Sexual abuse of women and children with disabilities is another area that has received an increasing amount of attention. Much of this literature is based on studies that show that women with disabilities are at a much greater risk of being sexually abused than other women. This is true in society in general, and within residential facilities in particular. The literature listed below reflects these studies, as well as writings that have attempted to explain the increased vulnerability of women and children with disability to sexual abuse, and suggestions about what preventive measures can be taken. At the end of this section is a list of further resources on sexuality and sexual abuse. The author would like to thank Missy Morton for her help in preparing this section.
TITLE: The courage to heal: A guide for women survivors of child sexual abuse
AUTHOR: Bass, E., & Davis, L.
PUBLICATION INFORMATION: 1988
This book is written for women who have been sexually abused as children and is one of the most comprehensive book on this subject. This is a very powerful book which is written by and for women survivors of child sexual abuse. It contains these women's stories of the abuse and the healing process and talks about the damage experienced by secrecy and silence. The book is in accessible and readable language and gives practical advice about the healing process, both for those who have been abused and their friends and lovers. The book does not focus on women with disabilities specifically but it includes them as a part of the main text. Although addresses and resources are included throughout the book the last part of the book lists a wide range of resources and advice that can be of value in the healing process as well as an annotated bibliography of readings on a variety of topics related to child sexual abuse. The bibliography includes readings about women with disabilities.
TITLE: Sexual intimacy between psychotherapists and clients: Policy implications for the future
AUTHOR: Bouhoutsos J.C.
PUBLICATION INFORMATION: 1984
In L. E. Walker (Ed.), Women and mental health policy (pp. 197-206).
The author traces the problem of sexual intimacy between healers and their patients back to antiquity and gives a brief historical overview of attitudes towards such sexual activities. She reviews the research literature on therapist-client sexual involvement and finds, among other things, that the overwhelming majority of reported incidents occurs between male therapists and female clients, and that such sexual involvement with therapists has been shown to be harmful to client. The author goes on to state that complaints are very rarely filed and lists various reasons why female clients do not take actions to file complaints. She reviews clients' possibilities in filing complaints and lists the advantages and disadvantages of different courses of action. The chapter concludes by suggesting that prevention is the best solution, but prevention requires policy changes in many areas of the mental health system.
TITLE: New sex therapies: Policy and practice
AUTHOR: Cammaert, L.P.
PUBLICATION INFORMATION: 1984
In L. E. Walker (Ed.), Women and mental health policy (pp. 47-266).
This chapter addresses issues of female sexuality and describes the dramatic changes in attitudes and norms around female sexuality and sexual behavior which have occurred during this century. The author reviews the literature on female sexuality, female "sexual dysfunctioning," and effectiveness of sex therapy for women. Although researchers and sex therapists have begun to accept that women's sexual needs and desires are just as important as men's, there is still a danger for inappropriate treatment, based on stereotypical and outdated ideas of women's sexuality. The author therefore advises women, who seek sex therapy, to be careful when they select a sex therapist. The chapter concludes with a call for more research on female sexuality and claims that the little that is known is mostly based on samples of white, well-educated, middle-class, heterosexual American women. Our understanding of female sexuality must be based on the experiences of all women: women of color, single women, lesbian women, poor women, celibate women, and women with a variety of educational levels, as well as women of all ages.
TITLE: Facing the challenges of sexual abuse in persons with disabilities
AUTHOR: Cole, S. S.
PUBLICATION INFORMATION: 1984
This article addresses causes, myths, and prevention of sexual abuse of people with disabilities. The author represents the view that sexual abuse has more to do with oppressive use of power than it has to do with sex. This leads her to examine the links between power structures, oppression and abuse, as well as the links between various forms of oppression. She states that it is essential to identify and change societal beliefs and norms which permit sexual abuse and exploitation to continue. The power structures in our society provide males with more power than females, able-bodied persons with more power than people with disabilities, and so on. This makes the less powerful, such as women, children, and people with disabilities likely candidates for sexual abuse. The author also draws parallels between incest within the family and sexual abuse of people living in residential facilities. Among the parallels are: (1) the abuser is usually someone the victim is physically or emotionally dependent on; (2) the perpetrators are frequently respected members of their communities; and (3) the victim can have confusing and conflicting feelings of love and hate towards the perpetrator. Among preventive measures the author recommends are increased public awareness of how common sexual abuse is, assisting parents and staff to feel comfortable about all aspects of sexuality, identifying societal norms that contribute to abuse, and training and education for parents, caregivers, professionals, and individuals with disabilities.
TITLE: Responding to the sexuality of people with mental handicap
AUTHOR: Coley, L., & Marler, R.
