People with TBI have the same relationship and sexual rights and responsibilities as everyone else.

Isolation and myths about the sexuality, or lack of it, of people with disabilities have deprived many people of information, skills or opportunities and made it difficult for them to exercise their rights and responsibilities in sexual functioning.

Workers in this field need clear information about sexuality as well as practice in talking about sexuality, so that they can be good allies to people with TBI. Being a good ally means working with their clients to support and maintain their human and sexual rights. It also means helping to break down myths and misinformation that people in the community may still believe about the sexuality of people with TBI.

( Adapted from Double Taboo: Sexuality and Disability produced by the Family Planning Association of NSW, 1990.)

Common myths

Common myths are that:

• people who have a cognitive or physical disability are asexual – they can’t do it and they don’t want it
• people who become disabled are no longer attractive to their partners
• sex is physically painful for people who have disabilities
• having to plan new positions and strategies for having sex destroys intimacy
• allowing people with cognitive disabilities access to sexual information or activity will lead to uncontrolled and inappropriate sexual behaviour
• there are no avenues for sexual expression available to people with disabilities
• people with cognitive disabilities cannot learn appropriate sexual and relationship behaviour
• they are best protected from exposure to any experience that might have a sexual aspect
• people who have severe disabilities are so unattractive to others that there is no need to protect them against sexual exploitation nor to teach them self-protective behaviours.

Countering the myths:

• People with TBI or other disabilities have the same range of needs for relationships and sexual expression as others in the community.
• People who acquire a disability may still be sexually attractive to their partners; although changes in roles in their relationship may affect the level of sexual desire, for example where one person becomes the carer for the other.
• There is no evidence to suggest that sex is more painful for people who have a disability. Experimenting with new positions for sexual intercourse can reduce discomfort where there is a physical disability.
• Having to plan position and timing may reduce spontaneity, but sex remains an important physical expression of intimacy even without previous levels of spontaneity.
• Access to information, skills acquisition and appropriate psycho-sexual opportunities are safeguards for both people who have had head injuries and the community. Even family members who are strongly opposed to sexual information being given, may see the sense in ensuring that their relative with a TBI has enough information to be safe from sexual exploitation.
• There are opportunities for sexual expression for almost everyone. These may include masturbation, erotic literature and videos, fantasy, long-term sexual relationships and visits to sex workers.
• Most people with cognitive disabilities can learn appropriate sexual behaviour. The
  content and method of teaching information needs to be tailored to fit their needs and best means of learning new information.
• All people are sexual beings. Protecting people with TBI from exposure to sexual
  experiences will not stop them from having sexual feelings; it will only limit their
  understanding and experience.
• Sexual abuse or exploitation occurs because of a power imbalance between individuals, not because of physical attractiveness in a stereotypical sense. Thus everyone needs to have some self-protective behaviours, as well as living with defined rules that limit the opportunities for others to exploit them sexually.