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Talking About Sex is Like Rolling the Dice: You Never Know What Will Come Up !. RCPA Conference Rehabilitation & Community Providers Association October 9, 2014 Presented by Beverly L. Frantz, PhD Institute on Disabilities, Temple University. Pandora’s Box Disability & Sexuality.

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talking about sex is like rolling the dice you never know what will come up

Talking About Sex is Like Rolling the Dice:You Never Know What Will Come Up!

RCPA Conference

Rehabilitation & Community Providers Association

October 9, 2014

Presented by

Beverly L. Frantz, PhD

Institute on Disabilities, Temple University


Pandora’s Box

Disability & Sexuality

Everyone not on the same page




Personal experiences

Lack of “how do”

the cost of sexual violence
The Cost of Sexual Violence
  • Each rape costs approximately $151,143 (DeLisi, 2010)
  • Traumatic experiences such as sexual violence can interfere with the ability to hold a job. (Bassuk, Meinick, & Browne, 1998).
  • Between 50% and 95% of women develop post-traumatic stress disorder (PDST) after being raped. (Johns Hopkins University School of Public Health, 1999)
    • What does this look like in terms of women with developmental and intellectual disabilities?
it s about us
It’s About Us!

Our experiences, personal and professional, shape the perspective we ultimately bring to bear on how we provide services and supports to people with intellectual and developmental disabilities.


The acceptance of sexuality and its manifestations has changed in recent decades to being considered a normal feature of the identity of each individual. Franco, Cardodo, Neto, 2012

However, people with intellectual disabilities have not benefited from this change in attitudes.

times have changed
Times Have Changed

Sexuality has long been closely related with the genital aspects, and its expression related only to marriage, regulated by moral and religious precepts.


because of the 20th Century social and cultural revolutions, sexuality is no longer understood as merely biological, but became inseparable from the basic identity of a person.


Person Centered Planning uses a series of charts/maps/symbols to engage the focus person and their family/community in planning.

impact of our silent assumptions
Impact of Our Silent Assumptions

…there are certain “silent assumptions” that probably still lurk in your mind. David Burns, 1980

aka: bias, stereotype, discrimination, belief, value, etc.

what s the difference sex or sexuality
What’s the Difference: Sex or Sexuality?

Anna Freud wrote:

“Sex is something you do, sexuality is someone you are.”

Parent of a Self-advocate said:

“Sexuality is between your ears, and sex is below your waist.”



Is a continuous experience

Is an integrated experience

Is shaped by family, culture, religion, education, personal experience, the media

Institute on Disabilities, Temple University

what is sex
What is Sex?

Dictionary definitions:

  • Sex is a way of distinguishing male and females members of a species…usually by their reproduction functions.
  • Sex refers to intercourse or coitus, an act that can result in reproduction.
  • Sex refers to the genitals.
memory road trip
Memory Road Trip
  • In high school, how

did you demonstrate

your sexuality?

  • How did you learn about sex?
  • How would you have liked to learn about sexuality and sex?
professionals said sex is
Professionals Said Sex Is…
  • complex
  • a main avenue for reproduction
  • a strong emotional bonding between people
  • an expression of love
  • consent of two people to kiss, touch and share an intimate experience together
professionals said sex is1
Professionals Said Sex Is…
  • a boy and a girl
  • not until you are married
  • the physical interaction of two individuals for the pleasure or stimulations of one or both of them
  • physical intercourse between animals
  • an intimate relationship between a married man & woman
components of sexuality




Five Components of Sexuality









All aspects of sexuality are influenced by a person’s self-esteem and personal sexual beliefs, attitudes, values and knowledge. It is also influenced by ethical, spiritual, cultural and moral concerns.

HUMAN DEVLOPMENT: Human development is characterized by the interrelationship between physical, emotional, social and intellectual growth.

SEXUAL BEHAVIOR: Sexuality is a natural and healthy part of life and individuals express their sexuality in a variety of ways.


Reproductive Physiology & Anatomy Growth and Development • Puberty• Reproduction• Climacteric & Menopause

Body ImageSelf-Esteem

Sexual Identity and OrientationGender Identity and Roles

EMOTIONS AND RELATIONSHIP: All human beings have the ability and need to experience emotional closeness to other and have it returned.


MasturbationShared Sexual BehaviorAbstinenceHuman Sexual ResponseFantasy


FamiliesFriendshipsLoving, Liking and CaringFeelings of Attraction & DesireFlirtingDatingIntimacyMarriage & Lifetime CommitmentsRaising Children


Sexual Abuse and IncestRapeManipulation through SexSexual Harassment


ContraceptionAbortionInfections and STis and HIV

Reproductive Health: • Genital Care• Breast Self Exam• Testicular Self Exam• Prenatal Care• Infertility

Sexual Dysfunction

SEXUAL HEALTH: Sexual health requires specific information, attitudes and actions to avoid the unwanted consequences of sexual behavior. It includes the care and maintenance of the sexual organs, attitudes and behaviors related to reproduction and health consequences of sexual behavior.

SEXUAL VIOLENCE: Sexual violence is any violence (abusive or unjust use of power) that has a sexual aspect or element. Sexuality can be used to influence, control or manipulate others.

erogenous zones

Erogenous Zones

Areas of the body that has heightened sensitivity, the stimulation of which may result in the production of erotic sensations or sexual excitement.

Erogenous zones are generally found on all humans, they are not specific from one person to another, and may not work depending on a personal sensitivity.

erogenous zones employment

Erogenous Zones…(employment)

are areas of the body that are particularly responsive to sexual stimulation.


