“AND THEN WHAT?” A guide for healthcare professionals for after you bring up sex and disability

Welcome back to Caring About Sex and Disability.

Talking about sex can be awkward, uncomfortable and uneasy for so many of us. What do you say? How do you help someone feel good about themselves and help them honour their sexuality? If you are a practitioner or rehab professional trying to be supportive of a client, it can be even more daunting because of professional boundaries, client comfort levels, lack of information and resources – the list goes on! Something that I think can be even scarier than the lack of information or the discomfort, is where to go after you’ve brought up the topic of sex and disability?

Now, you could sit in awkward silence together, but I want to give you a pathway forward with some suggestions from my own lived experiences, and what I wish clinicians would talk about after we’ve started talking about sex and disability.

So, let’s get cozy and get into it together!

#1: And Then… Ask About How Sexual Ableism Impacts Sexual Self-Esteem

I feel that one of the biggest areas that is missing when it comes to talking about sex and disability is sexual ableism. Just as a quick refresher: sexual ableism is when people make assumptions about a disabled person’s sexual ability through comments, jokes, actions or inaction.

Disabled people who are sexually active experience sexual ableism quite a lot (I do pretty regularly) and it can have a really negative impact on their self-esteem and their sexual confidence. I would suggest that after bringing up sex and disability with your client, that you gently inquire how sexual ableism plays a role in their sex life.

By offering them the opportunity to unpack sexual ableism with you, in a safe space, you will learn so much more about your client and build a trusting relationship with them. Additionally, this will help you design rehab options for your client around sexual confidence, and that is really important, and often overlooked. Give it a try!

#2: And Then… Ask About Current Partnerships

Another area that you may want to get into after bringing up sex and disability with a client is opening up the conversation about current or past partnerships. I’d suggest starting these conversations as gently as possible because a lot of relationship talk may trigger past ableism that your client went through, so you might try, “Can we talk about your past and current relationships?” If they are in a relationship, you might consider offering them a session with their partner.

I suggest this because I think it can offer some insight into how your client is seen by someone else. You can also find rehab exercises that the partners can do together that may help better their sexual relationship and I think that’s a pretty awesome potential opportunity. Test it out if you want!

#3: And Then… Ask about Sexual Wellbeing Products

You may also want to try having a conversation about sexual wellbeing products. You could ask your client if they’ve used them before and what the outcome was. As a disabled person who has tried SO MANY myself, you’ll probably get a treasure trove of stories about the inaccessibility of certain products; what didn’t work and why. If your client has had less than favorable experiences, you may even offer to go with them to a sex shop, or click through online with them and explore options. I believe that two things can happen here: 1) you learn about their issues with grip, dexterity, pain, etc. and these insights may help you in building a great rehabilitation plan for them AND you’ll help them build sexual confidence – confidence in general, too! If a client is worried about cost, you can advise them that many of the sexual wellbeing products can be covered through funding. A lot of people may be nervous about sexual wellbeing products, so I’d offer positioning it as yet another tool in your rehabilitation toolbox and seeing what happens.

#4: And Then… Sex Work

Now, this one might be a trickier one to really get into, but you might explore talking about a bodywork or sex work with your client. So many disabled people have had negative experiences trying to be sexual, and sex work can be a great bridge to help get them rebuild their sexual confidence.

To get into this topic, you might start by asking about new partnerships and what those experiences have been like for them. Ask about what that was like for them, and let them share it all with you. If you sense that they haven’t had much luck, offering a session with a bodyworker or sex worker is an option. You can remind them working with a bodyworker is just another tool in their toolbox, and it doesn’t have to be scary, and it doesn’t mean that their sexuality is diminished or less important than others.

Test this one out… you might give them the option that they didn’t know they needed!

I hope these suggestions help you make the sex and disability conversation a little less rocky! Remember, these are just suggestions, so use them as you feel comfortable doing so.

I hope you enjoyed this one, and I’d love to answer questions from clinicians about this, so feel free to leave comment below.

Until next time – keep caring about sex and disability, dear reader!

Xo

Andrew