|Quoting Flighty (Reply 34):|
Sex education is completely unnecessary for children who are medically handicapped and will not be having sex.
Very common misconception. In fact, during residency, I gave a presentation on sexuality and the disabled adolescent.
Patients with disabilities are often desexualized. Yet, a surprising number of individuals with disabilities, including mental, engage in consensual sex. And even more shocking, >80% of disabled women will be sexually assaulted at least once in their lives.
Almost all healthy adults will be sexually active at some point in their lives. Developmentally normal patients with physical disabilities experience the same urges as the rest of us and develop normal sexual desires. Developmentally delayed patients, depending on how profoundly delayed, may also develop sexual desires. And all consenting adults have a right to sexual activity if so desired.
For example, in a French study of 40 men aged 18-35 with spina bifida, 40% reported sexual activity in the previous 4 weeks.
Individuals with disabilities have specific sexual needs that should be dealt with respectfully and frankly by healthcare professionals. For example, at present, all patients with spina bifida are assumed to be latex allergic (because >70% are actually latex allergic). Thus, patients with spina bifida must be warned to use polyurethane condoms and not latex ones.
Yet, in spite of all we know, fewer than 20% of adolescents with spinal cord issues seek information regarding contraception and only 16% of those who are sexually active use contraception. And some authors argue that adolescents with chronic, disabling conditions are at least
as sexually active as their able-bodied peers.
Healthcare providers also need to be educated on certain issues to help their patients make the best contraceptive choices. For example, estrogen/progestin combined contraceptives may theoretically increase the risk for DVT
in women who use wheelchairs, although this is extrapolated data from post-operative patients. By contrast, progestin-only preparations don't increase DVT
risk, but may increase the risk for osteoporosis. These risks are common to all women, but are exaggerated in women who have mobility impairments because they are not bearing weight on their legs.
Now, obviously, the child who is has spastic-quadruplegic cerebral palsy with profound mental retardation won't benefit from sex ed. But the parents sure can. Because of the brain damage, these kids often hit puberty quite young and are prone to sexual abuse. Parents have decisions to make regarding such issues as contraception and control of menstruation.
Here's a reference: "Melberg Schwier K, Hingsburger D. Sexuality: Your Sons and Daughters with Intellectual Disabilities.