Before discussing sexuality with children and youth, it is important to reflect on your own values, beliefs and assumptions. We all have personal values, a collection of beliefs and principles that guide decision-making and choices. To provide children/youth and their families with the best possible care, it is helpful to be aware of how personal values influence our work.
Whether you are a parent or a service provider this exercise will help you to become more aware of your sexuality values and beliefs and how they may influence your communication about sexuality and relationships.
VALUES ACTIVITY
Read the value statements and then think about how that statement makes you feel.
- Do you agree with it? Why?
- Do you disagree with it? Why?
- Are you unsure?
- What are your emotional reactions to the statement?
VALUE STATEMENTS:
Instructions: After thinking about the value statement, click on it for a brief explanation.
I am aware of my own sexual attitudes and beliefs when discussing sexual behaviour with children.
- You may not have thought too much about how you feel about sexuality. Many people did not receive sexuality education when they were young. So the thought of talking about sexuality with others may be embarrassing.
- When you start talking, you may find that you have strong feelings about dating, relationships and how young is too young for teens to have sex! Take time to consider how you feel and how your values and beliefs affect this.
I am uncomfortable raising issues of sexuality with children and teens.
- Children with disabilities are developing physically in the same way as their typically developing siblings and peers. It is OK to feel uncomfortable, but talking about the physical, social and emotional changes that are part of being a healthy teen will help them stay happy and safe.
The more children and youth learn about sex, the more likely they are to be sexually active.
- According to the World Health Organization, there is no evidence to support that sexuality education encourages youth to be sexually active. In fact, youth are more likely to delay when they have sex (SIECCAN, 2010).
A child’s parents are the only adults that should talk to them about sex.
- There are many ways that children learn about sexuality – from their family, friends, school and the media. Teachers, health care providers and support staff can all help children develop knowledge and skills to make healthy choices.
Good
to
know:
Parents will always be their child’s key sexuality educator and most important influence.
My child will not live independently and have an intimate relationship so there is no need for them to learn about sex.
- Sex is more than having a sexual relationship. When a child learns about healthy sexuality they learn about body changes, personal hygiene, how to cope with sexual feelings how to make friends and have safe, healthy relationships.
Good
to
know:
Parents and service providers may be uncertain or uncomfortable about talking to children and youth with disabilities because:
- They fear that talking about sexuality will encourage youth to experiment.
- They are not sure what youth need to know.
- They are not sure about how to adapt the information to fit the cognitive level of the person they care for.
- Service providers may be worried that parents will feel these conversations are inappropriate (McCabe and Holmes, 2013).
Talking to other parents and service providers may help you to feel more comfortable, certain and supported.
CHALLENGING ASSUMPTIONS – MYTHS
People with disabilities are not always given the opportunity to learn about sexual health because of some myths and misunderstandings. Below are some common myths.
MYTH: Youth living with disabilities are childlike and sheltered.
Many youth with disabilities will go on to have fully consenting sexual relationships and some studies found that they were more sexually active than their non-disabled peers (East and Orchard, 2013).
MYTH: Sex is private.
There is a contradiction for people living with a disability and need help with personal care. On the one hand personal care involves allowing parents and carers to help with intimate care. On the other hand, youth are told that their sexuality is private (e.g., don’t talk about sex, don’t ask questions).
MYTH: People with disabilities can’t have real sex.
Definitions of sex are personal and include far more than the physical. Sex includes thoughts, feelings, attraction, sharing, being liked by others and how to give and receive affection (Esmail, Krupa, MacNeill, & Mackenzie, 2010).
MYTH: People with disabilities don’t need sexuality education.
Sexuality may not be a priority for families who feel frustrated that they must focus on their child’s major health problem or issue (McCabe and Holmes, 2013). However, children and youth who do not receive sexuality education that is inclusive to their needs, are at risk for abuse, sexual exploitation, sexually transmitted infections (STIs), HIV, social isolation, and lower quality of life (Public Health Agency of Canada [PHAC], 2013).
Parent
tip:
Parents are encouraged to share their family’s values and beliefs about sexuality with their children.
CONSIDERATIONS
Healthy sexuality includes physical, social and emotional development. Some youth with disabilities experience challenges in their social and emotional development compared to typically developing youth.
Challenges may include:
- Their social opportunities may be limited to a few social settings such as special needs class in school; this isolation may result in parents believing their children do not require sexuality education (East and Orchard, 2013). This may make it harder to develop friendships and relationships.
- “Life learning” may be limited due to a disability (e.g., a child with hearing impairment does not catch conversations or listen to music and TV that reflect popular culture). A youth with disability may not be able to get information due to a learning disability or visit a sexual health clinic confidentially because they need an adult to help them get there.
- They may be given a hard time over social mistakes – they may feel that they are living under a microscope (in comparison to a typically developing youth who makes a social mistake and can usually laugh off the situation).
- They may make inappropriate comments about sexual language and topics, repeating what they heard without understanding. This can lead to social isolation and even bullying.
Talking about sexuality and disability with youth helps them to develop healthy boundaries, build skills and stay safe.
Parent &
Service
Provider
tip:
As much as it is important for children and teens to understand the physical changes they will go through as they grow into adults (e.g., puberty changes, self-care and pregnancy prevention), the focus needs to be:
- Social skills.
- Negotiating relationships.
- Decision-making and assertiveness.
- Following social rules.
- Coping with feelings and emotions.
WHAT DO YOUTH WANT TO KNOW?
A study (East & Orchard, 2013) done in Ontario, Canada with youth with physical disabilities found that youth want to:
- Talk about everything their mainstream peers do! Having a disability does not mean that they don’t want to know everything every other youth are interested in.
- Be given the opportunity to talk about sexuality including sexuality and disability in mainstream classes/programs.
- See more reference to people with disabilities in their sexuality education classes.
- Talk more about sex positive topics including intimacy, arousal and masturbation rather than just hygiene and disease.
- Focus on resiliency NOT risk! Youth with disabilities may be at more risk of abuse and assault, but they want to learn how to be safe and have healthy, fun relationships.
East, L. J., & Orchard, T. R. (2014). Somebody else’s job: Experiences of sex education among health professionals, parents and adolescents with physical disabilities in Southwestern Ontario. Sexuality and Disability, 32(3), 335-350.
Esmail, S., Krupa, C., MacNeill, D., & MacKenzie, S. (2010). Best-practice: Sexuality education for children and youth with physical disabilities-developing a curriculum based on lived experiences. Retrieved from http://en.copian.ca/library/research/ccl/best_practice/best_practice.pdf
McCabe, J., & Holmes, D. (2014). Nursing, sexual health and youth with disabilities: A critical ethnography. Journal of Advanced Nursing, 70(1), 77-86.
Public Health Agency of Canada (PHAC). (2013). Questions & Answers: Sexual health education for youth with physical disabilities. Retrieved from http://librarypdf.catie.ca/pdf/ATI-20000s/26289_B_ENG.pdf
Sex Information and Education Council of Canada (SIECCAN). (2010). Sexual health education in the schools: Questions & Answers (3rd ed.). Retrieved November 24, 2010, from http://www.sieccan.org/pdf/she_q&a_3rd.pdf