Disability and paying for sex

Firstly – is sex a right?

Are we all entitled to have sex? I firmly believe we should all have the option of having a good sex life. We should all be able to choose to have sex in the context of a mutually beneficial situation where no one involved is forced, coerced or has no real alternative.

Which brings me onto sex workers. Which is a huge topic with so many different perspectives. Including people who freely chose to work in the sex industry. There are however many people who are forced, coerced or have no real choice. Women can get trapped in the sex industry and this has to be an important part of any conversation around the right to have sex. However they’ve entered, or whatever the reason they stay in sex work, we need to ensure that our desire for sex doesn’t further exploit sex workers. Whether it’s through trafficking, sex slavery, being wilfully mislead or whether it’s because they need the money, they’ve got addictions which need feeding or even situations as complicated as a history of abuse which makes them feel like they have no other option, sex workers deserve the same respect as anyone else.

“[sex] is every bit as important as the right to practice one’s chosen religion or to not be discriminated against. It should be included on this list because, like religion, nobody should be forced to participate, but similarly, nobody should be denied access either.” the conversation

Sex workers and sex surrogates

Within the context of disabled people paying for sex, the phrase sex surrogates comes up a lot. What does this mean?

Sex workers – a sex worker is anyone who works in the sex industry eg porn actors, prostitutes, lap dancers, phone sex workers, sex surrogates etc. The predominant definition requires the worker to be involved in “sexually explicit behaviour”.

Sex therapists – licensed mental health professionals, think counsellor. A sex therapist will not have sex with or engage in any sexual activity with the client.

Sex surrogates – a surrogate does engage in sexual activity with the client. They aren’t (or don’t have to be) medical professionals but they do engage in work which addresses particular sexual difficulties such as erectile dysfunction, anxiety, lack of confidence… Think of this more like a way of being able to practise sex or masturbation which the support of someone. There is an International Professional Surrogates Association which offers training for surrogates.

Should disabled people be able to pay for sex?

Firstly, who would be allowed? Would you have to show that you receive disability related benefits? Prove that you’re disabled? How do invisible disabilities factor into this? Would it just be for people who’ve proven they can’t find a partner? How would people with mental illness show that they were eligible? What would happen to people who faked disability in order to be legally allowed to use a prostitute?

Ok, so that was a bit of playing the devil’s advocate but this is a hugely complicated issue. If you decide that yes, disabled people can pay for sex, you then have a whole load of logistics and specifics to sort out. Especially if you’re also in a society where non-disabled people aren’t allowed to pay for sex.

Rewinding a bit, let’s look at the arguments for and against disabled people paying for sex.

Arguments for

Rachel Watton, from the Australian organisation Touching Base, believes for people with disabilities, being able to pay for sex is a right. She acknowledges that society should change but feels that in the meantime sex should be available.

44% of people in a Guardian poll said they had never had sex with someone with a physical disability and probably wouldn’t. Those odds don’t work well for a disabled person looking for a shag…

Rachel stars in a documentary, Scarlet Road, about her life and Touching Base and providing sex to disabled people.  The film doesn’t address the issues that some sex workers face in terms of exploitation, indeed, the white sex workers featured appear to dismiss and invalidate the experiences of exploited workers.  I was pleased to see that disabled people were included in the documentary but the language used about them wasn’t always so positive.  The word “they” to refer to all disabled people was used a lot, as was “deserving” which to me can conjure up ideas of pity and can feel demeaning.  Why do I deserve sex more than the next person?  Does my disability make me that special?

However, Scarlet Road wasn’t all bad.  They talked about developing training for sex workers who were working with disabled people.  This included things like manual handling, ways of communicating etc.  This has potential to lead to resources and a bank of knowledge for disabled people and their partners.

Within this discussion, the most important voices are those of disabled people and the sex workers. Disability Now conducted a survey in 2005 which revealed that 22 per cent of disabled male respondents (compared to an estimated 10 per cent if you look at the whole male population) reported having paid for sexual services compared to just 1 per cent of disabled women. Similarly, just 16 per cent of disabled women had considered paying for sex compared to nearly 38 per cent of disabled men.  This figure increases if you ask about paying to see specially trained sex workers.

Would legalising sex work for disabled clients make the industry safer for the sex workers? The pros and cons of legalisation are far too big a discussion to go into in this blog but it is an important part of the conversation so I’d highly suggest going away and doing some reading about it.

What about the therapeutic benefits of sex?  Orgasms can help reduce pain, being touched in a none functional way can have mental health benefits and sex can be relaxing.

