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“They Assume That You’re Not Having Sex”: A Qualitative Exploration of How Paediatric Healthcare Providers Can Have Positive Sexuality-Related Conversations with Youth with Disabilities

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Abstract

Every individual should have equal access to sexuality-related information and services. Regrettably, societal stigma revolves around the sexuality of youth with disabilities, with a common misconception that they are asexual, and therefore do not need to be taught about sexuality and sexual health. Healthcare providers (PHCPs) have reported barriers to having sexuality-related conversations with youth with disabilities, such as lack of time and personal discomfort. As such, we sought to examine what might facilitate PHCPs to have conversations about sexuality with their paediatric clients and families. A qualitative focus group study using a descriptive exploratory approach was conducted. Five PHCP participants from a paediatric rehabilitation hospital participated in a focus group. Five young adult (YA) participants with a self-reported disability took part in a separate focus group or individual interviews. Descriptive thematic analysis was used to identify, analyze, and report themes in the data. Results showed that persisting assumptions impede children and youth with disabilities from exploring their sexuality; that autonomy, safety, trust, and consent are critical topics that should be addressed in sexuality-related clinical conversations; and that sexuality-related services should be improved by providing greater disability-specific information, having age-appropriate discussions from an early age, and increasing interdisciplinary care. Normalizing sexuality-related discourse in clinical settings may help youth with disabilities construct a healthy sexual identity, fulfill their sexual needs, and develop adequate skills to deal with sexual situations safely and appropriately.

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Acknowledgements

The authors would like to acknowledge the following individuals for their contribution to the study and/or preparation of this manuscript: Alyssa Neville, Cristina Malana, Andrew Gurza, Dilshad Kassam-Lallani, and Marie Hooper.

Funding

This study was funded by Holland Bloorview Kids Rehabilitation Hospital, in partnership with the Accessibility Directorate of Ontario.

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Authors and Affiliations

  1. Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada

    Revi Bonder, Caron Gan, Shauna Kingsnorth, Christine F. Provvidenza & Amy C. McPherson

  2. Evidence to Care, Teaching and Learning Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada

    Joanne Wincentak, Shauna Kingsnorth & Christine F. Provvidenza

  3. Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada

    Joanne Wincentak

  4. Rehabilitation Sciences Institute and Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada

    Shauna Kingsnorth

  5. Rehabilitation Sciences Institute and Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

    Amy C. McPherson

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  1. Revi Bonder
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  2. Joanne Wincentak
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Correspondence to Revi Bonder.

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Bonder, R., Wincentak, J., Gan, C. et al. “They Assume That You’re Not Having Sex”: A Qualitative Exploration of How Paediatric Healthcare Providers Can Have Positive Sexuality-Related Conversations with Youth with Disabilities. Sex Disabil 39, 579–594 (2021). https://doi.org/10.1007/s11195-021-09686-z

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