Get to know what your client wants

Sex involves touching or looking at private parts for pleasure. Intimacy means feeling close to someone else. People who are intimate trust each other. They talk about what they think and feel.

Let your client know that: 

• You can be intimate without having sex. It could be a close friend, family member or companion. It could be someone that you love.
• You can have sex without being intimate. You can have sex with someone you just met. It can be fun. You don't have to love each other. 
• You can be intimate and have sex. It could be with a boyfriend, girlfriend, partner or close friend. 
• You can pay someone to have sex with you, like a sex worker. This kind of sex might feel intimate, or it might not.

Be curious. Ask your client what they want. It could be:

• A romantic partner.
• Someone to have sex with.
• To feel close to someone.
• They don't know yet. They want to experiment.

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Get to know what your client knows

Safe, healthy sex with consent depends on good sex education.

People with disabilities may not have had sex education. As a result, some may:

• Miss out on pleasure and sexual intimacy.
• Be vulnerable to sexual harm because they do not recognise bad behaviour.
• Use problematic sexual behaviours, like masturbating in public. 
• Not know how to manage the impact their disability has on sex.

Ask open-ended questions to find out what your client knows about sex. Then, work with them to fill the gaps. Remember, consent should be part of all sex education.

We have written a guide to Teaching neurodiverse clients about sexual consent (internal link).

We have written a guide to Teaching people with intellectual disabilities about sexual consent (internal link).

We have written a General guide to sex education (internal link).

Clients may also need education on healthy relationships and positive ways to build intimacy. Experiences of violence and abuse are common among people with disability. It could be helpful to talk about healthy and unhealthy relationships. We explain the difference here (internal link). 

Address specific issues

Your client is an individual. Avoid assumptions about the barriers they face to healthy sex and intimacy. Work together to choose issues to tackle.

You might need to address:

• Trauma to do with past violence or abuse
• Gaps in knowledge and understanding
• Problematic sexual behaviours
• Disability-specific issues
• Help finding opportunities
• Dating skills
• Help to feel that they deserve intimacy and sex.

Mental health services like counselling can help people recover from violence and abuse and improve self-esteem and confidence. You can learn about some options here (internal link). Our website also has a section on becoming stronger after hard experiences here (internal link).

We share strategies for addressing other issues below.

Problematic sexual behaviour

When human sexuality is neglected or suppressed, people may find other ways to get their normal and healthy needs met.

Some people with disability may not have received sex education that suited them. Others may have been told that any form of sexual expression is wrong or not for them.  They may have relied on the media (including porn) to learn about sex and intimacy. Or, they may not know much at all.

Mainstream online porn often links violence and pleasure. It may not show consent.

If supporters like family and carers don't provide opportunities and privacy for intimacy and sex, some people with disabilities may engage in unsafe or illegal sex. Examples include:

• Sex in parks or other public places
• Sexual behaviour in front of support workers who have not consented to see or hear sex.

Some clients may be charged with a crime due to inappropriate sexual activity. Other people with disability may face harsh restrictions. For example, a doctor may prescribe medication that suppresses hormones.

Education about sex and relationships is a more effective and fair approach to addressing problematic sexual behaviour. If your client shows this behaviour, focus on sex education. Talk about privacy and consent.

Family Planning Australia has developed excellent resources for people with intellectual disabilities. You can find them here (external link).

SECCA (external link) is also a great source of resources for people with intellectual disability.

We have written a general guide to sex education for people with disabilities. Find it here (internal link).

Disability-specific issues

There are many types of disability and many different causes of disability. It could be:

• Genes
• Birth complications
• Illness
• Injury
• Something else.

People with a disability might have difficulties experiencing sexual pleasure or having relationships. It could be due to:

• Direct effects of the disability
• Physical or emotional issues linked to the disability
• Physical injuries
• The side effects of medications
• Ageing
• Psychological factors like depression.

