Talking About Sex: Sexuality Education for Learners with Disabilities

From the Publishers:

Key social and emotional milestones during adolescence are often directly related to the abilities to initiate and maintain intimate relationships, maintain physically maturing bodies, and manage personal sexuality. Most adolescents with developmental disabilities have particular difficulty expressing sexuality in satisfying ways, consequently facing issues such as limited intimate relationships, low self-esteem, increased social isolation, deregulated emotional maintenance, reduced sexual functioning, and limited sexual health.
Appropriate sexual knowledge assists not only in achieving personal fulfillment, but protection from mistreatment, abuse, unplanned pregnancies, or sexually transmitted diseases (STDs). It also works to help solve problems of loneliness and problems with self-esteem.
This book will address this but also much more. Issues of physical and cognitive development will be discussed, including appropriate sexual development/urges and brain development, and innate similarities and differences of sexuality that could occur between people with autism spectrum disorders and intellectual or developmental disabilities, including the complexities of physical disabilities. The authors will also consider special considerations for group homes and recreational facilities, and specifically focus on concepts of ethics and models of consent (medical, legal, social, and educational), as well as how to deal with uncertainty.

How to Explain Sex to Someone with an Intellectual Disability

This may be more difficult than it appears at first.  I like to communicate and teach broad and complex ideas about what sex is, but this can be really difficult for folks to grasp at first.  I usually start out talking about reproduction because it’s a little more concrete and then move into sex more generally once reproductive intercourse, erection, ejaculation, and arousal have been covered.  So lets start with those (and I’ll toss in a couple other concepts that may be difficult to explain).  These are how I explain these concepts, but a curriculum you use may have other suggestions you find helpful.  I used board maker pictures here, but real pictures would also be appropriate in many cases.

Arousal: “When you have sexy feelings and you feel tingly or excited all over your body especially in your private area*.”

*You could substitute genitals, vulva, or penis for private area to be more concrete.  Sometimes with middle school students I say “you know where” to be intentionally more vague- but only if I’m confident they do know where.

Erection: “When blood fills the penis making it harder and bigger”.  I follow this up with the why it happens, “because you have sexy feelings.  You feel aroused.”

Sometimes I add, the blood fills up the spongy tissue of the penis, but other times I omit the blood part and just say the penis gets harder and bigger.  This would depend on the level of complexity the individual can handle.

Ejaculation/Orgasm: “You have sexy feelings, your body feels really good, and you get so excited that you have an orgasm- a big burst of sensation*.” If they have a penis, I add “then fluid comes out of the penis.”  If they have a vulva, I add “then some fluid may come out of the vagina”.  If they ask what kind of fluid you could add, “a sticky milky fluid” and then if they have a penis, “with sperm in it.”

*If sensation is an inappropriate word you could replace it with feelings.

Reproductive Intercourse: “When a person put their penis in another person’s vagina and releases sperm, ejaculates.  If the sperm meets with an egg then the person might get pregnant.  A baby might grow inside the uterus.”

As students are first learning I do call this sex but once they have this I build that sex is bigger than just one act.  It is heteronormative* to present reproductive intercourse as if it was sex.  It could make students who are not interested in vaginal intercourse feel as if their form of sexual expression is less valid.  At the same time, the students that I work with are often overwhelmed by all the new information and have difficulty navigating all the nuances.  When I call this form of sex, “sex”, I do match it with vaginal sex, reproductive intercourse, or intercourse to allude to the idea that there are other forms of sex.

*If you’re not familiar with the term heteronormative, it refers to when heterosexuality is used as the default.  It also refers to other lifestyles that are considered the default.  For example, a heteronormative definition of family would be if you used, implicitly or explicitly, a husband, a wife, and children as the definition of family.

Wet Dream: “Sometimes when you’re sleeping you have have sexy feelings.  These feelings can be so good that you may get really excited in your sleep.  You may feel so good that fluid comes out of your body.”

If they know erection and ejaculation, you can use those words too but I try to limit my use of those words if I’m not confident they have a full conception of the terms.

People with vulvas can have wet dreams too! Regardless of whether there is ejaculation, having organisms and arousal during sleep can be scary. It is an important thing to prepare children for as their bodies change with puberty.

Sex: “Sex is when two people have sexy feelings they want to share with each other so they touch each other’s private parts to make each other feel good.”  You can expand it further, “A person might put their penis inside a person’s vagina.  Sometimes people kiss and lick each other’s vulva or penis.  A person might put their penis inside a person’s anus*.”  If they ask why someone has sex, I would answer “Either because they want to have a baby, because they love each other and they want to share those feelings, or because they want to have fun.”

*I would use butthole if I thought that was a word the person understood better.  In this definition, I’ve defined sex as anal, vaginal, or oral intercourse.

Sperm/Egg: The cells inside a persons body that have genetic information.

Not all folks will grasp the concept of genetic information but they will probably know that it means scientific or medical information.

Next week, well be covering reproduction in Human Sexuality 101 so look check out the curriculum for that section for more information.