Crip-queer intimacy, alliance and activism: towards holistic sexuality education in Taiwan

ABSTRACT

This study investigates the significance of sexuality education for individuals with disabilities in Taiwan. It highlights the importance of understanding sexuality as a fundamental aspect of identity, encompassing intimate relationships and connection to others. Since the implementation of the Gender Equity Education Act in 2004, Taiwan has made efforts to include comprehensive sexuality education in the school curriculum and integrate disabled students into mainstream education. However, disabled individuals still face barriers due to ableism and heteronormativity, which impede their access to sexual and reproductive health services, including sexuality education. To address this issue, we conducted a qualitative investigation using narrative and policy data, drawing on Scott’s phenomenology of nothingness and crip theory to explore the intersection of sexualities and disabilities in educational contexts. Our findings reveal that individuals with disabilities in Taiwan often rely on pornography and other erotic materials as informal sources of sex education. Hand Angels, a volunteer-based group established in 2013, has been actively promoting sexual rights within disability rights organisations, advocating for a comprehensive, sex-positive, pleasure-focused, and rights-based approach to sexuality education. However, there are still gaps in knowledge production and policy implementation, which systematically deny people with disabilities their right to sexual agency.

KEYWORDS:

• (dis)ableism
• Hand Angels
• human rights
• intersectionality
• sexuality education
• special education

Introduction

Sexuality education for students with disabilities is significantly underdeveloped globally. However, since the 1990s, there has been increasing research and advocacy for the intersections of sexuality and disability as well as the sexual citizenship of disabled individuals (Bahner 2020). Various global movements have drawn attention to the limited availability and accessibility of sexuality education for students with diverse abilities (Bahner 2018).

Over the past last three decades, efforts have been made to create spaces in which disabled individuals can openly discuss their romantic lives and sexual desires. This shift is aligned with the disability rights movement, which has changed society’s perception of disability from viewing it in terms of personal limitations to examining and removing the environmental and social barriers that hinder individuals with diverse bodies and minds (Shakespeare, Gillespie-Sells, and Davies 1996). In response to Siebers’ (2008) call for a sexual culture that challenges dominant perceptions of disabled sexualities, this study explores how sexuality education can effectively engage people with diverse physical abilities.

International organisations consider sexuality education key to supporting young people in their physical and psychological development (IPPF 2010; UNFPA 2014; UNESCO et al. 2018). In recent years, the provision of Comprehensive Sexuality Education (CSE) in school, family, and community settings has been framed as a human rights imperative, particularly following the United Nations (UN) Committee on Economic, Social and Cultural Rights’ adoption of General Comment No. 22 on the right to sexual and reproductive health in 2016 (UNFPA 2018).

Taiwan, although not a member of the UN, has embraced the principles of the Convention on the Rights of Persons with Disabilities (CRPD) through its Implementation Act of 2014. This significant milestone has played a vital role in protecting the rights of disabled individuals within the country.¹ According to Taiwan’s 2020 Health and Welfare Report, approximately 1,186,740 people – 5% of the total population – are officially recognised as disabled (Ministry of Health and Welfare 2020). Notably, this estimate does not include other disabled people who do not satisfy the relevant clinical-legal criteria. Additionally, of 4,211,736 students across all educational levels in 2020, 118,043 were identified as having disabilities (Ministry of Education n.d..).

The Special Education Act enacted in 1984 aims to support students with disabilities or giftedness by providing appropriate education, fostering their potential, nurturing their personalities, and facilitating their access to social services (Article 1). The Act highlights the principle of reasonable accommodation, ensuring that curricular materials are appropriate, accessible, inclusive and flexible. With increasing recognition of the significance of inclusive education within the CPRD framework, Taiwan’s special education policy has strived to integrate, rather than segregate, children with disabilities into the general education system. Since the implementation of the Gender Equity Education Act in 2004, Taiwan has departed from an abstinence-based approach to sexuality education, embracing more comprehensive forms of sexuality education as part of its efforts to address sexual and gender-based violence in educational settings. Article 13 of the Act’s enforcement rules emphasises gender equity in education, sex education, understanding of gender differences, sex characteristics, gender expression, gender identities, sexual orientations, as well as prevention and responses to sexual assault, sexual harassment, and sexual bullying within educational institutions. This approach allows for the participation of sexuality and gender minority community members in shaping an inclusive approach to sexuality education, in line with gender equality policy goals.

