. It is, therefore, of great importance for everyone to understand how their bodies work and how to take care of them. Sex education should be place for young people to learn about puberty, reproduction, gender, sexuality, sex, the benefits and risks of sex, reproductive health, and interpersonal relationships. Unfortunately, many people across the country do not have access to comprehensive sex education. Individuals with disabilities are particularly affected by this. Society has trouble viewing people with disabilities as sexual and thus excludes them from sex education. When people with disabilities do receive sex education it is often an inaccessible curriculum that doesn’t fit their learning style or body. Better sex education for people with disabilities can have numerous benefits such as protection from sexual assault; better hygiene, social skills, and body positivity; and a more fulfilling sex life.
A major obstacle in getting people with disabilities sex education is the belief they’re all asexual, which is not true. Disability and an enjoyable sex life are not mutually exclusive. People with disabilities, just like anyone else, can fall anywhere on the spectrums of sexuality, gender, and expression. They are just as entitled to information about themselves and their bodies as their non-disabled peers. Because people with disabilities may require extra care and attention our society frequently sees them as perpetual children and denies them access to information they need in order to make healthy decisions and gain an understanding of themselves. Even if an adult with an intellectual disability and exhibits what some may call “child-like” intelligence, they still possess an adult body with reproductive organs and sex hormones. Sexual urges are not suppressed simply because one doesn’t understand sex or doesn’t have a body fitting society’s standard of normal. People with disabilities are capable of having satisfying sex lives, romantic/sexual relationships, and families. As people of equal importance, they deserve the sex education that will aid them in living their best life. Ignoring the sexuality of people with disabilities will not make it disappear. Better sex education for people with disabilities and the general public will, however, lead to a world more accepting of everyone’s sexual nature.
Other problematic views are seeing people with disabilities as hypersexual and oversexualizing/fetishizing them. Because some people with intellectual disabilities may have trouble understanding the difference between behaviors that are public and private, they may begin to touch themselves in inappropriate situations during puberty. Other may see this behavior and believe they have abnormal or an abundance of sexual urges that they cannot control. In reality it’s simply a natural urge that they don’t yet understand is only for private spaces. To further the issue of hyper-sexualization there are instances of people having their photos stolen off the internet and posted on websites fetishizing people with disabilities. One woman reported that she was only 12 when her photos were stolen and posted to a website for so-called “amputee devotees” (Henley 2017). The internet can be a dangerous platform where people with disabilities may be targeted. Actions like this are disrespectful, predatory, and harmful to the individuals involved and the disability community as a whole.
It’s an unfortunate fact the most sex education simply isn’t accessible. Frequently sex ed is taught during gym – a class many people with limited mobility may not attend. When sex education happens in the classroom, people with disabilities are sometimes asked to leave. On top of that, there is a huge lack of representation of people with disabilities within class materials for sex education. Finding an image of someone in a wheelchair or with a white cane in a sex ed textbook or video may be near impossible. These instances not only exhibit blatant discrimination but promote the problematic idea that people with disabilities, for one reason or another, don’t need sex education. It sends a terrible message to young people when they have little to no opportunity to participate in sex ed and if they do they won’t see anyone resembling themselves. It’s as if society is saying that people with disabilities can’t or shouldn’t have sex.
When students with disabilities do get sex education its often inaccessible and/or spreads misinformation. The responsibility of sex education is sometimes given to parents, but they are not always the best resource for information about sex. While it’s important for parents to talk with their children about sex, they do not have specialized training and may have received improper sex education when they were young. Parents may also portray inaccurate information to children due to their own lack of education, religious beliefs, or out of fear that talking about sex will be seen as giving permission for their child to have it. In the classroom students are often given a reproduction-only view of penis-in-vagina penetrative sex. While this is an important part of the reproductive process, it isn’t the only way to have sex and it isn’t the only way to have a baby. This education may be an abstinence-only approach to avoiding pregnancy or it may include the use of various contraceptives. A heteronormative and reproduction-only view of sex is problematic to everyone. Different couples are going to have different combinations of bodies and genitalia and therefore are going to need different resources to find what works for them sexually. This may include different barrier and hormonal methods of contraception, sex positions, and sex products. A sex positive curriculum that includes gender, sexuality, contraception, pleasure, and consent is vital to the development of a proper sexual education.
