Introduction: Centring Disability in Sexual Health
In a world that often devalues and marginalizes the experiences of disabled people, the topic of sexuality remains profoundly overlooked. Many disabled individuals are denied the opportunity to explore their sexualities, form romantic relationships, and access sexual health resources. This lack of acknowledgment stems from deep-rooted societal beliefs that view disabled bodies as either fragile or asexual—myths that strip away the agency and humanity of disabled individuals. As a psychotherapist working within an intersectional, anti-oppressive framework, I’ve witnessed firsthand how cultural ableism suppresses the sexual autonomy of disabled clients, often leaving them to navigate sexual desires and relationships in isolation or silence.
Sexuality is a core aspect of human experience. It encompasses not only physical intimacy but also emotional connection, self-expression, and the right to experience pleasure. When society denies disabled individuals access to these vital experiences, it upholds harmful systems of exclusion and inequality. In my practice, I’ve observed how these barriers impact not only the individuals but also the wider communities they belong to. For example, many disabled queer or trans* clients face compounded challenges, as their identities are doubly marginalized by ableism and cisheteronormativity.
To support disabled individuals in reclaiming their sexual autonomy, we, as clinicians, must commit to dismantling ableist assumptions embedded in healthcare and social services. This requires reframing disability as an integral part of identity, one that coexists with sexuality, rather than diminishing it. When we make space for discussions about pleasure, intimacy, and desire, we affirm that disabled people are not only deserving of these experiences but are entitled to them. It is not enough to view sexuality through a medical lens or to provide basic sex education. We must also create environments where clients feel empowered to explore their bodies and identities without shame or restriction.
In working from a disability justice lens, we must also consider how other marginalized identities intersect with disability. Many disabled individuals are also people of colour, members of the LGBTQIA+ community, or those living in poverty. These intersections compound the barriers to accessing sexual health services and affirming relationships. For instance, a trans* disabled person may face unique challenges in navigating both healthcare and societal acceptance, while disabled women and femmes may encounter higher rates of sexual violence and exploitation. By centring these intersections, we are better equipped to address the complex, nuanced realities that disabled clients face.
This blog post invites clinicians, caregivers, and clients alike to reflect on disability, sexuality, and the cultural barriers that limit access to fulfilling sexual lives. It’s an invitation to challenge the misconceptions that persist in both clinical practice and wider society, to promote the sexual well-being of disabled people, and to amplify their voices. Together, we can help create a world where sexual autonomy is not a privilege reserved for the able-bodied, but a fundamental human right available to all, especially those who are also navigating other marginalized identities like queerness, transness, or chronic illness.
Overview: The Silence Around Disability and Sexuality
The intersection of disability and sexuality is rarely discussed in mainstream discourse. Historically, disabled people have been infantilized, desexualized, or deemed incapable of having sexual desires or engaging in romantic relationships (Owens, 2015; Rohleder, Braathen, & Carew, 2018). This systematic erasure of disabled sexual identities reflects the ableist underpinnings of our societies—one that values only certain types of bodies and stigmatizes others for deviating from a narrow standard of “normalcy.” As a result, disabled individuals are often treated as non-sexual beings, which contributes to their exclusion from conversations about sexual health, intimacy, and agency.
These harmful assumptions do more than deny disabled individuals the right to express their sexuality; they perpetuate the idea that disability inherently negates pleasure, desire, and sexual connection. This societal desexualization leads to concrete barriers, including the lack of access to sexual health education that is inclusive of disabled experiences. Many disabled people are left out of essential conversations about consent, sexual safety, and pleasure because resources are often not designed with their needs in mind (Owens, 2015). For example, disabled people may be unable to find information on how to navigate sexual experiences in ways that account for mobility issues, chronic pain, or the use of adaptive devices. Inadequate education limits not only disabled people’s access to information but also their ability to advocate for themselves in intimate situations.
It is also important to acknowledge how care approaches further marginalize disabled individuals’ sexualities. Medical and therapeutic models tend to focus on the clinical management of disability, often seeing it as a condition that needs to be corrected or treated. This “fix-it” mentality reinforces the idea that disabled bodies are broken and incompatible with sexual expression. Instead of viewing sexuality as a natural, vital aspect of a person’s identity, the medical model frequently sidelines it, leaving disabled people to navigate their desires without proper guidance or support (Rohleder et al., 2018). This alienation from sexual health and sexual rights reinforces social narratives that reduce disability to a set of limitations rather than acknowledging the full breadth of disabled people’s lived experiences.