Compared to abstinence-only programmes, CSE offers a more inclusive approach to sexual diversity and gender equality. This latter paradigm recognises the increased risks faced by vulnerable populations who experience violence due to their non-conformity to social norms or marginalisation, such as gender non-conformity and disability (UNESCO 2015). However, current approaches fail to fully embrace the positive aspects of disabled sexualities within non-conforming bodies. An alternative paradigm – Holistic Sexuality Education (HSE) – aligns with CSE’s focus on gender relations and well-being but further highlights sexuality as a catalyst for ‘personal and sexual growth’ and ‘potential sources of joy and happiness’ (Miedema, Le Mat, and Hague 2020, 755). Both approaches aim to empower individuals; however, while CSE prioritises sexual and reproductive health promotion and violence prevention, HSE encourages sex-positive perspectives on pleasure and the right to a sexual life.

Since 2019, Taiwan has extended the duration of basic education from nine to twelve years, shifting the educational focus from nurturing talents to fostering good citizenship. This policy aims to provide a more accommodating educational space and curriculum by gradually including students with special education needs in regular classrooms and mainstreaming CSE elements into all subjects and educational contexts. These elements include respect for sexual diversity, mutual respect and boundary-setting regarding each other’s bodies, and awareness of power dynamics in interpersonal relationships. In theory, disabled students should receive the same courses and materials as their peers. However, tensions between self-determination and safeguarding against potential abuse persist in public discourse regarding disabled students’ sexuality (Brown and McCann 2018), and this has been fuelled by risk-averse family members who reject their children’s sexual agency (Shuttleworth, Julia, and Linda 2020).

Persons with disabilities are often wrongly perceived as lacking sexual desire or being too innocent to be educated about sexual behaviour, resulting in their exclusion from public and policy debates about sexuality education. Campbell’s (2017) extensive literature review reveals a significant knowledge gap regarding how disability discrimination creates and maintains barriers preventing individuals with disabilities from exploring and expressing their sexuality. The wide gap suggests an ‘inadvertent omission within the academy’ (Campbell 2017, 11) and lack of methodological and pedagogical options to guide educational and research programmes that aim to understand the interplay between sexuality, gender and disability.

Given this context, we were prompted to consider what sexuality education that not only includes but is also designed for disabled students might entail. The desire to overprotect individuals with disabilities from sexual violence and activity has resulted in their limited access to sexual autonomy. Sexuality education is often deemed unimportant for the well-being of disabled students. For example, in Europe, most available studies focus on people with intellectual or developmental disabilities, with very few addressing sex education for those with physical disabilities (Michielsen and Brockschmidt 2021). A similar situation prevails in Taiwan (Chou et al. 2020). Aware that disabled individuals may receive little sexuality education, this paper examines their experiences of sexuality education and invites them to envision what a high-quality, disability-friendly sexuality education might entail.

The study elicited valuable insights by gathering narrative data through in-depth interviews with individuals with disabilities and members of disability rights organisations. The findings reveal a significant gap in sexuality education for persons with disabilities, highlighting the inadequacy and even absence of comprehensive educational programmes. By engaging with individuals who are directly affected by this issue, this study offers a deeper understanding of the challenges they face and emphasises the urgent need for improved and inclusive approaches to sexuality education.

Materials and methods

For this study, participants were recruited using a three-step process:

1. Recruitment flyers (both hard and soft copies) were distributed to thirty points of contact, including social media groups, non-governmental organisations (NGOs), and academic institutions.

2. Respondents who expressed interest in participating and met the age and high school education requirements were provided with more information about the study and encouraged to express their concerns.

3. Selected participants were contacted at their convenience.

Many of the organisations we contacted were hesitant to participate. Considering the limited responses to our invitation and all participants’ differential mobility, we opted for in-depth semi-structured interviews (rather than focus groups as initially planned), which took place from late 2021 to early 2022. We conducted separate face-to-face interviews with two NGO leaders, initially approached to engage more potential participants, but later interviewed due to their unique position within the disability rights movement in Taiwan. Additionally, we conducted an online interview with one disabled individual and a face-to-face interview with two individuals together. All participants were recruited based on their responses to our survey form, and all were (1) aged between 20–50, (2) living with one and more disabilities, as recognised by Taiwan’s Ministry of Health and Welfare, and (3) willing to share personal experiences (seeTable 1).

Table 1. Study participants.