Along with what is actually taught in sex education, how it is taught matters a great deal. The information taught to students is going to differ depending on their age and learning ability. The curriculum needs to change as students mature emotionally and sexually. Modifications may need to be made to programs for people with intellectual disabilities. Because they learn in a way that’s different from most non-disabled people simply putting them in a more informative class won’t help. Some students may not be able to fully comprehend the human anatomy and physiology without extra help. The information needs to be presented in a way that’s meaningful and effective to the audience. This may include a greater use of visuals and role playing.
Sex education is also part of teaching students, especially young women, important hygiene practices. Beginning menstruation is a difficult part of every girl’s life but having a disability that may impede understanding what is happening or the physical process of handling menstrual products (pads, tampons, menstrual cups, etc.) can make it all the more difficult. Periods can very painful and can come with many other symptoms making them even harder to deal with. Good sex education can help these girls understand what is happening in their body, how to use menstrual products, how often to change menstrual products, how to treat their symptoms, and how different methods of birth control may help them manage their periods.
People with disabilities may have to look after their own reproductive health as well. People with disabilities are screened for STIs, breast cancer, cervical cancer, and other reproductive health problems at lower rates than those without disabilities (Heisley 2015). It’s important for people to understand the symptoms of genital infections and other reproductive problems to know when to seek help. A simple urinary tract infection can quickly spread to a bladder, kidney, and blood infection, which can be deadly. Several STIs can cause infertility and death if left untreated. Breast and testicular self-exams are often taught in sex ed are a vital step in catching cancer early. Sex education can save and improve the quality of lives but people with disabilities still receive a lower proportion of instruction on sex, birth control, STIs, and pregnancy (Boehning 2006).
The impact of sex education which may be of the most significance is its potential to decrease sexual assault. The instance of sexual assault among the disabled community is incredibly high. According to the World Health Organization children with disabilities are 2.9 times more likely to be victims of sexual violence. The number rises to 4.6 times more likely if they have intellectual impairments (World Health Organization n.d.). The problem may be even bigger than that, unpublished data collect by the United States Department of Justice was disclosed to NPR, who reported that people with disabilities are 7 times more likely to be victims of sexual assault (Shapiro 2018). There are, of course, still instances of sexual abuse that go unreported and undiscovered. An individual’s disability may prevent them from understanding that they’re being sexually assaulted or from communicating that something is happening to them. A person with a disability may also be afraid to report abuse due to fear or a lack of power. When people with disabilities are abused by a caregiver they find themselves is a position where there is an enormous imbalance of power. When someone is dependent on a caregiver they may feel powerless to report abuse out of fear of repercussions on their care.
Sex education can help decrease sexual assault among people with disabilities by helping them understand it. It can be hard for someone to name what is happening to them if they don’t understand it and don’t know the language to describe it. Sex education can teach students who it’s okay to touch and be touched by as well as what kind of touching is and isn’t appropriate. It can help students understand what consent is, how to give it, and that it can be revoked at any time. Simply teaching students “stranger danger” is ineffective because most of the time the victim knows their attacker. This is true even more so for people with disabilities. NPR again cites the DOJ’s unpublished data stating when someone with a disability is abused the abuser is a stranger only 14% of the time. In comparison when an able-bodied woman is assault the attacker is a stranger 24% of the time (Shapiro 2018). By educating students about consent, sexual assault, and what to do if abuse is suspected, sex education can help decrease sexual assault. When an individual can understand what’s happening to them they can say no, and they can report abuse when it happens.
By teaching students about healthy relationships and promoting body-positivity and self-confidence, sex education can help prevent people with disabilities from getting into abusive relationships. Young people with disabilities may believe that because they are different they would be lucky if anyone wanted to be in a relationship with them. A high level of loneliness paired with a belief like this makes a person vulnerable to getting into an abusive relationship. People have a tendency to accept less than they deserve because they think they can’t do any better. Young people are so impressionable and may need reassurance that they can have satisfying sexual relationships. Teaching students about the warning signs of an abusive partner and giving them resources can help if they ever do find themselves in an abusive relationship. Sex education can teach students to accepted themselves, their bodies, and their sexual nature so they can find a fulfilling relationship. Body positivity will even extend beyond someone’s sex life and impact the way they feel about themselves everyday.
