Sex Education for Physically Disabled Teenagers

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Sex Education for Physically Disabled Teenagers

The Department for Education and Employment 2000 publication “Sex and Relationship Education Guidance” makes no mention of physically disabled pupils, which goes a long way to explain why young people with physical disabilities are still at sea with their personal development.

The high moral ground of the guidance becomes even more shameful in light of the fact that some children with physical disabilities experience puberty much earlier than non-disabled children.

The publication does state that all children need to be considered but, without dealing with the very special and unique situations that physically disabled young people find themselves in, it denies such people any chance. This paper documents these situations in the hope that future guidelines will take physical disability into account.

The publication recommends that all sex and relationship education in schools be done in partnership with parents and the wider community. This is hardly fair on physically disabled pupils, who are already seriously stigmatized in society and are often considered to bring shame to the family. Parents, however well meaning and loving, tend to infantilize their physically disabled offspring as they grow up, attempting to ban sexual knowledge and expression in the process.



The publication also recommends that doctors and nurses supplement the teaching of sex education in schools. These are notoriously the worst professionals to recommend, for not only are they generally uptight about discussing sex, but they are also renowned for being ignorant about issues of disability, and they dislike disabled patients because their disability “cannot be cured”. These professionals are likely to dismiss the disabled pupil as asexual. Sex therapists and professional sex educators, and trained teachers, are the only professionals who should be providing sex and relationship education to teenagers.

Sex and Relationship Education Needs of Disabled Teenagers

Their teens are not an easy time for anyone, but disabled teenagers can experience many extra hurdles:


  • lack of privacy

  • lack of mobility

  • difficulty relating to standard sex education

  • the need for sex education in relation to their disability

  • not wanting to appear even more “different”

  • not wanting to feel they are being even more singled out

  • the fact that many disabilities seem too embarrassing to discuss

  • special problems of newly disabled teenagers

Lack of privacy


Those who are severely impaired — who cannot manage daily jobs like opening parcels, or going to the toilet by themselves — are denied privacy, which means having few secrets from their parents. Rebelling becomes very difficult when you depend on your parents for everything, and many disabled teenagers in this situation seem to completely miss the normal experiences of teen years — which is, in itself, an additional disadvantage. Sex education needs to address this issue.

Lack of mobility


Being denied the freedom to go out cycling, dancing, ferreting, etc. with your peers cuts you off from them. Many teenagers are very hung up on appearances, and having a visible disability is not held as an ideal. Secret chats in each other’s bedrooms about sex and bodies may not be possible if you cannot get up your best friend’s staircase, or compare how dishy members of boy and girl bands are. You may not be able to sneak behind the bike shed in a wheelchair. Basically, most disabled teenagers feel left out, rejected, and doubtful that they will ever find a partner, although they will dream, just like any youngster.

Difficulty relating to standard sex education

Even though physically disabled teenagers are integrated into schools with other teenagers, and sit in classes with their able-bodied peers, perhaps even given the chance to talk about disability in discussions, this is unlikely to be extended to discussions during sex education, such as it is. Sex education is not geared to address the needs, anxieties and physical problems that disabled people face with regard to sex. The result of this is that most disabled teenagers feel that they cannot relate, in any sense, to the sex education they receive in school. The results of this can be devastating. All the difficulties faced in childhood – abuse, shame brought to the family, social exclusion, being told they will not marry or enjoy relationships, being forbidden to wear make-up or do things that teenagers crave for, are consolidated by this inadequate and insensitive teaching so that the disabled teenager feels even more doomed.

The need for sex education in relation to their disability

What is required is that sex educators be trained in sex and disability, so that disability becomes included in their standard teaching, and the educators learn how to approach individual teenagers so that those who require help specific to their disability (or whatever), feel comfortable about asking for it. Obviously, the sex-education needs of a teenager who is deaf-blind might be totally different to one who has Spina Bifida andHydrocephalus , and again for someone with Juvenile Arthritis , osteogenesis imperfecta (brittle bones),Muscular Dystrophy , Spinal Injury , etc. But the most important thing of all is that their needs are acknowledged. This is no different to a gay person failing to relate to heterosexual information that includes conception in marriage. Disabled people won’t relate to information that is presented discussing people without disabilities. It is also important for the able-bodied, heterosexual teenagers to know about LGBTI issues and sex and disability issues One way to ensure everyone feels included, is the class of teenagers speak out about how the education has empowered them, and then they have to decide amongst themselves (perhaps in small groups) situations which might be most difficult. This can include situations where one is being forced into unwanted activities, preferred activities which meet with parental disapproval, bullying, teasing, flirting, and being labelled the “School Bike”. This might empower the disabled people to speak out about their own fears, doubts, and problems.

Not wanting to appear even more “different”


The trouble is that all but the most extrovert disabled teenagers will dread anything that focuses attention on things like their incontinence, lack of knowledge of, for example, what bodies normally look like, or worries about not being able to feel parts of their bodies, or that their bodies may not respond “normally”. The teacher might be nervous to draw attention to them, for fear of making matters worse. Sex educators need to use their professional training to deal with situations such as this.

