Disability and Sex
What do I mean by disability and sex?
Everyone has different capabilities and some people have more serious restrictions on what they can or can’t do. Whatever disabilities a person is faced with, they are still a person and still may have their wish to participate in a sex life. The nature of that desired sex life can encompass all the gender, sexual and relational diversity that we work with in the able bodied community. The Disability Rights UK vision is of a society where everyone with lived experience of disability or health conditions can participate equally as full citizens. Accordingly, in the realm of sexology, it is important to offer services that do not assume that the person’s disability is the basis of their problem. It is also important to have awareness and sensitivity to the additional barriers faced by those with a disability that restrict their opportunities to express their sexual self.
Types of disability
It’s worth remembering that not all disabilities are visible. People can experience disability in various ways and to varying degrees.
Physical disabilities, howsoever caused, can affect mobility, strength, dexterity and some aspects of sexual function.
Sensory disabilities can affect sight, hearing, communication, sensations (like touch, taste, smell and balance).
Neurological disabilities can affect coordination, expression and may result in pain.
Cognitive disabilities can affect how a person relates to others and the world (e.g. Autism Spectrum and ADHD).
Psychological problems can affect can affect how a person feels able to live (e.g. Dementia, Phobias and PTSD).
As psychotherapists and sexologists we are mostly concerned with the client’s lived experience and their relationship with their disability, rather than the disability itself. Medical specialists exist for that purpose.
How can a sexologist help?
It is up to the sexologist to create a welcoming, open minded space free from assumptions, prejudice, and ignorance. Within that mature space it would be hoped that the client can discuss their issues without reticence or shame, and that a teamwork approach can be created to find fitting solutions. A sexologist may also work with the intimate partner(s) of someone with disabilities, or with them all together. It can help to broaden the definition of what constitutes sex to encompass all the dimensions of eroticism and sensuality so that clients and their partners (if appropriate) can experience a satisfying expression of their sexuality. Often using humour can be a key to a more interesting, enjoyable and mutually pleasurable sex life.
Things to watch out for
All the usual rules of sex still apply, you still need to practice safe sex! There can be additional complications and medical issues with some types of disability. For example some spinal cord injuries can affect bladder and sphincter control, so sensible precautions can be introduced. Reduced sensation can lead to skin damage so again, sensible precautions and careful attention/lubrication can minimise problems. Sometimes there is a risk of a sudden rise in blood pressure (autonomic dysreflexia) so partners can be trained to spot the signs and know what to do if it happens. Good, clear, comprehensive and well informed communication is the best solution.
There are resources out there which can offer support, guidance and products to enhance the sex life of a person with disabilities. Here are a few examples:
www.disabilityhorizons.com has many articles on relationships and sex for people with disabilities.
www.pleasuregardenshop.co.uk and www.jodivine.com have articles on relevant sex toys and assistive devices.
www.erikalynae.com offers blogs covering a range of topics including sex toys for people with disabilities
A sex surrogate is a professional substitute sex partner. They stand in for actual sex partners so the client can practice and learn how to do things. They typically work as part of a team with a sexologist. COSRT’s position is that members may discuss sexual surrogacy with clients, but may not help secure these services for clients nor make specific recommendations.