”Why should I tell them about sex? One of them just jerks off all day and the other one thinks kissing is hard core sex.” – A nurse in a disabled supported living unit.
Those sentences can sum up the thoughts of many social and health care professionals about the sexuality of a person with a disability or an elderly person. You don’t want to see any kind of sexual activity on your own work shift, or certainly not to be helping someone who can’t express their desires in the right way. It would be sheer madness to even be enabling two disabled people who love each other to express their love. We have noticed that there is not enough public debate about sexuality for both these groups of people.
There are social taboos surrounding sexuality in these groups. For whom is sexuality allowed? The right to enjoy sexuality can only be realized if each person is free to express their own sexuality. However, in many societies, sexuality for children, young people, the elderly and minorities is still a taboo subject, often leading to a lack of respect for sexual rights. Sexuality of people with disabilities and the elderly is often not even acknowledged. We think that sex belongs to everyone no matter who you are. The UN human rights conventions also require sexual health services to be provided for people with disabilities, including the elderly (United Nations n.d., Article 25).
Choking off sexuality
Sexuality is as much about biology as it is about emotions and feelings. It is individual, multifaceted and develops throughout life. Sexuality can be expressed in many ways: through thoughts, beliefs and values, as well as through partnerships and relationships. Sexuality involves pleasure and the search for one’s own sexual identity. Sexuality is an essential part of human well-being and health. It is part of the well-being of the mind and body and can also serve as a resource. A good rule of thumb is that sexuality is what we are, and sex is what we do.
Various psychological and physical difficulties or limitations can be the cause of sexual problems. Suppressed sexuality causes many problems for people. These problems can appear as physical symptoms, low self-esteem and lack of sexual ability. A healthy social identity includes satisfying sexual needs, fulfilling preferences and finding one’s own sexual identity. (Kero Katja & Väisälä Leena 2019, Mielenterveystalo.) People need positive experiences of themselves and their sexuality throughout their life cycles. This neglect is evident, for example, in sexual and reproductive health care: in many countries, sexual health services are often offered only to adults or married people, and the needs of other groups are not taken into account. Clearly, untreated sexual problems add to the burden of health services. Sexual dysfunction is common and is sometimes linked to medical conditions or their treatment. It is important that problems with sex are not a taboo subject, more like a helping hand. (Brusila P. Kero K. Piha J. & Räsänen M. 2020.) For example, when doctors consider giving medicine to elderly people, they should consider that it can affect sexual ability negatively.
Sex in old age, really?
“As memory loss progresses, the blanket continues to flap and the inhibitions dry up.”
When we think about sexuality and sex in old people over 70 years old, the question arises: is there any of it? As we grow older, our sexuality is subject to interpretations and expectations. It is affected by the physical limitations and psychological changes that come with age.
For older people, the biggest factor influencing the realization of sexuality is the relationship. Ageing does not affect men’s sexual desires in the same way as women’s. The number of sexual intercourses decreases with age, but both sexes still enjoy having intercourses if they are physically able to. The majority of older people want a more active sex life, something our society should pay attention to. For older people, the availability of assistive devices, the offering or adjusting of medication, and making sexual activity possible also in nursing homes could increase older people’s satisfaction (Kontula 2009).
Disabled but not sexually dead!
The UN Convention on Disability defines persons with disabilities as those who have a long-term physical, mental, intellectual or sensory impairment which, in interaction with various barriers, may prevent their full and effective participation in society on an equal basis with others (WHO 2009).
People with intellectual disabilities need the same information about sexuality as everyone else. They also need information about physiological and psychological changes, acceptable sexual behavior, diseases, contraception and hygiene (Henttonen 2005).
There are as many sexual needs as there are different types of individuals. For many, a little kiss may indicate the best sex ever, but for others, 15 minutes of private time under the shower is enough. Self-suppression is often seen as aggression and behavioral disorders in people with disabilities. We have to make sure that everyone can have a healthy sex life with themselves or with their partners. Professionals working with disabled people should be aware of ways to improve the sexual well-being of clients with disabilities.
Happy ending
We think that sex improves mood, physical health, as well as adds to your immune system and brain activity. It is a healthy way to spend time and relax. It’s also damn fun. Sex reduces the risk of heart disease, extends lifespan and can protect against disease (Rajala 2008). Our own prejudice must not limit the life of another person and each of us has the right to self-determination.
Everyone will be old one day and you might even get disabled by accident. Everyone deserves to have well-being through their own sexuality in any case. We believe that sex is an expression of love, trust and a natural painkiller also for disabled and the elderly. When you are old or perhaps disabled…
….Would you be willing to give up love entirely?
….Would an orgasm improve your well-being?
….Would your suppressed sexuality affect your nature? Let’s finish with Erika Vikmans Eurovision song words … ICH KOMME!
Writers:
Granat Kristian, Kiljunen Ria, Kylmäaho Anri, Pesonen Johanna, Students of Welfare and Health Coordinator Master’s Degree Programme at Savonia University of Applied Sciences
Pehkonen Pirjo, Peteri Juha and Savela Sanna. Lecturers at Savonia University of Applied Sciences.
Sources:
The work has used AI as follows: DeepL Translate. Used for language correction 20.2.2025. https://www.deepl.com/en/write
Brusila P. Kero K. Piha J. & Räsänen M. 2020. Seksuaalilääketiede. Duodecim. Seksuaalilääketiede – Duodecim Oppiportti. Viitattu: 3.5.2025
HUS. Mielenterveystalo. Mitä seksuaaliterveys tarkoittaa? https://www.mielenterveystalo.fi/fi/omahoito/seksuaalisuuden-omahoito-ohjelma/mita-seksuaaliterveys-tarkoittaa. Viitattu: 5.3.2025
Kero, K. & Väisälä, L. 2019. Naistentaudit ja synnytykset. Duodecim. Naistentaudit ja synnytykset – Duodecim Oppiportti. Viitattu: 5.3.2025
Kontula Osmo 2009. Ikäihmistenkin seksielämä on aktiivista ja tyydyttävää. Duodecim 125(7):749-56. https://www.duodecimlehti.fi/duo97963 Viitattu 20.2.2025
Santalahti, T. 2024. Sukupuoli-identiteetin ja seksuaalisen identiteetin muodostuminen. Lääkärikirja Duodecim. Sukupuoli-identiteetin ja seksuaalisen identiteetin muodostuminen – Terveyskirjasto. Viitattu: 5.3.2025
I need sex too. Picture: Pixabay. https://pixabay.com/fi/illustrations/rakkaus-erityistarpeiden-kanssa-417823/. Viitattu: 3.4.2025
Different needs, different tools. Picture: Pixabay. https://pixabay.com/fi/illustrations/leluja-aikuisille-kuvakkeet-6990492/. Viitattu: 3.4.2025
United Nations n.d. Convention on the Rights of Persons with Disabilities and Optional Protocol. United Nations. https://www.un.org/disabilities/documents/convention/convoptprot-e.pdf Viitattu 5.3.2025 World Health Organization 2009. Promoting sexual and reproductive health for persons with disabilities: WHO/UNFPA guidance note. https://www.unfpa.org/sites/default/files/pub-pdf/srh_for_disabilities.pdf. Viitattu 20.2.2025