Disability and sexuality

About disability and sexuality

Most people are sexual beings, and have sexual thoughts, attitudes, feelings, desires and fantasies.

Having a physical or cognitive disability doesn’t change your sexuality and your desire to express it. In fact, the World Health Organization says sexuality is a basic need and aspect of being human that cannot be separated from other aspects of life.

If your disability impairs your physical ability to engage in a regular sex life, or makes you lack confidence, you may feel worried about having sex. Lots of people – with or without disability – have anxiety about sex and sexual performance, and these feelings are completely natural.

If you’re a carer of a person with a cognitive disability, you may find Family Planning Australia's All about sex factsheet series helpful.

Support and information are available if you feel you need help in developing relationships, exploring and expressing your sexuality, or accessing sexual health information and services. This also applies if your disability comes from a chronic illness.

If you’re over the age of 16, in Victoria you’re legally entitled to privacy and choice about your sexuality and sexual activity.

Concerns you may have about sex

Your disability may affect your ability to have the sex life you would like – you may have to approach sexual activity differently, and you may have questions and concerns relating to your physical or emotional health. For example, you may feel:

• concerned about finding a partner
• concerned about whether your partner will find you attractive
• a lack of confidence about your sexual abilities or performance
• concerned about how your body moves or works
• anxiety over your partner’s feelings about you
• concern over pain during sexual activity
• less energy and desire for sex
• concerned about whether you can have children
• worried about what others will think, and about discrimination.

It’s natural to feel frustrated about the effects of your disability on your sex life. It may help to try to understand that you and your partner may have to approach sex differently and find new or different ways to satisfy each other.

If your concerns about your disability and its effects on your sex life feel overwhelming, you may like to talk to your healthcare professional.

If talking to your healthcare professional about sex makes you embarrassed or afraid, remember, sex is a completely natural subject and your healthcare professional should be used to being asked questions about it.

Your healthcare professional can advise you on your unique situation – like whether you need relationship counselling or an aid or device, or ways to support your body during sex. If your healthcare professional can’t help, they may be able to refer you to a specialist who can answer your questions and allay any fears.

It may also help to learn as much as you can about your disability in relation to sex. Masturbation or sex aids may be useful for you, for example.

Social myths and discrimination about disability and sexuality

Society has many myths, and the ones around disability and sexuality are frustrating, offensive and incorrect.

Some of these myths include that a person with disability doesn’t need sex or can’t have ‘real sex’. Some other misguided notions include that a person with disability has more important needs than sex, or should not have children.

On top of this, many able-bodied people tend to regard sex for people with disability as a taboo subject and rarely discuss it openly. Society tends to have an idealised image of ‘sexually attractive’ and anyone – whether with disability or not – who doesn’t meet the standard can feel diminished or dismissed.

Information about disability and sex tends to focus only on function or fertility, and not on perfectly natural feelings and emotions, like attraction, desire and love. To be seen as a non-sexual being can be devastating.

If myths and misinformation are affecting your life, you may feel tempted to avoid sex or limit your opportunities to have sex (such as avoiding meeting a partner). When a lack of privacy from carers or living arrangements is involved too, you may find sex to be particularly challenging.

Disability Online Australia may be a useful resource for finding opportunities to meet people in Victoria and other states through activities.

Importance of emotions

Just as sexuality is an integral part of a human life, so is love. At our very core, most humans want to be loved and accepted.

Whether you have a disability or not, you will know how important love is to you. If you’re a carer or friend or partner of a person with disability, be aware of how important it is to express your love or regard.

If you’re not in a romantic or sexual relationship, the most important thing to remember is you are not defined by your disability or illness. You are a person who desires and loves like anyone else, and you have a right to it.