Would allowing disabled people to pay for sex normalise the idea of disabled people as sexual beings?  Or would it make it easier to see us as “freaks”..?

Examples of where this already happens

Mark O’Brien, a disabled writer, wrote: “I wanted to be loved … held, caressed, and valued. But my self-hatred and fear were too intense. I doubted I deserved to be loved … Most of the disabled people I knew… were sexually active, including disabled people as deformed as I. But nothing ever happened.” O’Brien went on to see a sex surrogate and lost his virginity with her, she speaks in a TEDx talk.

In Holland and Denmark, support needed around sexuality and sex is something which social workers discuss with their disabled clients and have funded visits to sex workers or sex assistants.

Side note: a sexual assistant is a Dutch model which seems to offer a none penetrative sexual service, instead more focussed on erotic massage, teaching etc. Some sites suggest no kissing, no oral sex and no penetration. Perhaps a sex surrogate lite?

The horrifically named, White Hands offer a masturbation service to disabled men in Japan (I’m hoping something got lost in translation of the name because there are some troubling connotations with it’s English version).  The video I watched spoke of clients who didn’t understand their sexual urges and desires and who got confused or ended up hurting themselves because they didn’t know what to do with their feelings.  The service appears to help clients understand how to react to sexual urges as well as providing masturbation for physically disabled men.  From my perspective, it felt rather clinical… Slightly reminiscent of the Victorian woman going to her doctor to have her hysteria treated by orgasm.

And against…

Returning to Rachel Watton’s stance on the issue – society should change but until it does sex should be purchasable – an argument could be made that providing the service could hinder or prevent society from changing. It puts a plaster over the issue and means that it’s less visible. Disabled people have a means of having sex so society no longer needs to address discrimination, perceptions of disabled people etc…

Legalising paying for sex for disabled people is a way of ignoring the issue of disability and sexuality, society doesn’t need to change because we can get sex at a brothel (assuming it’s accessible of course!)… It’s an attempt to pacify us.  It also assumes that disabled people are only looking for the physical side of sex and that we don’t want or don’t deserve an intimate relationship.  It feels like allowing sex work for disabled people ticks the box of the functional desire for sex and allows society to ignore the need for intimacy which would require a lot more change and participation of society to achieve.

Allowing disabled people to pay for sex focuses heavily on the individual disabled people who may want to use this service and adapting things for them rather than on changing society.  This approach feels much more in line with the medical model approach of disability, something is at fault with this person let’s fix them, rather than addressing how disability is perceived and how we are disabled by society.  If disabled people were seen as accepted members of the community, would we even be having this discussion?

In an Atlantic article, Alex Ghenis and Mik Scarlet echo this tokenistic gesture and the troubling implications on how we’re seen by others.

Alex Ghenis, an American disability advocate and former dating and relationships columnist says of paying for sex: “It commodifies sex in terms of an action. It makes it so society can check this box that men are getting laid, so we don’t have to have broader social change—we are giving them sex through a brothel, so we don’t have to change our social attitudes around socially excluded people with disabilities…And it pities and coddles us, as if we are being given things that will assuage us … rather than have society change around us.”

Mik Scarlet, a disabled TV presenter and musician: “Imagine this, I’m disabled, growing up in Luton, and it’s now legal for me to go to a brothel—to have sex for money—because apparently that’s the only way I’m going to lose my virginity. Instantly, my relationship with sex is distorted, and it means that everyone I meet afterwards is going to say, ‘He’s disabled, that means he’s paid for sex; I don’t want to go to bed with someone who’s paid for it.’ You’ve reinforced the fact that you can’t give it away because you’ve paid for it. We are reinforcing the idea that some people are too hideous and too disabled to have sex like the rest of us, and so they have to pay for it.”

Paying for sex risks making us more “other”.  It could demean our (none paid for) sexual experiences – the idea that if you’re disabled, you’ve probably had to pay for sex and if you’ve paid for sex, the experience is therefore lesser. Paying for sex could further marginalise people with disability. It reinforces the idea we are too ugly, too broken, too disabled to have sex and not pay.  It also makes us ‘special’, a subset of society who are “allowed” to buy sex.  It feels like a strange extension of the charity model of care…

Paying for sex is also expensive, especially if your disability means you can’t work or you live in poverty.  This could result in more division within the disabled community – a tier where more privileged disabled people can afford to pay for sex and less privileged can’t.  Some people would argue that benefits shouldn’t be spent on sex but I don’t feel you can police what people do with their money.  NB. some countries do pay for disabled people to access sex services rather than the disabled person paying themselves.

