Feature Issue on Sexuality and Gender Identity for People with Intellectual, Developmental, and Other Disabilities

Law & Policy:
Current Challenges to Developing Sexuality and Gender Identity


Quinn Oteman (he/him) is a graduate research assistant at the Institute on Community Integration and a doctoral student in social work at the University of Minnesota in Minneapolis. otema001@umn.edu

People with disabilities are facing threats to their self-determination and identity as sexual beings. Only three states specifically require that students with disabilities receive sex education in schools and a recent study showed 36 states exclude them from sex education requirements or do not provide accessible sex education learning materials. Today, several states are making it more difficult for people to receive healthcare supporting their gender identities. The American Civil Liberties Union says that there are 491 anti-LGBTQ+ bills across the country. Students with disabilities often experience meanness at school due to their disability or to their sexuality or gender identity, or all three. As of 2022, states including Oregon and Washington started requiring sex education programs that are accessible and inclusive of youth with disabilities. Several states, including Minnesota, are considering other ideas for sex education that is of good quality. The disability community and the wider community need to come together to support these ideas. We have to speak out to make sure people with disabilities get the healthcare and other support they need to live their best lives, and that includes their sexual lives and gender identities.

A lesbian couple in wedding dresses and veils are surrounded by their friends. They are outside in front of a stage with pink balloons.

In September, the Disability Rights Education & Defense Fund held a mass commitment ceremony for couples and allies to call for legislation to end the marriage penalty causing some people with disabilities to lose their Social Security benefits when they marry. Photo Courtesy of DREDF.

Entangled in a dichotomy between calls for better sex education and legislative backlash in the United States against it, people with disabilities today face significant challenges to their self-determination and identity as sexual beings.

Just three states explicitly require sex education be provided to students with disabilities, and five mandate accessible health education, according to a recent study by SIECUS: Sex Ed for Social Change , a not-for-profit advocacy organization. The report, based on 2021 data, noted that 36 states exclude youth with disabilities from sex education requirements or do not provide accessible curricula.

Meanwhile, states are placing mounting restrictions not only on sex education for all students, but on gender affirming healthcare, and other rights. In a 2023 mid-year report, SIECUS found that nearly two-thirds of 749 legislative bills related to sex education, LGBTQ+ rights, access to reproductive and gender affirming health care, and similar topics proposed to restrict rights , an increase of 24 percent over year-ago levels. In another report, the American Civil Liberties Union identified 491 anti-LGBTQ+ bills across the country. Earlier this year, Canada’s foreign affairs department issued a travel advisory to its citizens, warning about the U.S. restrictions.

Thirty-two states use abstinence-only- until-marriage (AOUM) programs when teaching about sexually transmitted infections (STI), the 2021 SIECUS report found, which limits the amount of information an educator can give about contraception. In addition, 40% of states do not require sex education to be evidence-based or culturally appropriate .

Beyond laws and education policy, students with disabilities often face a hostile climate at school, either due to their disability or their sexuality/gender identity, or both, as noted by the Gay, Lesbian & Straight Education Network (GLSEN). In its 2021 National School Climate Survey, nearly three-quarters (72.6%) of students heard negative remarks about students’ ability/disability on a regular basis and most LGBTQ+ students (75.7%) heard sexist remarks on a regular basis.

These struggles are rooted in a long history of oppression that includes forced sterilization, eugenics, and the societal perception that individuals with disabilities, particularly those with intellectual and/or developmental disabilities (IDD), were inherently asexual or unable to love someone romantically. Even today, people with disabilities can lose vital government benefits if they marry. Further, the anti-LGBTQ+ legislation should raise red flags for anyone in the political space who supports sexual health education for youth with disabilities, because the number of youth with disabilities who identify within the LGBTQ+ community is sizeable and their experiences in school are not getting better.

Potential Solutions

Promising initiatives to include people with disabilities in research and policymaking around sexuality and gender identity and to make high-quality sex education more accessible across the country need to be supported and expanded, not only for the health and safety of people with disabilities, but in regard for their inherent human rights.

In a 2017 scholarly commentary in the American Journal of Sexuality Education, researchers at the University of Nevada argued that receiving a holistic sexual health education depends largely on where a student lives . Some states offer abstinence-based sexual health education, while others provide comprehensive sexual health education. An abstinence-based approach teaches the individual that they should simply avoid any form of sex. Research has shown that this narrative has been ingrained in the culture of the United States for centuries and, despite its ineffectiveness, has been the common approach to teaching sexual health to youth in K-12 education for many years.

Comprehensive sexuality education, by contrast, employs a curriculum that helps people understand all aspects of sexuality, develop positive relationships, consider how their choices affect their own and others’ well-being, and protect their rights, according to UNESCO’s Comprehensive Sexuality Education Implementation Toolkit .

As of 2022, states including Oregon and Washington have been successful in implementing policies—that have subsequently become laws,—to require comprehensive sex education that are accessible and inclusive of youth with disabilities. Oregon requires that sex education include HIV/STI education and information on healthy relationships; be age appropriate, evidence-based, culturally appropriate, and medically accurate; and cover contraception. Several states, including Minnesota, are grappling with similar changes , offering hope for a more inclusive future. Minnesota state legislators, for example, have proposed a bill to identify one or more comprehensive sex education programs for elementary and secondary school students. Initiatives like these, while promising, will need active support from and beyond the disability community.

In addition to formal education in schools, a significant number of published and on-demand resources have been created in recent years that are also promising, but ensuring they can reach broad cross-sections of the disability community in culturally appropriate ways remains a challenge. People can’t use resources if they can’t find them, and the confusing array of policies and legislation across states makes it very difficult to find trusted, accurate sources of information.

A Look Ahead

People with disabilities still struggle to be recognized as sexual beings — in court, in the doctor’s office, in policies and the law, in film and television, and in their communities.

As we learn more about the wants and needs of people with disabilities regarding their own sexual identity, sexuality, and relationships, it is important for researchers, policy makers, practitioners, and families to honor them. We must develop and require coursework that allows people with the full spectrum of disabilities, from diverse cultural and ethnic communities, to explore the joys and responsibilities of sexual relationships and identity. This education should be anatomically correct and align with the standards outlined by the Future of Sex Education Initiative , a partnership between SIECUS and other organizations.

We must insist on appropriate healthcare as people with disabilities live into their sexuality and gender identities. And we must train direct support professionals, doctors, teachers, parents, and others about the ways to support people with disabilities as they pursue intimate relationships and/or their own identities, critical components to living a full, happy life.

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