Academic journal article Electronic Journal of Human Sexuality

Re/developing Models for Understanding Sexuality with Disability within Rehabilitation Counselling

Academic journal article Electronic Journal of Human Sexuality

Re/developing Models for Understanding Sexuality with Disability within Rehabilitation Counselling

Article excerpt

Introduction

The relatively recent inclusion of sexuality in rehabilitation is based on the theory that all people have a right to sexual education, intimacy and intimate relationships (Parker, 2007). According to the World Health Organization (2012) sexual rights include "the right of all persons, free of coercion, discrimination and violence," to attain the highest possible "standard of sexual health, including access to sexual and reproductive health services". Sexual rights further include the right to seek, receive, and pass on information about sexuality and the right to sexuality education. Foremost, sexual rights encompass "the right to have one's bodily integrity respected and the right to choose--to choose whether or not to be sexually active, to choose one's sexual partners, to choose to enter into consensual sexual relationships, and to decide whether or not, and when to have children" (Parker, 2007). In addition, research has shown that sexuality is a key component for psychosocial wellbeing (Grov, Parsons, & Bimbi, 2010; Niet et al., 2010; Street et al., 2010). According to the World Association for Sexual Health (2012) "sexual health is more than the absence of disease. Sexual pleasure and satisfaction are integral components of well-being and require universal recognition and promotion". Considering these conventions sexuality would be well placed within rehabilitation counselling as it can address potential sexual issues and provide understanding and education about sexual choices, sexual health, sexual negotiation and acknowledges the need and/or desire for satisfying sexual relationships.

Sexual Script Theory and Disability

According to Simon and Gagnon (1986, 1987, 2003) human sexuality is constructed via public, interactional and private sexual scripts. Public sexual scripts describe who is an appropriate sexual partner (Simon & Gagnon, 1986). However, this often excludes individuals with disabilities and their experiences of sexuality (Guildin, 2000). If people with disabilities are excluded from public (i.e. popular culture) portrayals of sexuality they may subsequently be excluded from sexual opportunities and be perceived (by themselves and others) to be unviable sexual partners (Dune, 2012a; Overstreet, 2008). Exclusionary constructions of sexuality with disability have a detrimental impact on how people living with cerebral palsy experience their sexuality (see Rurangirwaa, Van Naarden Braun, Schendel & Yeargin-Allsopp, 2006; Wazakili, Mpofu & Devlieger, 2009; Xenakis & Goldberg, 2010). Lawlor et al. (2006), for instance, indicated in their qualitative research on families of children with cerebral palsy that "reported barriers to participation were the attitudes of individuals and the ingrained attitudes of institutions". The attitudes of strangers towards the child and family which altered the choice of activity for some families" (p. 225). Thus sexual participation and negotiation as mediated by public and interactional sexual scripts may discourage sexual behaviour with people with a disability. As such, people with disabilities as well as typical others may internalize sexual scripts which ignore the variance in the human condition and experience (Esmail, Darry, Walter, & Knupp, 2010; Rembis, 2009). Without an appropriate model for sexuality with disability to inform rehabilitation counselling people with impairment may be relegated to expressing their sexuality within the confines of typical and performance-based frameworks.

Questioning Models of Sexuality with Disability

It is widely acknowledged within the field of rehabilitation that human sexuality is integral to clients' quality of life and overall wellbeing (Brashear, 1978; Esmail, Darry, Walter, & Knupp, 2010; Rembis, 2009; Wiwanitkit, 2008). While incorporating aspects of sexuality into rehabilitation counselling is imperative to overall quality of life and wellbeing, the model, or lack thereof, upon which this is enacted, may be inherently exclusionary. …

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