To move toward a more inclusive understanding, we must embrace a rights-based approach that situates sexuality as a fundamental aspect of identity. This approach emphasizes the right to pleasure, bodily autonomy, and access to sexual health resources, regardless of one’s physical or cognitive abilities (Kattari, 2024). In this framework, disability is not a barrier to sexual expression but rather a part of the diverse spectrum of human experiences. A rights-based approach challenges the notion that disabled people need to conform to able-bodied standards of sexuality and instead encourages them to explore their desires, build meaningful relationships, and advocate for their own sexual health.
Books like Exploring Sexuality and Disability by Shanna Katz Kattari provide powerful frameworks that centre disability justice and queerness, pushing us to rethink traditional views of sexual health and expand our understanding of sexual and emotional well-being (Kattari, 2024). These works offer crucial insights into how we can support disabled clients in reclaiming their sexual autonomy. They invite us to explore the intersectionality of disability, queerness, and sexuality, recognizing that disabled individuals often navigate multiple layers of marginalization. By prioritizing inclusive sexual health education and addressing the gaps in care, we can create spaces where disabled people feel seen, validated, and empowered in their sexual identities.
In this context, sexual health care becomes more than just a clinical service—it becomes a means of affirming disabled individuals’ right to experience pleasure, intimacy, and love. This shift from a medical model to a rights-based approach is vital in ensuring that disabled people are no longer sidelined in conversations about sexual health. As practitioners, we have the responsibility to break the silence and foster environments where disability and sexuality are fully acknowledged, respected, and celebrated.
Key Concepts: Affirming Sexual Rights through Disability Justice
A central theme in working with disabled clients is the recognition of their sexual rights, rooted in the belief that sexuality is a fundamental aspect of human experience. All individuals, including those with disabilities, have the right to explore their sexual identities, experience intimacy, and form meaningful relationships (Rohleder, Braathen, & Carew, 2018; Kattari, 2024). Yet, the mainstream understanding of disability continues to prioritize survival, functionality, and physical care over pleasure, intimacy, and connection. This often leads to the erasure of disabled people’s sexualities, reinforcing the false narrative that their primary concern should be physical health rather than the joy, connection, and healing that sexual expression can bring.
This tension is reflected in societal norms, which typically place disabled people on the periphery of conversations around desire, attraction, and intimacy. Instead of celebrating the full spectrum of their identities, disabled individuals are often depicted as asexual, infantilized, or as needing to be “fixed” before they can engage in meaningful sexual or romantic relationships (Owens, 2015). This erasure not only dehumanizes disabled people but also strips them of the agency that all individuals deserve when it comes to their bodies and sexualities.
Disability Justice and Sexual Rights: A Framework for Empowerment
At the core of this conversation is the disability justice framework, which challenges traditional, ableist views of disability and centres the lived experiences of disabled individuals. Rather than treating disability as a deficit or something to be overcome, disability justice views it as a rich and valuable part of identity—a source of strength and resilience, rather than limitation. This perspective is particularly important when addressing sexual rights, as it affirms disabled people’s inherent right to sexual health, autonomy, and consent (Luczak, 2015; Kattari, 2024).
The disability justice framework also stresses the importance of intersectionality. Disabled people exist at various intersections of identity, including race, gender, sexuality, and class, and their experiences of sexual oppression are often compounded by these overlapping systems of discrimination. For example, a disabled trans woman of colour may face layers of marginalization that affect both her sexual and disability rights, creating barriers to accessing affirming care and support (Kattari, 2024). This intersectional lens is critical in developing inclusive therapeutic practices that respect and acknowledge the complexities of clients’ identities.
By adopting a disability justice approach, clinicians and caregivers can move beyond the limited, medicalized focus on physical care to include the emotional, psychological, and relational aspects of disabled people’s lives. This means creating spaces where disabled clients feel safe discussing their sexual desires and boundaries without judgment, shame, or infantilization. It also requires recognizing that disabled individuals have the right to access sexual health resources, engage in relationships, and make informed choices about their bodies—just like anyone else.
Creating an Inclusive Therapeutic Space for Disabled Sexualities
To fully support the sexual rights of disabled clients, clinicians must educate themselves on the specific needs and experiences of disabled individuals. This includes understanding how various disabilities—whether physical, intellectual, or sensory—might affect a person’s sexual health or experiences, and how to create therapeutic spaces that encourage openness and self-exploration. Many disabled clients may have had previous negative experiences in medical or therapeutic settings where their sexualities were ignored or dismissed. As a result, clinicians must take an active role in creating environments where disabled people feel seen, heard, and empowered to discuss their sexual health.
