A UK social work student, Ann*, was on placement in an Adult Services Team. In a case discussion Ann proposed that perhaps the recent unusual and more frequent challenging behavior of a young man with Learning Difficulties could be related to sexual needs. Her suggestion was dismissed out of hand and no further discussion was invited. Ann reflected on the ethical and practice related difficulties in enabling and facilitating the developing sexual identity of a young person with additional needs but was also concerned that ignoring sexual needs was oppressive and perpetuated the discriminatory notion of disabled people as non-sexual beings.
In social work we have a significant and positive history of providing for the functional and support needs of people with disabilities. Research however, demonstrates that there continues to be an underpinning assumption that people with disabilities are asexual. As a consequence support and advice about sex and rights in relation to sexual activity are infrequently discussed (Stonewall: 2015). This is further compounded by the notion of disability as homogenous which leads to the failure of service providers to consider the interrelationship between social divisions which in turn leads to individuals feeling more vulnerable to discrimination (Molloy et al: 2003) Valuing People outlined that “Good services will help people with learning disabilities develop opportunities to form relationships, including ones of a physical and sexual nature” (DH 2001:23). However, a subsequent national survey in England in 2004 showed that 92% of the near 3000 adults with learning difficulties surveyed were single and had always been single (Emerson et al 2005: 3). A number of studies have shown that people with learning difficulties may have little understanding of contraception (McCarthy: 2009); and may take their sex education from the media and this information is likely to be inadequate in relation to the emotional and psychological aspects of intimate relationships (Lockhart et al: 2010, 118).
Social work students were asked to consider an article in the Guardian (Ryan: 2013) which featured a photograph of the late Helen O’Tool, disabled activist protesting against proposals to criminalise clients of sex workers. In the photograph she is wearing a poster saying ‘disabled and horny’. In a discussion students did not feel they would be comfortable discussing sexuality and sexual needs with a service user. They suggested a lack of awareness of physical needs and abilities “Even if it was part of my role I don’t think I could ask someone about whether they were able to masturbate”; lack of awareness of legal boundaries “Is it legally OK to give advice about where to find a sex surrogate?”; lack of awareness of where sexuality and sexual needs might fit in a holistic assessment and lack of awareness of support services to refer to. Interestingly, subsequent discussion with a group of experienced practitioners suggested that many felt they were equally as unprepared to discuss sexuality with service users.
It has been argued that our theories and actions as social workers contribute towards a social construction of sexuality (Hicks: 2008). Awareness of the ways in which we uphold the rights of individuals to experience good sexual health allows us to challenge oppressive stereotypes and practice in an empowering and inclusive way. In the context of issues such as the successful referendum heralding changes to the Irish constitution on same sex marriage (May 2015) many of us have become self-congratulatory about our liberal acceptance. However, as Ann’s experience indicates, sexuality continues to be both a challenging aspect of social work and central to our work if we are to truly recognize and support diversity and make services fully accessible.
*Ann is a pseudonym
Emerson, E., Malam, S., Davies, I. and Spencer, K. (2005) Adults with Learning Difficulties in England 2003/4, London, National Statistics / NHS Health and Social Care Information Centre.
Hicks, S. (2008) Thinking through Sexuality. Journal of Social Work Vol 8:1 pp65-82
Lockhart, K. & Guerin, S. & Shanahan, S. & Coyle, K. (2010) ‘Expanding the Test of Counterfeit Deviance. Are sexual knowledge, experience and needs a factor in the sexualized challenging behavior of adults with intellectual disability?’, Research in Developmental Disabilities, Vol. 31, pp. 117-130.
McCarthy, M. (2009)’I have the jab so I can’t be blamed for getting pregnant’: Contraception and women with learning disabilities. Women’s Studies International Forum. 32: 3. Pp198-208.
Molloy, D., Knight, T., Woodfield, K. (2003) Diversity in disability: Exploring the interactions between disability, ethnicity, age, gender and sexuality. Research Report 188. DWP: London. http://webarchive.nationalarchives.gov.uk/20130128102031/http://research.dwp.gov.uk/asd/asd5/rrep188.pdf (accessed 28/5/15)
Ryan, F. (2013) I want a world where disabled people are valid sexual partners. The Guardian 12 February 2013. http://www.theguardian.com/society/2013/feb/12/disabled-people-valid-sexual-partners
Stonewall (2015) LGBT Disabled People. http://www.stonewallcymru.org.uk/what_we_do/research_and_policy/health_and_healthcare/3478.asp (accessed 28/5/15)
About the author:
Dr Lel Meleyal is a Lecturer in Social Work and Social Care at the University of Sussex where she delivers sexualit/ies teaching sessions to BA and MA social work students. Her research interests relate to conduct, boundaries, boundary transgression, personal and professional identity and the epistemology of regulatory failure. Her personal and professional interest in sexuality issues have origins in her history of lesbian feminist activism.