PUBLICATION INFORMATION: 1987
In G. Horobin (Ed.), Sex, gender and care work(pp. 66-81).
This chapter states that the sexuality of people with mental handicap has been largely ignored and in the few instances where it has been considered, the response has been restrictive and over-protective. (The book is British and uses the word mental handicap for mental retardation). The authors trace some of the restrictive attitudes to the way human services are operated. For example, many group homes are run by Christian groups who insist that residents live up to what is see as "Christian principles of high morals and values."
The authors state clearly that people with mental retardation have the same rights and needs to enjoy their sexuality as anyone else, and should have the same right to marry or cohabit as anyone else.
Although the chapter does not direct much attention to issues of specific concern to women with disabilities it raises issues of great concern to them, such as forced sterilization and forced abortion.
TITLE: Who cares? A handbook on sex education and counselling services for disabled people
AUTHOR: Cornelius, D. A., Chipouras, S., Makas, E., & Daniels, S. M.
PUBLICATION INFORMATION: 1982
Based on a survey of 97 individuals with disabilities, the authors examine the myths that are created when we have a combination of disability and sexuality, and how both individuals and agencies react to the sexuality of people with disabilities. The authors state that, when we evaluate the responses of people and organizations, it is important that we differentiate between attitudes toward sexuality in general, attitudes toward disability in general, and attitudes toward disability and sexuality. The survey shows a discrepancy between the expressed need for services and what is actually available. Rather than creating special disability oriented services, the authors recommend the use of generic community based services.
TITLE: Prevalence of a history of sexual abuse among female psychiatric patients in a state hospital system
AUTHOR: Craine, L. S., Henson, C. E., Colliver, J. A., & MacLelan, D. G.
PUBLICATION INFORMATION: 1988
This is a study of the history of sexual abuse among women living in state psychiatric hospitals. A sample 105 women was randomly selected from 11 state hospitals serving mentally ill persons in Illinois. The women ranged in age from 13 to 81 and were of diverse racial and cultural backgrounds. The authors found that 51% of these 105 women had been sexually abused as children or adolescents, and that in the majority of cases hospital staff were unaware that these women had histories of sexual abuse. Only 20% of the 105 women believed they had been adequately treated for sexual abuse. The women who reported a history of sexual abuse were significantly more likely to have a range of symptoms commonly linked with sexual abuse. Despite this, 56% of the abused women had never been identified as victims of sexual abuse and were not being treated for the abuse. A recent study of the prevalence of sexual abuse in the general population reported that 16% of women reported incestuous abuse and 38% reported extrafamilia abuse, before the age of 18. The authors conclude that their study suggests that the prevalence of sexual abuse is much higher among women who become inpatients of psychiatric hospitals than among the general population, and call for increased awareness of sexual abuse from hospital staff and a more accurate diagnose, which would result in appropriate treatment of women who have histories of sexual abuse.
TITLE: Sexuality, schooling, and adolescent females: The missing discourse of desire
AUTHOR: Fine, M.
PUBLICATION INFORMATION: 1988
This article examines diverse perspectives on adolescent sexuality as well as current sex-education practices. The article is based on a thorough review of the literature, as well as the author's research on sex-education in public schools, and is informed by a study of numerous current sex-education curricula. The author identifies the three prevalent discourses of female sexuality inside public schools as being, (1) sexuality as violence, (2) sexuality as victimization, and (3) sexuality as individual morality. As a result, young women are educated primarily as the potential victim of male sexuality, they are not seen as sexual agents, and young women continue to be taught to fear and defend in isolation from exploring desires. The naming of desire, pleasure, or sexual entitlement, particularly for females, barely exists in the formal agenda of public schooling on sexuality. As an alternative to the prevailing discourses of female sexuality, the author presents a case for the discourse of desire, which would acknowledge female sexual desire and pleasure. Although this article does not mention women with disabilities it is very informing for anyone interested in female sexuality and sex-education, and provides an excellent framework to think about female sexuality and sex-education for all women, including women with disabilities.
TITLE: Sexual assault of handicapped individuals
AUTHOR: Longo, R. E., & Gochenour, C.
PUBLICATION INFORMATION: 1981
Based on their work with sex offenders the authors report that rape and child sexual assault are not related to sex but to issues of control and power. Abusers will look for and use vulnerability to create the opportunity to rape. This vulnerability is increased in people who are marginalized, dependent and in need of affection. The authors describe ways to support victims of sexual assault and emphasize that support is equally important for people with disabilities as it is for anyone else.
TITLE: Patterns of institutional sexual assault
AUTHOR: Musick, J. L.
PUBLICATION INFORMATION: 1984
Response to Violence in the Family and Sexual Assault, (3), 1-2 & 10-11.