Part of this work involves addressing the ableism embedded in traditional sexual health education, which often assumes that only able-bodied people are interested in, or capable of, sexual activity. This assumption leaves disabled individuals without adequate sexual education, resources, or tools to explore their sexual identities in a safe and affirming way. Clinicians must work to fill these gaps by offering comprehensive, inclusive sexual health information that reflects the diverse realities of disabled clients (Rohleder et al., 2018). For example, this might involve discussing adaptive strategies for intimacy, exploring sensory play, or introducing body mapping exercises as a way for clients to reconnect with their bodies and discover new forms of pleasure.
Clinicians also have a responsibility to challenge ableist norms within their own practice. This includes recognizing and addressing their own biases, as well as advocating for policies and practices that support the sexual rights of disabled individuals. It’s important to ensure that conversations around disability and sexuality are not relegated to the margins but are treated as essential to the therapeutic process. Only by doing so can we foster environments where disabled people can fully embrace their sexual autonomy and thrive in their relationships.
How Disability Justice Impacts Our Work as Clinicians
In therapeutic practice, addressing the sexual needs of disabled clients requires clinicians to confront ableism and other forms of oppression head-on. This is particularly crucial when working with clients who hold multiple marginalized identities, such as those who are trans* or queer, as they face compounded barriers to accessing sexual health resources (Kattari, 2024; Rohleder, Braathen, & Carew, 2018). The intersection of ableism, transphobia, homophobia, and other forms of systemic oppression creates unique challenges for these clients, often leaving them excluded from conversations about sexual health, desire, and agency. It is our responsibility, as clinicians, to actively dismantle these barriers by cultivating environments that affirm the full breadth of their identities.
A key aspect of this work is the creation of safe and inclusive spaces where disabled clients feel comfortable discussing their sexualities without fear of judgment, stigma, or condescension. For many disabled individuals, particularly those who have experienced medical trauma, the very idea of discussing sexuality with a clinician may evoke anxiety. As therapists, it is critical to acknowledge this hesitation and approach the conversation with sensitivity, care, and an openness to learning from the client. Active listening is essential here; by allowing clients to lead the discussion about their sexual needs and boundaries, we avoid the paternalistic model that too often dominates healthcare settings.
Moreover, as clinicians, we must recognize the diversity of experiences within the disabled community. Not all disabled clients will approach their sexualities in the same way, and it’s important to avoid generalizing their needs or assuming that sexuality is not a priority. Some clients may require guidance in exploring their identities, while others may need support in navigating intimacy in the context of physical or cognitive limitations. In either case, our role is to provide a space where clients can safely engage with these topics and receive the tools they need to advocate for their own sexual health and well-being (Rohleder et al., 2018).
Integrating creative modalities like art therapy is one powerful way to help disabled clients explore their bodies, identities, and relationships in a non-threatening, empowering manner. For instance, body mapping exercises can allow clients to reconnect with their physical selves and affirm their right to pleasure and desire. This visual, experiential process encourages clients to identify the areas of their body that evoke positive or negative emotions, enabling them to reclaim agency over their sexualities (Kattari, 2024; Owens, 2015). Through this work, clients often begin to release internalized shame or discomfort around their bodies, opening the door to new possibilities for sexual expression and connection.
In addition to art therapy, body-centered approaches such as somatic work or Sensorimotor Psychotherapy can also play a transformative role in helping disabled clients navigate consent, autonomy, and intimacy. These approaches emphasize the importance of being attuned to the body’s signals and learning to communicate one’s needs clearly. For many disabled clients—particularly those who have experienced medicalization, trauma, or violation of consent—this can be an essential step in regaining a sense of control over their bodies and their intimate experiences (Rohleder et al., 2018; Luczak, 2015). By fostering these conversations and providing clients with practical tools to advocate for themselves, clinicians can help shift away from a model that focuses solely on care and management, and instead support the client’s journey toward independence, agency, and self-discovery.
How Disability Justice Supports You, the Readers
Whether you are a clinician looking to deepen your practice or an individual seeking to explore your own sexuality, understanding the intersection of disability and sexual health is essential. For therapists, this work begins with self-reflection. Are there ways in which your practice may inadvertently reinforce ableist assumptions? For instance, are you assuming that your disabled clients are not interested in discussing their sexual identities, or are you creating spaces where they feel comfortable bringing up these issues? It’s important to reflect on whether your interventions take into account the unique physical, emotional, and relational needs of disabled individuals.