Primary: areas that contain dense concentration of nerve ending

Secondary: other areas of the body that become eroticized because

they are touched within the context of sexual intimacies.

primary secondary

Mouth (lips, tongue, entire oral cavity)




Inside of thighs



Primary Secondary








Breast (especially nipples)

sex and mind

Sex and Mind

The mind is the greatest sex organ.

How we think and feel about our bodies and ourselves, and how we interpret the physical contact we have with others is really what distinguishes good sex from bad sex.

sex and spirit

Sex and Spirit

For Some…sex is spiritual because they feel like it brings them closer to a “higher power”

For Others…it is their personal religious beliefs that guide their sexual behavior

Regardless…of how it impacts you, your religious or spiritual beliefs and convictions make up part of your personal definition of sex.

sex and health

Sex and Health

The World Health Organization defines sexual health as:

“…a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity.

Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence.

For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled.”

fun fact

Fun Fact

What was the date of the “Free Love Movement?”

a. 1820

b. 1920

c. 1960

d. 2003

Institute on Disabilities, Temple University

friendship and relationships
Friendship and Relationships

Institute on Disabilities, Temple University

healthy relationship mutual and consensual
Healthy RelationshipMutual and Consensual

Mutual Interest





Sexual Intercourse

Friendships and Relationships Come in all Forms and Many will Change Over Time.The meaning of friend & touch also changes over time.
relationship skills

Relationship Skills

Developing successful relationships can be difficult, particularly for individuals with disabilities.

Everyone enjoys being chosen as a boyfriend or girlfriend.

Successful relationships don’t all lead to marriage or sexual intercourse.

what s the difference

What’s the Difference?

Friend Friendly Friendship

Girl friend Girlfriend

Boy friend Boyfriend

Institute on Disabilities, Temple University


Institute on Disabilities, Temple University


TOUCH is the “mother of all senses”

Our tactile system is the earliest sensory system to become functional (in the embryo) and be the last to fade (Fosshage, 2000).

It is our only reciprocal sense – we can not touch another without being touched ourselves

touch ethnicity culture
Touch, Ethnicity, Culture
  • The meaning of touch can only be understood in its cultural context.

(Halbrook & Duplechin, 1994)

  • People from different cultures were observed in casual conversation and the number of times they touched in one hour were counted.(Jourard, 1996)
      • Puerto Rico – 180 times Paris – 110 times
      • United States – 2 times London – 0 times
good touch bad touch
Good Touch/Bad Touch

Touch is tangible and reciprocal (concrete).

Describing touch is based on speech, vocabulary, experience, culture, and more (abstract).

When describing touch both the sender and receiver must be on the same page, understand the intensity and emotion of the touch.

when is an embrace a hug or a hold
When is an Embrace a Hug or a Hold?

How do you tell the difference?

  • Personal experience
  • Professional experience

Are the consequences the same?

Is a “label” created?

case scenario
Case Scenario___________________________
  • A 20 year old young woman with Down syndrome attends a public school and discloses to her mother that the boy “bothered” her.
  • The young woman’s behavior changed. Family physician and psychologist recommended medication.
  • Six months later the young women stated the boy “hurt” her.
  • Police are called.

The Full Frontal

Total body contact, heart-

To-heart embrace and firm

Squeeze. For parents, children

And good friends

Time, February 23, 2009


The Ass-Out Hug

Nothing touches below the

Shoulders. Reserved for the

Office, bad dates and references

To Vince Vaugn

Time, February 23, 2009


The Hip-Hop Hug

A.k.a. the man hug and the

Hetero hug. Shake with right

Hand and hug with left, two

Slaps on back

Time, February 23, 2009

social skills and sexual etiquette



social skills sexual etiquette

Social Skills/Sexual Etiquette

Social skills/etiquette are behaviors and convention that let others know what we want without being rude, disruptive, etc.

They are the passport to acceptance.

social sexual contract expectations and manners

Social/Sexual Contract, Expectations,and Manners

Social contacts and expectations are more than manners.

Example: Stopping for a cup of coffee

Stand in back of line

Move up in line

Decide what you want to order

Get your money ready

Place your order

Pay for your order

Receive your order

sex fun fact 2
Sex Fun Fact # 2

Were Kellogg's Cornflakes developed to support the medical model of self-restraint and abstention from masturbation.

True or False

language and vocabulary



sexual language

Sexual Language



Accurate sexual language

Appropriate sexual language

Appropriate sexual expression

Understanding intent and consequence

past vs present

Going together

Getting pinned

Going steady


Making Out

Getting to 1, 2 or 3 base

Going all the way

Past vs. Present


Friends with benefits

Sliding it in

Hooking up

vocabulary family friends school work etc

VocabularyFamily, friends, school, work, etc.

We change our vocabulary depending upon who we are talking to.

Parents/guardians often give names to their child’s genitals.

Can be confusing because of the many different names/meaning given to one word.

helpful hints
Helpful Hints
  • Supervise Television/Movies
    • Drugs, alcohol, exploitative/aggressive sex, language, reaction to language
  • Debrief after movies, television shows
  • Insist on comprehensive sex education
  • Debrief/talk about telling/responding to sexually/violent jokes
  • Discuss safety planning
  • Develop a comfort level talking about SEX!
  • Don’t wait. Start the discussion now.
  • Listen and answer questions as they come up.
  • Pay attention to what is being said and what is being watched on TV/movies.

Take the first step…you don't have to see the whole staircase, just take the first step.

Martin Luther King, Jr.


Institute on Disabilities at Temple University1755 N 13th StreetStudent Center, Room 411SPhiladelphia, PA 19122Tel: 215-204-1356 Fax: 215-204-6336Email: IOD@temple.eduWeb: www.disabilities.temple.eduDr. Beverly L Frantz:Tel: 215-204-5078Email: