Sexuality and disability is a topic regarding the sexual behavior and practices of people with disabilities. Like the general population, individuals with disabilities exhibit a wide range of sexual desires and adopt diverse methods of expressing their sexuality. It is a widespread concern, however, that many people with disabilities do not receive comprehensive sex education, which could otherwise positively contribute to their sexual lives. This stems from the idea that people with disabilities are asexual in nature and are not sexually active. Although some people with disabilities identify as asexual, generalizing this label to all such individuals is a misconception. Many people with disabilities lack rights and privileges that would enable them to have intimacy and relationships. When it comes to sexuality and disability there is a sexual discourse that surrounds it. The intersection of sexuality and disability is often associated with victimization, abuse, and purity, although having a disability does not change someone's sexuality, nor does it change their desire to express it.
For physical disabilities that change a person's sexual functioning, such as spinal cord injury, there are methods that assist where needed. An individual with disabilities may enjoy sex with the help of sex toys and physical aids (such as bed modifications), by finding suitable sex positions, or through the services provided by a sex worker.
History Much of the sexual biases in the United States are traced back to Puritan ethics. Issues on the acceptance of sexuality and disability root back to 2000 years. The review of history on sexuality in philosophy, religion, and science leads to the modern day views on sexuality and disability. Religious institutions were the first entities to combat sexuality. They believed that sex was a sin and should not be practiced unless it was done with intents of reproducing. Then doctors began developing medical views on sex. Sexual pleasure was deemed a sickness. The taboo around sexuality being a disease and sin restricted many people from expressing their sexuality, especially people with disabilities.
After much groundbreaking research, it was not until the 20th century that sex and pleasure became normalized. With the normalization of sex, pleasure became the main focus. Healthy sex meant a good performance that led into an orgasm. If a person was not able to orgasm during sex they were seen as inadequate for sexual intercourse. With this a sex therapist would help the individual explore oral sex, and clitoral orgasm. When a person with a disability is not able to achieve an orgasm it was not seen as problematic, because they did not have sexual desires. The neglect on the sexual lives of people with disabilities roots from the idea that they are childlike and asexual. Because people with disabilities do not fall under the category of being sexual, there were no resources for them to seek sexual assistance.
Over the years sexually disenfranchised groups were working towards sexual acceptance for all people, including queer and disabled communities. The work of these groups began to open doors for people with disabilities to become more expressive of their sexuality. Even with these new found opportunities, sexual pleasure for people with disabilities remained unspoken of.
Self-image Having a disability may sometimes create an emotional or psychological burden for the individual with disabilities. They may feel inhibition about pursuing relationships, fearing rejection on the basis that they have a disability. Self-image may suffer as a result of disfigurement, or lack of confidence. A New York disabled dating service manager explains, "Sexuality, travel, mobility, pain: Everything takes on a different dimension." In The Ultimate Guide to Sex and Disability, Miriam Kaufman points out that attempting to hide a disability or minimize its existence is ultimately an added burden, encouraging readers to "come out" to themselves as having a disability, to accept their disability.
There is often fear associated with the intersection of sexuality and disability. Many people with disabilities embody a fear of being rejected due to the way they look. This hypersensitivity causes the individual with disabilities to keep interactions platonic. Author of Sex and Disability Robert McRuer studied a man with disabilities. McRuer gave insight on the individuals sexual and non-sexual encounters. This man had a belief that crossing the line into sexual encounters meant it would cause severe bodily harm for him. During a sexual encounter, the man felt very uncomfortable and could not cross the sexual boundary. This was due to his fear of being judged. This is an issue common in some people with disabilities. The "evaluative gaze" coming from others causes people with disabilities to feel judged and uncomfortable in their own bodies.
It is a common misconception that people with disabilities are insecure and have a negative self-image. A study was done on 7 adolescents with cerebral palsy, to assess their self-image. Of the group there were 3 girls and 4 boys, ranging between 12 and 17 years old. A personality inventory was conducted and the results came out to be positive. The group of adolescents with disabilities viewed themselves very positively, rating their self-image higher than norm groups. After the inventory, the interviewer Lena Adamson wrote this conclusion in her "Brief report—Self-image, Adolescence and Disability", published in the American Journal of Occupational Therapy:
In contemporary society
Individuals with disabilities are rarely regarded in society as sexy or believed to be sexually active. When sex and disability are linked, it is common for marginalization to occur. Many people shy away from the idea that individuals with disabilities can have sex. This is due to a lack of information on the subject. Popular scholarly texts on disability rarely discuss sex, conversely disability is rarely discussed in the field of sexuality studies. Disability studies is a new field, it is just recently beginning to have a voice in the scholarly communities. Cultural theory on HIV and AIDS is one area of study that has broadly considered disability and sex. Since the AIDS epidemic, the queer community have been including physically and intellectually disabled individuals in their activist interventions. Even with these efforts, the correlation between sexuality and disability are not discussed in disability studies.