Therapists should also consider the language they use in session. Are you framing sexuality in ableist terms, or are you allowing your disabled clients to define their sexual experiences on their own terms? Offering affirming, inclusive care means recognizing that disabled people are entitled to the same sexual rights, pleasures, and relationships as anyone else. It also means challenging the biases and gaps in sexual health education that may have left your clients with limited access to information. Inclusive care involves ongoing education on the clinician’s part—reading works like Exploring Sexuality and Disability (Kattari, 2024) or Supporting Disabled People with their Sexual Lives (Owens, 2015) can provide a solid foundation for supporting your clients in this area.
For clients and individuals, the message is equally empowering: your sexuality matters, and you have the right to explore your desires, form fulfilling relationships, and access sexual health resources that reflect your identity. Whether you’re disabled, queer, trans*, or navigating any combination of intersecting identities, you deserve to be seen and validated in your sexual expression. If you feel that your current therapist isn’t supporting these conversations, consider advocating for your needs. You may ask your therapist directly about discussing sexual health, or seek out a clinician who works from an intersectional, inclusive framework that honours your whole self.
It’s important to remember that the journey toward sexual self-discovery is deeply personal, and there’s no one “right” way to experience it. For some, it may mean exploring new relationships or deepening existing ones. For others, it may involve reconnecting with their body through art, movement, or touch. Whatever the path, know that your desires are valid, and you have the right to seek pleasure, intimacy, and connection on your own terms.
Conclusion: Centering Disabled Voices in Sexual Health
Disability and sexuality are not mutually exclusive, yet societal taboos and misconceptions continue to overshadow the lived experiences of disabled individuals. These harmful narratives perpetuate the myth that disabled people are either asexual or incapable of fully engaging in romantic and sexual relationships. To dismantle these beliefs, we must actively center disabled voices in discussions about sexual health, pleasure, and autonomy. This involves not only amplifying the stories and experiences of disabled individuals but also reshaping the way we, as clinicians, approach sexual health in our practices.
As clinicians, we have an ethical and moral responsibility to provide care that acknowledges and affirms the sexual rights of all individuals, including those who are often marginalized. This work requires us to confront our own biases, expand our understanding of sexuality beyond ableist frameworks, and create spaces where disabled clients can safely explore their desires, needs, and boundaries without shame or judgment. In doing so, we offer our clients the opportunity to reclaim their sexual identities, fostering a sense of agency and empowerment.
By embracing a disability justice framework and committing to inclusive, compassionate care, we challenge the societal norms that have long denied disabled individuals their right to sexual fulfillment. When we affirm disabled people’s autonomy, we create space for them to experience pleasure, intimacy, and love on their own terms—whether through relationships, self-exploration, or redefining their connection to their bodies.
The journey toward creating a more inclusive and affirming sexual health landscape is ongoing, and it requires collective effort. However, by centering disabled voices and acknowledging the complexities of disability, sexuality, and identity, we can move closer to a world where all individuals are free to explore and express their sexualities in ways that are meaningful, fulfilling, and true to who they are.
Let’s Continue the Conversation
If my thoughts on disability justice and sexuality in this blog resonate with you, or if you’re a clinician looking to enhance your practice, I invite you to connect with me for a deeper conversation. Whether you’re seeking therapy or professional guidance, I’m here to help you navigate these essential aspects of anti-oppressive therapeutic work. I invite you to book a peer consultation or an individual therapy session, and be sure to bookmark this blog for future insights, reflections, and updates.
References
Kattari, S. K. (2024). Exploring sexuality and disability: A guide for human service professionals. Routledge.
Luczak, R. (2015). QDA: A queer disability anthology. Squares & Rebels.
Owens, T. (2015). Supporting disabled people with their sexual lives: A clear guide for health and social care professionals. Jessica Kingsley Publishers.
Rohleder, P., Braathen, S. H., & Carew, M. T. (2018). Disability and sexual health: A critical exploration of key issues. Routledge.
Disclaimer: This blog offers general educational information and does not constitute professional advice or establish a therapist-client relationship. Please consult a healthcare provider for personalized guidance. Any decisions based on the content are the reader’s responsibility, and Clayre Sessoms Psychotherapy assumes no liability. All case studies are hypothetical with fictional names and do not reflect actual people. We prioritize your privacy and the confidentiality of all of our clients. We are committed to maintaining a safe, supportive space for 2SLGBTQIA+ community care.