The Sexuality and Disability Unit: Applications for Group Training

In 1976, the Sex and Disability Unit of UCSF's Human Sexuality Program received two three-year grants from the National Institute of Mental Health and the Department of Health, Education, and Welfare to train two specific population segments. The NIMH grant funded the development and training of a year-long socio-sexual, peer counselor-educator project in the field of sexuality and disability. The DHEW family life education training module targeted nationwide participants working with special education populations in a four-day workshop format. In this presentation I will discuss those two projects and necessity for the existence of such projects in the field of sexuality and disability today.     

Current Issues in Sexuality and the Disability Movement

The theme of this plenary speech is an account of the lessons learned by the author's putting her efforts into sexual and reproductive rights policy in the lives of disabled people. She offers some strategies to use disability rights law to correct inequities such as: marriage penalties, child custody, sex education, and the right to privacy. These examples can provide the disability community with a framework with which to infuse sexual and reproductive rights into the larger disability rights agenda.     

Sexuality and Disability: The Role of Health Care Professionals in Providing Options and Alternatives for Couples

Disability affects both the individual and his/her partner and, if health care professionals are to work with clients in a holistic manner, they will need to include the partner. A comprehensive review of the literature was completed to examine the impact of disability on sexuality as it relates to couple relationships and to explore strategies health care providers can utilize to help couples deal with these issues. The literature describes some common intervention strategies that have been shown to be effective in helping couples affected by disability or illness address the issue of sexuality. Specific concerns and difficulties faced by couples are also identified. Finally, the various intervention strategies will be incorporated into a framework known as the P-LI-SS-IT model. With this framework, health care providers will be able to determine the client's needs, as well as assess their own level of comfort and expertise in dealing with this very important task.     

Sexuality and Quality of Life Among People with Physical Disability

This study was designed to evaluate the association between the sexuality and quality of life of people with congenital physical disability. Sixty people with congenital physical disability (33 males, 27 females, mean age = 28.64 years) who were living in the community participated in the study. Each respondent completed the Sexual Knowledge, Experience and Needs Scale which assesses levels of knowledge, experience, feelings and needs in 12 different areas of sexuality. Respondents also completed the Comprehensive Quality of Life Scale which assesses both subjective and objective dimensions of quality of life in seven broad domains. Surprisingly, there were few associations between sexuality and the quality of life domains. The strongest associations were between sexual intimacy and importance of quality of life. The implication of these findings for the lives of people with physical disabilities are discussed.     

Letting Go of Restrictive Notions of Manhood: Male Sexuality,Disability and Chronic Illness

In this article I share my personal story and professional perspectives on the impact of disability on male sexuality. Because disability is experienced in the context of gender, I have integrated literature on concepts of male socialization and learning about sex. I explore how acquiring a disability may affect sexuality and create treatment concerns. Finally, I make treatment suggestions for working with men with disability or chronic illness.     

Sexuality,Parenthood, and Cognitive Disability in Brazil

This article will review the different methods used to control the sexuality and fertility of Brazilian women with cognitive disabilities throughout the twentieth century, and how practices such as eugenic sterilization, institutionalization, and other repressive measures of social control grew out of cultural notions of gender, race, class, sexuality, and disability. The article will first outline eugenics practices and the vulnerability of women with cognitive disabilities in the United States and Europe. It will then trace the historical treatment of Brazilian women with cognitive disabilities. Finally, it will describe modern cultural perceptions and practices related to the sexuality and fertility of Brazilian women with cognitive disabilities.     

Cross-Cultural Views of Disability and Sexuality: Experiences of a Group of Ethno-Racial Women with Physical Disabilities

The field of sexuality research as it pertains to women with physical disabilities from different ethno-cultural communities is limited. This may be due to the lack of understanding among health care providers and researchers regarding the issues related to sexuality for women with disabilities. The impact of cultural beliefs and values related to sex and sexuality can further hinder women with disabilities from expressing themselves as 'sexual beings.' The purpose of this paper is: 1) identify issues and barriers experienced by women with disabilities from different ethno-cultural communities within an urban setting and 2) identify commonalities in experience of women with disabilities along the lines of cultural values about disability and gender.     

