Sexuality refers to a dimension of one’s personality expressed through sexual feelings, physical sensations, attitudes, behaviors, and beliefs. Sexuality is a primary way “humans share intimacy” (Schover & Jensen, 1988). Masters and Johnson (1986) define human sexuality as multidimensional: biological, psychosocial, behavioral, clinical, and cultural. Cultural and family attitudes about sexuality and disability significantly impact survivors’ personal experiences and perspectives, and consequently, their self-images and expression of sexuality (Masters et al., 1986).
In the past, sexuality was defined only in terms of physical activities involving the genitals, and sexual attractiveness was equated with appearance and performance of sexual acts. People with disabilities often were viewed as asexual (Masters et al., 1986) and undesirable as intimate partners. The women’s and disability rights movements have challenged these attitudes. In response, the World Health Organization identified “sexual health” as an integration of a person’s physical, emotional, intellectual, and social qualities expressed in ways that enrich one’s personality, communications, and experience of love (Schover & Jensen, 1988). This holistic view recognizes the relationship of sexuality and intimacy, the value of respect for oneself and others, and the need for respect and acceptance from others.
Some people deny and sublimate their sexuality through compulsive behaviors such as overworking, drinking alcohol, or overeating. Others who participate in sexual experiences lacking respect, safety, and intimacy, may even develop sexually compulsive patterns. These responses to the human need for comfort and physical closeness may harm one’s health, self-image, and relationships. For this reason, feeling safe, lovable, and respectful about oneself and others, is essential to healthy sexuality and intimacy.
Research (Nosek et al., 1997) reveals that people with disabilities are vulnerable to sexual exploitation by individuals in positions of power and by others on whom they depend physically, medically, or financially. Individuals can protect themselves by learning about personal boundaries, what constitutes healthy touch, and one’s own vulnerabilities; as well as how to listen to one’s intuition, to communicate assertively, and to find suitable professional resources.
People with disabilities can learn ways to creatively adapt their physical abilities to their sexual needs, for example, through positioning. Many rehabilitation centers offer professional assistance with these issues.
Satisfaction with sexual experiences may be increased by considering:
- Clarification of goals, expectations, capabilities, limits, and feelings. Explore ways to respond sensitively and respectfully to oneself and one’s partner.
- Ways to identify and adjust interferences which create distraction.
- Timing, when one is most energetic.
- Positioning that is easiest for the person to breathe, move, and communicate.
- Pacing of physical movement and timing to suit one’s abilities and limitations.
- Environment in which one is most comfortable and agile. Select setting, temperature, lighting, sounds, textures, and assistive devices that are most supportive.
These factors can (and ideally should) be talked about with any potential sexual partner. Talking about these issues can lead to a feeling of greater safety, deeper intimacy, and satisfaction.
References
Masters, W., Johnson, V., & Kolodny, R. (1986). Sex and human loving. Boston, MA: Little, Brown & Company.
Nosek, M.A., Howland, C.A., Rintala, D.H., Young, M.E., & Chanpong, G.F (1997). National study of women with physical disabilities: Final report. Houston, TX: Center for Research on Women with Disabilities.
Schover, L, & Jensen, S. (1988). Sexuality and chronic illness: A comprehensive approach. New York, NY: The Guilford Press.