There is also potential for sex workers who specialise in sex with disabled people, to be seen as a higher class of sex worker.  An elevated role.  Or by allowing sex workers for disabled people, the argument for sex work more generally could be justified.

When it comes to consent, there is the issues of the sex worker, are they freely consenting to the work they’re doing as well as issues of consent for the disabled person. If you happen to have seen Who’s Driving Doug, you may recall a scene where Doug (a disabled man) has been bought a prostitute by his driver. He seems reluctant to make use of this “present” but ends up going ahead with encouragement from the driver, his friend and the worker (who possibly wouldn’t get paid otherwise?). Whilst I think it was a consensual act, it highlighted the pressures that can lead to coerced consent. Feeling that peer pressure means you can’t refuse. Spending the money and then changing your mind but again, feeling you can’t call a stop to things. The pressure society puts on people to lose their virginity… Situations where someone is nonverbal and someone else decides that of course this person would want to use a sex worker because it’s “normal” to have sex… What about situations involving dementia or other memory issues? And what if someone appears to be consenting but actually doesn’t have the mental capacity to do so?  And communication issues?

All about the (straight) men?

Perhaps unsurprisingly, most of the information around this topic I could find is focused on disabled men… From what I could find, there are far more female sex surrogates which suggests that it’s easier for straight men to find someone.  Something I read but can’t find also suggested that disabled women felt more at risk of abuse from male sex workers than disabled men with female sex workers.

And in conclusion…

I’m not actually going to conclude anything.  It’s a complicated, multi-faceted topic and there’s too much I still don’t know and I still have too many questions.  I hope that this post has raised some of the arguments for and concerns with the idea of sex workers for disabled people.  I’d love to hear your thoughts and further arguments for and against.

Disability Devotees

Whenever we are discussing people’s sexual attraction it is necessary to be open minded. People can’t choose what/who they are attracted to and society has a very narrow definition of what is ok to sexually desire. We have to remember that until recently, homosexuality was considered a mental illness.

With this in mind, my intention here isn’t to cast out devotees, rather I want to open up the conversation and raise concerns with practising devoteeism. To desire something does not mean you have to act on it.

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My wheelchair, functional, pretty, but is it desirable?

What is a devotee?

“Someone who identifies as having a sexual attraction to disability — someone who finds the kinds of bodily difference that impairment can invoke sexually appealing, titillating and desirable.” – Kirsty Liddiard

Often this is focussed on a particular aid such as wheelchairs, canes, splints etc. Indeed, two of the most common types are an attraction to mobility impairments (and the related equipment) and an attraction to missing limbs.

What’s wrong with that? 

The disability, it would seem, has to be physical, it has to be visible:

“When we were in bed together I couldn’t see his disability at all so that would sometimes hamper things for me and I’d be looking over to the side at his chair or his cane to keep me going. Disability is a really important part of my sex life. I don’t orgasm without it.” – Meet the Devotees

If that was me, I’d feel like I was being rejected. I would understand very clearly that this woman wasn’t attracted to me, she was with me for my wheelchair. And is that any different to being with someone for their money? Our relationship certainly wouldn’t feel like an equal one. And what would happen if I suddenly got better and didn’t need the wheelchair?

One of my major concerns with devoteeism is the reduction of a person to their wheelchair, leg brace, impairment etc.  Obviously not all devotees will do this, having done a bit of reading, there is, as with most things, a spectrum.  Some people are however, attracted purely to the aides.

As Emily raises in her BBC documentary, often devotee porn is focused on an everyday, nonsexual, part of being disabled such as transferring from a wheelchair to a car. Indeed, as part of her research, Emily released a self made video of her doing just that which has received thousands of views.

To me, this is sexualising the everyday struggles (or potential struggles) of someone with a disability. Surely this is much more about power or pity than sex? And watching people struggle so you can get off feels pretty degrading…

My ankle splints, and piggy socks!

Devoteeism objectifies disabled people who are already objectified a lot by society as it is.  It treats disabled people as things and that can reduce the perceived need for consent – if you are a thing, then it doesn’t matter that you’ve not consented.  This doesn’t even consider situations where informed consent is hard to gain eg communication issues.  And if the person is not open to you about their devoteeism, can you truly consent?

We cannot ignore the fact that we live in a society which sees a lot of disabled people as asexual and reducing us to our impairment or our aids is further objectification which risks undoing any progress we have made towards being seen as sexual beings. We are more than our wheelchairs, we are people and in my opinion, devoteeism can do a lot of damage to our identities.

