Sex Education for Teenagers with Special Needs

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The teacher returned from lunch and saw the teenager leaning forward with puckered lips. One adult was smiling and leading him on while the other was laughing silly. They both looked at the teacher’s face and became placatory,

Hey, he doesn’t know what he is doing! There is no harm in that! He is innocent—almost like God.”

The student, a teenager with autism, began to rock and hum as he paced around the room. The teacher disagreed with the two adults and had to take it up with his superiors.

“What is your opinion about this incident?” I asked a group of professionals in this field. Almost all of them identified that the two adults had crossed that adult—student boundary and that they were wrong to do so. The ‘God-like’ (unique to our Indian society?) and ‘child-like’ attributions were a plenty and a few were worried that the student would repeat this behavior with others. Quite a few people were concerned that to acknowledge their sexuality, and the need for sex education for teenagers with special needs would lead to serious societal problems.

a) If we teach them sex education, isn’t it teaching them how to have sex?

b) Isn’t sex education taking away these children’s innocence?

c) They don’t have self-control. What if they hurt others (physically/sexually)

d) How dare they? They can’t take care of themselves, but you expect them to have sex?

e) This may be acceptable in the West but sex education in India is not possible.

These confusing and sometimes conflicting views stop us from accepting a basic fact—that young people with special needs have the same biological, emotional and physical needs as the rest of us. They may have some limitation in understanding certain rules or in how they express their affection in a safe and appropriate manner to a member of the opposite sex. They may be more trusting than other teens and not fully comprehend the ramifications of their actions. The level of dependence in their daily life leaves these teenagers vulnerable to exploitation.

Sex education in India can be a bit more complicated, especially for teenager with special needs. While all societies do frown on certain behaviors in public (for example, masturbation) reactions to these can be more intense or punitive in India.

These very reasons argue for a systematic approach to sex education for teenagers with special needs.

Sex-education-for-Indian-Teenagers-with-special-needs

Considering the cultural mores of Indian society the first step for adults who engage with the student—as parents, extended family members, caregivers, educators and therapists, is to explore their comfort level in discussing body awareness and sex education. It sounds like a given but in reality, deeply held inhibitions do impact how we approach this topic. With this population we can expect some unexpected questions and reactions to the discussions. If the adults around the teenager are uncomfortable or reactionary it doesn’t benefit the teenager with special needs.

Another key factor is that all adults stay on the same page—to the best of their abilities. We come with diverse values where sex is concerned. Personal experiences, sociocultural, or religious values can be vary within the same family or school environment. Having to deal with conflicting values is confusing to the teen with special needs. Discuss your stand before starting the program and make sure everyone else is ready to follow the same approach. If an individual has misgivings due to personal reasons, do excuse this person from being part of the program.Sex education can include a lot of information. Gear your program based on the teenager’s comprehension level.

Body Awareness

Start with body awareness. Many teenagers don’t know all parts of their body or their respective functions. One way to approach this is to read picture books on the human body.Read books about our body, kept it simple. Use picture books suited to comprehension levels. Do explain the physical differences between the two sexes. Remember to keep your tone matter of fact. When you introduce the topic it is natural for your child/student to be curious and to ask questions. Be prepared for questions. Use natural language without cryptic remarks. Don’t expect them to ‘read between the lines’ or to understand euphemisms. Use anatomically correct names of body parts.

Note: In India we shy away from using anatomically correct names of body parts but using these protects your child. It removes any sense of shame about our bodies and helps the child communicate clearly if he or she has to report abuse.Depending on their comprehension level the teen may ask questions or comment at strangers. They may do so in public places. For this reason, when you read about or discuss the body, reiterate that they can ask questions of you and other safe adults. Make a list of safe adults so they know who to talk to if they have questions. Similarly, go over the places where they can ask these questions—at home, at school, etc. The FDDC link gives a very clear way of teaching when and where a behavior is appropriate on page 19. I recommend that you take the idea and using your camera, take pictures of familiar locations to create materials meaningful to your child/student.

Puberty and our Changing Bodies

Puberty is a time of physical and emotional changes. Your teenager may notice the difference but not know why or what is happening. Use concrete examples to explain the changes. The FFDC site has clear information and charts on the changes during puberty in boy and girls. Read through it to use relevant facts for your program.

Note: Parents, keep those regular visits to the gynecologists for your neuro-typical and your special teen. Teach them how to do a breast examination and focus on menstrual hygiene. For the boys, talk about routine testicular self exam. Ask your son’s doctor or have a responsible male caregiver teach this.

Understanding Personal Space and Respecting Boundaries

Young people with special needs are the most vulnerable to sexual abuse. Address personal space—explain comfortable distance between family members, friends and others, in different settings. Reinforce the message that no one should touch their body. It is meaningful to do this along with body awareness. Role play is a good tool to demonstrate appropriate personal space and to practise saying ‘No’. Make a list of people your child comes in contact with. Reiterate that neither strangers nor these ‘helpers’ can touch their private parts. Teach them that if anyone tells them that it is a secret, they must inform you.

Affection and demonstration of affection can be confusing to these teenagers. Discuss ways to show affection that are safe and appropriate. Show pictures (thank Google Devta) and discuss good touch and bad touch (safe/unsafe). Discuss the way different family members show affection so the teenager sees how one’s own family unit works.In my experience I’ve noticed a significant divide between rural and urban families towards sexuality, marriage, and having children. In the urban setting, it is more common for young people with physical disabilities to marry and be sexually active. In the rural setting it is not uncommon to see youngsters with intellectual disabilities married. This is more due to accepted social norms. Now there is a greater recognition amongst families that this is also about the individual’s rights.

One of the most confusing aspects of our society is how love, affection and sexual attraction are depicted in our media. Indian films give contradictory messages on appropriate ways to show affection. It can be very confusing to even a neuro-typical teenager. In this context do be aware of what films your child watches and what is being shown on TV. If you can, discuss the appropriateness of what is depicted—is it real? Is it safe?

Caution: The incident mentioned at the very beginning is not imaginary. A few details have been changed yes, but the incident was reported by the teacher. Many parents share that caregivers, staff members and even family members make innuendos about the sexual needs of teens with special needs. When confronted these adults have always protested that it was harmless fun. If you ever see or hear anything like this be firm with them. There is no such thing as harmless fun. It is an insult to their dignity! There is an additional danger—these kids may imitate the adults and comment or approach others. They don’t fully comprehend what they say or do, leading to sexual abuse or punitive actions from others.

Note on Masturbation

This is normal behavior for boys and girls. It may make you uncomfortable but do keep in mind that your children may not have the same inhibitions. Nor will they comprehend your reasons. So what can you do? Depending on your personal beliefs, teach your teenager that he or she can masturbate in safe, private places, and must clean oneself after masturbating. Professionals must remember to follow the parents’ belief system to avoid confusing the teenager.Here are some websites that offer extensive information on sex, sexuality, sex education and the role of parents. While these are addressed to a Western audience the basic principles can be applied for sex education in India as well.

This site has an extensive list of sites which serve as resource for teachers and parents. For parents, the links on ‘Materials on Specific Disabilities’ is particularly helpful. Please do read through the sites on sexuality and autism.

http://www.parentcenterhub.org/repository/sexed/

As for the content, this site will be less daunting to parents and with more practical tips:

http://www.fddc.org/sites/default/files/file/publications/Sexuality Guide-Parents-English.pdf

Some guidelines and reminders while teaching sex education to teenagers with special needs:

Intellectual disabilities | Teachers | SexualityandU

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