The things taught in sex ed can have positive impacts in other areas of people’s lives such as in their social skills. Adults with intellectual disabilities who didn’t receive adequate sex education may struggle later in social and workplace situations. Skills such as how to effectively and politely refuse and offer, carry on a conversation, and maintain self-control may be taught in a sex ed class for the intellectually disabled. These skills are often taught in the context of initiating romantic/sexual relationship with others but are easily translated to a host of other social situations. People with intellectual disabilities may struggle to understand what sort of behaviors are appropriate for public and which are for private, causing them to exhibit inappropriate sexual behaviors in public. Through sex education these people can come to understand the urges they’re feeling and conduct them in appropriate spaces.
Sex education materials aren’t just for young students, they also benefit the lives of adults. Sex education is extremely important before and during puberty but is nonetheless important as an adult. We need better sexual resources now for adults who didn’t receive them when they were younger and for people who didn’t become disabled until adulthood. Acquiring a disability is a major change in someone’s life that, of course, is going to have an effect on their sex life. A disability can change both the logistics of sex and how someone feels about their body. As, with any other life change, it’s going to take some getting used to. People need to feel comfortable with their bodies and understand how to work with their differences in order to achieve their desired sex life.
There isn’t an abundance of resources for adults to learn about how sex is going to work for them after becoming disabled or for adults with disabilities looking to improve their sex life. One study showed that 50% of disabled adults felt dissatisfied with their sex life and complained about a lack of resources (Boehning 2006). After someone has an injury resulting in a disability sex isn’t discussed frequently or in depth. Patients mostly learn about toileting, getting dressed, skin care, etc. with little mention of sex even though it’s just as normal as getting dressed every morning. It’s to be noted that men generally acquire about their ability to get an erection almost immediately while women’s concerns are generally later in the recovery process (Heisley 2015). It can be difficult for doctors to discuss this with their patients, but sex may be important to their overall quality of life.
Health care professionals need to be better equipped to talk about sex after disability and there needs to be a greater number of resources. Patients may need instruction from their doctor about how to go about having sex while disabled. After injuries that have resulted in decreased genital sensation people can still find ways to experience pleasure. The brain rewires and can make adjacent areas such as the cervix and abdomen more sensitive. There is even a host of adaptive sex toys designed for a number of conditions. There are high powered vibrators for such cases of decreased sensations and stain proof blankets exist for people who have poor bladder/bowel control during sex. The Intimate Rider is a piece of sex furniture designed for men with spinal cord injuries (SCI) and/or limited mobility (HealthPostures LLC n.d.). It’s a chair that moves back and forth using the abdominal muscles and/or arms allowing couples to enjoy a wider variety of positions and a more active sex life. Sex is an important part of a relationship and doesn’t have to be thrown away because one or both partners is disabled. Sex fosters intimacy within a relationship no matter what form it takes. If educators and health care professionals were more comfortable talking about sex and had a greater number of resources, the lives of many patients could be improved.
Even though the Individuals with Disabilities Education Act (IDEA) (originally called the Education for All Handicapped Children Act) was enacted in 1975 and the Americans with Disabilities Act (ADA) was enacted in 1990, people with disabilities still struggle to achieve equal rights. Sex education is one such area where they particularly struggle. Students with disabilities are sometimes asked to leave sex ed classes or not offered the opportunity at all because they take place during gym, a class they may not attend. When people with disabilities do access sexual education materials they are often inaccessible and/or inaccurate. People with disabilities can be just as sexual or unsexual as anyone else and have the same right to sex education. The benefits of sex education even extend beyond that of sex itself to better hygiene, protection from sexual assault, and social skills. Proper sex education would be a major step in achieving equality and breaking stereotypes about the sexuality of people with disabilities. In order for this to happen society needs to accept people with disabilities for who they are and make a change in the way they treat them.
Advocates for Youth. n.d. “Sexual Health Education for Young People with Disabilities – Research and Resources for Educators.” Advocates for Youth. http://www.advocatesforyouth.org/publications/publications-a-z/2559.
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