104 Understanding Sex Education for Women with Disabilities

Faculty Mentor: Sara Simonsen (Nursing, University of Utah)

Introduction

Education is vital to equip people with the knowledge and skills they need to have sexual health. Receiving sex education has been shown to “lower sexual activity, sexual risk behaviors and adolescent pregnancy” (APA, n.d.). Furthermore, research has found that women who received education about a greater number of sex education topics had a higher chance of using a contraceptive at first intercourse (Namkung et al., 2021). Sex education plays a vital role in keeping women safe for example, by teaching what abuse looks like and how to report it. Women with a disability are at a disproportionately higher risk of abuse than their able-bodied counterparts (Anyango et al. 2023).

Women with disabilities may have challenges when it comes to healthy relationships that could be aided by sex education. Some women have disabilities that are not physically apparent, and deciding when to disclose they have a disability is a source of stress in pursuing relationships (Basson, 1998). For those with physical disabilities sexual intimacy may not look the same and there is little educational information that is inclusive.

Caregivers and parents also share a responsibility in providing sexual education. However, the sexuality of women with disabilities is often disregarded. “Inappropriate or misguided sexual remarks made by women with cognitive disabilities may provoke anxiety in her caregivers but are often ignored rather than being met with a helpful response” (Basson, 1998). Parents especially have a challenging time acknowledging and discussing sex with their children especially when they have disabilities. “Most parents [of daughters with a disability] deny or conceal the inappropriate sexual behaviors and sexual problems of their adolescent girls” (Goli, 2020). By removing stigma around discussing sexual health, those with disabilities could be more equipped to manage healthy relationships and sexual desire in a healthy way. The need for accurate education is not only in schools but continues into adulthood. Women with disabilities need caregivers to be able to provide resources for sexual health information.

Sex education plays a significant role in helping people understand and recognize stigma and misconceptions they face or believe and helps dismantle harmful ideas as well as provide the facts. Those with disabilities face many challenges accessing sexual health information due to it being oftentimes inaccessible and created with an able-bodied audience in mind. However, because of the higher risks for disabled women in many sexual health areas, it is even more important that they are receiving sex education.

Objectives

Women with physical and mental disabilities are often less likely to report receiving sexual education. There are a variety of factors that cause this problem such as social stigmas where women with disabilities are perceived as non-sexual and therefore not in need of sexual education. An additional barrier is that learning materials may not include education tailored for people with disabilities. Education plays a crucial role in giving people the skills to have positive sexual health. This study aims to compare women with physical disabilities, cognitive disabilities, or both physical and cognitive disabilities on exposure to sex education.

Methods

This national study was an online survey of women with self-reported physical and/or cognitive disabilities. The study included an 83-question internet survey. The survey questions were tested by disability experts and designed to understand the healthcare needs of women with a disability and identify areas of improvement. Data were collected on various sex education topics and respondents were asked whether the information was received from a parent/guardian or in a school, church, or community center. SPSS software was used to calculate descriptive statistics and chi-square tests to compare women with different types of disability. Survey data were compared to national data.

Results

A total of 224 women participated in the study: 135 with a physical disability, 49 with a cognitive disability, and 40 with both types of disability. A total of 98.5% of those with physical disability and 100% of those with cognitive disability reported receiving education about one or more sex education at topics at home, and 99.3% with physical and 100% with cognitive disabilities reported education about at least one topic at a school, church, or community center. 100% of those with both physical and cognitive reported receiving at least one or more topic from a parent or guardian and from a school, church, or community center.

Conclusion

More research is needed to understand barriers to comprehensive sex education among women with disabilities in both home settings and church/community/school settings. Sexual education is important for women with disabilities because it equips them with the skills needed to have healthy sexual lives.

References

American Psychological Association. (n.d.). Abuse of women with disabilities. American Psychological Association. Retrieved July 11, 2022, from https://www.apa.org/topics/disabilities/women-violence

Anyango, C., Goicolea, I., & Namatovu, F. (2023). Women with disabilities’ experiences of intimate partner violence: a qualitative study from Sweden. BMC women’s health, 23(1), 381. https://doi.org/10.1186/s12905-023-02524-8

Basson R. (1998). Sexual health of women with disabilities. CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne, 159(4), 359– 362.

Centers for Disease Control and Prevention. (2017, August 14). NSFG – listing S – key statistics from the National Survey of Family Growth. Centers for Disease Control and Prevention. Retrieved April 3, 2023, from https://www.cdc.gov/nchs/nsfg/key_statistics/s.htm#sexeducation

Goli, S., Noroozi, M., & Salehi, M. (2020). Parental Experiences about the Sexual and Reproductive Health of Adolescent Girls with Intellectual Disability: A Qualitative Study. Iranian journal of nursing and midwifery research, 25(3), 254–259.https://doi.org/10.4103/ijnmr.IJNMR_258_19

Namkung, E. H., Valentine, A., Warner, L., & Mitra, M. (2021). Contraceptive use at first sexual intercourse among adolescent and young adult women with disabilities: The role of formal sex education. Contraception, 103(3), 178–184. https://doi.org/10.1016/j.contraception.2020.12.007