Sex and Relationship Education for Individuals with Disabilities: A Review of the Literature Through an Ecological Systems Lens
Abstract
1. Introduction
The Present Paper
2. Theoretical Frameworks
2.1. Chronosystem and Macrosystem Influences: Historical Events, Cultural Attitudes, Policy
2.2. Exosystem and Mesosystem Influences: Responsibility for Teaching Relationships and Sexuality
2.3. Microsystem Influences: Perceptions of Caregivers and Educators
2.4. The Role of the Individual: Experience, Preference, and Voice
3. Summary and Key Points
Challenge Outlined in the Literature | Supporting Evidence | Emerging Literature, Practical Solutions, and Future Directions | Supporting Studies |
---|---|---|---|
1. There are misconceptions about disabilities, disabled individuals’ needs and desires, and the relevance of SREs for individuals with disabilities. | Educators and caregivers often carry implicit biases that skew their perceptions of disabled individuals. Sociocultural values and sociopolitical contexts influence whether SRE is offered and how and what is taught. Societal beliefs that people with disabilities ‘lack sexual desire’ or are ‘incapable of understanding or taking part in sexual relationships’ influence access to SRE. There are minimal or no requirements for people with disabilities to receive SRE within or outside school settings. | There is a need to: Address stigma around disability. Recognize and remove implicit biases about sexuality in people with disabilities. Understand disability through an asset-based lens, viewing people with disabilities as capable and sexual beings with rights, interests, and autonomy. View sexuality as important for a positive self-view. | *[9] [37] *[2] *[1] [7] *[25] [29] *[43] [42] |
2. Caregivers often feel uncomfortable initiating and facilitating conversations centered on sexuality and relationships. | Caregivers have turned to healthcare professionals for guidance. Caregivers have indicated that SRE may not be appropriate or useful for their children. Caregivers often do not give permission for their child to participate in SRE programs. Caregivers often shelter their disabled children from education in an effort to keep them safe. Studies have found that shared responsibility of SRE content delivery between caregivers and educators reduces caregiver discomfort. | Researchers have begun developing programs to help empower families with SRE delivery. There is a need to: Acknowledge and address attitudes and feelings of uncertainty or discomfort. Facilitate conversations with caregivers centered on problems with sheltering people with disabilities. Develop comprehensive and ongoing collaborative training with and for caregivers, educators, and service providers that includes depth and breadth of relationship and sexuality topics. | *[33] *[36] [37] [35] *[1] *[38] *[31] *[34] |
3. There is limited training for educators in addressing sexuality and dating with disabled individuals. | There is ambiguity about who feels responsible for delivering sexual education. Educators often feel they do not have the expertise to teach SRE or provide mentorship to their disabled students. Teacher preparation does not exist, or it is limited or inadequate. There is often limited curricular time and resources for SRE. Educators have felt some resistance from caregivers. | There is a need to: Include relationship development and sexuality topics within educational curriculum; embed SRE instructional time and resources into the school day. Better prepare general and special educators as well as school specialists in SRE instruction. Improve communication between educational teams, outlining student goals and aims centered around sexuality and relationship development. Improve communication between caregivers and educators about the importance of SRE. | [28] [30] [29] *[31] [35] *[36] [7] |
4. SRE curricula content often does not align with individuals’ interests, desires, and lived experiences. | There is often an over-emphasis on the biological aspects of human sexuality within SRE programs and an under-emphasis on social aspects of human relationships and sexuality. Individuals with disabilities have unique perspectives, needs, and experiences that significantly influence their understanding and approach to relationships and sexual health. There is a mismatch between what an individual wants and what others want for them. | Studies are starting to include people with disabilities in the design and development of SRE and develop tailored SRE curricula. There is a need to: Listen to and learn from the perspectives and experiences of people with disabilities. Co-develop SRE content to align with the needs, desires, interests, perspectives, and experiences of the disability community. | *[6] *[24] *[1] [7] *[2] [8] [40] |
5. Rigid or highly structured SRE may overlook individual differences and focus on extinguishing problematic behavior rather than supporting human development. | People with disabilities show varying levels of SRE knowledge and skills, have different experiences, and need different degrees of support. Implementing rigid, rule-based instruction without a more holistic approach leaves people with disabilities feeling unsure of how to navigate relationships and sexuality. Educators have viewed developmentally appropriate sexual behavior as disruptive or problematic rather than as part of the human condition. | There is a need to: Develop person-centered programs that are adaptable to individual needs and strengths and responsive to cultural contexts and lived experiences. Ensure that people with disabilities have agency and control over their personal goals. Focus on application and generalization of learned skills. | *[31] *[2] [37] *[1] [42] *[45] |
6. High-quality SRE is often inaccessible to people with disabilities. | Studies have documented that people with disabilities feel safe discussing SRE topics with their peers and learn from their peers’ experiences with relationships and dating, yet people with disabilities often have limited access to connect with peers and participate in socially rich learning opportunities. People with disabilities often seek information about sex and relationships from unreliable, unregulated, and often, inaccurate media sources and online forums. Studies have documented vast variability in the content, delivery, and quality of SRE offered to the disability community. | There is a need to: Promote opportunities for people with disabilities to discuss content with peers, social skills training and relationship modeling and coaching, and peer-to-peer education opportunities. Promote inclusion, understanding, and accessibility of content through a range of teaching methods and tools, such as using technology, video modeling, social narratives and scripts, and pictures. Provide clear, practical, relatable guidance and feedback and information about on-line safety. | *[26] [40] *[38] *[5] *[4] *[6] *[1] [37] |
Limitations and Areas for Future Research and Directions
Funding
Acknowledgments
Conflicts of Interest
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Oppermann, G.; Van Zant, C.; Coughlan, I.; Howarth, S.; Sparapani, N.; Pedgrift, K. Sex and Relationship Education for Individuals with Disabilities: A Review of the Literature Through an Ecological Systems Lens. Sexes 2025, 6, 52. https://doi.org/10.3390/sexes6030052
Oppermann G, Van Zant C, Coughlan I, Howarth S, Sparapani N, Pedgrift K. Sex and Relationship Education for Individuals with Disabilities: A Review of the Literature Through an Ecological Systems Lens. Sexes. 2025; 6(3):52. https://doi.org/10.3390/sexes6030052
Chicago/Turabian StyleOppermann, Gustav, Caroline Van Zant, Isabel Coughlan, Sophie Howarth, Nicole Sparapani, and Kathryn Pedgrift. 2025. "Sex and Relationship Education for Individuals with Disabilities: A Review of the Literature Through an Ecological Systems Lens" Sexes 6, no. 3: 52. https://doi.org/10.3390/sexes6030052
APA StyleOppermann, G., Van Zant, C., Coughlan, I., Howarth, S., Sparapani, N., & Pedgrift, K. (2025). Sex and Relationship Education for Individuals with Disabilities: A Review of the Literature Through an Ecological Systems Lens. Sexes, 6(3), 52. https://doi.org/10.3390/sexes6030052