Name	Chi-Wei	Vincent	Tom	Xiaobu	George
Disability type*	Musculoskeletal	Musculoskeletal	Musculoskeletal	Neuro-musculoskeletal	Facial
Age	45–49	50–55	35–39	20–25	35–39
Senior high school graduation	2007	Unsure	2004	2014	2007
Sex **	Male	Male	Male	Female	Male
Affiliation	Hand Angels & Tongzhi Hotline	Hand Angels & DBQueer	Hand Angels (volunteers)	Hand Angels (volunteers)	Adisability community organisation

*All participants received a diagnosis according to their disability when receiving primary education.

**All participants’ gender identities conform to the gender roles according to their sexes assigned at birth.

Using an interview guide, we asked participants to discuss their experiences related to learning and exploring sexuality, as well as their imagination of what disability-friendly sexuality education might comprise. Most interviews were conducted individually, while the two-person interview allowed for a more collaborative approach to exploring an ‘ideal’ version of sexuality education, especially as the individuals concerned were of different genders. All interviews were recorded and transcribed. The study proposal and protocols were approved by the National Taiwan University Research Ethics Committee, addressing resources for managing traumatic events, accessibility issues, and other ethical considerations.

Among the five participants, pseudonyms were chosen for Xiaobu, Tom, and George. Chi-Wei and Vincent, the other two participants, were founders of Hand Angels, an NGO established in 2013 to provide sexual counselling and masturbation services to severely disabled individuals. The sexual needs of severely disabled persons are usually met by non-profit organisations, whose members voluntarily provide pleasure-focused sexual services (Appel 2010). Chi-Wei and Vincent have also been long associated with other organisations, including the Tongzhi Hotline Association (Taiwan’s largest LGBTQ+ organisation) and DBQueer (the first ‘queer-crip’ organisation in Taiwan). Their activism for, and tenacity regarding, disability rights fuelled their decision to participate in this study, so they declined anonymity. Information about Hand Angels, initially not the focus of the study, was triangulated against the report Practicing Disability Rights to Sex: The Case Study of the Netherlands, Japan, and Taiwan, published by Hong Kong Women Christian Council in 2016 as part of its ‘Love Has No Disability’ project.

The two-person interview with Xiaobu and Tom lasted for approximately two hours, with breaks scheduled to combat fatigue. The interview had two phases; the first explored their experiences regarding sexuality education and what they believed to be appropriate content for people with physical disabilities. Phase two was open-ended, allowing participants to identify the topics they would love to see addressed in sexuality education. Unfortunately, this was the only group interview possible. George’s interview took place online.

During data collection, we viewed interviewees as co-producers of knowledge (involved with shared accountability and mutual regard) rather than just informants.² The same applied to our terminological choices surrounding (dis)abilities. Drawing on crip methodology, we aimed to challenge ‘normative’ and non-disabled categorisations of bodies/minds (Mollow and Robert 2012) to destabilise hierarchies between those perceived as more useful/usable (and thus more-normal) and those seen as less-than-normal. Since the term ‘disability’ implies a lack of functionality under ableist hegemony, we advocated for the preferred term ‘persons with diverse abilities’ to acknowledge people with different body-minds and capacities (McRuer 2006). This perspective gave us insight into how to interact with participants and understand their desire to explore diverse sexualities.

The interview data were analysed using a narrative analytical approach. We drew on Scott’s (2019) two-way take on the Husserlian phenomenology of reality: presentation and presentification, which respectively attend to lived and unlived experiences as backgrounding the present and the self. Presentation is the recognition of empirically actual, manifest experiential and embodied events, while presentification involves imaginatively invoking things that are not empirically present yet (Scott 2020). This approach allowed us to interpret narratives in terms of lived experiences and envisioning.

Scott’s phenomenology of unlived experiences and a crip critical approach to lived disabilities guided our creation of thematic codes. Audio data were transcribed into texts and translated from Mandarin Chinese to English. Thematic codes, generated from exchanges between the two authors, centred on participants’ actual and desired experiences and on their responses to hypothetical questions (e.g. what if there had been sexuality education catering to my bodies and needs?). We realised that both forms of reality co-constituted participants’ lived and lost sexual lives.

Crip theory prompted us to critically approach such nothingness, a negative social space devoid of sexuality education for diverse sexualities and abilities. Unlived/lost experiences were socially constructed and accounted for by uncovering ableist biases, presumptions of unimportance, and lack of educational infrastructure (Swango-Wilson 2011; Shakespeare and Richardson 2018). Methodologically, not all ideas and terms used by participants were easily translatable into English, so we discussed translations extensively (The first author’s first language is Mandarin and the second author’s English). We referred to the audio files whenever meanings were in doubt, developing a reflexive practice before and during drafting the results (Wong and Kwong-Lai Poon 2010).

