Sexuality and disability can interact with one another in complex ways. For some, disability has no effect on sexual desire or activity, while for others, it may pose challenges.
Sometimes, these challenges result from the disability itself, but they can also stem from myths or prejudice against disabled people.
This article explores the relationship between disability and sexuality, including how disability may affect sex and educational resources.
Disability does not necessarily change a person’s sexuality. Disabled people can have just as much desire and ability to have sex as nondisabled people.
The idea that all people with disabilities are not sexual is a myth. It links to a broader idea that people with disabilities are passive, childlike, or incapable of making their own decisions.
That said, disability and chronic illness can affect sex sometimes. Whether it does depends on the person, their situation, and their experiences.
Lux’s story
“When I first started getting sick, it really worsened how I felt about myself. I didn’t feel ‘sexy,’ and it was hard for me to get in that sexual mindset when I felt at war with my body.
“Sex became associated with all this anxiety and baggage. I was often tired or in pain, but that was often something I could work around. The real issue for me was that I was hyperaware of how different I looked and felt, so it was hard for me to break through that psychological barrier.”
There are many types of disability, and each can affect people differently. Some may not affect sex, while others may affect:
- mobility
- vision, hearing, or touch
- cognition
- communication skills
- energy levels
- mental health
Any of these factors could interfere with or change a person’s sex drive or physical capabilities.
A 2020 survey found that chronic illness often affects sexual activity and satisfaction, even if the condition does not directly relate to sex.
Shanna’s story
“I think at first, I saw all the effects as negative. Fatigue meant that sometimes I wanted to have sex but didn’t have the energy to do so, and pain meant I couldn’t do some of the things I enjoyed most in the ways I had always done them.”
Another challenge that can affect sexuality in disabled people is ableism. Ableism is prejudice or discrimination against people with disabilities.
Some examples of ableist beliefs about sexuality include that disabled people:
- have no interest in sex
- should not make decisions about their own bodies
- cannot or should not have children
These beliefs can have negative consequences, such as:
- a lack of sex education, which makes people more vulnerable to unhealthy relationships and abuse
- obstacles to dating, such as a lack of accessibility on dating apps or in venues
- difficulty connecting with people
- discrimination
- low self-esteem
Lux’s story
“I was reading a lot of romance books while I was at my sickest, and I didn’t see one woman who had so much as seasonal allergies or acne. The heroines were always the picture of physical health. I was definitely picking up on those indirect messages that sex wasn’t for sick people, especially not sick women.”
With the right resources, many disabled people may safely explore sexuality. This requires:
Sex education
A healthy exploration of sex begins with knowledge. People need to understand how their body works, how sex works, and what is safe.
For any person, sex education also needs to be easy to understand, accurate, and relevant. This may mean finding sex education tailored to a particular disability.
It may be helpful for disabled people, their partners, and caregivers to learn this material.
Shanna’s story
“I learned almost everything I know from other disabled people and chronically ill people. As a community, we are creative and scrappy, and always so generous around sharing what we have learned works for our body-minds.”
Self-knowledge
The United Kingdom charity, Scope, recommends that people identify what they want from sex and learn what they enjoy before they have it.
For example, some people may only like specific types of sex or physical sensations. Some may want fun, while others may want a relationship.
Having answers to these questions may give people more confidence in relationships or help them find suitable partners.
Lux’s story
“Writing and reading fiction about chronically ill characters helped me detach myself from all the negative feelings I was having about my body. When I was empathizing with these characters, it was easier to empathize with myself and find that self-love.”
Communication
For safety, being able to communicate a “yes” or a “no” is essential for safe sex.
But communication also helps people express affection, explain what they like, or understand what their partner likes, which can make sex more enjoyable.
Not everyone communicates in the same way. Hand gestures, sign language, and signals such as nodding or shaking the head can also work. The important thing is that all partners understand what these signals mean in advance.
Shanna’s story
“As much as I can be frustrated at having to change things sexually to meet my access needs, it’s also made me much more creative and communicative. I share more about what I want and need, and in turn, have found my sex life to be much more robust and satisfying.”
Adaptations
Some people physically adapt their approach to sex to accommodate their needs. For example, they might use:
- pillows, cushions, or other devices to support their bodies
- certain sex positions that avoid pain or tiredness
- sex toys
People can also engage in different types of sex that may be easier or more enjoyable than others. For example, mutual masturbation can be less physically demanding or less overwhelming to the senses than penetrative sex.
Lux’s story
“There’s this idea that adapting sex to your disabled partner’s needs has to be difficult or inherently interrupts the flow of good sex. In reality, a lot of accommodations are easy and straightforward.
“If you can’t tolerate a position, you switch to another. Room gets too hot for you? Turn on a fan. Need a break? Go ahead and take one. When partners can ask for what they need, it makes for better sex.”
A
There are several theories about why this relationship exists. For one, discrimination against LGBTQIA+ people may affect health, potentially leading to acquired disabilities.
The two groups also have some shared experiences. For example, people with disabilities may already live or feel differently from others. This may heighten their awareness of how they differ from people without disabilities.
A 2023 review of past research describes challenges people in both groups can experience, such as:
- a lack of education on sex or relationships
- a lack of understanding about being LGBTQIA+ from healthcare professionals
- discrimination within the healthcare system
It is important for educators to be aware of this link when helping those with disabilities.
While sex can be safe and enjoyable, disabled people can also be more vulnerable to sexual abuse.
A 2022 study found that disabled women reported approximately double the amount of sexual violence than women without disabilities during their lifetimes.
This included women with any type of disability. The rates among those with multiple disabilities or cognitive disabilities were higher.
The authors of the study noted that these figures may not represent the true extent of the problem, as stigma, disbelief, and other factors mean that people may often underreport sexual violence.
People can find resources for sex education at:
- Mencap, a United Kingdom charity for those with learning disabilities
- Choice Support, an organization with a Supported Loving tool kit with guides on a range of topics
- Family Planning NSW, an Australian organization with a series of fact sheets
- Disability Belongs, a nonprofit that lists a range of books, courses, and articles on its site
- Sex Ed for Self-Advocates, by the Organization for Autism Research
- the Down’s Syndrome Association
Planned Parenthood has also produced courses that teachers can use to learn more about delivering comprehensive sex education.
RAINN provides support for people who have experienced sexual assault, and lists further resources for people with additional needs on their website.
Help is available
If you or someone you know is in immediate danger of domestic violence, call 911 or otherwise seek emergency help. Anyone who needs advice or support can contact the National Domestic Violence Hotline 24/7 via:
- phone, at 800-799-7233
- text, by texting START to 88788
Many other resources are available, including helplines, in-person support, and temporary housing. People can find local resources and others classified by demographics, such as support specifically for People of Color, here:
The relationship between sexuality and disability can be complex, but it is not always. Disability can vary significantly from person to person, and how it affects people is highly individual.
Some people find their disability has little or no effect on their sexuality, while for others, the condition causing the disability could pose challenges.
Sex education is vital for empowering disabled people to make informed decisions around sex and relationships.