Safer Sex for Women with Disabilities

What is Safer Sex?

Humans have an inherent desire to feel loved and experience touch. Sexual activity and intimacy are two of the most wonderful things in the world, and yet they can be dangerous 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). It is inaccurate to refer to those behaviors as safe sex, because having sex with a partner is never 100% without risk. Prevention is key; the most effective way to prevent or reduce the risk of STIs is for partners to avoid exchanging body fluids such as ejaculate and cervical, vaginal, or rectal fluids. Examples of safer sex practices include limiting the number of sexual partners, using condoms for vaginal or anal intercourse, practicing other forms of sexual activity such as oral sex with a condom covering the penis, mutual masturbation, or abstinence.

Having a physical disability does not reduce or eliminate a person’s desire for intimacy and affection. However, it can affect how people engage in sexual activity as they may face barriers and challenges associated with their disability.1,2 Having a physical disability may necessitate experimenting with, or perhaps readjusting, notions and expectations of sexuality and intimacy. Below are four topics that are important to consider when planning to have safer sex when living with a disability. Safer sex goes beyond the usage of contraceptives and includes health and wellness, communication, and consent.

Contraceptives

Contraceptive use is an important part of safer sex. Although people use contraceptives to prevent unplanned pregnancies, they also use them to reduce the risk of acquiring or transmitting an STI during sexual activities. To learn more about contraception, contraceptive methods, and their applicability to women with physical disabilities, see Reproductive Health page, Contraception.

Communication About Sexuality

Communication is a vital component of sexual health. It is important for sexual partners to engage in open and honest communication to better understand one another’s preferences, which can lead to a more favorable level of sexual satisfaction. Communicating about sex can involve respect, patience, open-mindedness, trust, and compassion towards one another. Sexual partners should speak, listen, and truly seek to understand what each other is saying. Communication regarding HIV and other sexually transmitted infections and risks, regardless of their sexual orientation or their past or current sexual experiences, is also important. For more information, visit our Sexual Communication with Partner page)

Remember, when communicating  use active listening and open communication (See Communication Subpage).3

What is active listening?

  • Paying close attention to what someone is saying
  • Engaging with and communicating back to the person that you hear and understand what is being said

What is open communication?

  • Creating a space that conversations can be initiated in a safe and respectful manner, even in difficult or uncomfortable topics
  • The ability for partners to express feelings or opinions effectively with one another
  • Knowing it is okay to disagree
  • Saying what you mean and meaning what you say
  • The ability to resolve conflicts effectively or come to an understanding of one another

Consent

Consent is a voluntary, necessary, and clear agreement between people to engage in specific sexual activity such as touching, groping, fondling, hugging, kissing, oral sex, or intercourse. Prior to engaging in any sexual activity, people should make sure that all partners are willing, comfortable, and in agreement to continue. Consent is about communication, and it should happen every time you engage in a sexual or intimate activity.4 Giving consent for one occasion does not necessarily mean consenting for repeated sexual contact, nor does it mean giving consent for increasing sexual contact.

People always have the right to say no before or during sexual activities. Before engaging in sexual or intimate contact, not only do people need to give consent, but they also need to know if their partners give their consent as well. Communication and honesty are extremely important so that you understand and express what you want and do not want, as well as what partners want and do not want.4

Giving consent and asking for consent involves communicating effectively, setting and maintaining personal boundaries, and respecting partners’ boundaries. If it is not clear that consent has been given, it is important to stop sexual activity, think about the situation, and communicate further with their sexual partners or potential sexual partners.5

Planned Parenthood provided the following guide to recognize and remember consent5:

Freely-given: consenting is a choice you make without pressure, influence, or while using alcohol or other drugs.

Reversible: anyone can change their mind about what they feel like doing, at any time, even if they have done it before, and even in the middle of sexual activity.

Informed: all parties have all the information about what is happening, and there is nothing misleading or hidden. This includes talking about birth control and whether either party has had any STIs.

Enthusiastic: when it comes to sex, you should only do the things you want to do, not things that you feel you are expected to do.

Specific: saying yes to one thing (kissing) does not mean you have said yes to others (having intercourse).

You have the final say over what happens with your body. It does not matter if you have been sexual or intimate with this person before; you can say “stop” at any time, and your partner needs to respect that.

Healthcare for Women

Healthcare for women with disabilities is essential. Preventive healthcare is not only intended to keep women healthy, but it can also play a role in safer sex. The following is a list of preventive healthcare measures women with disabilities may take to help keep themselves healthy and safer from sexually transmitted infections, unwanted pregnancy, and more. Preventive healthcare also gives women the opportunity to communicate effectively with their doctors if they are struggling with any discomfort, apprehension, vaginal dryness, pain, or other issues during sexual activities. Examples of topics that could also come up during preventive healthcare visits may include:

  • Wellness visits
  • Pelvic exams
  • Basic blood tests
  • Reproductive and sexual health exams
  • STI testing, treatment, and vaccines
  • HIV testing
  • Discussing menopause
  • Discussing LGBTQ+ issues
  • Monitoring emotional well-being
  • Contraceptives

Resources

Department of Health & Human Services. (2017, October 10). Physical disability and sexuality. Accessed Dece. 13, 2021.

Holland, K. (2017, Dec. 20). A woman’s guide to safe sex basics. Dec. 13, 2021.

Our Sexuality, Our Health: A Disabled Advocate’s Guide to Relationships, Romance, Sexuality and Sexual Health. Accessed Dec. 13, 2021.

RAINN Rape, Abuse & Incest National Network. (2020). What consent looks like. Accessed Dec. 13, 2021.

Ratini, M. (2019, Dec. 18). Safe Sex. Accessed Dec. 13, 2021.

Scope Staff (2020, May 10). Disability and getting ready to have sex. Accessed Dec. 13, 2021.

References

  1. East LJ, Orchard TR. Why can’t I? An exploration of sexuality and identity among Canadian youth living with physical disabilities. Journal of Youth Studies. 2014;17:559–576.
  2. Milligan MS, Neufeldt AH. The myth of asexuality: A survey of societal and empirical evidence. Sexuality and Disability. 2001;19:91–109.
  3. Dryden M. What school psychologists should know about Prader–Willi Syndrome: Communique. National Association of School Psychologists. 2019; 47(5):4.
  4. Rape AINNR. What consent looks like. 2020; Accessed Dec. 13, 2021.
  5. Planned Parenthood. Sexual Consent. 2020; Accessed Dec. 13, 2021.