Findings

The study’s findings are organised into two parts. The first part explores participants’ experiences of formal and informal sexuality education, while the second part addresses what they hope to experience should Holistic Sexuality Education ever be put in place. In summary, interviewees strongly expressed the need for a more critical, holistic approach to sexuality education to address the heteronormative and ableist assumptions that have prevented the exercise of their sexual rights. Beyond formal education, they wanted to explore alternative spaces to ‘learn’ about sexuality. This is a vacuum which Hand Angels hope to fill with their advocacy and voluntary sexual services. Thus, we also discussed this organisation’s sexual rights campaign and related educational events and materials, although this was not the original purpose of our study.

Backgrounding experiences: social and policy contexts

In Taiwan, the concerns and needs of disabled individuals regarding sexuality education have been neglected (Chou et al. 2020). The Disabled Persons Welfare Act of 1980 underwent revisions in 2007, leading to today’s People with Disabilities Rights Protection Act. Since the passing of this Act, disability rights have been a crucial policy issue in Taiwan. However, health education for disabled persons has largely focused on preventing disability through reproductive medical interventions in the context of the People with Disabilities Rights Protection Act, the Genetic Health Act, and the Assisted Reproduction Act combined (Su 2023). As participants mentioned, such a policy discourse has resulted in many disabled people’s ambivalence about engagement with reproductive health topics.

The Twelve-Year National Basic Education, which includes CSE, began in 2019; therefore, no participant in this study had any experience with it. All participants (except Xiaobu, who was younger) experienced class or school segregation for ‘special education’ in which no sex education was provided. However, Xiaobu benefited from sexuality education covered by the gender equity education curriculum. One theme emerging from our conversations was the omission of disabilities from current dialogue about sexuality education and the lack of concern for sexuality in the disability rights movement. Participants also reflected on what might constitute ‘ideal’ sexuality education. Trust and open-mindedness, intimate feelings and emotional health, agency and empowerment, and sexual rights emerged as key issues throughout this study.

Discussions with the participants also highlighted concerns regarding ‘taking control’ of one’s own body. Chi-Wei, a former special education teacher, recounted instances where sterilisation had taken place without the consent of the disabled individual: ‘[the] parents of these children would ask the doctor to remove [uterus], either surgically or through medication’. According to Chi-Wei, ‘either for eugenic reasons or to protect their children from unintended pregnancy, these parents seem to believe hysterectomies for girls with disabilities are justifiable’. Such attitudes affected individuals’ self-perceptions, causing them to grow to see some bodies as more ‘useful’ and desirable than others and legitimising abuse, discrimination, and loss of autonomy. Vincent and Tom also identified society’s double standards, which encouraged ‘normatively bodied’ people to form sexual relationships and reproduce whilst dissuading disabled persons from pursuing the same goals.

Analysis of participants’ narrative data highlighted the following topics: (1) the longstanding negligence of intersectionality between sexualities and disabilities in public discussion; (2) disabled persons’ ambivalence towards learning about sexuality in the context of special or mainstream education; (3) informal sources of information and education to engaging with one’s sexual desires; and (4) the emotional and mental health dimensions of learning – and not learning – about sex.

Omission of intersected concerns of disabilities and sexualities

Despite a degree of consensus among disability rights activists regarding the importance of sex education among persons with disabilities, sexuality remains a taboo. According to Chi-Wei, mainstream disability rights groups ‘would prefer to avoid […] discussion in their advocacy’. Vincent stated: ‘only certain parts of the CRPD are included while others, such as sexual rights, are largely ignored … there is little to no incentive for human rights advocacy groups to implement the CRPD fully’. More specifically, ‘older and more conservative groups are less likely to participate in events and initiatives hosted by more progressive groups such as DBQueer’, said Chi-We. ‘They just prefer not to be associated with Hand Angels whose agenda falls outside the scope of conventional disability rights advocacy’.

Similarly, Tom mentioned that ‘disabled people’s perspectives and experiences are lacking within the women’s and LGBTQ rights movements’. According to a study conducted by one of the authors, certain types of bodies and sexual practices were not considered ‘legitimate’ in sexual rights and sex-positivity advocacy (Lee 2017). Despite national and international efforts to uphold disability rights as human rights, participants argued that conversations centring on crip sexualities are far from becoming accepted.