If we are told over and over again that we are not sexual, and then someone comes along who is fetishising our disability, we are at risk of seeing that as the only sexual option for us. And this further tips the scales of equality against us. It reinforces the idea of disabled people as helpless, pitiful, in need of care.

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Me in my wheelchair, complete with the scary figure of death watching over me (or  my nice OT but that’s a less dramatic interpretation)

As with most things, there are two sides to the story, some disabled women will enjoy the experience and find it empowering but others will be disgusted by it.  The issues of awareness and consent are crucial to the outcome and Kirsty Liddiard notes that “Devoteeism can enter abusive territory very quickly”.

I think, for me, as I said at the beginning, the important thing is what you do with your feelings and your attraction. That is the difference between a loving, empowering relationship between a disabled and abled person and a creepy, manipulative, potentially abusive one.

Side note: Stealing pictures

There is a part of the devotee culture (not sure if culture is appropriate but I hope it gets my point across) that is undeniably seedy. Like society in general, there will always be a cross section of morals and ethics.  I am referring here to those people who are in the habit of stealing photos, for example from facebook, to be used on devotee porn sites, an act which can only be construed as sexual violence. These photos then receive obscene comments causing further pain, shame etc for the victims.

Another increasing concern is the photographing or filming of disabled people in public who are unaware and unconsenting and who are just going about their life. These images and videos are used as porn and, in a way which has horrible parallels with child abuse, devotees can and do collect and save these images for their sexual pleasure.

Whilst I’m on the subject, the stealing of photos of disabled people is a wider issue, one which Beth raises from her personal experience.  Kirsty Liddiard writes more about this in her paper, Liking for Like’s Sake – The Commodification of Disability on Facebook (PDF).

Side question: Everything I came across on devotees was about non-disabled people, are there many or any disabled devotees?  I think that’d be an interesting perspective on the subject.  If you’re out there and want your views heard, let me know, I’d love to interview you!

When sex hurts: Sex and chronic pain

The post is looking at when sex exacerbates existing non sex related pain rather than pain caused purely by sex.  Although not discussed here, changes to appearance, self esteem etc will all impact on your psychological wellbeing which can then impact on your sex life.

Chronic pain can be distracting, it hurts obviously and it can impact heavily on your life. Including your sex life…  Being in pain all the time does not make you (or at least me) feel sexy.

I wanted to do a post specifically about pain because I think the impact pain has on sex can be different to other disabilities. My first point would be to talk to your doctors… However,  I know that that isn’t always all that helpful… indeed, the NHS seems a bit lacking for in depth support…  (but yay, they have something, I guess)

I don’t have a magic wand to make sex with chronic pain easier but having sex can help with the pain so it’s worth a try, right?!  Orgasms cause endorphins to flood your body which helps with pain relief.

In no particular order, here’s some things to consider:

  • Communication – talk to your partner, its ok to be worried about the impact of sex on your pain, particularly if you’ve been avoiding it. Talk about where the pain is worse right now, should your partner avoid touching parts of you today etc
  • A lot of conditions fluctuate, make sure your partner understands this; being able to do something one day doesn’t mean you can do it the next.
  • Plan ahead. Unlike the movies, sex doesn’t always have to be spontaneous.  There are so many reasons why that doesn’t work such as children, working unusual hours, carers etc.  And if it helps, you can try and schedule in some rest time before hand and recovery time afterwards.
  • Find out what the best time of day is for you in terms of low pain, higher energy levels and higher libido
  • If being touched is painful (or even if it isn’t!), use none contact ways to arouse each other eg sexting, phone sex, talking flirty or dirty, mutual masturbation, pornography, erotic literature or try light touch such as feathers and silk
  • Massage is another way of being intimate, just be careful with painful joints, muscles etc
  • If your hands are in pain, try using your tongue
  • Warming the bed beforehand eg with an electric blanket may ease some of your pain
  • Sex toys might be easier for you and your partner
  • Cushions – well placed cushions can be invaluable! Think propping up hips etc
  • Where are you having sex? Would your wheelchair or riser recliner chair or electronic bed be more comfortable or in the water?
  • There’s also the impact of pain meds, they can decrease your libido, and you need to make sure you are on the right meds for you at the right dosage. If your pain isn’t controlled at all then of course sex will be harder
  • If your partner is your carer and you need help getting changed or into position, maybe you could ask someone else to get you ready or make the care into the foreplay.
  • Go long and slow or short and sweet, whatever works better for you
  • Have a think about what positions are best depending on where your pain is etc
  • Try not to stay in the same position for a long time if this causes you pain
  • Depending on where things are in your sex life, go back to basics with date nights, flirting, kisses, holding hands, cuddles…
  • Muscle relaxants, a warm bath, massage, a glass of wine might all aid things by relaxing you and your muscles
  • If something doesn’t feel good, say something.  Don’t assume your groans are conveying the right message! Maybe even have a safe word or be clear that stop means stop right away.
  • Use Google, look up good sex positions for ehlers danlos or whatever you have
  • edited to add, lube, lube is good

None of this is going to be a quick and easy solution unfortunately…

I’d really like to hear from you if you’ve got any more tips.