Sexuality in neurologic disability: An overview

Sexuality concerns commonly arise in individuals with both acquired and congenital neurologic disabilities. As health care professionals it is critical to have an understanding of the potential consequences of neurologic impairment on sexuality as well as sexual function. Psychologic, latrogenic, and secondary medical issues must all be taken into consideration when addressing the primary sexuality concerns. An understanding of normal neuroanatomy and neurophysiology is critical if one is to propose interventional strategies in this patient population. Basic concepts regarding sexual functioning in specific neurologic conditions including spinal cord injury, cerebral vascular accidents, traumatic brain injury, peripheral neuropathies and multiple sclerosis will be reviewed. The General Rehabilitation Assessment Sexuality Profile will be reviewed as it pertains to the sexual history, sexual physical exam, and clinical sexual diagnostic testing. Lastly, treatment options for both genital and nongenital sexual dysfunction in neurologic disability will be examined.     

Sexuality and people with intellectual disabilities: A historical perspective

Until the 1960s, the sexuality of people with mental retardation was handled by denial and suppression. The eugenics movement of 1880–1940 led to forced mass sterilization and the segregation of these members of our society. The civil rights movement and the sexual revolution were among the catalysts for change as was the move toward normalization and deinstitutionalization of people with mental retardation. In the last 25 years, parents and professionals have begun to work together to find ways to help mentally handicapped individuals to understand their sexuality and to engage in appropriate self-affirming sexual behaviors. We have established goals, guidelines, and curricula for sexuality education. We have trained parents and staff and developed policies for handling sensitive issues, such as sterilization and problematic sexual expression. The AIDS epidemic has provided new impetus for improving education and training in this emerging field.A.C.S.W.Private practice (as a consultant, lecturer, and trainer in sexuality and mental retardation).     

The Development of a Regional Association to Address the Sexuality Needs of Individuals with Disabilities

This article describes the development of a regional Association to address the needs for sexuality related staff training, and consumer and family education. The Association completed several initial steps including generating a philosophy statement and a statement of basic rights; conducting a needs identification and offering training for professionals and families. Further steps followed from the concerns of providers regarding the availability of appropriate educational resources. The Association collected information about available resources and developed and piloted a tool to evaluate these curricula. This article will also discuss the Associations's recommendations for future expansion of networking activities.     

Sexuality and Disabled Parents with Disabled Children

This is not your typical academic article. Although it provides references and research information, the perspective is a little different. We intend to share stories from a lifetime of participant observation on disabled adoptive parents. The stories are part of the empirical evidence that makes up our collective lives. But they are not stories well represented in the literature—either qualitative or quantitative. We know we are not average. We are more than one standard deviation from the norm and we celebrate this. This article provides a radical reconceptualization of the sexuality experiences of disabled parents. Think of it as a participatory ethnography. Placed in the context of the growing literature base around families, adoption, and sexuality, our stories reflect the lived experience of the parents who have shared their lives with us.     

Psychological and Medical Aspects of Sexuality Following Stroke

The study was aimed at investigation of the sexual life after stroke. One-hundred-thirty-nine consecutive stroke patients admitted to our rehabilitation units were interviewed. They suffered from stroke one month before. Among these, 86 subjects could be enrolled for the study. After one year, 57 men (79.2%) and 15 women (20.8%) could be interviewed again about their sexual life. Their mean age was 63.7 years (s.d. 8.4). At this time Beck scale for depression to non-aphasic patients and Functional Independence Measure (FIM) scale were also applied. We confirmed the sexual decline in the aftermath of the stroke. At individual level, the mean decline was about 34% in the frequency of performance, but the percentage of patients experiencing a decline was quite high (83.3%). Neither gender nor injured hemisphere accounted for the sexual decline. Lack of correlation was also found with age, education, disability and depression. Our data agree with the opinion that psychological issues, rather than medical ones, account for disruption of sexual functioning in stroke survivors.     

