Sexual and Reproductive Health Awareness Day is for disabled people too!

Today is Sexual and Reproductive Health Awareness Day across Canada and a few SHR2016other countries.  Thisis an especially important day this year given the rise of the #MeToo movement. Designed to bring about awareness of sexual and reproductive health issues, including the spread of sexually transmitted diseases, this day highlights how far we have come in getting such topics out in the open. While our society has gotten much better about talking about sexual and reproductive health over the last decades, one community is often left out of the conversation – people with disabilities. While this is a Canadian-derived effort, social workers around the world could learn from their model, especially if we are sure to recognize the unique sexual and reproductive health needs of people with disabilities.

Sexual and reproductive health is important for all people, it but may be complicated by the legacies of the eugenics movement for those with disabilities. Historically, those with disabilities have been perceived as asexual, although this is often not the case, leading to the failure of sexual and reproductive health providers to provide information, screening for sexually transmitted infections, or assessment for contraception needs. In fact, the sexual health needs of people with disabilities are often complicated by lack of sexual health knowledge and intersecting social identities.

Reproductive health professionals often lack training and experience related to working with people with disabilities and may also be hesitant about bringing up the topic of sexual health, a fact that is compounded by a lack of clinical guidelines for this work. This can translate into people with disabilities having a lack of information about sex, limited language for identifying sexual abuse, and limited opportunities for sex education, all of which curtail their human right to consensual sexual expression. This is especially problematic given that those with disabilities experience higher rates of sexual abuse and assault, which may often be under-reported.

Barriers to reproductive health care and counseling for this population are structural, attitudinal, and informational. Special techniques for a modified gynecological examination can be employed, and disabled women can work in partnership with health care providers to promote comfort, respect, and safety in that arena. There are also specific considerations for the use of different contraceptive methods in women with movement limitations, sensory impairments, latex allergies, medical problems relating to absorption of birth control pills, and more. Social workers can partner with health care providers to create a welcoming climate to both recognize people with disabilities as sexual beings and show respect to those who are seeking sexual health care. For social workers in congregate care settings, it will be important to encourage clients with disabilities to seek out information about sexual health and to support them in their efforts to express their sexuality.

But the problem doesn’t stop with sexual health, we also have to consider the fact that access to services for pregnancy and parenting are also often inaccessible to people with disabilities. Coupled with the problems of access to information about sexual health are barriers to information, services, and supports for women with disabilities who are pregnant and/or parenting. Common assumptions about women with disabilities include the ideas that they are either unable to get pregnant, that they should not be parents, that they do not want to be parents, and/or that they are not capable of parenting. In fact, in the last century, over thirty states permitted involuntary sterilization of women with disabilities.

As social workers develop an anti-oppressive practice model that is sensitive to the needs and choices of the communities of people with disabilities around sexual and reproductive health, they would do well to start talking about sexual and reproductive health with their clients directly! Be sure to ask about sex!