The Sexual Needs and Rights of People with Impairments

The subject of sexuality and disability is highly emotive, and difficult for carers and families to consider fully. If it’s hard for them, we need to consider how difficult it must be for say, a woman with a learning impairment, in sheltered accommodation, to address. However, new legislation requires us all to reconsider this area with care and sensitivity, and to put into practice some fresh ideas and practices.

In this book I have drawn together many different strands of learning and experience relating to people with disabilities and those that care for them. My hope is that this will enable improved understanding and communication about this delicate subject, both between professional carers themselves and between them and their clients. I have remained aware of the potential conflict of interest between those who have a duty of care for their clients and their clients’ own perceptions and needs, and have addressed this conflict throughout.

This work encompasses the legal framework, medical implications and ethical considerations of sexual expression in cared-for clients. It explores society’s attitudes to impairment and challenges the logic of our assumptions about disabled people, and their assumptions about their carers.

The book arose partly from my work, but also from first hand experience of living with people with different impairments, and I am indebted to the many individuals, both clients and their carers, who have shared their thoughts and experiences with me over the years. The Social Model of Disability and recent Human Rights legislation provided a starting point and will be referred to throughout.

Chapter One: To be Human is to be Sexual

Although most women, and an increasing number of men, will have experience during their lifetime of caring for frail or vulnerable family members, this is often a temporary state of affairs, managed alongside other commitments. However, for a very large number of men and women, caring has become their profession and their way of life. These carers, paid and unpaid, are part of an almost invisible army, and the people they care for are still, despite our efforts, marginalized within our society. People who have serious impairments have little alternative but to accept some level of care to enable them to function with maximum efficiency, and to protect them from exploitation and physical or emotional harm. It is a mutually dependent relationship: the carer relies on having people with impairments to care for, and the person who is the recipient of that care has little choice in the matter.