I’d also suggest popping over to The Hippy Geek who has joined two beds together so she can have an adjustable bed and still share a bed with her husband which I think is awesome*!

*be in no doubt here, as awesome as the idea is, if you ever end up in a relationship with me, you’ll be in the spare room! I love my double bed and all it’s very specifically arranged accessories and I’m not giving up my middle of the night internet for anyone!

Sex toys and disability

Going to assume, given the hush hush nature of talking about sex toys, that this should come with an 18+ warning…  That’s your warning.  I’m going to be talking about sex toys and disability, in case the title didn’t provide you with enough info… Personally, I don’t feel the info is explicit in nature but I’m aware people may disagree…

(Side note: this is focused on people with physical disabilities)

Apparently, three quarters of women own at least one sex toy and 36% of men own a sex toy. So even if people are ashamed of talking about sex toys, most people will have some experience with them.

And they’re great.  They can enhance sex or masturbation, and if you have a disability or not, they can stimulate you or your partner(s) in ways which could not happen otherwise.

So, what are the best sex toys for disabled people? 

Let me refer you to a previous point I made about how everyone is different.  Everyone has different sexual interests and people with disabilities are exactly the same.  Also, you will need to consider your own disability as everyone has different needs, even with the same condition.

To help get you thinking about what’s going to work for you, the key issues for me and sex toys would be; I can’t be penetrated; my energy levels are crap; my hands are quite unhelpful when it comes to things like repetitive movements and fine motor skills (like buttons). I have high levels of pain throughout my body as well but I’m going to look at pain and sex in more detail in another post.

What should I consider when I’m looking for a toy?

A good question to ask yourself when you’re looking at sex toys is what I do want to use this for?  Yes, I know, stupid question.  In particular, are you wanting to use this alone or with someone or have someone use it on you etc?  All of this will effect what’s going to be the right choice for you.

Further considerations include, can you hold and manipulate your sex toy?  No?  Maybe look at something which fits into underwear and can be held in place that way.  Can you control it using on the toy buttons or would a remote control be easier?  Does it matter what it’s made from?  Do you have allergies?  Does your skin tear easily?  Yes? Then maybe look for something made of a very smooth material like silicon or glass and maybe something which doesn’t vibrate.

Can you get the batteries in?  Would you feel comfortable asking someone else to do it?  If not, either manually operated or rechargeable toys might be best.  Also remember that sex toys need cleaning.  If you’ve got a partner they may be able to do that but if not, and you can’t, you’ll need to ask someone else.

Do you live with carers or your parents?  If so, you might prefer a quieter vibrator or toy without a motor.  If you’ve got decreased or increased sensation, then perhaps look at toys which have different levels of vibration etc or something which doesn’t vibrate.

From the point of view of energy levels, lighter is probably better when it comes to weight as would be something you don’t need to hold in place.  Or you could place a cushion so that the toy can rest on it whilst still stimulating you or buy a cushion made for the job.  And cushions are good for sex more generally – great for propping up joints etc.

You can get dildos which attach to the floor, tiled walls, your leg, your face.  Think how much more exciting your sex life could be compared to all the people who think disabled people can’t have sex.  To the 44% of people who wouldn’t entertain having sex with a disabled person, your loss.

Think about the wider environment, nice sheets can make a huge difference to how you’re feeling and make it easier to move around.  Or how about using handcuffs to help keep you in one place?  And use lube (again, if you’ve got allergies check the ingredients or ask for a sample and test it on  your arm or somewhere first. Do not try it out on your genitals if you think you might be allergic!).  You might find particular places easier for sex, on the bed or propped up on the floor by the bed or in your wheelchair or in a sex swing.

I’m afraid I’m focusing heavily on cis women here, I’m not sure I’ve got much to say about men’s sex toys but hopefully someone else does.  If that someone is you, please add advice in the comments (actually, everyone should do that, just keep it on topic please).

Most importantly, try things, have fun and learn what works for you.

