Let’s start with something that shouldn’t be controversial but somehow still is: people with disabilities have sex lives. They have desires, relationships, fantasies, and needs for intimacy—just like everyone else. Yet we live in a world that consistently denies this reality. A world where 84% of people with intellectual disabilities report having been in sexual relationships, but institutional policies and social attitudes work overtime to prevent exactly that from happening. A world where the right to sexual expression is recognized as a human right by the World Health Organization, yet individuals with disabilities face systematic barriers to accessing even basic sexual health education. This isn’t just about sex. It’s about autonomy, dignity, and the fundamental right to be seen as a full human being.
The Ableism Baked Into Everything
Before we go further, we need to talk about ableism—the system that values bodies and minds based on socially constructed ideas of what’s “normal,” intelligent, or productive. Ableism isn’t just individual prejudice; it’s woven into the fabric of our institutions, our research, even our language. And here’s the uncomfortable truth: anthropology and disability studies themselves have perpetuated ableist ideologies. Much of the existing discourse about sexuality centers able-bodied experiences, treating disability as deviation rather than difference. Academic research has historically been based on colonial models that privilege “able body-minds” and treat everything else as lacking.
This ableist framework is rooted in oppressive ideologies like eugenics, colonialism, and capitalism—systems where a person’s value depends on their physical attributes, productivity, or perceived social power. Within this framework, disabled sexuality becomes either invisible or threatening. When sexuality remains taboo in general society, it becomes exponentially more difficult to address for people with intellectual disabilities. The result? A deafening silence around a fundamental aspect of human experience.
The Competence Question
When disability enters the conversation, competence immediately becomes the elephant in the room. Are disabled people capable of consent? Do they understand what they’re doing? Can they make informed decisions about their bodies and relationships?
These questions, while sometimes legitimate in specific contexts, often function as blanket assumptions that strip disabled people of agency before any individual assessment even happens. Disability justice advocates—many of whom are disabled themselves speak to the profound shame this creates. Regardless of context, disabled people are often perceived as fundamentally incompetent.
Now add sexuality to the mix, and that judgment amplifies exponentially. Society already struggles with frank discussions about sex. Combine that discomfort with ableist assumptions about competence, and you get a toxic cocktail that denies disabled people one of the most basic aspects of being human.
The Double Bind of Vulnerability and Desire
Here’s where it gets complicated, and why this conversation requires nuance rather than easy answers. People with intellectual disabilities face significantly higher risks of sexual abuse. Studies vary, but the statistics are sobering: one study suggests that one in three adults with intellectual disabilities experience sexual abuse. Another found rates between 7-34%. This vulnerability is real and cannot be ignored. But here’s the problem: the instinct to “protect” disabled people from sexual harm has morphed into broad policies that restrict their access to relationships, intimacy, and sexual expression entirely.
The logic seems to be: if we just prevent disabled people from having any sexual experiences, we’ll keep them safe. But this paternalistic approach doesn’t actually protect anyone—it just infantilizes adults and leaves them even more vulnerable when they do encounter sexual situations, because they’ve been denied the education and agency to navigate them safely.
We need to hold both truths simultaneously: people with intellectual disabilities face heightened vulnerability to abuse AND they have the right to sexual expression, relationships, and pleasure. These aren’t contradictory—they’re interconnected. Comprehensive sexual health education actually reduces vulnerability while supporting agency.
The Stereotypes Doing the Most Damage
When disabled sexuality isn’t invisible, it’s usually viewed through one of several harmful lenses:
Deviance. Sexual expression by disabled people is often labeled as inappropriate or abnormal, something that needs to be controlled or suppressed.
Victimization. Disabled women, in particular, are seen exclusively as potential victims, never as people with their own desires and agency.
Aggression. Disabled men, conversely, are viewed as potentially aggressive and “unhinged,” their sexuality seen as threatening.
Asexuality. When not viewed through one of the above frameworks, disabled people are often assumed to lack any cognitive capacity for sexual arousal or desire at all.
None of these stereotypes leave room for what’s actually true: disabled people have varied, complex, individual relationships to sexuality just like everyone else. Perhaps most troubling, the lack of education and support around sexuality has led to some disabled individuals being labeled as sexual offenders for behaviors that might simply reflect a lack of understanding about social norms and boundaries. Comprehensive sexual health education could substantially reduce these situations while creating safer environments for everyone.
How Institutions Fail
The contradiction at the heart of institutional care for people with intellectual disabilities is striking: they’re simultaneously viewed as dependent and highly vulnerable, yet denied the support systems that would actually address that vulnerability. Research examining cross-cultural contexts reveals a depressing pattern. Studies from Europe, North America, Brazil, and Sweden show caregivers consistently suppressing, ignoring, or trivializing the sexuality of disabled people in their care. The one exception? Denmark, where progressive disability legislation, pro-sex work rights, and an expansive welfare state create an environment that actually supports sexual and intimate relationships for disabled people. What accounts for the difference? Policy, culture, and training.
