Disability, Intimacy, and Sexual Health

Foreword by Michael S. Shafer
About the Authors
Acknowledgments

Chapter 1: Disability and Sexual Citizenship

Chapter 2: History of Policies Restricting the Sexual Rights of People with Disabilities

Chapter 3: Healthy Sexuality Begins in Childhood

Chapter 4: Romantic Relationships, Intimacy, and Sexuality

Chapter 5: Sex Education

Chapter 6: Romantic Relationship Vulnerability and Victimization

Chapter 7: Pregnancy and Parenting

Chapter 8: Cohabitation and Marriage

Chapter 9: Intimate Relationships in Older Adulthood

Chapter 10: Overview of the Implications for Social Work Practice

References
Index

Kristen Faye Linton, PhD, is an assistant professor of health science at California State University, Channel Islands, in Camarillo. Prior to her research career, she spent over a decade as a social worker, supporting people with disabilities and their families to live independent, fulfilled lives in the community. Her research focuses on disability and health disparities with particular attention to sexual health, brain injury, race, and ethnicity. Her education and experience as a social worker and qualitative and quantitative methods researcher has prompted her to conduct community-based intervention research and evaluation that responds to community needs.

Heidi Adams Rueda, PhD, is an assistant professor at the Department of Social Work, University of Texas at San Antonio. Her research focuses on adolescent dating and sexual relationships within ecodevelopmental contexts, particularly among understudied youth populations including Mexican American youths, pregnant and parenting youths in foster care, and adolescents with disabilities. Within a holistic approach to dating health, her work aims to prevent teenage dating violence and to foster strong foundations for healthy adolescent and lifelong partnering. She uses mixed methods to inform the design and evaluation of effective preventative interventions and social work practice with adolescents.

Lela Rankin Williams, PhD, is an associate professor and coordinator at the School of Social Work, Arizona State University, in Tucson. Her interdisciplinary training in psychology and human development and family studies is informed by an ecological perspective, including the importance of regarding cultural and familial relationships as meaningful contexts within adolescent romantic relationships. She is committed to the development, evaluation, and implementation of culturally meaningful youthdriven prevention and intervention programs. As an active leader in both academic and community settings, she places a high priority on conducting rigorous and culturally relevant research in collaboration with community partners that is both meaningful and accessible.

Earn 3.5 CEUs for reading this title! For more information, visit the Social Work Online CE Institute.

“ I hope he has a good sex life.”

More than 25 years ago, I heard these words from a mother of a teenage son with cognitive and physical disabilities when I asked her what her greatest hope was for her child. Not a job, not a safe and secure living environment, but a good sex life. In its purest forms, sex affords a degree of intimacy, tenderness, and vulnerability that define, in some important way, what it is to be human and what we as humans so desperately require to thrive.

In this groundbreaking work, Kristen Faye Linton, Heidi Adams Rueda, and Lela Rankin Williams step into this taboo topic and provide guidance for social workers and other helping professionals working with people with disabilities. This text provides the reader with a unique and unparalleled synthesis of Linton and her colleagues’ own research with a wealth of existent findings, historical context, policy directives, and practice guidelines to shine light on this challenging and complicated issue. As noted in chapter 2, society’s historical approach to addressing the issues of sexuality among people with disabilities has been fraught with oppression. Many people with disabilities were forced to undergo procedures designed to deny and impede any expression of sexuality, including mass sterilization and castration. The growing recognition of the sexuality of people with disabilities might be considered a natural outgrowth of the continuing march toward full community inclusion launched more than 40 years ago with deinstitutionalization and the disability rights movement.

The interplay among self-esteem, social relationships, and sexuality during childhood and the development period has been well documented. Chapters 3 and 4 provide the reader with an examination of the normative experiences of relationships, friendships, and intimacy that children and adolescents with disabilities face.

The authors note that during this period growing self-awareness of being different and challenges in establishing friendships can have devastating effects on the self-esteem and mental health of young people with disabilities. For parents of young people with disabilities, venturing into the topic of sexuality with their child can present unique challenges. Chapter 5 provides a terrific summary of research regarding the status of sex education for people with disabilities and offers some excellent resources for the social worker. The authors then go on to address some of the more significant concerns emerging from sexuality among people with disabilities, including victimization; considerations of the parenting demands of women with disabilities; and, finally, considerations of marriage, cohabitation, and the resulting impact on disability benefits. The juxtaposition of interview extracts and Bronfenbrenner’s (1977, 1979) ecological systems theory, a tool that the authors use throughout this text, provides the reader with a familiar orientation to consider the various topics. The authors conclude with an examination of the special issues associated with sexuality and aging.

For readers new to working with people with disabilities, and for those who have struggled to provide support to their clients regarding their sexuality, this text serves as a thoughtful, well-developed, and considerate primer to an important topic. I wish that I had had the benefit of this text many years ago, as I started my own career of working with people with disabilities and their parents.

Michael S. Shafer

PhD Arizona State University