The politics of sexual citizenship: commercial sex and disability

This paper breaks a long silence by bringing together two areas of literature that have generally been considered separately: that of sexuality and disability with findings from studies on sex work. Presenting empirical findings from two studies, one with sex workers who work from indoor sex markets and the other with men who buy sex, this paper exposes the existing relationships and practices between men with physical and sensory impairments who seek out commercial sexual services from female sex workers. In the discussion the politics surrounding sexual rights and commercial sex will be addressed. In the context of commercial sex, quality of life issues, complex power dynamics and the common ground between disabled people and sex workers rights are discussed. This paper considers the negative aspects of promoting commercial sex for people with impairments, as well as the positive aspects regarding the wider campaign for sexual citizenship. Finally, I set out recommendations and a new research and policy agenda that investigates the complexities of commercial and facilitated sex.     

My home, your workplace: people with physical disability negotiate their sexual health without crossing professional boundaries

This paper aims to describe research that examined the views of people with physical disability, living in Australia, of their sexual well-being needs from their own perspective. We explored the impact their sexual well-being needs had on their relationships with professional carers. A social model of disability was used to understand how sexual well-being is facilitated or denied in community care. We also explored whether clients' sexual well-being needs could be met without carers or clients 'crossing the line'. Our findings indicate the multiple ways that 'professional boundaries' were negotiated between clients and professional carers. The data show that the location of the 'line' changed, depending on a range of personal, social, economic and environmental factors. The data also show a gap between the sexual well-being needs of people living with a physical disability and the level of support provided at the social and organisational levels. Suggestions are made for research and practice directions.     

The relationship between physical disability and narcissism: A critique of the literature

This article critically examines some of the major psychoanalytic writings on the relationship between physical disability and narcissism. Tracing the evolution of thought about narcissism from Freud's original formulation to a self-psychological approach, it considers and contrasts pain, illness, and adult disability on the one hand and early onset disability on the other. The conclusion reached is that disability and narcissism are related in complex ways, depending on a variety of physical, developmental, and environmental factors. Thus, clinicians must avoid making a priori assumptions in work with disabled patients, for such assumptions may be countertransferential.     

The positive consequences of stigma: Two case studies in mental and physical disability

This paper adds to the literature on labeling and stigma by focusing on the positive effects, benefits and rewards of possessing a stigma or identity mark. Through an examination of chronic and non-chronic ex-psychiatric patients and involuntarily childless females, we illustrate that such positive responses include: the legitimation of deviant behavior and the deviant role; exemption from normal social roles and obligations; provision of interpersonal and social opportunities; strengthening of familial relationships; opportunities for career growth and change; and personal growth experiences. These specific responses are divided into three generic categories of positive responses to negative labeling: therapeutic opportunities, personal growth experiences, and interpersonal opportunities. We also develop a typology of labeling which incorporates positive and negative labeling and the positive and negative consequences which follow.This is a revision of a paper presented at the 1988 annual meetings of the North Central Sociological Association, Pittsburgh, PA. The research was supported by grants from the Social Sciences and Humanities Research Council of Canada and from the Government of Ontario, Canada. Correspondence should be directed to Dr. Nancy J. Herman, Department of Sociology, Central Michigan University, Anspach/140, Mt. Pleasant, Michigan, U.S.A. 48859; or Dr. Charlene E. Miall, Department of Sociology, McMaster University, Hamilton, Ontario, Canada L8S 4M4. We wish to thank Dr. Harry Mika and the anonymous reviewers for helpful comments and suggestions on earlier drafts of this paper.     

Childhood physical and sexual abuse in China

In order to determine the prevalence and characteristics of childhood physical and sexual abuse in China, the authors conducted a survey in Shanghai. The Dissociative Disorders Interview Schedule was administered to 423 inpatients and 304 outpatients at Shanghai Mental Health Center, and to a non-clinical sample of 618 workers at a clothing factory. The results were compared to a previous sample of 502 respondents in the general population in Winnipeg, Canada. The identities of the perpetrators of physical and sexual abuse, and the types of sexual abuse reported were similar in the two countries; however, the rates of reported abuse were lower in China. Childhood sexual abuse appears to be far less common in the general population in Canada than in China.     

Treatment issues for survivors of physical and sexual abuse*

Many clients who participate in family therapy have experienced trauma such as physical and sexual abuse in their families of origin. Extensive literature suggests that abusive experiences can result in post-traumatic stress disorders, depression, anxiety, personality disorders, and other long-term effects. Without recognition of the effects that abuse can have on individuals, it is possible to misdiagnose clients or fail to provide them with adequate assistance. This study is an attempt to compare the symptomology of nonabused clients with physically and sexually abused clients using an empirically sound measure. The results demonstrate that the majority of clients who experienced physical and/or sexual abuse in their backgrounds scored in the clinical range on scales from the Millon Clinical Multiaxial Instrument (MCMI) (Millon, 1984). In contrast, clients who did not report abuse had significantly lower scores than the abused clients, and the majority of the nonabused clients scored in the nonclinical range on the scales of the MCMI. Treatment and theoretical implications surrounding the issues of abuse are discussed, and recommendations for marriage and family therapists are provided.     