DBQueer, another organisation launched by Vincent focusing on LGBTQ people with disabilities, purposefully uses the adjective ‘queer-crip’, which is different from ‘crip-queer’, in its writings. Crip sexualities are considered queer due to the normative expectations imposed on disabled persons and because they complicate the hetero/homosexual binary and related theories of sexual hierarchy. Flipping the order within the compound word and making it ‘crip-queer’ aims to re-centre (dis)abilities in the larger gendered and sexual context (Fernández, Andrea, and Almeda Samaranch 2017). With this conscious word choice, it is possible to identify and envision, through participants’ eyes, the intimacies, alliances and sometimes tensions between social movements for sexual rights and disability justice.

Experiencing formal sex education: segregation or integration

Regarding integrated classes, Vincent believed that one problem lay in ‘how teachers incorporate teaching materials to ensure students receive adequate and relevant information irrespective of abilities’. Although the Ministry of Education has provided guidelines and tailored materials for disabled students, participants questioned how the syllabus and course plan would be customised for students with unique needs. George mentioned, ‘Integration cannot be forced without careful consideration and adjustments’.

‘Of course, there are positive aspects of integrating students with different abilities’, Tom stated while critically reflecting on how this has often been done so as to integrate disabled students into ableist structures of instruction in which ‘“normal” students continue to learn comfortably’. Tom believed that sex education might benefit from an expansion of the attributes of inclusive education and deliberately teaching non-disabled students about disabled students’ sexual needs to ‘genuinely create disability-friendly spaces’.

Xiaobu recalled learning about menstrual health while her counterparts (who were male) were learning about condom use. Even though Xiaobu’s school had offered sex education, boys and girls were taught separately and offered different teaching materials. George commented, ‘It is strange to learn about sex only based on your assigned sex at birth (without even considering diverse gender identities), so we know nothing about our counterparts’. Schools may have the power to decide which course materials comply with the law, providing what is required, but Vincent stated that this ‘may be insufficient or not meaningful enough to help students navigate their sexual lives’.

Vincent’s experience differed considerably from Xiaobu’s. Apart from some chapters on anatomy and physiology of the body in a health education textbook, ‘not much was discussed’. The worst part was that ‘the teacher even asked us to review the chapters ourselves’. This self-study method, which is not rare among Taiwanese students especially regarding sex education, deprives students of the opportunity to engage with, and reflect on, the textbook knowledge. It also ignores the fact that ‘not everyone learns best through self-study, especially those with diverse learning abilities and skills’, commented Chi-Wei.

Informal sources of sex education and daily hidden curriculum

Every participant spoke about the importance of the ‘home setting’. According to Chi-Wei and Vincent, disabled students spend a lot of time at home, and thus, parents and other family members naturally become their primary sources of knowledge regarding the body, sex and sexuality. Therefore, ‘it is also important to include parents in providing sexuality education and related health information for their kids’. However, Chi-Wei noted that ‘most of the time, parents are the biggest obstacle in this regard’. Xiaobu mentioned, ‘not just parents … my caregiver did not feel comfortable discussing sex and sexual desires with me’. As a polyamorous person, Xiaobu realised that ‘being a disabled “queer” woman’ had made people around her ‘not know how to deal with her’.

Tom echoed this, stating that ‘finding people willing to support these sexual experiences is extremely difficult’. When having sex with his intimate partner, Tom said ‘I need to reposition my body from time to time’. Although Tom’s partner currently cares for this specific need, having an assistant would significantly help in many ways. His attempt to recruit a personal assistant for this had resulted in ‘pushbacks by the hiring and placement agencies’. According to Xiaobu, for disabled persons, expressions of sexual desire, even those as simple as holding hands, can lead to ‘strange looks on people’s faces and awkward silences’.

Asserting that ‘sexual rights are human rights’, Vincent said, ‘everyone is a sexual being and should have the opportunity to exert their sexual agency without feeling shame, guilt or neglect’. He believed that sex is a natural part of life, in that people should not be ‘disabled’ simply because ‘they can’t do what other people “normally” do’.

All participants mentioned online pornography as a primary source of ‘sexuality education’. Yet, lack of representation in porn, said Chi-Wei, can lead disabled persons ‘to believe that their bodies are not desirable or “useful”’. Xiaobu echoed this by explaining that ‘without proper education, we could be deceived by porn into believing that our bodies are not worthy of pleasure’. Chi-Wei and some Hand Angels volunteers have been working on creating porn videos featuring persons with diverse abilities. Chi-Wei explained that ‘these videos depict a wide range of crip-queer people … though there is “vanilla sex” content too’. The Hand Angels team attempts to eroticise assistive devices as part of sex scenes, believing that ‘this representation shows everyone’s expression of desires as they are “enabled” regardless of the device used’.