Sex toys and aids could help your client manage some of these barriers. See the section on sex toys below.

Sensory issues

Some people with disability have sensory sensitivities, where certain sounds, sights, textures, or smells can make them feel upset. It can be hard to manage. At work, be mindful of these sensitivities and create spaces where clients feel safe and comfortable.

You could also remind clients that this may be why they or their sexual partner could be enjoying or not enjoying sex. As your client becomes aware of these issues, they can learn to manage them.

Specific disabilities

Peak organisations often offer information about sex and specific disabilities. For example, MS Australia has a page on sexual issues, which you can read here (external link).

Look for resources relevant to your client. They might prefer to access the resources alone, with you, or with another supporter. 

People facing more complex challenges with sexual sensation or function can seek guidance from a health care worker, sex therapist, or support group. A specialist can work through options and communication skills to negotiate their needs.

Sex without a partner

Some people with disabilities want to have sex but don't have a partner. If this is your client's situation, they could use a sex worker. However, sex work is illegal in some states. Go to Touching Base [external link] and Scarlet Alliance [external link] for information about connecting people with a disability to sex workers.

People with disability have the same rights to access sex therapy and sex work services as everyone else. For some people with disabilities, sex work services may be the only way they can enjoy sexual pleasure. It can be an important type of therapy.

Sex Toys

Sex toys can help people with disabilities get what they want from their sex lives. Sex toys can help people:

• Give and receive pleasure
• Be more intimate with a partner
• Have fun alone.

It can be challenging to find a suitable toy. Not all sex toys are easy to use. If you are not sure what you are looking for, it can be hard to know where to start.

A dildo or vibrator that is large and grippy with big buttons can help with mobility issues. Some toys work hands-free, resting on the bed or a pillow. A simple toy with few functions may be easiest. Different toys stimulate in different ways. It could be hard or soft, fast or slow and so on.

Help your client think about what they want. If they don't know, look for a toy with options.

As a safety note, people who use a vibrator hands-free must make sure they can turn it off or remove it from the body easily.

Masturbation sleeves can be a great way to enjoy new sensations around the penis. Some have been made to meet the needs of disabled people, with features that don't need movement or an erection to feel good.

Some clients may have pain, fatigue or stiffness during sex. Or, they may have limited mobility and need support to stay in a comfortable position. In that case, they could try sex pillows or wedges, which hold their firmness and position.

Sex swings, ramps, and bondage tape can help achieve and enhance certain positions with sex toys and partners. These aids are made to be hygienic and easy to use.

Good quality lubricant is an essential part of everyone's sexual pleasure, especially people who have vaginal dryness. It is often called "lube". Your client could buy it in a chemist, supermarket, sex shop or online.

The main types of lubricants are:

• Water based, which is cheap and can be used with all kinds of sex toys.
• Silicone based, which is thicker and lasts longer. However, some types can't be used with silicone sex toys.
• Oil based, which should not be used. It can make bacteria grow in the vagina and rectum. If the oil is made from petroleum, it can destroy latex. This means that condoms will not work.

When buying lube, check the ingredients and avoid anything with glycerine, parabens or sugars.

Empowerment

Looking for sex and intimacy in a safe and pleasurable way requires personal power, which people with disability may lack because of the way society treats them.

People with disabilities are rarely visible in mainstream media. As a result, they may feel that they are not attractive, sexual or socially okay.

People who have personal power know that:

• They deserve sex and intimacy.
• They deserve to take up space.
• Sex should be fun and pleasurable.
• Rejection doesn't mean there is anything wrong with them. They know how to cope with whatever comes their way.
• Being open about feelings is a skill that can be learned. It is also attractive.
• From each sexual or intimate experience they have, they can learn and grow.

All humans have aspects about them that are attractive and interesting. Spend some time talking about those things with your client. Tell them what you like about them. It could be their sense of humour, love of dinosaurs, the colour of their eyes, their dress sense, or a cool new pet.

