How prejudice denies people with disabilities their sexual and reproductive rights – Bhekisisa

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Research finds that stigma and inaccessibility excludes people with disabilities from accessing sexual and reproductive health services. (Judita Tamošiūnaitė, Pexels)
  • Using sexual and reproductive health services can be difficult. This feeling of discomfort can discourage people from asking their doctor about birth control options or checking for infections.
  • For people with physical disabilities, there are additional challenges such as the prejudices of healthcare workers about their right to have sex and have children.
  • The South African Constitution grants people with disabilities the same access to health care as the rest of the population. But as the results of a South African study show, the reality is quite different.

Few people appreciate the prospect of using sexual and reproductive health services. Such encounters can be a little awkward at best, and at worst, uncomfortable enough to discourage anyone from doing what is necessary to maintain their health and well-being. Buying condoms, asking a doctor about birth control options, getting checked for infections, discussing whether or not you have any bleeding, erections, or not having them, are difficult for most people.

Therefore, sexual and reproductive health services should be organized with the emotional comfort of the user in mind. Doctors and nurses, the atmosphere in clinics, and even the physical layout of family planning centers should enable people to get past the frenzy and do what is necessary for their health.

But some potential service users are discouraged from seeking help, rather than being supported. When service providers have bad attitudes or do not know the situation of patients, buildings are inaccessible, and health facilities are poorly equipped, additional barriers to care arise.

People with physical disabilities are a group of people who may face these challenges while taking care of their sexual and reproductive health. People with physical disabilities are not a homogeneous group and there is a wide variety of experiences, functioning, histories and needs of individuals. We use the term “group” here to refer loosely to individuals with somewhat shared experience of conditions in the body which make it more difficult to perform certain activities and interact with the world around them. Yet despite this diversity, many people with disabilities share a common experience of difficulties accessing health services, including sexual and reproductive health services.

In our recently published delivered We document some of the experiences people with physical disabilities face when trying to use sexual and reproductive health services in South Africa. We have found that some service meetings are intolerably uncomfortable, creating barriers to access. These barriers prevent people with disabilities from realizing their right to health, independence and inclusion.

What people without disabilities think about the sexuality of people with disabilities

Between 2015 and 2017, our research group conducted a study on the sexual and reproductive health of people with disabilities in South Africa.

The study had two parts: the first was a large survey of South Africans without disabilities. We wanted to explore their attitudes towards sexuality and the sexual and reproductive health rights of people with disabilities. The second was a photo-voice study (participants were given cameras to document their lives) conducted among people with physical disabilities in the Western Cape. In the survey, we asked 1,723 non-disabled South Africans questions about dating a person with a physical disability. We also asked about their perceptions of the sexual and reproductive health rights and needs of people with disabilities.

The results has shown that many people without disabilities have problematic attitudes towards the sexuality of people with physical disabilities. They do not believe that people with physical disabilities have the same sexual health rights and needs as people without disabilities.

In the second part of our research, we asked 13 people about their personal experiences of sexuality and relationships as a person with a physical disability.

From results In this part of the project, nurses’ testimonies asked them why they had become pregnant when they “were not fit to be parents”.

A woman who uses a wheelchair spoke of trying to get contraceptives at a clinic: “Oh, the nurses were like that too, why? What are you doing here? I came to prevention… Why? Do you have a boyfriend? Yes, nurse, I have a boyfriend. No, it is not fair.

The attitudes that people with disabilities may encounter when trying to access sexual and reproductive health care are extremely dissuasive. Some of these problems may be related to health workers’ unfamiliarity with disability issues and their own discomfort.

Attitude issues aren’t the only concern.

Access – if people can get what they need – has at least three levels.

  • Is there an appropriate service to meet their needs?
  • If there is such a service, is it possible to access this service? For example, is there appropriate transportation? For example, can a wheelchair user enter the building where the service is offered? Can the user afford the service?
  • Are there social or cultural forces that prevent people from accessing services? For example, do others think they are not allowed to use these services?

One or more of these layers may apply to people with physical disabilities.

In terms of Politics and South Africa Constitution, people with disabilities have the right to the same access to all health care as the rest of the population. This includes sexual and reproductive health services. But as our research participants have shown, the reality is quite different. It is influenced by factors such as lack of access to transport, inaccessible buildings and untrained or inexperienced workforce. The policies and the theory can sometimes seem rather empty.

How stigma prevents people with disabilities from accessing sexual health services

Our to study disability and sexuality in South Africa has shown that the sexual and reproductive health rights of people with physical disabilities are routinely violated.

It also showed that much of this exclusion stems from assumptions about the sexuality of people with physical disabilities, especially those without disabilities.

Our research, like others studies, clearly shows that there are many prejudices about disability and sexual rights. Many people without disabilities believe that people with physical disabilities are asexual and that it is a problem if they engage in sexual activity. As a result, women with disabilities who are pregnant may be reprimanded for having had sex, for example.

The people with disabilities we have worked closely with (and who co-produced our book) tell story after story of feeling excluded and misunderstood about their sex lives and their decisions to have children. They emphasized the desire to make others recognize that people with disabilities are no different from people without disabilities – they represent a full range of sexual experiences and interests. Most importantly, they also represent the full spectrum of human needs for sexual and reproductive health services.

All layers of inaccessibility – from problematic attitudes of healthcare workers to conceptions of disability in society to the way buildings are constructed – need to be addressed so that people with physical disabilities can exercise all of their rights.

This article is republished from The conversation under a Creative Commons license. Read it original article.

Xanthe Hunt is Senior Global Health Researcher, University of Stellenbosch, Leslie Swartz is Professor in the Department of Psychology, University of Stellenbosch, Mark Carew is Honorary Research Associate at University College London, Poul Rohleder is Lecturer in the Department of Psychology Social and Psychoanalytic Studies at the University of Essex.

The conversation

Xanthe Hunt is a senior researcher in global health at the University of Stellenbosch.

Leslie Swartz is Professor in the Department of Psychology at Stellenbosch University.

Mark Carew is Honorary Research Associate at University College London.

Poul Rohleder is Senior Lecturer in the Department of Psychosocial and Psychoanalytic Studies at the University of Essex.


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