Living with a disability, regardless of severity, often comes with regular contact with health services and allied health support. These supports are usually focused on maintaining health and supporting people with disabilities to maintain their ability to complete routine daily tasks. But one aspect of this often overlooked in health care is discussions about our relationships and intimacy.
Social relationships, especially intimate ones, come with a range of health benefits including enhancing quality of life, better emotional wellbeing, more favourable mental health, an increased sense of belonging, stronger self-worth, and lowered stress (Friedman, 2018). People with a disability have the same desires for intimate friendships and romantic relationships as anyone else, but can often be limited in their ability to explore their sexuality due to barriers that make this more difficult, including limitations in social opportunities and networks, the stigma associated with disabilities in the wider community, a lack of access to sexual health services, physical challenges such as pain and fatigue, changes in relationship dynamics for partners now providing a caregiver role, as well as privacy or freedom to express their sexuality (Friedman, 2018) (BetterHealth Channel, 2023). So where do you start?
There are many health services available in the community to help address these challenges, but knowing how to find them or where to begin is often another challenge in itself.
Occupational Therapists are health professionals that specialise in supporting people to ensure they maintain the ability to engage in meaningful activities. This is inclusive of supporting people to complete daily self-care tasks such as showering and other personal hygiene, eating, as well as household tasks such as shopping, meal preparation, medication management, and a range of other daily tasks. This often involves looking at rehabilitative methods to support people to build their skills, changes to the environment to support participation, as well as the use of assistive aids and assistive technology, and these concepts can also be applied to engaging in sexual relationships and intimacy. It is a conversation that Occupational Therapists are perfectly situated to explore due to our training in addressing person specific goals and outcomes, task analysis, understanding of physical health and sensory processing, working with neurodiverse populations, and looking at adaptation and modification of tasks where necessary.
While not every Occupational Therapist may be best equipped to help address challenges with sex and intimacy, having the conversation can usually be the first step in helping you seek the right support needed to address these challenges, and support you in finding the right professional for your needs. Should you not have access to any professional support, or don’t feel comfortable having this discussion with your care team, there are many other good starting points for people to access information to guide them through their health journey, including the following:
Facebook groups (closed groups for privacy)
- Sexuality and Disability Support Group
- Disability and Sexuality
- SexAbled
- Sexual health for women with disabilities and chronic illness
- Disability – Inclusive Sexual Health Network
Online Blogs:
- XES Products
https://www.xesproducts.com.au/blogs/news
- Occupational Therapists for Sexuality and Intimacy
- Institute for Sex Intimacy and Occupational Therapy
https://www.sexintimacyot.com/blog
- Shantelle Otten – Psycho-sexologist
https://chantelleotten.com/blog/
Podcasts:
- OT After Dark
- The Spicy Boudoir
- Disability After Dark – Andrew Gurza
- Stroke Foundation – Young Stroke Podcast (dating after stroke)
Websites:
- Sexual Education Counselling and Consultancy Agency (SECCA) – support for people with disabilities to learn about relationships, sexuality, and sexual health.
- XES Products – online sex toy store with a focus on empowering individuals physical, cognitive and sexual health conditions.
https://www.xesproducts.com.au/
- Queensland Health – Sexual health information including public health information and sexual health services available in Queensland
https://www.health.qld.gov.au/clinical-practice/guidelines-procedures/sex-health
- Pleasurable – Sexual device manual for persons with disabilities
Article written by,
Max Walton
Occupational Therapist