The emotional and mental health aspects of learning about sexuality

Beyond sexual and reproductive health, participants described how emotions transcend the physical realm. George delved into the psychological components of relationship building. For him, sex was not only a physical act between participating people but also about the human connection behind the bodies involved and the emotions attached to the experience. He believed ‘so-called intimacy … has been missing from both formal sex education and pornographies’. According to George’s conception of sexuality education, ‘sex is just one component, and the psychosocial and socioemotional dimensions should receive the same amount of attention’.

Similarly, Tom believed that a focus on emotion as part of sexuality education is urgently needed by disabled people, ‘who rarely have opportunities to explore this part of a relationship and have someone to talk to’. Xiaobu had difficulty making friends, mainly because they believed she lacked the necessary social skills to integrate with other students, partially because she was home-schooled. She wanted to learn ‘how to communicate her needs without hurting people or being offensive’ and stated that ‘understanding notions such as autonomy, consent practices, and setting personal boundaries would be helpful’.

Besides social skills and emotion management, George mentioned that a precursor to sexuality education should be mental health support and resilience building. As a man with disabilities, ‘the body and mind affect one another’. George stated that, ‘not only does the physical environment discriminate, but [the] mental aspects of discriminatory minds perpetuated by an ableist society also actualise the harm [done] to us’. Relatedly, Vincent commented, ‘That is where pleasure comes from’. ‘Enjoying sex’ is important because ‘it matters even more for our mental health’. He continued, ‘sexuality education generally pays disproportionate attention to sexual health (risks) – the negative side of sex – while ignoring the good part of it, which links our bodily senses to our feelings’. According to Xiaobu, to account for the positive side of sex is ‘to be both independent and dependent on the person you trust’. She continued, ‘I need a way to learn to love and care for myself; I need to know that I am desirable’.

The interviews revealed that for people with disabilities, it is not enough to learn about the physical and health aspects of sex; it is also essential to consider personal agency and confidence building as key components of sexuality education. Xiaobu explained that ‘taking control in a relationship has helped me to grasp the idea of consenting to care’, a crucial life skill to negotiate and address power dynamics between those providing care and those receiving it. Whether sexual or not, Xiaobu said, ‘when disabled women have no opportunities to participate in the process of consenting to or refusing care, we feel “disabled” and “disempowered”’. ‘This may go beyond the scope of sexuality education’, George iterated, ‘but that’s the impact sexuality education can have’.

The Hand Angels model: A new approach to sexualities

Hand Angels’ advocacy and pedagogic work had inspired the interviewees, most of whom were or had been involved in events organised by the group. As a result, they were encouraged to speak about the support and assistance they needed within an intimate or sexual relationship.

Hand Angels believes sexuality is part of life, even for persons with disabilities. The organisation provides sexual services for severely disabled people and adopts a holistic approach to sexuality education. Vincent stressed the importance of genuine connection and a trusting relationship between service providers and clients. Clients must contemplate their past and present experience through written reflections after receiving services. According to Chi-Wei, this approach ‘creates a safe learning environment suited to equip clients with disabilities with the necessary tools to explore the personal and affective dimensions of sexuality’.

Apart from these methods of instruction, Hand Angels incorporates other forms of visual and kinaesthetic learning. In 2017, they held a social night tagged Unbinding, during which people with different abilities participated in a sexuality education course explicitly designed for them. They learned about the human body and how to engage in self-pleasure. According to Chi-Wei, this teaching format and ‘pedagogy’ differs from other educational efforts because ‘Hand Angels not only identifies gaps in knowledge but is also willing to work with people who are interested’.

Taking disabled women who had never seen an erect penis as an example, Chi-Wei said, ‘with the male model’s consent, the model pleasured himself and allowed curious participants to touch his genitals’. Similarly, with the consent of a female model, the male group could touch the model’s breasts and look at her genital area. Both groups could interact with the models, ask questions, and share perspectives in ways they could not before this experience. Vincent and Chi-Wei argued that Unbinding was innovative in approaching the use of the body, regarding consent where the private/public divide is blurred, and in dimensions of pleasure and joy in sex and intimate encounters. By doing this, Chi-Wei, Xiaobu, and Tom stated, ‘we somehow challenged the shame, guilt and ambiguity surrounding crip-queer people’s “bad sex”’.

Although these methods may not be feasible in schools, Hand Angels’ ethos remains relevant. Vincent commented, ‘we want to raise awareness that for disabled persons, exerting our sexual agency and exercising our sexual rights is not just an individual battle’. Since Hand Angels insists on disabled people’s right to a sexual life, Vincent had invited the whole disability community to question why some people are allowed, and even encouraged, to have sex while others are restrained. At any rate, ‘we should not accept silencing as the strategy to negotiate [with] mainstream society’.

