Sexual Esteem for Women with Disabilities

What is Sexual Self-Esteem?

Psychotherapist and certified sex therapist Gila Shipiro¹ defines sexual self-esteem as, “the feelings you have about your body and your confidence level in how you relate intimately to someone else. It’s what you bring of yourself, both emotionally and physically, to sex and relationships — what you do with that and how you share that with someone else. Sexual self-esteem affects every sexual choice you make.” Others have defined sexual self-esteem as the “…positive regard for and confidence in an individual’s capacity to experience his or her sexuality in a satisfying and enjoyable way.”²

Self-esteem is how you describe your own self-worth, that is, how you feel about yourself and your abilities as well as your limitations.³ This can be in terms of your own beliefs, appearance, emotions, and behavior. Positive self-esteem also involves confidence, so if you have low confidence in yourself and who you are, you may have doubts or a lack of confidence in how you feel about yourself regarding sex and sexuality.⁴ Therefore, healthy sexual esteem will likely lead to greater confidence in your ability to experience sexuality in a way you desire.

So how can you boost your sexual self-esteem? Because it is part of our general self-esteem, we must look at ways to overcome barriers that prevent us from allowing ourselves the satisfaction of being confident in ourselves overall. For women with disabilities, some of these barriers can be extremely difficult to overcome both emotionally and physically. There may be anxiety regarding sexual self-esteem, leading women with disabilities to ask themselves, "Will I perform in a way my partner likes? Is my body sexy enough? What if I need to ask for help positioning? Am I desirable? Am I worthy?”⁴

The process of increasing your sexual self-esteem will likely take some time and effort. But you have already taken the first step by looking up this information. 

Here are Suggestions for Enhancing Self-Esteem That We Have Heard from Women with Physical Disabilities Over the Years:

• Accept yourself the way you are.
• Respect yourself.
• Acknowledge the things about yourself that make you feel good.
• Remember: you have worth and value.
• Take time for yourself.
• Take care of your body, mind, and soul.
• Appreciate your sexuality.
• Do things you enjoy.
• Believe in yourself.
• Stand up for your values and beliefs.
• Be with people who have a positive effect on you.
• Do not compare yourself to others.
• Learn to accept compliments.
• Practice saying “no.”
• Practice doing things that challenge you in new ways.
• Practice replacing negative thoughts with positive ones.
• Celebrate yourself as a wonderful woman with a disability.

Remember:  It can be helpful to consider seeking professional counseling for problems with low self-esteem. Enhancing self-esteem is often a lifelong, challenging process that may require not only self-help but also professional assistance.

Communication and Sexual Self-Esteem

Communicating with a partner is an essential component of sexual activity and intimacy. Being open and honest with each other can lead to greater sexual satisfaction. Being able to talk to your partner about sex can be difficult for many individuals. There can be a discomfort level that arises when a person tries to discuss their desires but is unsure how to express them effectively. For more information, please visit our sexual communication page.

Body Image and Sexual Self-Esteem

Women must deal with a variety of barriers that come with being disabled and being a woman. Our society has placed narrow definitions on what the ideal feminine beauty standard “should” be. If a woman does not match this specific standard, others may perceive her as unattractive or undesirable. Buying into the “ideal” societal standard of beauty may create barriers to forming intimate or sexual relationships.⁵

Women with disabilities have been found to be at a higher risk for lower self-esteem and lower body image, leading to frustration and lower sexual satisfaction.^4,6 Although many women with disabilities accept and love their bodies, they may still have to deal with the societal expectation of how women “should” look. It is important to keep in mind that your body image can be influenced by many factors, including attitudes of peers, social media, cultural background, and family environment.⁷

Having a physical disability may cause some people to resist entering into relationships due to low sexual esteem.8 Consequently, they may feel discouraged when it comes to their sexuality.⁹

Low sexual self-esteem and sexual anxiety can result from harmful interactions with others. Name-calling and sexual insults can damage one’s sexual self-esteem. Unsuccessful sexual interactions, sexual victimization, and one’s own self-destructiveness in a sexual encounter can also affect an individual’s sexual self-esteem.¹⁰

Depression and Sexual Self-Esteem

Depression can also contribute to low self-confidence regarding intimacy and sexual  relationships, which could intensify existing insecurities such as those related to poor body image.⁶ This process can lead to a cycle that can be hard to break, and sometimes requires professional help.

Traumatic Experiences and Sexual Self-Esteem

Traumatic experiences (such as childhood abuse or interpersonal violence in adulthood) can affect one’s sexual self-esteem and interfere with sexual and emotional functioning.¹¹ Research suggests that some women with disabilities fear being alone and not having a relationship with an intimate partner.¹¹ Consequently, some women with disabilities may lower their standards when entering a relationship and may even be more likely to tolerate abuse rather than being alone. Furthermore, research reveals that women with physical disabilities who have low self-esteem and low sexual self-esteem are more likely to stay in an abusive relationship.¹¹ For additional information, visit our page on Interpersonal Violence. Hence, all this plays into a woman’s perception of sexual self-esteem, making it even more important to use resources to work on loving and caring for herself.

Self-Care is Important!                        