Useful links:

http://disabilityhorizons.com/2014/07/disability-and-sex-lets-be-frank-about-sex-toys/

http://disabilityhorizons.com/2014/04/sex-tips-sexy-crip/

http://www.autostraddle.com/our-bodies-our-sex-toys-6-accessible-sex-toys-320004/

http://www.comeasyouare.com/sex-information/sex-and-disability/

Nonsexual virgin vs the hypersexualised fiend; stereotypes of disability and sexuality

This should probably have been the first in my blog posts about disability and sexuality…  Essentially, there are two ideas of the disabled person and sexuality; the nonsexual* virgin and the hypersexual, unstoppable fiend.

Where do these ideas come from?

When it comes to physical disability, people are reduced to things, objects to be pitied, to be looked after.  There is a view that the disabled person is childlike and this is a barrier to seeing disabled people as sexual.  Society wants to prevent disabled people from having sex in the same way they do children.

Then there’s the issue of reproduction – even when a disability has been acquired, somehow it’s assumed that the child would also have a disability and regardless, that having a disabled parent would mean that child suffers.  There is this idea that a person with a disability cannot, or should not, have children and the obvious conclusion is then that that person cannot or should not have sex.

And who would actually want to have sex with someone with a disability…? As disability is still viewed on many levels as a deformity, an abnormality, people with disabilities are considered undesirable.  So no one would be interested in a person with a disability so general thinking doesn’t even have to consider the idea of a sexual disabled person.  And tied up in this is the concept that disabled people can’t have sex; this will feed into and be fed by the idea of the nonsexual disabled person.

Historically people with disabilities have had to live in institutions which often strongly discourage intimacy between residents, again reinforcing this idea that disabled people don’t have sex.

At the other end of the spectrum, the hypersexual stereotypes are more commonly linked with learning disabilities, bipolar disorder and other mental health issues.  This seems to be because of a perception of lack of control which leads to indulgent, hedonistic behaviour which the person may not fully understand or be fully lucid for.

“Because people with mental disabilities are often not taught or shown the difference between social and private behaviour (or are unable to learn this difference), activities such as masturbation, displaying of one’s genitals, and inappropriate sexual advances may be carried out in public, or in the company of others. For the most part this does not have to do with a lack of intelligence, but a lack of informative education and teaching methods that allow people living with mental disabilities to live within a larger society.” – http://infochangeindia.org/disabilities/disabled-sexualities/asexuality-and-hypersexuality.html

What damage do these stereotypes do?

The nonsexual image means that often people with disabilities aren’t see as prospective partners.  Depending on the disability, research has shown that disabled people are less likely to have a long-term partner or marry than non-disabled people. Then we have the sickening results of a 2014 newspaper poll (I think it was the Guardian) which asked people if they had ever had sex with someone who had a physical disability, 44 percent said “No, and I don’t think I would.”  Given that estimates suggest 20% of the world’s population has a disability, this is ruling out a lot of potential partners! Although if you were one of the 44%, then I probably don’t want to have sex with you either…

At the other end of the spectrum we have the assumption that people with disabilities are out of control when it comes to sex, this tends to be an assumption used when the person has a learning disability or mental health issue as opposed to the nonsexual person with a physical disability.  Concerns around unplanned pregnancies have led to a history of forced sterilisations under the guise of protecting the person with the disability.  This comes from both the angle of protecting the person as well as protecting the potential child who could have a disability and from the belief that a person with a disability can’t be a good parent.  There’s a great podcast about this issue over on Stuff Mom Never Told You.  Whilst it’s mostly focused on the historical aspect of racially motivated sterilisation it’s still a relevant and interesting piece.  As is their Sex and Disability podcast.  edited to add: The Australian magazine Marie Claire also looks at the forced sterilisation of girls and women with disabilities (pdf).

As well as forced sterilisation, we also have the issue of inappropriate sex education.  I’ve heard of disabled young people who missed out on any sex education because it wasn’t deemed necessary… And if you are lucky enough to receive sex ed, then it’ll probably be aimed at ‘normal’ people and you still won’t be empowered through information.  And it’s not just that you don’t know how to “do it” safely; if you don’t get a comprehensive education, you can find yourself at risk of abuse or struggle to do anything about abuse – without empowering information, how do you work out appropriate boundaries, how do you tell someone that your friend put his finger in your vagina if you don’t have a word for vagina… This is turning into a post about the importance of sex ed so I’ll leave this point (almost) there.  The important message is we should all get appropriate sex ed. Thankfully we live in the world of the internet (if you’re reading this you do anyway, I acknowledge that there’s still a lot of the world without it) and sites such as Chronic Sex and Sexuality and Disability are out there to help (although they still require a certain level of literacy and understanding so will exclude some people…).