This article describes a study which was designed to identify patterns of sexual abuse of patients in psychiatric settings and the institutional practices which contribute to the vulnerability of patients. The findings in this article were primarily derived from an analysis of 80 separate incidents of assaults reported by 26 former mental patients, and about 100 separate incidents reported by 39 facility staff. Among the disturbing findings of this study was that the assaults were most frequently perpetrated by male direct-care staff. That is, by the staff patients were most dependent on and with whom patients had the greatest amount of contact. Assaults by male patients against female patents tended to be violent rapes, while male staff assailants most often did not use direct force, instead many took advantage of opportunities when female patients were completely helpless, in restraints or heavily medicated. The author also provides a very insightful analysis of the institutional practices and structures which contribute to the vulnerability of inmates to sexual abuse.
This is the first article in a series of articles--based on the same research project--to be published in Response. People who are interested in learning more about this research project might want to trace these articles.
TITLE: Violence and sexual assault plague many disabled women
AUTHOR: O'Toole, C. J.
PUBLICATION INFORMATION: 1990
This article reports that recent research indicates that battering and sexual assault figures may be two to three times higher for women with disabilities than for other women. The article criticizes the general sexual assault and domestic violence programs for ignorning women with disabilities, and the disability community for not having been able to solve this problem. The auhor suggests ways generic sexual assault and domestic violence services can use to reach women with disabilities and describes a few successful attempts to include this group of women in generic programs.
TITLE: The something that happened before I was born
AUTHOR: Saxton, M.
PUBLICATION INFORMATION: 1985
In A. J. Brightman (Ed.), Ordinary moments: The disabled experience (pp. 127-140).
In this chapter the author talks about her experiences of being female and having a physical disability. Among the things she discusses candidly is her sexuality.
TITLE: Vulnerable: Sexual abuse and people with an intellectual handicap
AUTHOR: Senn, C. Y.
PUBLICATION INFORMATION: 1988
The author of this book claims that while sexual abuse has become a major issue in recent years, the sexual abuse of people with an intellectual handicap (i.e., mental retardation) has been virtually ignored in the public discussion and policy-making around the issue.
The author explores the myths surrounding sexual abuse and the myths surrounding people with mental retardation. The book focuses both on children and adults and the author shows how the myths surrounding disability contribute to the vulnerability of people with disabilities. This vulnerability seems to be well recognized, yet the author reports that it is almost impossible to get accurate measures of either prevalence or incidence of sexual abuse. Through a review of the literature which contributes to the understanding of sexual abuse of individuals with mental retardation the author suggests: (1) when sexual abuse is reported, 99% of the victims are assaulted by people known to them, (2) only 20% of assaults are reported, and (3) depending on the sampling and information gathering techniques used, estimates range from 25% to 83% of women, and up to 32% of men, with mental retardation have experienced sexual abuse. The author concludes that children with disabilities are at higher risk for sexual abuse than other children and adolescents, and that girls and women with disabilities are the most likely victims.
The author describes ways people with mental retardation use to indicate that they have been sexually abused and explores treatment and prevention issues. The book also addresses issues such as inaccessibility of services for individuals with mental retardation, offenders who have mental retardation, and legal issues in sexual abuse of children. The book concludes with recommendations to protect individuals with mental retardation from sexual abuse.
This book is, to the best of my knowledge, the first comprehensive study of sexual abuse of people with mental retardation.
TITLE: Sexuality, disability, and abuse: An annotated bibliography
AUTHOR: Sobsey, D., Gray, S., Wells, D., Pyper, D., & Reimber-Heck, B.
PUBLICATION INFORMATION: 1990
This annotated bibliography lists literature from a wide range of disciplines and perspectives relevant to sexual assault and abuse of people with disabilities. It is an attempt to provide a comprehensive review of the literature in this area and lists research studies, position papers, program descriptions, clinical reports, and media accounts. This should be an excellent resource for anyone looking for materials on sexual assault and abuse of people with disabilities.
This annotated bibliography will also be distributed through TASH, The Association for Persons with Severe Handicaps, 7010 Roosevelt Way, N.E., Seattle, WA, 98115.
TITLE: Sexual assault and abuse of people with disabilities: Networking directory
AUTHOR: Sobsey, D., Wells, D., & Gray, S. (Eds.)
PUBLICATION INFORMATION: 1989
This networking directory is intended to facilitate communication among people concerned about sexual abuse of children with disabilities, sexual assault of adults with disabilities, sexual assault of adults with disabilities, and other forms of sexual exploitation of individuals who have disabilities. This area of concern crosses a wide range of disciplines and a wide range of related topics. The directory reflects this by listing individuals representing a wide range of roles, disciplines, and interests.