Not wanting to feel they are being even more singled out


The educator needs to deal with the “difficult” areas all together, rather than singling disability out, because there are many others including:

  • gender issues such as intersex

  • sexual identity issues such as bisexuality

  • genital abnormalities such as the micropenis and pyrones disease, congenital absence of the vagina

  • cultural and religious issues such as female genital mutilation

  • fetishes such as exhibitionism, BDSM (bondage/domination/sadism/masochism)

  • masturbation and its value

  • pornography and the law, compulsive buying, shame and guilt

  • sex and learning disabilities, with situations for example where people with Autism fancy objects

  • sexual problems associated with various physical disabilities

  • sexual problems associated with various sensory disabilities
  • sexual dysfunctions such as pre-orgasmia, vaginismus, premature ejaculation, erectile dysfunction, lack of desire.


Students need to learn:

  1. where to find help, and that sex therapy is far better than taking pills and potions;

  2. that sex is not the same as sexual intercourse — people who are unable to have sexual intercourse because of erectile dysfunction, for example, enjoy extremely fulfilling sex using their hands, fingers, mouths, imaginations and skill; they can share fantasies, enjoy mutual Masturbation , and become much closer than couples who just get under the covers for a shag;

  3. that knowledge can be gained from responsible sources and that the media — especially television and women’s and men’s magazines — are not the best places to learn.

It has been proven that the more a disabled person understands about their disability and impairment, the better they will be able to make sexual adjustments. Sex educators also need this awareness. Sex educators requiring knowledge on what issues are relevant to specific disabilities can find descriptions online at http://www.loversguide.com/sex_articles.0.html?&tx_ttnews[tt_news]=650&tx_ttnews[backPid]=199&cHash=540f698f32

The fact that many disabilities seem too embarrassing to discuss

As well as passing on knowledge about how specific disabilities affect sexuality, special attention needs to be paid to the difference between obvious and hidden disabilities. People with hidden disabilities such as ostomies and catheters have to learn how to explain, when to disclose, and how to overcome embarrassment and lessen the chances of rejection. Having sex with a catheter in place can be demonstrated as easily as “putting a condom on”. It needn’t be clinical but can be done in an affectionate, flirty way, that is in keeping (fitting in) with sex-talk.

Special problems of newly disabled teenagers


Teenagers who have been disabled all of their lives may have become hardened to the teasing from other children, being a disappointment to parents, and being stared at in the street; but teenagers who are newly disabled have a lot to deal with. They may have already started dating, and had relationships destroyed. Their teens are often the time when people acquire an accident-related disability. Attention is focused on rehabilitation — including everything except personal needs, masturbation, sexual aspirations and sexual activity.

The fear of rejection can be much more than almost anybody else could ever imagine. It can spill over into fear of sex, fear of the opposite sex, dislike of their own sexual organs. It is not surprising that many disabled people don’t start to seriously make the effort to find a partner and enjoy sex until they are into their 30s — and, even then, they are in many cases still terrified. It’s sometimes best to go and visit a sex worker, to experience sex in a non-emotional situation, to try an settle the nerves.

Although these problems cannot be dealt with in the classroom, having everything explained in positive way means that they are comforted in the knowledge that, in the end, they will be able to find what they are looking for and enjoy a fulfilling personal life.

Matters to be addressed during Sex Education of disabled teenagers might be best done in a small group of disabled people rather than in a raucous classroom.

The sex educator may not know which teenagers in a class have disabilities, and these students may not wish to be singled out, but the door should be constantly open for disabled teenagers to discuss their sexual worries and problems.

A perfect way to help this to happen would be to invite a famous disabled person to come to the school to offer peer counselling, as this may encourage the disabled students to join the session. Topics that could be covered include:-


  • Lack of privacy and how to overcome the difficulties

  • Lack of teenage experiences

  • Feeling left out

  • Not being able to relate to sex

  • Feeling bad about sex

  • Having no sensation in genitals

  • Experiencing sexual dysfunction

  • Embarrassment over ostomies and continence issues

  • Low self esteem and poor body image

  • Dealing with any past abuse, so that they respect themselves and won’t put up with it again

  • Understanding that having an able bodied partner will not make you able bodied, but accepting your own body and learning to love yourself will encourage other people to love and fancy you

The US body, ADVOCATES FOR YOUTH provides the following guidelines for Professional Sex Educators.

Each young person is unique and may require a specialized programme or resources. That is, each adolescent living with a disability is also an individual with individual reactions and needs regarding sex education.



Thus, this document offers general guidance and should be used with care. It may or may not offer adequate resources to meet the particular needs of an individual.

  1. Remember that young people have feelings, sexual desire, and a need for intimacy and closeness. In order to behave in a sexually responsible manner, each needs skills, knowledge, and support.

  2. Understand that youth with disabilities are far more vulnerable to sexual abuse than are their peers. Youth who live with developmental disabilities are especially vulnerable. Sex education must, therefore, encompass skills to prevent sex abuse and encouragement to report and seek treatment for unwanted sexual activity.
  3. Remember that youth who confront disabilities feel the same discomfort and suffer the same lack of information that hampers many of their peers regarding sexuality and sexual health.


  4. Learn as much as you can about the disabilities of the populations with whom you work.

  5. Be sure that the material addresses boundaries and limits — both setting boundaries and respecting others’ boundaries. Rely on role plays and interactive exercises. Use concrete teaching strategies.

  6. Be creative. Develop specialized teaching tools and resources for the youth with whom you work. For example, in working with youth who have developmental disabilities, you may need to use visuals like models, dolls and pictures. For youth with physical disabilities, it may be useful to use stories and examples of others with similar disabilities who have loving, satisfying intimate relationships.

Dr Tuppy Owens, Outsiders Trust

trust@outsiders.org.uk


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