The myth of asexuality? Disability stigma as a barrier to sexual relationships in South Africa Literature review

Reading note 8. Access to sexual and reproductive health services: Experiences and perspectives of persons with disabilities in Durban, South Africa.

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Keywords

Emotional and sexual life.

Author’s note

Sexual and reproductive health is recognised as an essential component of good health and personal development. However, a number of studies suggest that persons with disabilities (PWD) are often marginalised by sexual and reproductive health programmes. In this study in-depth interviews were conducted with sexually active women and men of reproductive ages with different types of disabilities in order to examine access to sexual and reproductive health services in Durban, South Africa. The majority of respondents revealed that sexual and reproductive health services are a big part of their lives. However, there seemed to be a huge gap between their need for services and their rights to access these services. Gender compounded the negative experiences for women with disabilities. Women mentioned that health providers appear surprised that they will need family planning services, and they are not given choices about suitable birth control methods. The findings reveal a need to address access to sexual and reproductive health services for PWD.

Commentary

In this peer-reviewed article (C4), Mavuso and Maharaj investigate the experiences that persons with disabilities have of accessing sexual and reproductive healthcare in Durban, South Africa. Despite steps toward the sexual and reproductive rights of persons with disabilities in South Africa being taken in theory, the authors draw attention to the fact that more improvement is required in practice. Therefore, they set out to document the current experiences of persons with disabilities when accessing sexual and reproductive healthcare in Durban (C1). To do this, they interviewed a sample of 16 individuals with disabilities, who reside in a large home that facilitates independent living and co-habitation (i.e. with spouses and children). Given that many research projects still do not leave room for persons with disabilities to speak on their own behalf, this represents a valuable collaboration with actors in the field (C2). Mavuso and Maharaj’s findings are numerous. Firstly, they note that the sexual perceptions of respondents appear to be gendered (e.g., males view sex as self-gratifying, women use sex to establish emotional attachment). In terms of sexual and reproductive healthcare, participants asserted that attempts to provide sexuality education to persons with disabilities were poor. This criticism applied across both public and private spheres of life. For instance, respondents reported receiving a lack of accessible public educational material and did not gain this information from their families either, whose members generally endorsed the myth that persons with disabilities are asexual. Furthermore, participants noted several social (e.g., negative attitudes, behavioural discrimination) and structural (e.g., inadequate transportation, inaccessible facilities) barriers when using healthcare services, which contributed to an overall detrimental experience of them. In light of the above, the authors are able to provide practical recommendations of how access to sexual and reproductive health services in South Africa should be improved (e.g., more mobile clinics within the community; C3). Many of the barriers to access identified in the study are grounded in the (mis-) perceptions of sexuality that participants perceive South Africans without disabilities to hold. However, an overall limitation of this area of research is that there has been very little direct investigation of the views that the general South African population hold about persons with disabilities. Pursuing this investigation would enable more targeted recommendations to be made to improve access to sexual healthcare.

Reading note 9. Sexual self-esteem and body image of South African spinal cord injured adolescents

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Keywords

Child and teenager; Emotional and sexual life;

Author’s note

Although adolescents sustain a large portion of spinal cord injuries, the area of spinal cord injured adolescents and the issues surrounding their sexuality are under-researched. This is the first South African study on the sexuality of spinal cord injured adolescents and attempts to address this paucity. It is generally postulated that the sexuality of adolescents who have sustained SCI will be detrimentally affected by the consequences of having a physical disability, resulting in developmental lags relative to non-disabled peers. The focus of this article is to explore the impact of spinal cord injury on adolescent’s sexual self-esteem and body image. A qualitative study was conducted, with data being collected via in-depth individual interviews, which were subsequently analyzed thematically. A disparity was found between dominant ableist discourses of the SCI adolescent as a sexually immature and passive spectator, and the lived experiences of the participants involved in the study. The study concluded that entrenched socially constructed attitudes appear to limit the opportunities for spinal cord injured adolescents to express their sexuality more than the limitations by their disabilities.

Commentary

 In this peer-reviewed article (C4), Potgieter and Khan qualitatively investigate the impact of spinal cord injuries on South African adolescents’ sexual self-esteem and body image. The sexuality of persons with spinal cord injuries, particularly adolescents, has received very little attention in prior research. The authors argue that one reason for this gap is the way that sexuality has been constructed in traditional academic discourse, i.e. stressing physical changes in the body that facilitate sexual development, versus cultural or societal factors. Potgieter and Khan challenge this in their work by exploring the discourses of spinal cord injured adolescents directly (C1). The authors conducted biographical interviews with seven adolescents, accessed through South African schools. As this study is the first to focus on the sexuality of South African adolescents who had spinal cord injuries, agency is given to a section of the population who have previously been without a voice (C2). The findings illustrate a sense of confusion among spinal cord adolescents regarding whether they are objects on onlookers’ sexual interest or pity and curiosity. However, respondents differed over the relationship they possessed with their own bodies. For example, some participants viewed their body positively as a site for celebration, while others were ambivalent or felt self-loathing as a result of negative bodily images. Potgieter and Khan bring to the fore discourses that challenge traditional notions of disabled sexuality (C3). They note the importance of work that dispels these constructions, particularly that which focuses on social and structural barriers to disabled sexuality. The points raised speak to the need for intervention research in the future; as such Potgieter and Khan’s study represents (and claims to be) only a first step toward addressing prevailing myths of disabled sexuality among South African spinal cord injured adolescents.