The directory includes names, addresses, phone numbers, and brief descriptive information for each person listed. A number of indexes have also been included to assist the readers in locating the particular information they require.
The directory is not a comprehensive listing of people with this concern, and although the editors would have liked to include all individuals in North America, their location in Western Canada has resulted in over-representation of individuals from that area. Despite this geographical bias this directory should serve as a good starting point.
TITLE: Women in the mental health system
AUTHOR: Stefan, S.
PUBLICATION INFORMATION: 1987
In this short article the author points out that many of the problems confronting women in psychiatric settings are similar to those women face in society at large: sexual abuse and lack of control of their own bodies. But she claims that these problems are greatly magnified when a woman is institutionalized. An institution is by its very nature an authoritarian, hierarchical place where men exercise even more control than in the society outside the institution. Rape and sexual assault are major problems in many institutions. As an example she cites a survey conducted in Texas mental health facilities where the clients themselves ranked rape or sexual assault as the most serious area of abuse and neglect. Other specific issues facing women in the mental health system are related to pregnancy and mothering. Pregnant women are often given psychoactive drugs that may affect the fetus and there are reports of pregnant women who have been given electroconvulsive therapy. With regard to mothers she claims that the mental health system tends to separate women from their children rather than provide the supportive services they need to maintain the family unit. Evidence shows that some women, especially low-income women, avoid seeking treatment because they fear that their children will be taken away as a result. Susan Stefan claims that both lawyers and mental health advocates have made little effort to address these issues systematically.
TITLE: Violence against women: Implications for mental health policy
AUTHOR: Walker, L. E.
PUBLICATION INFORMATION: 1984
In L. E. Walker (Ed.), Women and mental health policy (pp. 197-206).
This chapter describes how the concern for women's safety from men's physical and sexual violence has been an important factor in promoting changes in mental health policies. The author provides a short historical overview of the responses to women who were victims of violence and sexual assaults and the increased awareness and recognition of the extent of violence and sexual abuse of women. The chapter outlines legal and psychological developments which have influenced a change in public policy. The author concludes that despite recent developments, the legal and the psychological systems still operate with sexist biases against women, especially those women who are victims of violence and sexual abuse.
TITLE: Talking about the best kept secret: Sexual abuse and children with disabilities
AUTHOR: Watson, J. D.
PUBLICATION INFORMATION: 1984, September
This article discusses sexual abuse of children with disabilities and outlines the following reasons why these children are more vulnerable to sexual abuse than other children: (1) they are more likely to be dependent on adults for physical and emotional care, (2) they are encouraged to be passive and compliant, (3) they lack information or experience about appropriate sexual behavior, (4) the reluctance of families and institutions to discuss sexual abuse. The author makes suggestions about how to prevent sexual abuse, and how to respond to actual or suspected abuse.
Disability Studies Quarterly
Summer 1989, 9(3)
This issue focuses on "The politics of sex and disability," and contains a wealth of information and resources.
Sexuality and Disability
This journal is a good source of information about issues of sexuality and sexual abuse. The journal was published regularly for a number of years, but has been published irregularly since 1987.
Response to Violence in the Family and Sexual Assault
This journal frequently contains articles and resources on sexual abuse and violence against women and children.
Coalition on Sexuality and Disability
This coalition is a network of people with and without disabilities committed to advancing the full social integration of people with disabilities. The coalition wants to increase the availability of accessible, client-responsive sexual health information and services. Members of the coalition act as educators and advocates for the right of people with disabilities to a full social and sexual life. The coalition publishes a newsletter focusing on current issues and developments in the area of sexuality and disability, including a listing of publications, conferences and other events that may be of interest to its members.
SIECUS
This is an educational organization established in 1964 to promote healthy sexuality as an integral part of human life. It publishes bibliographies of current materials and resources in over 80 specific categories. Two of these bibliographies focus on disability and sexuality: "Sexuality and disability," published in March 1986 (6 pages nearly 100 items), and Nov-Dec 1988 "Sexuality and the developmentally disabled" (3 pages 25 items). These bibliographies list books, curricula materials, teaching aids, audiovisual material, organizations, and information about databases. SIECUS has information and library services where people can requests information on specific topics.
University of Alberta: Sexual Abuse Prevention Project
One of the research projects at the University of Alberta is a study of sexual abuse of people with disabilities. Project staff have compiled a wealth of information and have published an extensive annotated bibliography on sexual abuse and a networking directory (both reviewed earlier in this section).
The project has also collected and analyzed cases of sexual abuse of people with disabilities, and are in the process of identifying and developing improved methods for abuse prevention, detection, reporting, and treatment. Additionally, the project intends to prepare model protocols for police, social services, educational, health care, and a number of other key community agencies. For more information contact Dick Sobsey at the address above.
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