"I Feel out of the Loop": Young Disabled People's Experiences Accessing Sex-Positive Support

Background and Purpose: Young people with disabilities experience significant barriers to accessing sex-positive support in community and healthcare settings that promote their sexual well-being and reproductive health. In addition to a lack of relevant education and resources, additional barriers such as societal stigma, ableist misconceptions of asexuality, and the taboo nature of the topic prevent social workers and other service providers from integrating sex-positivity into their practice approaches with disabled people. While research has explored social workers’ levels of preparedness and comfort addressing matters related to sexual health, there is a dearth of research that explores how social workers can support young disabled people using sex-positive approaches. This is one of the first studies to explore young disabled people’s experiences accessing community and healthcare services related to their sexual and reproductive health.

Methods: Fifteen in-depth, semi-structured interviews were conducted with young people (ages 18 to 24) who self-identified as living with a disability and had previously worked with a social worker. Participants were diagnosed with cerebral palsy, cystic fibrosis, Autism Spectrum Disorder, multiple sclerosis, and several other chronic health conditions. Young people were recruited using purposive sampling from social media and snowball sampling. The interviews were transcribed verbatim. Interpretative phenomenological analysis guided the coding process through several iterative stages to identify key themes. NVivo software supported the coding and data analysis stages.

Results: The data analysis reveals that young people with disabilities experience ableist and heteropatriarchal barriers that negatively impact their access to sexual and reproductive health services. Many participants stressed the importance of social workers avoiding personal opinions of sexual and reproductive health in practice and approaching topics with openness and curiosity. Most young people expressed feeling infantilized and dismissed by service providers when they initiated conversations about their sexual and reproductive health. The findings also suggest that sex-positive information and education were scarce and rarely met the needs of young people with disabilities. While most young people valued social work support and were eager for more access, they felt social workers were complacent in systems that perpetuated further marginalization of minority groups.

Conclusion and Implications: These findings suggest several implications for how social workers and other service providers can better support young disabled people with their sexual and reproductive health. By adopting sex-positive approaches in practice and recognizing young people's self-determination, social workers can create space for conversations about sexual and reproductive health in their therapeutic relationships. Additional research with young people and social workers is called for to identify and establish best practices for sex-positive social work approaches with disabled people.