Eugene Viljoen

Disability and Sexuality

Ethical and practical issues impacting on the subgroup in South Africa

The aspects of a free and fulfilling sex life in the disabled has long been denied or not studied at all. The result which came about shows the disabled or people with disfigurement still experience some exclusion from being able to have a fulfilling sex life.

Sex and disability tends to be a taboo area for many abled bodied persons and is rarely discussed in the same sentence. As a result more than 50% of disabled people do not have any form of a regular sex life.

According to the World Health Organisation, “Sexuality is an integral part of the personality of everyone: man, woman and child; it is a basic need and aspect of being human that cannot be separated from other aspects life.“

People with physical or intellectual disabil

Consulting Rooms: 308 Nicolson Street                              Tel: 012 346 4760 Brooklyn, PRETORIA                                       Fax: 012 346 6455 South Africa 0181                               Cell: 0834542000   Intercare Irene                                    Pretoria Heart Hospital   email:  
Dr Eugéne Viljoen Registered Clinical Psychologist/Kliniese Sielkundige B.Sc.,B.Sc Honns (Physiol), B.Sc. Honns (Psych), M.Sc. Clin Psych, Ph.D PR:8614792  

ities in today’s society are often regarded as non-sexual adults, due to the able bodied world and legislative processes, not giving attention to these basic needs in the disabled. Many disabled people refer to the ways in which they are treated, as being excluded from the ways in which people would view normality. The fact that the body is disfigured or bend, in a way gives the assumption that the mind/psyche or human needs are also affected.

Sex is very much associated with youth and physical attractiveness, and when it is not, is often seen as “unseemly”. If sex and disability are discussed, it is very much in terms of capacity, technique, and fertility – in particular, male capacity and technique and female fertility – with no reference to sexual feelings by ignoring aspects of sexuality, such as touching, affection, and emotions.

In addition, opportunities for sexual exploration among disabled people, particularly the young, are very limited. There is often a lack of privacy and they are much more likely than other young people to receive a negative reaction from an adult if discovered. The general reduction in life choices also has an impact on self-esteem which in turn affects sexuality.

A person with a disability of some kind may tend to feel unattractive, or even less worthy of sexual partnership or relations, because they think that they can’t live up to the idealised image todays society has set. If the disability happened later on in their life, the person may recall how they used to look and feel very unattractive by comparison to who they once were.

Disability stereotypes add to the difficulty and stigma experienced by people with disabilities.

The following myths about people with disabilities have been identified:

  1. Men and women with disabilities don’t need sex.
  2. Men and women with disabilities are “oversexed.”
  3. Sex must be spontaneous and/or have a set time.
  4. Men and women with disabilities can’t have ‘real’ sex.
  5. Men and women with disabilities are not sexually attractive.
  6. Boys and girls with disabilities don’t need sexuality education.
  7. Men and women with disabilities have more important needs than sex.
  8. Men and women with disabilities, such as retardation, should not have children and should not be allowed to have children.
  9. In relation to intellectual disability, society frequently takes the view that intellectually disabled people have no rights at all to pursue social and sexual relationships. They have often been completely denied sex education.
  10. Intellectually disabled people are sometimes regarded as sexually deviant because they may exhibit socially inappropriate sexual behaviour.
  11. Just as can happen in the rest of the community, some intellectually disabled people grow up in situations (e.g. institutions) which differ from the norm in many ways. This can cause difficulties in social and personal development, and can contribute to the development of socially inappropriate behaviour. It can also be more difficult for intellectually disabled people to distinguish between public and private behaviours.
  12. A child’s sexuality education comes from a range of sources, including their parents, teachers and friends.
  13. People with intellectual disability also need sexuality education that: Teaches them that people with disability can have fulfilling sex lives Is delivered in a way that a person with intellectual disability can understand. Explains social rules, such as telling the difference between private and public behaviours. Covers age-appropriate sexual issues that may be associated with their particular disability
  14. For paraplegic and quadriplegic people, a loss of sexual function does not mean a corresponding loss of sexuality. Sexual function may be impaired but can, like other functions, be increased.
  15. After spinal cord injury the spinal centre for sexual function is generally intact; it is the communication from the brain to the spinal centre that is usually disrupted. Unless some sensation in the area of the sexual organs remains, the usual sensation of orgasm is lost, but phantom orgasm elsewhere in the body may be experienced.

However, the physical and emotional aspects of sexuality, despite the physical loss of function, continue to be just as important for disabled people as for non-disabled people.