Almost all of the women with and without disabilities in this study reported having had sexual activity at some time in their lives. Only 3 percent of the able-bodied women and 6 percent of women with disabilities had never had sexual intercourse. About half of women with disabilities are currently sexually active, compared to about two-thirds of women without disabilities. There were, however, significantly lower rates among women with disabilities of having intimate touch (58 percent versus 68 percent) and sexual intercourse (49% versus 61%) within the past month. Most problems with sexual activity reported by women with disabilities were different from those reported by women without disabilities. Women with disabilities reported that problems with sexual activity often related to weakness (40 percent), vaginal dryness (39 percent), lack of balance (38 percent), hip or knee pain (32 percent), and spasticity of legs (28 percent).
The women with disabilities we interviewed for this study talked about sexuality in terms of desire, activity, response, and satisfaction with their sex lives. We first investigated whether or not there were differences between women with and without disabilities on these four dimensions. We found significant differences in level of sexual activity, response, and satisfaction, with women with disabilities reporting much lower levels. There were no differences, however, between the groups on sexual desire.
Next, we wanted to know if age at onset of disability made any difference in sexual functioning. There were no differences in levels of sexual activity, response, or overall satisfaction with sex life. Women who had childhood onset of disability reported higher levels of sexual desire than women with adolescent or adult onset of disability.
Finally, we examined how psychological factors and factors related to disability, social status, social attitudes, or environmental barriers affected sexual functioning among women with physical disabilities. Sexual desire was most related to social status variables, including work status and age. Women who were younger expressed more sexual desire. Women who perceived more negative stereotypes in society's attitude toward sexuality and disability experienced higher levels of sexual desire.
The strongest predictor of sexual activity was, not surprisingly, whether or not the woman lived with a significant other. Secondary predictors were in the psychological domain. Women with disabilities who had a more positive sexual self image and who perceived themselves to be approachable by potential romantic partners also had higher levels of sexual activity. It is very notable that severity of disability was not significantly related to level of sexual activity.
We were not successful in predicting sexual response. The only factors that had some relationship were more positive attitudes toward the use of assistive devices, less concern about stereotypes, and higher household income. It is difficult to interpret the meaning of this finding. Women with spinal cord injury and stroke reported the lowest scores.
Social status and psychological variables were the best predictors of sexual satisfaction. Women with disabilities who lived together with a significant other, and therefore had a higher level of sexual activity, also reported greater sexual satisfaction. Interestingly, lower household income was positively associated with sexual satisfaction. Women who felt more positive about their use of assistive devices and who had never experienced sexual abuse reported higher levels of sexual satisfaction.