Women across the world are embracing the hashtag #MeToo to publicly share their own experiences with sexual abuse and assault and to seek empowerment. The result of this movement has sent shock waves through our society as powerful figures in politics, journalism, and entertainment have been identified as abusers and suffered consequences. Yet one group has been conspicuously absent from this conversation—the disabled. And unfortunately, the disabled are among the most vulnerable in our society to sexual abuse and assault. Nancy Thaler, deputy secretary of the Pennsylvania Department of Human Services, said, “If this were any other population, the world would be up in arms. We would be irate and it would be the No. 1 health crisis in this country.”
According to unpublished Justice Department data, persons--male or female--with any type of disability are two times more likely to be sexually assaulted than persons without disabilities. Among this group, persons with intellectual disabilities are sexually assaulted at a rate more than seven times higher than that of people without disabilities. The National Crime Victim Survey in 2008 reported that people with disabilities are victimized at higher rates than persons without disabilities (40 incidents per 1,000 compared to about 20 per 1,000 without disability). Approximately 25% of women with cognitive disabilities referred for birth control have a history of sexual abuse. These numbers, which do not include persons living in group homes or residential settings, are likely to be underestimates.
There is a difference between sexual assault (which is a single instance) and sexual abuse, which occurs repeatedly and over a longer period of time. Studies indicate that 49% of people with intellectual disabilities experience 10 or more sexually abusive incidents in their lives. Additionally, persons with disabilities, particularly cognitive impairments, are much more likely to be abused by persons known to them more than 86% of the time. In comparison, women without disabilities are assaulted by a stranger 24% of the time. The assault and abuse of persons with disabilities is likely to occur during the day—at schools, at group homes, or other at self-contained settings. Advocates point out that persons in residential settings encounter hundreds of different caregivers over the course of a year, many of whom are helping them with the most intimate needs. Teaching adults with cognitive impairments the concept of “stranger danger” is thus pointless; they know their abusers.
This data indicates an “epidemic” of sexual abuse against persons with intellectual disabilities that is “unrecognized, unprosecuted and unpunished.” According to Ms. Thaler, persons with intellectual disabilities are the “perfect victim.” “They are people who often cannot speak or their speech is not well-developed. They are generally taught from childhood up to be compliant, to obey, to go along with people. Because of the intellectual disability, people tend not to believe them, to think that they are not credible or that what they are saying, they are making up or imagining. And for all these reasons, a perpetrator sees an opportunity, a safe opportunity to victimize people.”
It is astonishingly difficult for a person with a disability to report sexual abuse or assault for a myriad of reasons. There is no outreach to this community, the person may lack the vocabulary to report, and police or abuse counselors may lack accessible materials for the disabled. Given their communication issues, reporters are fundamentally not believed. Courts question the veracity of reporters with cognitive impairments who may delay reporting, have difficulty with sequencing of events, and perhaps change narratives. One conviction of a man found guilty of raping a young woman with Downs syndrome was overturned by an appellate judge who felt the woman had not “behaved like a victim.” Horrifically, the abuse can be minimized due to a belief that the disabled are unaffected by it. A psychologist who testified in a case involving the rape of a 9-year-old girl opined that she was “less traumatized” by the five assaults due to a possible “protective factor” against emotional trauma due to her cognitive impairments.
Some proponents argue that the best way to prevent sexual abuse and assault is to improve sex education and advocacy for the disabled. Yet, persons with cognitive impairments are historically excluded from sex education classes, which is a mistake. Persons with cognitive impairments need to have information on what constitutes a safe, healthy, consensual relationship. Materials need to be made accessible to them and they must participate, not only to provide them the ability to advocate for themselves, but also to recognize their own needs.
Frankly, I make the point at meetings that working on independent hygiene routines is one way to attempt to limit the potential for sexual abuse. Even when the student has not mastered toileting for years, I still insist that efforts be made to continue as a matter of dignity and safety. I have also been in IEP meetings where I was the only male present advocating for independent female hygiene routines for a teen girl with intellectual disabilities. After some red faces and uncomfortable talk, they finally wrote a goal when I made the point of expressing it in terms of safety, dignity, as well as being developmentally appropriate.
This discussion may be uncomfortable for parents and other educators who have de-sexualized the disabled and consider sex education “taboo." Instead, they wish to "protect" those with intellectual disabilities. As a result, those persons with cognitive impairments are infantilized or even considered oblivious to sexual needs. According to Kehau Gunderson of Health Connected, a non-profit dedicated to providing comprehensive sexual education programs to the disabled in California, “Educators are thinking more about these students’ physical needs. They don’t see them as being sexual people with sexual needs and desires. They don’t see them as wanting relationships.” Disability activist Nidhi Goyal wrote, “The idea of people with disabilities as asexual beings who have no need for love, sex, or romantic relationships is ridiculous. However, it is one that has a stronghold in most people’s minds.” Educator Katherine McLaughlin says, “There’s a lot of loneliness.” And it is that very loneliness that leaves the disabled vulnerable to abusive relationships. “We don’t think of them as having sexual needs or desires,” said McLaughlin. “Often they’re thought of as children, even when they’re 50 years old.”
There are a variety of sex education programs for persons with intellectual disabilities, but not all may be effective. A 2015 study addressed concerns about the difficulty of persons with cognitive impairments to generalize the information received in these programs. But according to Ms. McLaughlin, “it simply takes a lot of practice and eventually, most will ‘get it’.”
Addressing the sexual needs of their cognitively impaired children may be an uncomfortable and difficult task for parents, yet it is imperative. Parents and IEP teams need to avail themselves of the sensitively prepared resources available to help children and young adults with cognitive impairments learn to protect themselves. Goals must be developed in IEPs that address this issue certainly from junior high school through transition. We need to break out school personnel of their comfort zone. We must promote understanding of healthy boundaries and provide children with the advocacy skills to ensure a student’s self-determination.