In society, it is widely believed that women with disabilities are asexual. One reason for this belief is that individuals with disabilities are seen as eternal children. Others see the intertwine of sex and disability as an acrobatic act. It is difficult for many people to imagine an individual with a disability having sex, because of the restricting impairments. Viewing women with disabilities as asexual has issues. In contemporary United States, women with disabilities are not viewed as physically attractive because society does not view them as sexually desirable. This results in women with disabilities to be limited and constrained in their capacity to love and be loved.
In the United States, pleasure and sex have been largely ignored, especially when it comes to individuals with disabilities. Medical facilities, public schools, and religious groups have created a "don't ask don't tell" policy when it comes to sex education.
The idea that sex is meant for reproduction can be damaging to the sexual lives of individuals with disabilities. Because some disabilities restrict an individual from having children, the idea of this person having sex is eliminated. Additionally, the hereditary nature of certain disabilities may make caregivers of disabled adults uncomfortable allowing them to engage in sexual activity. There also exists a history of forced sterilization of disabled people, such as the Buck v. Bell case legalizing the practice in the US and the Law for the Prevention of Hereditarily Diseased Offspring mandating disabled people be sterilized in Nazi Germany.
Sexual activity
General The mechanics of sex may be daunting, and communication, experimentation, medication and manual devices have been cited as important factors for sexual activity where disability is involved. Additionally, recognition of the pleasure that is derived from sexual activity beyond penetration and intercourse is also highlighted. For example, changes may take place in a person's sexuality after spinal cord injury; sensitivity to touch can increase above the lesion location in someone with a spinal injury. From research undertaken by the Christopher and Dana Reeve Foundation, orgasm was achievable for 79% of men with incomplete spinal cord injuries and 28% of men with complete injuries.
Oral sex and manual sex are other alternatives where penetration is not possible or not wanted, and wedge devices can be used to aid with positioning. Sex toys may be used as assistive devices as well; for example, vibrators can be used to provide extra stimulation and in circumstances where hand mobility is impaired. Other supportive devices include manual stimulation pumps, for erection promotion and maintenance, and "sex furniture", whereby rail or clamp enhancements, or specialised designs facilitate sexual activity.
Writer Faiza Siddiqui sustained a serious brain injury that led to a decrease in her sexual drive and the loss of her ability to orgasm, with the latter most likely the result of damage to Siddiqui's hypothalamus. Siddiqui explained her learning process in relation to sexual activity following the accident in a 2013 article:
Some people with a spinal cord injury are able to "transfer their orgasm" using sexual energy to any part of the body that has sensation. For example, Rafe Biggs acquired a spinal cord injury in 2004. Through his work with a sexologist he discovered during a massage that when his thumb was being massaged, it felt very similar to his penis.Biggs, Rafe. "Strange Sex – Surrogate Manhood (Pt.1)." YouTube. Rebiggs1, 30 Apr. 2011. Web. 01 Mar. 2016. It was through this experience that he learned that he could transfer his orgasm, using tantric energy, to his penis. Kenneth Ray Stubbs also has a spinal cord injury and is able to use tantric bodywork to obtain an "orgasmic feeling".Tzigany, Becca, and Kenneth Stubbs. "Sexual Shamanism." YouTube. YouTube, 27 Sept. 2014. Web. 02 Mar. 2016. If a person is able to use sexual energy correctly then they would be able to experience an orgasm in any part of the body that is capable of feeling sensation.
Fetishes and BDSM Sexuality for people with disabilities is often linked to fetishes and "freakish excess". Abasiophilia is when an individual's sexual arousal is dependent on a sexual partner with a disability. The obsession is most common for people with disabilities who wear leg braces. Apotemnophilia is self demanded amputation. Apotemnophilia is when an individual amputates their own limb for sexual pleasure. A case research done in the Journal of Sex Research states "Apotemnophillia is related to erotization of the stump and to overachievement despite a handicap." Little is known about the relationship between sexual pleasure and amputated limbs. Apotemnophilia was first introduced to the public in the magazine Penthouse in late 1972. The fetish was brought up by a young man with a disability who practices this fetish. After reading his accounts some editors of the magazine related with this feelings and published his story.
Some individuals who have this fetish have made successful amputation attempts. For those who want to be amputated but do not have the means or strength to do so, are able to get professional assistance. Devotism is the sexual attraction someone has for a person with disabilities