Approximate reading time: 5 minutes

Ability is not something we either have or don’t have; rather it is a concept that lies in perception, constantly in flux as we cope with pain, emotional distress, sickness and accidents. Neurodivergent or physical differences that we could be born with can give us insight into the way society is often created without flexibility in mind, as we develop techniques to navigate and live our lives to the fullest. The qualities of being differently-abled or disabled exist on continuums from visible to invisible, and are experienced in ways that are psychological and physical.

Sexuality connects with ability in profound ways that can be beneficial to explore. While people who are differently-abled or disabled are often placed together under these umbrella terms, the reality of individuals’ experiences is vast and multidimensional. The mainstream media effectively erases the experiences of individuals who are differently-abled or disabled, and, through reduced representation, limits opportunities for individuals to see people like themselves engaged in relationships and exploring their sexuality.

Psychological Health

Looking at sexuality as it connects with mental health is vitally important because people who are coping with conditions like anxiety, depression, bipolar disorder, ADHD, trauma, schizophrenia, and substance dependence may experience changes in their self-perception related to the status or severity of current flare-ups of their symptoms. Sexual risk-taking behaviour, relationship distress, taking medication (prescribed or self-medicating), and body image are interwoven with mental health status and sexual functioning. Some symptoms can either increase (i.e., manic episode) or decrease (i.e., depressive episode) sexual desire or responsiveness, or increase risk-taking behaviours. Medications often have sexual side-effects that can be addressed by changing medications (after discussing this with a doctor) or seeking substance use treatment. People who are neurodivergent or who experience cognitive impairments are sometimes desexualized by caregivers, teachers and healthcare workers, which opens them up to engaging in risky behaviours because they do not have access to much-needed information regarding their bodies, boundaries, and consent (Manoj & Suja, 2018; Grove et al., 2018). Thus, education, resources, and support tailored to each individual’s experiences and related to their psychological abilities are necessary.

Providing individuals with the tools to understand their mental health diagnoses and the ways in which these connest with their sexuality can be empowering. Mental health symptoms can also make people feel uncomfortable and uneasy within their minds and bodies (dysphoria). For instance, normalising and validating the way that hypervigilance and trauma reminders can interfere with relationship intimacy and sexual engagement, and developing methods to cope with the underlying trauma, will benefit sexual functioning. Treating people holistically and recognising that sexual difficulties are often a surface-level symptom for other interconnected struggles is important.

Physical Health and Pain

Being differently-abled or disabled physically can be something people experience across their lifespan, or developed at some point in time. Some people may be able to fully heal and some may have residual symptoms. Illnesses can be acute (sudden) or chronic (present over a long period). These experiences may be visible (e.g., wheelchair, cane, hearing aid, hair loss) while others may be invisible (e.g., pain levels, fatigue). Some examples of physical health concerns are: cardiovascular diseases, cancer, autoimmune diseases, diabetes, multiple sclerosis, cerebral palsy, experiencing visual or auditory differences, and spinal cord injuries (paraplegia and quadriplegia). All of these can impact desire and cause sexual difficulties. Relationships with one’s own body and self-perception shift throughout different stages of illness, pain, frustration, and acceptance. Relationships with others change as lovers may also become caregivers and feelings of weakness or relying on others can cause strains in this dynamic. Reframing roles and letting go of labels allows for greater possibilities. Loss of a body part due to a surgery or injury can cause specific self-image alterations, challenge feelings of attractiveness and self-worth, and cause people to question aspects of their femininity and/or masculinity.