Perspectives of Portuguese People with Physical Disabilities Regarding Their Sexual Health: A Focus Group Study

Abstract

The World Health Organization has considered sexual health as a major dimension of global health and a sexual right. However, the sexual health of people with physical disabilities is still poorly addressed by health and social care professionals, and it is very stigmatized by society. This study aimed to assess the perspectives of Portuguese people living with physical disabilities regarding issues affecting their sexual health. Nine women and 17 men with different physical disabilities participated in the study. Participants were recruited from a professional rehabilitation facility located in the North of Portugal and were assigned to four groups in one-hour sessions. Three main categories emerged from the content analysis: (1) meanings and beliefs regarding sexuality; (2) experiences of sexuality; (3) necessary changes. Despite the positive social changes towards sexuality, participants expressed that their sexual rights are still unfulfilled, as they live in a context that perpetuates their dependency. They pointed out low self-esteem, prejudice and social isolation, poor architectural accessibility and scarcity of financial support as some of the barriers to their lives and their sexual health. Finally, participants identified the main needs regarding their sexual health, such as: access to specialized information; training for health professionals. This study gives voice to people with physical disabilities and sheds light into both individual and contextual factors affecting their sexual health. Of utmost importance, this study draws attention to the need for reinforcing sexuality of people with disabilities in the social agenda and brings implications for future research and practice.

Sex workers’ narratives about clients with disabilities: can training improve sexual health in Portugal?

“…The discourse of sex workers match the interest expressed by Portuguese people with disabilities in experiencing sexuality and pleasure (Pereira;Nobre, 2018), which is a human right (WAS, 2019). The involvement of penetrative practices was frequent and are common among untrained professionals (Limoncin et al, 2014).…”

“…This might be explained when people with disabilities mention the lack of resources and social stigma in the Portuguese context, which directly affects sexuality and leads to sexual inhibition. Even the clients who overcome the difficulties of accessing sex work tend to search for commercial sex services by themselves because social networks do not help them achieve sexual expression (Pereira;Nobre, 2018).…”

“…Specifically in Portugal, Santos & Santos (2017) draw attention to a constant desexualization of this group of people. Moreover, recent research on the perspectives of Portuguese people with physical impairments about their sexual health point out to several physical, social and economic barriers, such as lack of accessibility in public spaces, social isolation, stereotypes, and poor financial support (Pereira;Nobre, 2018).…”

“…Some people with disabilities show a desire for romantic relationships as the base of sexual expression (Gammino; Faccio; Cipolletta, 2016; Lane; Cambridge; Murphy, 2019). In fact, the sexual sphere is more easily addressed by health professionals when the person is in a relationship (Pereira;Nobre, 2018); in a dating scenario, general population also manifest higher acceptance towards the sexuality of people with disabilities (Girard;Sastre;Mullet, 2018). Yet, nondisabled people, fearing social stigma and possible dependency, report concerns in establishing a relationship with people with disabilities (Hunt et al, 2017).…”

Sexual Behaviors and Sexual Perceptions of Portuguese Adults with Physical Disabilities

“…The silence surrounding sexual problems and physical disabilities is reflected in the lack of social role models and reliable and accessible information throughout the world [18], which are key components of being able to make autonomous decisions about sexual behaviors [19]. This is also the case in Portugal, where there is still much progress to be made regarding the deconstruction of myths and spreading a political and social message that people with physical disabilities' right to a sexual life is as important as their rights to accessibility, employment and other basic rights [20]. Furthermore, research on sexuality and physical disabilities in Portugal is still scarce, and more studies are necessary to consolidate this research field in the country.…”