Since the late 1990’s, researchers from or affiliated with the Center for Research on Women with Disabilities (CROWD) have conducted multiple studies involving group programs designed to enhance the self-esteem and personal safety of women with physical disabilities.^12-15 These programs emphasized the importance of self-love and self-care. Here are a few suggestions for you to consider:

• Call or text a loved one.
• Build and maintain close relationships.
• Set and maintain good boundaries.
• Go for a walk or roll outside, even for just a few minutes.
• Sit in the sun.
• Make a list of things you love about yourself.
• Watch your favorite movie.
• Do something new.
• Stretch!
• Make sure to drink enough water.
• Take a nap.
• Take a few minutes to recline and rest in your wheelchair.
• Play with your pet.
• Listen to your favorite music.
• Do something nice for someone.
• Remember it is OK to ask for help when you need it.
• Be sure to offer, as well as receive, positive support.
• Do some deep breathing or meditate.

An Important Message

"If you truly believe you are a woman of value, you gain tremendous strength to forge your way through the most stubborn of barriers."

- Margaret (Peg) Nosek, Founder, Center for Research on Women with Disabilities (CROWD)

Books

Kaufman, M., Silverberg, C., & Odette, F. (2010). The ultimate guide to sex and disability: For all of us who live with disabilities, chronic pain, and illness. San Francisco: Cleis Press Inc.

McKay, M., & Fanning, P. (2016). Self-esteem: A proven program of cognitive techniques for assessing, improving, and maintaining your self-esteem. Oakland: New Harbinger Publications.

Websites

Bradley University. (n.d.). Disability & body image.

Gerber, C. (2020, March 22). The cultural and body image challenges people aren't talking about. Accessed December 13, 2021.

Goddard, A. J. (2020). 5 ways your self-esteem impacts your sexuality. Accessed December 13, 2021.

Healthy Women Editors (2020, July 12). What's your sexual self-esteem? https://www.healthywomen.org/content/article/your-sexual-self-esteemHibbert, D. (2017, March 09). Self-esteem vs. self-worth: Q & A with Dr. Christina Hibbert [plus video]. Retrieved from Accessed December 13, 2021.

Kislev, E., PhD. (2020, June 25). Sexual self-esteem: Who has more of it? Accessed December 13, 2021.

Mayo Clinic. (2020). Self-esteem: Take steps to feel better about yourself. Accessed December 13, 2021.

Mayo Clinic Staff. (2020). Self-esteem check: Too low or just right? Accessed December 13, 2021.

McCarley, M., & Walker, L. (n.d.). Sexuality and intimacy after a spinal cord injury. Accessed December 13, 2021.

Raising Children Staff. (2019, June 12). Body image: Pre-teens and teenagers.

Ratzka, A. (1998). Sexuality and people with disabilities: What experts often are not aware of. Accessed December 13, 2021.

Shapiro, G. (2017, July 21). Sexual self-esteem: A short course. Accessed December 13, 2021.

1. Spinal Cord Injury BC. Sexual self-image. 2019; https://scisexualhealth.ca/sexual-self-image/ Accessed December 13, 2021.
2. Taleporos G, Dip G, McCabe M. The impact of Sexual Esteem, Body Esteem, And Sexual Satisfaction on Psychological Well-Being in People whit Physical Disability. Sexuality and Disability. 2002;20(3):177-183.
3. Mayo Clinic. Self-esteem: Take steps to feel better about yourself. Healthy Lifestyle, Adult health 2020; https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/self-esteem/art-20045374 Accessed December 13, 2021.
4. Beers L. Living with Muscular Dystrophy: Sexual Education: College of Social and Behavioral Sciences, Walden University Online; 2018.
5. Bradley University. Disability & Body Image. 2020; https://www.bradley.edu/sites/bodyproject/disability/body/ Accessed December 13, 2021.
6. Kolzet J, Quinn H, Zemon V, et al. Predictors of body image related sexual dysfunction in men and women with multiple sclerosis. Sexuality & Disability. 2015;33:63–73.
7. Raising Children Staff. (2019, June 12). Body image: Pre-teens and teenagers. https://raisingchildren.net.au/pre-teens/healthy-lifestyle/body-image/body-image-teens
8. Kim E. Asexuality in disability narratives. Sexualities. 2011;14:479–493.
9. 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.
10. Mayers KS, Heller DK, Heller JA. Damaged sexual self-esteem: A kind of disability. Sexuality and Disability. 2013;21:269–283.
11. Hassouneh-Phillips D, McNeff E. "I thought I was less worthy": Low sexual and body esteem and increased vulnerability to intimate partner abuse in women with physical disabilities Sexuality and Disability. 2005;23(4):227-240.
12. Nosek, M. A., Robinson-Whelen, S., Hughes, R. B., & Nosek, T. M. (2016).An internet-based  virtual reality intervention for enhancing self-esteem in women with disabilities: Results of a feasibility study. Rehabilitation Psychology, 61(4), 358-370.
13. Nosek, M. A., Robinson-Whelen, S., Hughes, R. B., Porcher, E., Davidson, G., & Nosek, T. M.  (2011). Self-esteem in Second Life: An inworld group intervention for women with disabilities. Journal of Virtual Worlds Research, 4 (1), 3-8.
14. Robinson-Whelen, S., Hughes, R. B., Taylor, H. B., Markely, R., Vega, J. & Nosek., M. A. (2020). Promoting psychological health in women with SCI: A pilot study of an online self esteem intervention. Disability and Health Journal, 13(2), 100867 doi: 10.1016/j.apmr.2016.08.238
15. Hughes, R. B., Robinson-Whelen, S., Taylor, H. B., Swedlund, N., & Nosek, M. A. (2004). Enhancing self-esteem in women with physical disabilities. Rehabilitation Psychology, 49,295-302. doi:10.1037/0090-5550.49.4.295