This article was written by Amber Melvin. It was originally posted on the Unite for Reproductive and Gender Equity (URGE) website on February 19, 2015. It has been posted here with both her permission and the permission of URGE.
Please note this article uses the term “disabled person” rather than the person-first language of “person with a disability” to acknowledge how disabilities are not a result of one’s body, but disabilities are created by structural barriers that make it more difficult for folks with different bodies to navigate the world.
Disabled people have sex. Disabled people sometimes have sex with able-bodied partners, sometimes with partners who are also disabled, and sometimes disabled people have sex with themselves. These statements are often shocking to the uninformed because many people do not think of disabled people as being interested in or capable of having sex.
Some people’s ability to experience sexual pleasure may be altered by their impairment or disability; however, this is not often the case. While there has been some research into the sexual dysfunction of people with physical impairments, outside of the physical limitations of the body, there has been very little analysis of what we need to do to meet the sexual needs of disabled people.
The issues for disabled people in regard to our sexuality are diverse and complicated; therefore the solutions for them will likely be just as complex. Sadly, whether it is academic research or training for health professionals, the reality and needs of disabled people who want to have healthy sex lives is largely ignored.
As a teenager with a visible impairment, sexual and reproductive health was not discussed with me until my late teenage years. While my peers were hearing about the birds and the bees, the only nod to my future sex life was when I was urged to see a geneticist to discuss the likelihood of having disabled children.
None of my healthcare providers ever mentioned sexual activity or protection from sexually transmitted infections (STIs) to me. My only interaction with medical professionals regarding sexuality and reproduction was done in a way that could have potentially dissuaded me from having children in the future.
Like many disabled people, I was treated like a case to be solved. My disability was looked at as a condition to be overcome through medicine, science and adaptive devices. I was not seen as a whole person who might do things differently, but who has the same desires, fears and questions that any teenage girl would have.
A critical first step in addressing the unmet needs of disabled people is to look at the work being done by the reproductive health, rights and justice movement and identify the missed opportunities. We cannot advocate for comprehensive sex education if it does not include reference to the needs and acknowledgement of the sexuality of disabled people. While many young people learn sexual knowledge from their peers, a study of disabled young people looked at how disabled youth have even less access to health education from peers because they may be socially isolated.
Disabled people are often seen as asexual, so discussing their needs in a school-based, sex education class can actually help to change that image and open up the opportunity for young, disabled people to feel better able to talk about their own fears and desires. The fact is that communication skills are important to all young people as they try to create healthy relationships. By encouraging people to consider the specific needs someone with a disability might have, we would be helping all young people to have an awareness of and begin to develop the language to navigate things like needs, consent and pleasure.
Ensuring inclusive information in the classroom is critical. We also need to look at improved access to the services to manage and protect the sexual health of disabled people. With the passage of the Affordable Care Act, there has been both renewed attention and some funding to support cultural competency in health care. As part of these efforts, we should look at how to better train health professionals to consider the needs of disabled people.
Young able-bodied people may be asked by their doctors if they are sexually active or how many partners they have had, or they may have had condoms or birth control offered to them; while people with visible impairments may not receive the same questions or concerns due to assumptions about their sex life or desires. Further, some disabled people may have different needs in accessing these things if they are unable to bring them up out of shyness, embarrassment or because of language that assumes that disabled people would not need the same kind of information or support.
Disabled folks, just like other young people, should be counseled and educated about STI testing, resources on safer sex practices for all sexual identities including LGBTQ folks, birth control, and vaccinations against STIs beginning in adolescence. Health professionals should also have resources or information about issues related to sex and disability.
But safe sex and contraception are not the only sexual and reproductive health needs of disabled people. As we go through life, we ask the same questions of whether or not we would like or are ready to be parents. We may need to seek abortion care. We may want to become pregnant. Gynecologists should talk to disabled people about plans for pregnancy and families and any particular preconception needs we may have. Many disabled people I have talked to expressed concerns and assumptions about their own ability to carry a pregnancy or raise children. We should be able to seek out health professionals to help support us in finding the information we need to consider our parenting options, without encountering bias and fear-mongering because of assumptions others (yes even medical professionals) have about our ability to parent.
Expanding the way that we look at sex education and cultural competency in health care are just some of the ways that we can begin to meet the reproductive and sexual health needs of disabled people. Taking these important first steps would show that while we don’t always get it right, we are a movement that is trying to represent and respect the voices, lives and experiences of all people.
Amber Melvin is the Programs and Policy Assistant at Reproductive Health Technologies Project and an URGE alum from California State University, Long Beach.