SWAD Sex & Intimacy Card. This is a great icebreaker to start any awkward conversations! (Picture image for use on your mobile phone – just download it to your photo gallery) – It is free to share as much as you like as long as it remains the same as the original.
Supported Loving toolkit
Aids and equipment
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People have a right to support around their sexuality, which includes finding appropriate equipment and aids to facilitate sexual activities.
This toolkit page is about appropriate equipment and aids to facilitate sexual/intimate activities. This topic is important because sometimes people need grab rails and other aids to enable sex to take place. Also, introducing sex toys can make sex and intimacy more playful! People with disabilities can be just as interested in having more fun with intimacy as any able-bodied person! Not everyone can use mainstream sex aids or toys due to physical impairments.
Disability and sexual expression, are two of the nine characteristics of individuals protected by:
- Equality Act 2010
- Section 1 of the Care Act 2014 - relating to the Principle of Wellbeing
- UN Convention on the Rights of People with Disabilities (in particular, Article 19 of the Convention)
- Article 8 of the Human Rights Act 1998
- CQC report “Promoting Sexual Safety Through Empowerment Report 2020.”
This means that people have a right to support surrounding sexuality if they need this.
Physical touch increases levels of dopamine and serotonin, two neurotransmitters that help regulate your mood and relieve stress and anxiety. Dopamine is also known to regulate the pleasure centre in your brain that can offset feelings of anxiety. Physical touch is known to improve the function of your immune system, as well as reduce diseases such as those associated with the heart and blood. Some people need equipment and aids to enable them to access this therapeutic touch.
For disabled people (both with and without a sexual partner), an accessible sex toy may be their main mechanism for achieving orgasm. It has been proven that a certain frequency of ejaculation is necessary to reduce the risk of prostate cancer (for prostate owners). An extra benefit for people with muscle spasticity is that hormones released during orgasm can be a route to relaxing their muscles.
What are the most common challenges faced in this area and how best to support people to overcome them?
Disabled people, including those with hearing and visual impairments, may find it difficult to access shops or websites that sell sex aids. Some groups of people with learning disabilities, and autistic people have limited access to sex education, even if this was provided it would have been unlikely to have been sex-positive/pleasure-based. New legislation has been introduced which requires sex education to be taught in all schools from 2021, including special schools, which will hopefully remedy this. People may not be aware that such websites exist. Staff or carers may have, in the past, also prohibited access or discouraged usage due to restrictive organisational policies surrounding supporting sexuality. Professionals may be reluctant to ask people in assessments if they have any support needs surrounding sex or intimate relationships, which could include support around aids and equipment.
Professionals, including support staff, need to talk about sexual activities in the same way as we discuss other activities of daily living, such as eating and toileting. Regularly cover sexual expression in staff meetings to normalise these conversations. Display sex-positive information posters on noticeboards and have leaflets about sexual health matters alongside any other health-related information leaflets. An example of a good Easy Read information leaflet is in the resources section below. Ensure that staff teams are aware of your organisation’s sexuality policy, including support around aids/equipment and positioning. If no such policy exists… it’s time to generate one! While you are at it, include some content on sexual expression in your welcome pack and contract to set the tone of openness for the duration of their time with you.
If a person you support wants to buy a sex toy and has the capacity to choose the equipment, you can help them to do this. Sources of information on which pieces of equipment might be suitable, are not always presented in an accessible way eg British Sign Language (BSL), Easy Read, or audio versions. If someone you support wants to access a sex shop (eg Ann Summers), or some practical help with using a computer to access an online sex shop (eg The Pleasure Garden or Lovehoney) support staff can provide that support. Shop staff are very knowledgeable and virtually shock-proof and can help select a suitable device! Some people may not understand how to look after their sex toy and keep it hygienic. Explain that if sex toys are used, they must be cleaned as per the instructions that came with the toy. You may need to provide accessible information on how to do this.
As a result of their disability, some disabled people have short arms/no arms, and can’t reach their genitals without an aid. If a person wants to use a sex toy, but cannot use it independently, you can position the sex toy and then leave them to use it privately. There are sex toys that can be used ‘hands-free’. For example, the Pulse Solo Essential by Hot Octopuss allows for hands-free stimulation of a penis. For people with a vulva, Lovehoney's Venus Butterfly 10 Function Hands-Free Vibrator is designed to be worn alone or under underwear and the Venus Butterfly is bursting with 10 explosive vibration modes, which are operated by a wired controller. Bondage tape can be used to adapt a wide range of sex toys for hands-free use. It can be used to firmly fix toys in place to a pillow, bed or chair, without leaving any sticky residue.
Explain that using lube for masturbation can help avoid friction damage. There are some disabilities and health conditions that can cause vaginal dryness, making lube an essential part of a sex toolkit. Introducing a good quality lubricant can help reduce discomfort and increase pleasure during sex. The main types of lubricant are water or silicone-based. Water-based lubes are generally cheaper and can be used with all types of sex toys. Silicone lube is thicker and lasts longer but is sometimes incompatible with silicone sex toys.
If someone you support has not expressed a desire to purchase a sex toy or lacks the capacity to do so, but there are concerns regarding use of inappropriate objects or issues relating to poor technique, introducing one may reduce harm. Providing education about sex toys will be the first step, so that the person you support can access information about an item they may have never realised was available to them. However, any introduction of equipment for a harm reduction reason, without the informed consent of the person you are supporting, needs to be approached carefully, within a Multi-disciplinary Team (MDT) approach and as part of a best interest decision.