Despite the ostensible similarities between voluntary sexual services and sexual surrogacy services for severely disabled persons, their difference lies in their perspectives towards service receivers. Sexual surrogacy refers to therapeutic practices that involve a sex therapist and problematise the ‘clients’ as needing intervention. Contrastingly, voluntary sexual services, such as those offered by Hand Angels, have empowerment as their primary purpose. The Hand Angels model sees service receivers as people whose sexualities have been disabled and who are disempowered. Its aims also differ from commercial sex for disabled persons, which, in the Taiwanese context, views the relations between service providers and receivers primarily through the lens of economic transactions, despite the potential friendship developed through emotional labour and care work.

Discussion

Taiwan has gradually incorporated CSE, which goes beyond a focus on abstinence, gender binaries and sexual health, into its basic education curriculum. However, mainstream CSE still reinforces assumptions about the link between sex and reproduction, emphasising that all individuals with sexualities have reproductive goals, which are less urgent for disabled people and less relevant to ‘crip queers’, according to our findings.

Towards crip-queer intersectional conversation and curriculum

In Taiwanese society, it is widely believed that the disability rights movement should not get involved with sexuality, and although this intersection is vital to progressive politics, it is not practised, especially in Taiwan. Meanwhile, sexuality education beginning at birth implies that knowledge about sex can be acquired from informal avenues and not just through formal education, and parents can help children understand their bodies, desires, and happiness. Thus, sexuality education should include children of diverse abilities and their social relationships at home; yet this too has been lacking in Taiwan.

An intersectional perspective on disabled sexuality seeks ‘a space for imagining new ways of being and living, based on access, empowerment and solidarity, and where cultivating sexual agency and bodily autonomy are made possible’, according to Shuttleworth, Julia, and Linda (2020, 23–24). Representation matters based on who is watching and what messages are communicated – what power do disabled sexualities have to challenge normative constructs of desirability and pleasure? Crip-queer porn, inspired by feminist porn of the 1990s, seeks to re-centre the subjectivities of persons of non-normative body-minds and confronts – instead of accepting or avoiding – mainstream heterosexist-ableist imageries (Egner 2019).

Towards a holistic and relational approach to sex and the body

Depending on their abilities, people need varying degrees of support to accomplish things in life, including sexual expression and behaviour. As many participants in this study stressed, a focus on the emotional and psychosocial dimensions of sex is key to developing sexuality education. Intimacy is complex and experienced in a multitude of ways, including at emotional, spiritual, and intellectual levels.

Support networks for disabled individuals should collaboratively and open-mindedly address the power dynamics between individuals and in each interpersonal relationship. For example, support systems can assist in gathering the items needed for masturbation or help with hygiene care after a person concludes a self-pleasure moment. Alternatively, assistance can mean (re)positioning the bodies before, during and after sexual experiences, an act which Bahner (2020) terms ‘sexual facilitation’. This requires genuine trust and belief in the agency and autonomy of persons with disabilities. Meanwhile, most caregivers are women, and the gender relations between female caregivers and male caretakers often complicate the establishment of a mutual understanding regarding sexual desires and how to address them.

Formal sexuality education, even that informed by CSE, often perpetuates ableist assumptions and fails to teach individuals how to set boundaries and communicate the need for sexual assistance. Sexuality education, including the emotional, psychosocial and relationship components, should focus on human connections based on an appreciation of diverse experiences. Holistic Sexuality Education thus encompasses both the external and internal relationships of the individual.

Towards a human rights-based approach to sexuality education

Our study participants believed that sexuality education should empower them to challenge the shame and guilt associated with their sexualities. Disability is often used to justify removing the ability to express ‘normal’ sexual wants, so persons with disabilities are categorised as ‘nonsexual’ or ‘perverted’ if they persist in expressing themselves sexually (Galvin 2006). Rather than the impairment, prejudiced attitudes and aesthetic biases constitute the social structure of oppression and significantly limit disabled people’s sexuality (Higgins 2010; Anna and Beckett 2021). The ableist/disabling system controls resources and information about sex, leaving little room for disabled persons to exert sexual agency.