If you’re in a relationship and dealing with issues around your disability and sexuality, these tips may help:

• communicate – openly discussing your feelings and concerns is the best way to solve problems together. State your needs clearly, not only around intimacy and sex, but everyday life too
• read up – learn all you can about sex in relation to your condition or disability. Having plenty of knowledge may help you feel more comfortable talking to your healthcare provider too
• seek help – if the problems seem bigger than you and your partner can work out, consider counselling. Sometimes it helps to get an outside perspective
• keep an eye on each other – watch for signs of poor health or other issues, for example depression. It’s natural to feel sad, but depression is more than sadness and will need to be addressed. If your partner is also your carer, remember, carers need support and respite
• acknowledge your new normal – if you acquired your disability, from an accident or chronic illness, for example – try to accept that your relationship may be forever changed by your disability, and see whether you can come up with a new ‘normal’ for you both
• see friends – staying socially connected may help you to feel more positive about life
• address stress – money issues, new divisions of labour and family responsibilities can cause a lot of stress. Try to address these issues so they don’t affect your life, including your desire to be physically intimate
• consider kindness – doing something nice for your partner every day can help to build intimacy and loving feelings.

Practical matters – enjoyment, contraception and sex education

Enjoyment

It takes energy to participate in and enjoy sex, so your disability may get in the way of your sex life to some extent. Factors that may limit your ability to be sexual include:

• pain – pain, especially chronic pain, can certainly make you feel less like sex, but if you can find sexual pleasure in ways that minimise discomfort, you may find it helps ease the pain (for a while)
• fatigue – sex can feel like just another burden when you’re fatigued. If there are times in your day when your energy levels are better than others, consider engaging in sex then. Or take it slow and easy: sex doesn’t have to be a sprint
• mental state – if you’re not feeling positive, or you’re suffering from anxiety or depression, you are unlikely to feel like sex. Talk to your doctor or a counsellor about your feelings, and seek help
• medication – medication can affect your sexual interest, thoughts and moods. Talk to your healthcare professional about your concerns.

Contraception

You have the right to make your own informed choices about the method of contraception you use, but your disability may narrow the range of contraception options available to you. Talk with your healthcare professional.

Sex education

A young person with disability needs sex education as much as a young person without disability. In addition to a general sex education approach, sex education for a young person with disability should also cover:

• the fact that people with disability can have fulfilling romantic and sexual lives
• sexual issues that may be associated with their disability
• social rules such as public and private behaviours, and personal boundaries.

Sex education for a young person with cognitive disability should be delivered in a way that the young person can understand.

If you’re a parent of a young person with disability, it may be helpful to have appropriate information about puberty, menstruation (most disabilities don’t affect when menstruating starts) and romantic and sexual relationships on hand for your young person.

Young people with with cognitive disability, may need longer to get used to the idea of the changes that come with puberty. You can help them by preparing before puberty starts (from age 8 to 13 in girls, and 9 to 14 in boys).

Sexual abuse and people with disability

Rates of abuse, especially sexual abuse, are shockingly high for people with disability. According to research by Women with Disabilities Australia, 90% of women with an cognitive disability have been sexually abused. And a quarter of reported rapes against women in Victoria are against women with disability.

This sexual and other abuse often goes unreported, and often occurs before the person being abused reaches the age of 18.

If you’re a friend, family member or carer of a person with a cognitive disability, and you are concerned about their wellbeing, call the National Disability Abuse and Neglect Hotline on 1800 880 052 or email hotline@workfocus.com. They can help you find the best way to deal with an issue and will usually refer you to an appropriate service.

Other support services in Victoria are listed at the bottom of this page. The Office of the Public Advocate safeguards the rights and interests of people with disability in Victoria. Its advice service (Tel. 1300 309 337) can help with a range of queries about abuse and other legal matters.

Where to get help

• Your GP (doctor)
• Sexuality Education Counselling and Consultancy Agency – for sex education and courses for people with a disability
• Yooralla Tel. (03) 9666 4500, TTY (03) 9916 5899
• Centres Against Sexual Assault (CASA) Tel. 1800 806 292 – crisis line
• 1800RESPECT – National Domestic, Family and Sexual Violence Counselling Service Tel. 1800 RESPECT (1800 737 732), (24 hours, 7 days)
• Office of the Public Advocate Tel. 1300 309 337, TTY 1300 305 612
• Sexual Health Victoria (SHV) – book an appointment online or call Melbourne CBD Clinic: (03) 9660 4700, Box Hill Clinic: (03) 9257 0100 or (free call): 1800 013 952. These services are youth friendly