Pain from conditions such as arthritis and fibromyalgia can mean that a favourite sex position is no longer achievable. Neurological and muscle weakness factors can cause difficulty for some people in maintaining a body’s position during sex. The IntimateRider is a small swing chair especially designed to offer a natural gliding motion that will improve sexual mobility. No motors or springs, just the movement of your upper torso is enough momentum needed to enhance sexual performance. Certain pieces of equipment associated with BDSM sex play, (bondage, discipline (or domination), sadism, and masochism (as a type of sexual practice)), are quite clearly related to that use. However, some standard pieces of disability equipment, such as perching stools and hoists, could be used for sex. You can read more about the devices available here. If support surrounding positioning for sex is required, staff can assist with this, as agreed/documented in the support plan, but must not be present while sexual activity is taking place.
A significant amount of disabled people live isolated lives due to the lack of accessible environments in which to socialise. This can be an obvious barrier, like no ramp or lift access into pubs/restaurants etc, but can also be due to the lack of an accessible toilet. Access to toilet facilities may not be an obvious sex aid, but it’s hard to be relaxed and fully engaged socially during dates if you’re constantly calculating how long you can safely leave it before you need to change your stoma bag/continence pads etc. Factoring in commute times to a known accessible toilet is not something the general population generally gives a thought to. While there are more Changing Places toilets planned nationally in the near future, there will still be room for improvement.
Watch a selection of videos that show and describe some useful sex toys or equiptment, which could be used to enhance enjoyment either alone or as a couple.
Case study
Alex, a 35-year-old man with a learning disability, has been asking lots of questions about sex. It is impacting on the time available to care staff in supporting him with other daily activities. He has several pornographic magazines by his bed that have a lot of photos of semi-naked men in them, which some of the staff have been offended by. Alex’s support worker has noticed, when helping him with his personal care, that his penis is quite red and inflamed. The staff team weren’t sure what they could or couldn’t say to Alex, but knew that they had to do something, as the situation was starting to affect his health. The variety of attitudes within the staff team as to what should be done was also starting to cause friction.
Response:
- Provide an Easy Read general information leaflet about relationships, sex and sexual health. Invite a speaker from the sexual health team to demonstrate how the penis works on an anatomically correct model.
- Arrange for some extra hours to be added to Alex’s care package, while the situation is being resolved. Introduce clear boundaries regarding available time, who the best staff members are that he can discuss RSE matters with, and in what location.
- Advise staff that if the porn magazines are in Alex’s personal space, they should just be ignored - it is his home.
- The skin integrity of the penis should be dealt with pragmatically. Give advice regarding using lube, check back after a few days and refer to a health professional, if necessary. A sex toy like The Pulse Solo may be a better alternative to poor technique by hand stimulation.
Top tips
- Remember that the human body was built for pleasure, and pleasure should be available to everybody, no matter what their level of physical ability.
- Good sex can be clean, dirty fun... and laughter is fantastic medicine!
- People with disabilities should have the best possible opportunities to sexually express themselves, whether or not the sex is good, bad, or indifferent.
Lorraine Stanley, CEO of SWAD
The views expressed in the Supported Loving toolkit are not necessarily those of Choice Support.
Regarding aids, equipment and products listed on this toolkit page, Supported Loving and Choice Support cannot be held responsible for any damage or loss caused by any inaccuracy, or on linked sites/pages. Inclusion of a product is not an endorsement from Choice Support or Supported Loving.
Resources
SWAD (Sex With A Difference)
SHADA (Sexual Health and Disability Alliance)
SHADA’s mission is to support and facilitate the sex and relationship needs of all people with disabilities and is campaigning to remove the stigma attached.
TLC Trust
The TLC Trust is a branch of The Outsiders Trust, which is a social, peer support and dating club, run by and for people with invisible and visible disabilities. This branch of the charity focuses on the provision of sexual and intimate services that are paid for by clients to service providers.
SWAD (Sex With A Difference)
SWAD (Sex With A Difference) is a training organisation specialising in the area of disability and sex.
SPOKZ
Products and services aimed at enhancing one’s physical, mental and sexual wellbeing.
Enhance the UK, Love Lounge
Down to earth advice, and practical tips on sex, relationships and flirting. This has a lot of resources in BSL for people with hearing impairments.
Disability Horizons
Disability Horizons touches on every facet of disabled people’s lives. Articles aim to give you self-esteem, upskill you with invaluable knowledge and ultimately, enable you to achieve your goals.
Pleasure Garden
The Pleasure Garden is the UK’s inclusive sex shop. They believe that everyone – regardless of gender, sexuality or disability has a right to a fulfilling sex life. Pleasure is important.
Top Sex toys for disabled users
If you have a disability that makes intercourse, foreplay, or masturbation tricky, you may find one of our top sex toys listed here can enhance your sexual happiness.
Supported Loving toolkit
The Supported Loving network has produced a series of guides to help support people with issues surrounding sexuality and relationships.
Read more
What is Supported Loving?
For some people finding love is often more than just chemistry – it can come down to getting the right support
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Supported Loving network
Supported Loving is not a formal membership organisation. Anyone can take part, it is free.
Read more