As mentioned above, since 2014 Taiwan has embraced the principles enshrined in the Convention on the Rights of Persons with Disability and seeks to act on the basis of relevant human rights obligations. In the most recent round of international reviews of state reports, the 2021 Parallel Report on the Convention on the Rights of Persons with Disability coordinated by Covenant Watch reported the widespread experience of suppressed and repressed sexual agency by disabled people in Taiwan. This explains why all our interviewees repeatedly mentioned sexual rights. For a rights-based approach to sexuality education to be achieved in Taiwan, education policy must first acknowledge the sexual desires and needs of persons with disabilities. Such policy recognition should be legally binding rather than optional. Its legitimacy, based on human rights norms, gives front-line teachers, who are willing to provide sexuality education for disabled students, the power to negotiate with conservative colleagues and overprotective parents (Lee 2018).

Berglas, Constantine, and Ozer (2014) have argued that a rights-based approach to sexuality education must recognise the sexual rights of people (of all abilities) and utilise a participatory pedagogy that encourages students to reflect on their sexual choices. In Taiwan, promoting the sexual rights of disabled persons requires a collective effort by the state (through national policy) as well as by community support systems including families, schools, friends, caregivers, assistants, and intimate partners. Regular communication between disabled students and their support systems can create an enabling environment for the realisation of their sexual rights. To facilitate this, a material and informational infrastructure for both sets of interlocutors should be put in place.

Limitations

This study has several limitations. We encountered difficulty recruiting a larger number of interviewees due to time constraints and the sensitivity of the topic, which, for ‘gatekeepers’ such as social services organisations and caretakers, keeps the information from circulating. Thus, our analysis is based on in-depth interviews with only a small number participants. Moreover, most of the views elicited in this study came from men, whose intimacy and sexual needs differ from those of women. Our study also embraced a limited range of abilities, the majority of which were musculoskeletal in nature. In addition, all the interviewees had, to varying extents, been involved in disability rights campaigns or the provision of social support services and had a better knowledge and stronger opinions about policy. We did not target such individuals, but they were more willing to express their views about our study topic. A different recruitment method would be needed to engage participants with fewer connections to activism, requiring support from gatekeepers such as family members and caregivers.

Conclusions

This study explored how sexuality and disability intersect in the educational context in Taiwan. Using narrative data on experienced and imagined realities of sex, we identified what participants had learned and not learned through formal education. Our study findings challenge the legitimacy of processes that infantilise, overprotect, and desexualise disabled people and present a significant barrier to accessing sexuality education for disabled students. In Taiwan as elsewhere, ableist assumptions are prevalent in both informal and formal educational settings, with the result that the experiences and concerns of persons with disabilities remain largely unrecognised and unattended to. Taiwan’s current sex education policies and curricula have been much informed by the gender-sensitive, rights-based model of comprehensive sexuality education promoted internationally in recent years. Yet, our study documents the desire of persons with disabilities for a more holistic, sex-positive approach to sexuality education – which includes a focus on emotional health and relationships, issues of consent, and so on, that enable persons with disabilities to exercise their sexual rights and agency.

Acknowledgments

We thank Poyao Huang and JhuCin Jhang from the National Taiwan University for their valuable comments, as well as Chong-Min Su and others who assisted us throughout the study process. We owe a debt of gratitude to study participants for sharing their voices in this study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This work was an integral part of Stephanie Torres Celis’ Master’s degree dissertation submitted as part of the National Taiwan University Global Health Program, which partly funded the research process. This study is also partially supported by the Population Health Research Center from Featured Areas Research Center Program within the framework of the Higher Education Sprout Project by the Ministry of Education (MOE) in Taiwan (Grant No. NTU-112L9004).

Notes

1. Disability studies uses both ‘person-first’ (e.g. people with disabilities) and ‘identity-first’ (e.g. disabled people) phraseology. Researchers vary in their agreement on this matter, depending on the stance they take with respect to disability politics. The phrase ‘people with disabilities’ emphasises the common humanity shared by people with and without disabilities, and the term ‘disabled people’ sees disability as part of an identity construct and membership in minority politics (Campbell, Löfgren-Mårtenson, and Santinele Martino 2020). In this paper, we use both phraseologies depending on the context. The term ‘crip’ is also used, as is the term ‘queer’ in writing, to interrogate the discursive realities taken for granted as ‘the normal’ (McRuer 2006).

2. Throughout the process, we referred to participants as ‘partners’ with the goal of seeing the data collection process as that of co-learning with community members. Hence, the core of the study lay in human connection, trust, and uncovering ableist practices in society and among researchers. However, to avoid confusion regarding methodological terminologies, we use the terms ‘participants’ and ‘interviewees’, which are used more often in reporting qualitative work.