Here’s what typically happens in institutional settings like group homes:
- Privacy is restricted, making intimate relationships nearly impossible
- Policies explicitly limit the right to safe, healthy sexual engagement
- Support staff receive no training on how to address sexuality
- When they do encounter sexual expression, staff responses are inconsistent, driven by personal discomfort rather than best practices
- Fear of accountability and role uncertainty paralyze staff, leading them to default to restriction rather than support
A study examining support staff attitudes found that the personal experiences and values of paid caregivers directly impact their views on sexuality—and therefore the quality of education and support they provide. This matters enormously, because disabled individuals often rely almost entirely on support staff for education about relationships, acceptable sexual behaviors, and other critical topics.
Support staff and family members frequently become “gatekeepers”—sometimes unknowingly—preventing the people they support from developing or initiating intimate relationships at all.
What Disabled People Actually Want
Lost in all the hand-wringing about protection and competence is a simple question: what do disabled people themselves want? In a study of 360 people with intellectual disabilities, 87% said they would like to be in a relationship. Among those surveyed, 84% had already been in a sexual relationship. The study made clear: relationships matter, and pleasure is an important aspect of life for disabled people. This shouldn’t be surprising, yet somehow it still needs to be stated and restated. The desire for connection, intimacy, and sexual expression isn’t contingent on IQ or physical ability. It’s part of being human.
The Education Gap No One Wants to Fill
So if disabled people want relationships and sexual expression, and if education would reduce both exploitation and harmful behaviors, why isn’t comprehensive sexual health education standard? The barriers are multiple:
Definitional problems. The psychiatric approach to intellectual disability in the DSM-V offers a broad, universal definition that completely ignores sexual expression and behavior. If the medical framework doesn’t account for sexuality, it’s easy for institutions to pretend it doesn’t exist.
Policy vacuums. Most institutional settings lack specific policies addressing sexuality and agency. This “gray area” creates confusion about whose responsibility it is to provide education—and when in doubt, most institutions simply avoid the topic entirely.
Lack of training. Support staff receive little to no training on how to address sexuality, leaving them anxious, uncertain, and likely to default to restriction.
Societal discomfort. We live in a culture that’s already squeamish about discussing sex openly. Add disability to the equation, and that discomfort multiplies.
The result? A comprehensive failure at every level—societal, institutional, and individual—to provide disabled people with the information, support, and agency they need to navigate sexuality safely and joyfully.
What Disability Justice Demands
Disability justice, as a framework, focuses on intersectionality—how disability and ableism intersect with other forms of oppression including racism, sexism, homophobia, and economic marginalization. It recognizes that disabled people have multiple, overlapping identities that shape their experiences.
When it comes to sexuality, disability justice demands several things:
Recognition of variability. Sexual expression looks different for different people. Disability justice means respecting diverse ways of experiencing intimacy and pleasure without forcing everyone into a narrow norm.
Language that honors nuance. We need vocabulary that encompasses the many ways disabled people navigate relationships and experiences, rather than flattening everything into simplified categories.
The right to pleasure. Pleasure isn’t frivolous—it’s a fundamental aspect of wellbeing and human dignity. Social authorities benefit from limiting whose pleasure is considered legitimate. Disability justice challenges that restriction.
Intersectional analysis. We can’t understand disabled sexuality without also considering race, class, gender, sexual orientation, and other intersecting identities that shape people’s experiences and access to resources.
Moving Toward Real Change
What would actually help? Several things, operating at different levels:
Comprehensive sexual health education designed specifically for people with intellectual disabilities—and for the staff who support them. This education should be both inclusive and respectful, valuing equity rather than assuming incompetence.
Clear policies at the institutional level that specifically address sexuality and agency. The current “gray area” serves no one. Disabled adults deserve policies that respect their rights while providing appropriate support.
Training for caregivers and support staff that addresses their own discomfort, clarifies their role, and gives them practical tools for supporting healthy sexual expression rather than suppressing it.
Cultural shift that challenges the pervasive stereotypes about disabled sexuality. This means media representation, public conversations, and deliberate work to dismantle ableist assumptions.
Research that centers disabled voices. Too much disability research has been done about disabled people rather than by or with them. Disabled scholars and advocates must lead these conversations.
The Bigger Picture
This isn’t ultimately about sex, though sex is part of it. This is about whether we recognize disabled people as full human beings with the same rights, desires, and dignity as everyone else.
Every time we deny someone access to information about their own body, we’re saying they don’t deserve autonomy. Every time we prevent adults from forming relationships, we’re saying they’re perpetual children. Every time we assume incompetence without evidence, we’re perpetuating the same dehumanizing logic that has justified eugenics, forced sterilization, and institutionalization throughout history.
The opposite of this—disability justice in the realm of sexuality—means creating systems and cultures that support agency, provide education, respect difference, and center the voices and experiences of disabled people themselves.
It means recognizing that “disabled” and “sexual being” aren’t contradictory terms. It means understanding that protection and agency aren’t opposites—done right, they support each other.
Most fundamentally, it means taking seriously the idea that everyone—regardless of cognitive or physical ability—deserves to experience connection, intimacy, pleasure, and love on their own terms.
Disabled, not dead. Not asexual by default. Not perpetual children. Not problems to be managed.
Human beings, with all the complexity and dignity that entails.
The conversation requires ongoing learning, humility, and most importantly, listening to disabled voices. If you work with or care for someone with a disability, examine your own assumptions. If you’re creating policies, center the people those policies affect. And if you’re just learning about these issues, keep learning and speak up when you see ableism perpetuated.
The Journal 