Self-Claiming Sexuality: Mobility Impaired People and American Culture

This paper reports on a small piece of the research I recently conducted on how people with mobility impairments self-interpret and self-claim their sexuality in light of cultural assumptions which largely desexualize them. I will first offer a quick overview of the larger project. Then, I will discuss the manner by which dominant cultural notions of sexuality and disability are—at times—simultaneously challenged and reinforced by participants as they self-claim their respective sexualities.     

Gynecologic Care and Sexuality Issues for Women with Disabilities

Approximately ten percent of the world's population has a disability. In the United States, it is estimated that there are 43 million disabled people and roughly 30% of them are women. There is often limited physical and structural access to health care for disabled women. As young girls, women with disabilities are often told that marriage is not a possibility, which can lead to feelings of asexuality. Barriers to contraception for women with disabilities may be twofold; attitudinal as well as knowledge based. Sexually transmitted disease detection and prompt management interventions may be hampered by a number of factors. Women with disabilities that become pregnant have identical issues in many ways as compared with nondisabled women. Fertility and sexuality are closely intertwined. As a woman with a disability undergoes an infertility evaluation, her sexuality as well as identity as a woman may be threatened. Disabled women are living longer and are reaching the age of menopause while remaining active and involved in their family life, social life, and in the workforce.     

Persons with Intellectual Disability: Sexual Behaviour,Knowledge and Assertiveness

BackgroundPersons with ID most often have incomplete, contradictory and imprecise knowledge of sexuality and sexual intercourse itself. They are not provided with sufficient information on their own body and sexuality, and are often discouraged from and sanctioned for trying to sexually express themselves. Sexual abuse due to low sexual assertiveness is also common.AimThe principal aim of this study was to establish the presence or absence of sexual activity in adults with ID residing in institutional housing, as well as the level and structure of their knowledge of sexuality, their sexual assertiveness and preparedness to react in a sexually dangerous situation.MethodsThe sample consisted of 100 participants with ID residing in institutional housing. The instruments used included the General Sexual Knowledge Questionnaire, What-if test and Hulbert index of sexual assertiveness. Comparative statistics included coefficient of linear correlation and multiple regression analysis.ResultsThe results showed that 82% of the participants are sexually active. Most participants admitted to sometimes having sexual intercourse against their wishes as well as to having difficulty asserting themselves. Their knowledge of pregnancy, contraception and sexually transmitted diseases was very low. Female participants and those that reported having sexual intercourse had more sexual knowledge and were also more sexually assertive.ConclusionKnowledge of sexuality and sexual assertiveness of persons with ID residing in institutional housing is very low. Additional information on sexuality is necessary, as well as support in learning to express their own desires and to deal with unwanted sexual activity.     

Sexuality and People with Psychiatric Disabilities

This article explores the topic of sexuality and intimacy of people with severe mental illness by addressing a series of questions about the nature of psychiatric disability and its effects on sexual identity and behavior. After describing the characteristics of people with psychiatric disabilities, the paper explores where they fit in the disability rights movement and examines how society treats persons with psychiatric labels. Barriers to full sexual expression are explored, first, from consumer perspectives, and then from the research literature, including a look at impediments to use of contraception and safer sex practices. Finally, the analysis asks a series of questions about issues for women mental health consumers in the expression of their sexuality and access to women's health services, along with sexuality issues for gay, lesbian, bisexual, transgender, and HIV-positive consumers. Finally, the paper concludes with suggestions for ways the disability community and larger society can support mental health consumers' efforts to freely express their sexuality and combat stigmatizing societal representations of it.     

Training in Sexuality and Relationships: An Australian Model

This article examines some of the dominant discourses which impacted on the process of developing a curriculum for staff working with people with an intellectual disability in the area of relationships and sexuality within a medium sized Government bureaucracy providing services to people with a disability. Constructions of sexuality as being solely a biological function, sex as dangerous and sex as penetration are challenged as are some of the dominant discourses of learning.