Supporting disabled people with their sexual lives: a clear guide for health and social care professionals

Owens and de Than’s Supporting Disabled People with Their Sexual Lives is a practical, earthy sort of book, aimed squarely at care professionals working with disabled people. As Owens explains at the outset, the book comes out of her work with Outsiders Club and SHADA. Clare de Than contributes a chapter on disability, sex, and the law. The book offers advice, from starting conversations with disabled clients about sex, through further resources, to practical ideas on sexual positions and sex toys; this is its overwhelming strength. As a practical introduction which clearly points towards a sexually liberated, sex-positive caring climate, it is a solid beginning.

This is not to say that the book is without its issues; Owens admits a lack of formal training as a care professional (she has some training as a sex therapist), but she does have a wealth of well-meaning experience in working with disabled people. She does not use formal, academic language – her voice is clear and forthright – but this lack of training also means that there is a great deal missing in terms of what might be called ‘joined up thinking’ – Owens is not always able to back up her advice with knowledge of the practicalities, or of the links to existing work or best practice. For example, while she encourages professionals to seek out sex toys on NHS prescription, she does not elaborate on whether or not such requests have been successful. Owens also couches her advice in medical model terms – not just in terms of advice centred in medical care, but in positioning disabled people’s lives as tragic (especially so if they live without sex), and reinforcing difference based on diagnosis. This is not a new critique of Owens’ work (see Shakespeare, Gillespie-Sells, and Davis 1996), but it does make for occasionally uncomfortable reading.

This discomfort is not helped by what appear to be several assumptions underlying the book: that all disabled people want to have sex; that those relationships will be with other disabled people (with the exception of relationships with disability fetishists or devotees, and sex workers); and finally that the care professionals whom the book is aimed at are not themselves disabled. Owens’ belief that sexual relationships are a central need and right for all people is explicit in the book; she positions sex as a solution to the tragedy that disabled lives must be, and offers a list of reasons why sex improves lives (although without any reference to evidence) – and dismisses the problematic and complex issues that may arise as prudishness or laziness.

This dismissal of issues is particularly problematic when it comes to Owens’ positioning of disabled people, such as when she writes ‘I have heard many complaints about an increasing lethargy amongst disabled people. It is difficult when you prepare to support then in their sexual expression, and they don’t show much interest or want to make any effort’ (72), states that disabled people ‘need to be taught how to minimize the impact of their condition on finding potential partners’ (337), or identifies disabled people interested in ‘disability rights movements or radical political groups’ (75) as angry, aggressive, and hostile. It is this positioning of disabled people as tragic or problematic that is the biggest issue, weakening Owens’ account of her authority and expertise – and making her advice somewhat harder to listen to, despite its value.

Owens does offer some advice on how to counteract discomfort, and emphasises the value of communication. She encourages professionals to talk to each other, as well as to more unusual sources of knowledge – particularly sex workers. While there is an assumption that disabled people are willing to engage with sex workers – and vice versa that sex workers are willing and capable of engaging with disabled clients – Owens expands the scope of engaging with sex workers beyond the normative, pointing out that they may be able to provide opportunities for touch-based education, including teaching masturbation. Owens tends to dismiss the more problematic aspects of engaging the services of sex workers (see Liddiard 2014), but this aspect of the book provides a great deal of food for thought.

Clare de Than’s chapter on legal issues surrounding disability and sex is also practical, although aimed much more at illustrating how laws in the United Kingdom, along with the EU’s Human Rights Act, could be used to support disabled people. The chapter argues that human rights law means that the state ‘must take action to enable people to exercise their sexual autonomy rights’ (88), and demonstrates through reference to existing cases that there is a great deal of legislation already in place. This reading of legal precedent does identify that there is frequently a problem with care providers and local councils being concerned about both their funding and public perception, ‘so they over-regulate even when it would be lawful to support residents’ needs’ (92–93). de Than acknowledges that people with learning disabilities, people using touch-based communication methods, and disabled people under 18 years old are most disadvantaged under the law as it stands, and that there are definite grey areas, where a less permissive reading of the law would place much greater restrictions on disabled people’s access to pornography, buying sexual contact, and sex education. The chapter’s focus on rights is somewhat at odds to Owens’ dismissal of wider disability rights movements, but it is a coherent introduction to the legal issues.

Overall, Supporting Disabled People with Their Sexual Lives is a disparate mix of solid, experience-based advice and discomforting positioning which is often at odds with the professed aims of Owens’ work. While it does contain a great deal of useful advice for care professionals, there is the need to read it with care, and to take its advice with a pinch of salt.

Emma Sheppard
Social Sciences, Edge Hill University, Ormskirk, UK
[email protected]
© 2016 Emma Sheppard
http://dx.doi.org/10.1080/09687599.2016.1214426