And then there’s the impact the nonsexual physically disabled person myth has on health care.  I recently tried to get a coil fitted, failed miserably, and then asked if I could try another kind of contraceptive pill.  On both occasions, the two different doctors I was dealing with, both assumed I didn’t need it as a contraception.  I don’t but that’s not the point.  The point is I could have needed it as a contraception but because they assumed not, I didn’t get asked the same questions or given the same advice such as if you’re sick it might not work.  Or any information about using condoms to prevent STIs.  Thankfully I’m fairly clued up on sexual health but a lot of people aren’t, I return again to the issue of poor sex ed…

*I’m using the phrase nonsexual or desexualised because asexuality is great, when it’s your identity, not when it’s forced on you by society and I think using the same terminology will confuse the issues and take away from someone’s actual identity.

Mental health and sexuality

Mental health and sexuality…what a tangled web…

I’m talking here about mental health conditions such as depression, anxiety, personality disorders etc rather than learning disabilities although there will be overlapping issues.

I’m also not going to look at vulnerability to exploitation or abuse here. I think that’s a big topic which deserves its own space and overlaps a lot with physical disability.

This blog post will be partly informed by my own experience of mental ill health; anorexia, depression, anxiety and suicidal feelings as well as reading I have done into the subject.

There’s two key areas I want to look at; sexuality causing mental ill health and the impact mental ill health has on sexuality.

Sexuality causing mental ill health

Sexuality is a complicated, very highly personal identity to navigate. In my case I am a bisexual woman who wasn’t really aware that bisexuality was a real thing and an identity I could own until I was about 18. In my case, a history of mental ill health predates the significant stage of forming of my sexual identity. I’ve had depression for as long as I can remember and definitely dating back to when I was seven and experienced my first suicidal feelings. For other people, unfurling sexuality may be the trigger for mental illness.

We still live in a society which makes it hard to be anything other than heterosexual. LGBTQA teens have higher rates of mental illness. You’re at a stage in your life when your creating your sexual identity, you may feel you don’t fit it, you may be persecuted. And there’s a host of additional factors which come in if you don’t think you’re the gender you’ve been performing for the last ten fifteen years. A confusing time for anyone, adolescence as LGBTQA can be far worse.

This increased risk of mental health issues continues past adolescence. For example, in Australia, it’s estimated that 36.5% of trans people and 24.4% of lesbian, gay and bisexual people will at any time meet the criteria for a major depressive episode. Trans women (male to female) are especially likely to suffer from mental health issues. Gay, lesbian and bisexual Australians are more than twice as likely to experience an anxiety disorder as heterosexual Australians are (31% compared to 14%).

Historically, the World Health Organisation only removed homosexuality as a formal psychiatric diagnosis in 1992. It’s still illegal in over 76 countries. Even if you are lucky enough to live in an accepting community, you’re still exposed to discrimination and hatred and it’s hard for that not to impact you in some ways.

The impact of mental ill health on sexuality

Looking now at the impact of mental ill health on sexuality I’m going to talk about the mental illness first and then move on to any effects that medication plays.

  • You may feel increased or decreased sexual desire
  • You may experience low self esteem or symptoms which make you believe you’re unattractive or unworthy
  • You may experience loss of interest in people, activities etc
  • You may experience loss of motivation
  • Your self care skills may be affected leading to poorer hygiene which in term affects confidence
  • You may find it difficult to meet people, for example if you’re spending long periods of time in hospital or find it difficult to leave your home

Obviously a loss in sexual desire is going to have a huge impact on your sexual expression but the other examples show that there’s lots of factors at play here. With my anorexia at it’s worst, I would have struggled to let someone else see or touch my body. I had a head filled with calorie counting and self loathing and there was no space in there for sex. I was also constantly exhausted and had no interest in anything. With depression, I find myself in a place where I think no one can like me, that I’m worthless and horrible and that’s not conducive to a good sex life! I also self harm and again, I would find it incredibly difficult for someone to see recent injuries.

And if your mental health problems are related to issues such as abuse or rape, then the subject gets even more complicated.

And then there’s the medication… Side effects of medication can cause loss of libido, vaginal dryness, problems getting an erection, problems orgasming, weight gain which can affect confidence etc.

I want to briefly mention substance or alcohol misuse (which can occur because of, or be considered, a mental health issue) because that can have quite a huge impact on sexual behaviour. For example, if you’re under the influence of drugs or alcohol, you may do things you wouldn’t normally do; having sex with someone you wouldn’t normally, having unprotected sex or engaging in sexual acts which you wouldn’t normally (eg sex in public places, being filmed, particular types of sex). Similar behaviour may also arise from a manic state.