Find ways to boost your client's confidence. You could remind them of past success or a time they stood up for themselves in a tricky situation. It doesn't have to be about dating. You could say something like:

"Remember when you went to the shop and told the shopkeeper they gave you the wrong change? You were brave and assertive. You can act like that when dating, too."

If your client struggles to feel empowered, counselling could help.

Building intimacy and relationships

No one is born knowing how to find a romantic or sexual partner. However, people without disabilities have many role models like friends, family members and the media. Your client may never have seen someone like them in a relationship. They may not know if it is possible or how to get it.

Explain the basic steps to your client. Help them plan and build confidence. For example, people need to know what types of touch can happen between which kinds of friends and which behaviours are public and private.

Here is a list you could share with your client. It explains how a relationship might progress.

1. Deep chats
2. Flirting
3. Dating
4. Holding hands
5. Hugs
6. Kisses (cheek then lips)
7. Sex.

Let them know that they need consent before each step. No step should be skipped. However, each step can have an alternative. For example, if someone does not like holding hands, they could link arms instead. Instead of hugging, they might cup someone's face, pat their bottom, or look in their eyes.

Have conversations about each step. For example, ask your client what lets them know it is the right time to kiss? How do you tell someone you have romantic feelings for them? Consider sharing resources about sex, safer sex and masturbation.  

Some useful dating tips

We share information about dating and disability elsewhere on our website (internal link). Here are some extra tips to share with your client, as needed. Whether each tip is relevant will depend on your client's disability and who they are as a person.

• Look for people with shared interests, not necessarily the same diagnosis.
• Technology can help. For example, there are chat sites and apps for people with disabilities, such as alvie.com.au (external link). Help your client decide what approach suits them. SECCA has an online dating brochure for people with intellectual disabilities. You can find it here [external link]. 
• Look for community-led, peer-based social opportunities, like meetups, speed dating and discos.
• Before a date, prepare some things to discuss in case it's hard to start the conversation.
• Plan interesting questions and discuss how your client could respond to the answers. For example, tell your client to avoid giving advice. Don't make every conversation about yourself. Show interest and empathy. You can help your client practice these skills if needed.
• Be yourself. The person you date needs to see the real you, including your disability.

• Some people with disabilities don't like eye contact, so consider doing a side-by-side activity together rather than sitting opposite each other.
• Talk with your client about inappropriate behaviour, like calling twenty times a day, stalking and inappropriate jokes. Let them know that these things can make people less eager to connect. Harassment can cause real harm. Depending on the behaviour, it may be against the law.
• Consider discussing communication difficulties or communication styles. It might be a good idea to discuss these things with their date. Help them plan how to raise the topic if needed.
• Some people with disability don't understand sarcasm. Have a discussion with your client about sarcasm. Emphasise that it can be confusing for self or others. Help your client prepare some ideas for moving beyond missing a sarcastic comment.
• Suggest that your client keeps the first date simple with low pressure, such as coffee and a walk in the park. If they spend a lot of time planning, they may feel very disappointed if things don't work out.
• Try role-playing to prepare for a date. Include some tricky situations and ways to recover from embarrassment or mistakes.  
• Help your client choose an outfit, or suggest that they ask another supporter to help. The right outfit makes you feel confident.
• Text-based communication can be great but challenging without tone of voice, facial expressions, and context. Support your client in taking the time to clarify and consider things before replying to text messages.
• Talk about being careful when sending and sharing messages. Discuss how the message might make the other person feel. Let them know that they need consent before sexting, for example. Make sure they understand that images they send to one person could be shared with others. If they are unsure about whether to hit send, they could talk to a trusted friend.
• Encourage your client to trust their instincts. If something feels unsafe, then it is. Don't hesitate to avoid people who feel unsafe.
• If your client is using online dating, suggest that they arrange a video date before meeting in person. If they do meet in person, it should be in public.

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