The World Health Organization1 defines sexual health as “a state of physical, emotional, mental and social well-being in relation to sexuality. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safer sexual experiences that are free of coercion, discrimination, and violence.” Women with disabilities are sexual beings who have the right to make choices about their sexuality and its expression.
Sexual pleasure and intimacy are sometimes referred to as fundamental and innate human needs.2 However, meeting these needs can be challenging for people with physical disabilities.3 Impaired mobility may cause some women with physical disabilities to avoid sexual intimacy due to a lack of sexual health education that is routinely provided to individuals without physical disabilities.4
Historically, women living with a physical disability have been seen as asexual or even incapable of having sex.3,5 As such, health care professionals, educators, family, and friends often do not consider sexuality a concern for individuals with physical disabilities.4 These misconceptions and lack of consideration can result in girls and women with physical disabilities not receiving basic sex education, advice, and guidance, especially when confronted with issues such as sexual dysfunction or the need to adapt their sexual activities due to secondary health conditions or disease progression.6,7 This lack of attention may violate the sexual rights of people with disabilities and reduce their potential for satisfying sexual and intimate relationships.
Sexual health and well-being can play a positive role in a person’s life and overall health throughout all phases of life. Sexual health is more than sexual functioning. It also involves sexual self-esteem, healthy relationships, societal views of disability and sexuality, and so much more.
Here we address six topics of importance to the sexual health of women with physical disabilities.
Sexual self-esteem is described as a person’s sexual feelings, thoughts, and behaviors. Positive sexual self-esteem may help people to effectively communicate their sexual needs to an intimate partner and lead to greater sexual satisfaction.8 Sexual self-esteem is an important aspect of one’s self-esteem. Self-esteem is your sense of self-respect, your sense of your own self-worth.9 In other words, self-esteem is how you feel about yourself and your abilities as well as your limitations.10 For more information, view the Sexual Self-Esteem page.
Communicating with a partner is an essential component of sexual activity and intimacy. Being open and honest with each other about sexual desires and preferences can lead to greater sexual satisfaction and a stronger intimate relationship. Talking about sex is often difficult and even embarrassing for many individuals and couples. Discomfort may arise when a person is unsure how to express their sexual desires. To learn more about communicating with a partner about sexual activities, view our page Sexual Communication.
Sex is an innate, human drive. Sexual activity and sexual intimacy are two of the most wonderful things in the world, and yet they can introduce problems if partners do not practice safer sex. Safer sex refers to behaviors that people engage in to lower their risk--and their partners’ risk--of acquiring sexually transmitted infections (STIs). View our page Safer Sex to learn about how safer sex goes beyond the use of contraceptives to include health and wellness, communication, and consent.
Disability may affect muscles and joints in the back, hips, knees, and hands - body parts that are involved in the experience of sex, pleasure, and intimacy. Since every person’s body and experience of disability is different, sexual positioning is an important issue to keep in mind. Our page Positioning describes how important positioning can be for sexual intimacy. For example, positioning the pelvis can help relieve loss of bladder control, muscle strain, fatigue, and more. This guide offers some basic suggestions for sexual positioning for women with physical disabilities. The sexual positions can be done with a partner or when using a sex toy or adaptive device.
Self-pleasuring, also known as masturbation, can be sexually satisfying in itself as well as serve as an effective way for women with disabilities to learn how their bodies experience sexual pleasure. The page Self-Pleasuring describes the health benefits of masturbation and explains how masturbation can be an effective way to explore your body to determine what does and does not feel good, which can make it easier to communicate with a sexual partner.
Sex surrogates are also referred to as surrogate partners. This page defines sex surrogates and describe ways in which a sex surrogate may be used by a woman with a mobility impairment. Sex surrogates are educated and trained to help their clients gain skills related to self-awareness and physical and emotional intimacy. Surrogate partner therapy experiences include, but are not limited to, relaxation techniques, effective communication, sensual touching, sexual touching, and social skills training. To learn more about this topic, visit our page Sex Surrogates.
- World Health Organization. Sexual and reproductive health: Gender and human rights: Sexual health. 2020; Accessed December 13, 2021.
- Maslow AH, Frager R. Motivation and Personality. 3rd ed. New York: Harper & Row; 1987.
- O’Dea S, Shuttleworth R, Wedgewood N. Disability, doctors and sexuality: Do healthcare providers influence the sexual well-being of people living with a neuromuscular disorder? Sexuality and Disability. 2012;30:171–185.
- Schairer LC, Foley FW, Zemon V, et al. The impact of sexual dysfunction on health-related quality of life in people with multiple sclerosis. Multiple Sclerosis Journal. 2014;20:610–616.
- Kim E. Asexuality in disability narratives. Sexualities. 2011;14:479–493.
- Areskoug-Josefsson K. Muscular dystrophy and sexual health. OA Musculoskeletal Medicine. 2013;1(2):1–6.
- Rowen TS, Stein S, Tepper M. Sexual health care for people with physical disabilities. The journal of sexual medicine. 2015;12:584–589.
- Oattes MK, Offman A. Global self-esteem and sexual self-esteem as predictors of sexual communication in intimate relationships. Canadian Journal of Human Sexuality. 2007;16(3/4):89-100.
- Rosenberg M. Conceiving the self. New York: Basic Books; 1979.
- Mayo clinic staff. Self-esteem check: Too low or just right? 2020; Accessed December 13, 2021.