As you can see, there’s a lot of interacting issues when it comes to mental ill health and sexuality. I could go on and on, but really, the purpose of my post was to highlight the issue. And try and get people talking about it. Mental health and sexuality on their own aren’t topics people talk about much so mental health and sexuality together doesn’t stand much of a chance.  And yet, communication is a key part of building a healthy sex life.

If you need help with any of the issues raised, please speak to your GP, care team, partner, friends or helplines.

In the UK, the Samaritans are open 24/7 to listen to you.

If you’re struggling with your sexual orientation, have a look at Mind’s useful contacts.

Disability and sexuality, part 1

I was on a train about a year ago, the first time I’d been on a train in my wheelchair. I was sat in the wheelchair section along with some guys off to a football match. It was ten in the morning and they’d been drinking. And were talkative. I ended up left alone (as far as I was aware – it turned out there was a women round the corner listening to this who only spoke up once they’d got off the train…) with them for the 22 minutes between York and Leeds. And they were awful. They completely invaded my space, leaning on my chair and many other things which I’m not going to go through. But then, basically out of nowhere, one of them asked if I could have sex what with being in that thing, insert wild gesturing towards my chair. What the f***?

I’d “known” them about ten minutes and now they wanted diagrams about my sex life. And felt it was completely fine to ask for them. Not ok. Way way way not ok. But I was alone with them and had no idea how far they were travelling and I couldn’t move to another part of the train.

So I handled it in the only way I felt safe, with humour and changing the subject. Inside I was fuming and wanted to have it out with them about how inappropriate it was but I felt too vulnerable. If they’d turned nasty, I’d have been stuck. Indeed, when they left one of them hugged me and the other full on kissed my lips. Again, not ok.

But… and I am in no way excusing their behaviour, society paints people as asexual so when they were faced with a young woman in a chair I suspect they genuinely couldn’t put two and two together. I suspect they’d have hit on anyone who was female and near them on the train but it just so happened that it was me and my disability. And I think it threw them through a loop.

Which is why we need to talk about disability and sexuality.

So, can disabled people have sex?

Yes.

Wait, you want more than a one word answer? I think you’re probably wanting to ask how disabled people have sex then. And the answer is long. Probably infinite. Because, like with abled bodied people, everyone likes different things and is capable of different things. Indeed the sex that a disabled person has will probably vary depending on the partner, like with abled bodied sex…

But isn’t it a bit rubbish?

No. Again, everyone enjoys different things and are able to do different things.

I think it’s important to remember that we have mental disabilities, sensory disabilities and physical disabilities and obviously they will all have a different impact on sex. Often the difficulties people have in understanding how disabled people have sex is with regards to physical disabilities. Issues around learning disabilities tend to focus more on before sex, in particular around things like consent. And people seem to on the whole forget about mental illness when talking about how disabled people have sex… FYI, depression, anxiety and other mental illnesses can impact on your sex life. Perhaps that’s a different blog post.

Go on then, how do you do it?

Firstly, what do you mean by sex? So many people are referring to penis in vagina penetration when they talk about sex. Which is so uncreative… I can’t have penetrative sex as I’ve discussed here previously but I still enjoy lots of other things. You just need to explore more, see what works for you and your partners. Kiss, cuddle, use sex toys, make use of the bed raiser, have strategically placed cushions…

And communicate. The odd grunt and groan here and there probably isn’t going to cut it – can you tell the difference between the “keep going that’s amazing you’re rocking my world” groan and the “shit, my hip just dislocated but I don’t want to say something and ruin the mood” groan? Make it sexy, make it dirty, make it intimate.

You might need to talk beforehand about some things – where are you in pain, where should I avoid touching you, what happens if…, is the bed or the floor or the bath best for you, how does your disability affect you when it comes to sex…

There might need to be another person involved for example to help you get undressed or to get you onto the bed etc.

And if things go off course, humour is helpful. Except if you’ve just accidentally knee-ed your male partner… Turns out that’s not so funny… Oops!

But other than that, it can be a lot like “normal” sex.

Sexuality and disability has information about sex with partners and masturbation including ideas for particular conditions etc. And talk to your professionals.  Some of them will be squeemish and not answer your questions or try and deter you from having sex but that’s their issue not yours.  Keep trying until you get the info you want.  Sexuality is part of who you are and a healthy sex life can be great for your overall wellbeing.  Plus, orgasms are apparently great for pain relief.

Have fun and stay safe!