Puerto Rican drug users experiences of physical and sexual abuse: comparisons based on sexual identities

This study integrates the results of quantitative and qualitative methods to elucidate the association between sexual identity and physical and sexual abuse among Puerto Rican drug users. A structured questionnaire was administered to 800 subjects in New York and 399 in Puerto Rico. A total of 93 subjects (7.9%) self-identified as homosexual or bisexual. Gay males were significantly more likely than heterosexual males to report first occurrence of physical abuse by a family member in childhood. Both gay and bisexual males were more likely than their heterosexual counterparts to report first experiencing unwanted sex in childhood and intimate partner physical abuse later in life. Lesbians were more likely than female heterosexuals to report unwanted sex in childhood. Qualitative data were collected through in-depth life histories with 21 subjects and suggest that gay and lesbian subjects perceive antihomosexual prejudice on the part of family members as one cause of childhood physical and sexual abuse.     

The relative effects of intimate partner physical and sexual violence on post-traumatic stress disorder symptomatology

This study examined the relative effects of intimate partner physical and sexual violence on Post-Traumatic Stress Disorder (PTSD) symptomatology. Severity of physical and sexual violence as well as PTSD severity were assessed in a sample of 62 help-seeking battered women. The results of this study were consistent with prior research, finding significant and positive relationships between physical and sexual violence as well as sexual violence and PTSD symptoms. In order to further clarify these relationships, the unique effects of sexual violence on PTSD were examined after controlling for physical violence severity. Results indicated that sexual violence severity explained a significant proportion of the variance in PTSD severity beyond that which was already accounted for by physical violence severity. These findings have important implications for mental health and social service professionals who work with battered women.     

Research on physical disability in sociological social psychology: The state of the field and future directions

We discuss the state of the research literature on physical disability in sociology, focusing particularly on social psychology. We first trace the history of treatments of disability in the field, noting a movement from a medical model that located disability in the individual to a social model that recognizes physical disability as an important social characteristic that is both produced by and has important consequences for social interactions. We then summarize contemporary research, identifying areas in which sociological research tends to be located, particularly in critical approaches, health‐related outcomes, and stigma. Finally, we discuss areas in which more research on physical disability would be fruitful. We believe that research on group processes, intersectionality, and identity would each especially benefit from greater attention to physical disability.     

Exploiting the Fifty Shades of Grey craze for the disability and sexual rights agenda

This paper does not present a literary critique of Fifty Shades of Grey, nor does it aim to take sides in the fierce disputes about the ‘rights’ and ‘wrongs’ of the storyline. Instead, it examines these debates with curiosity. It becomes apparent that the popular trilogy by E.L. James has encouraged more open discussions about sex and sexuality amongst groups who, until recently, have taken a backseat. The significance and usefulness of drawing on these debates is highlighted. For instance, a revived openness towards sexual issues could be an advantage for disabled people seeking support with creating spaces and opportunities for intimacy. At the same time, there is a risk that ‘kinkphobia’ could inform some adult protection interventions. This paper reflects on the opportunities that would arise if disabled people would seek to make the most of the possibilities arising from the Fifty Shades of Grey craze.     

Substance use during sexual and physical assault in HIV-infected persons

Data from the HIV-Alcohol Longitudinal Cohort was used to determine the prevalence of substance use by victims and assailants during physical and sexual assault against HIV-infected persons and whether these findings differed by gender. Of the sexually assaulted participants, 31% of victims and 70% of assailant(s) had used drugs/alcohol during sexual assault. Compared with men, women had higher odds of substance use during sexual assault (adjusted odds ratio [OR] 3.8, 95% confidence interval [CI] 1.6 to 8.7) and of substance use by their assailant(s) during sexual assault (adjusted OR 5.9, 95% CI 1.7 to 20.6) in adjusted analysis. Of the physically assaulted participants, 66% of victims and 85% of assailants used drugs/alcohol during physical assault; these results did not differ by gender.     

A grounded theory of living a life with a physical disability in Taiwan

This study explores the experiences of disability for a number of Taiwanese adults with a physical disability. Using a grounded theory approach, their experiences of living a life with a physical disability were gained through in-depth interviews. The resulting grounded theory ‘it is more than just the impaired body’ presents the dynamic interactions between the participants and the context in which they were living their lives and how they managed their lives within that context. With its inclusion of the cultural dimension, a holistic way of understanding the daily lives of those who experience physical disability in Taiwan is provided.     

The anti-social model of disability

Social theories are usually developed to enable a clearer understanding of a situation or problem. The 'Social Model' in various forms is currently the dominant model for researching disability, addressing disability from within a socio-political framework that draws substantially on a 'social constructionist' perspective. This article critiques some of the core sociological assumptions of the Social Model, questioning what 'work' this kind of theory does in informing a set of practical concerns around the design of assistive technologies, suggesting an alternative framework of analysis, supported by extensive ethnomethodologically informed ethnographic research     

Interviewing victims of sexual abuse with an intellectual disability: a dutch single case study

The approaching to use with people with an intellectual disability who are (suspected) victims of sexual abuse is a challenge for social professionals. Being at the mercy of professional facilities, the victims are in a vulnerable position. They have limited capacities to defend themselves against the intimidations of perpetrators and to deal with the consequences of the terrifying happenings. Finally, sexual abuse is a criminal offence. Much depends on the quality of the interviews. In the Dutch practice of forensic reactions to (suspected) sexual abuse of people with an intellectual disability, experience has been acquired with different types of interviewing.

With the help of a single case study between a health professional and a victim, these forms of interviewing are demonstrated. The professional pursuit is to let the client disclose what has happened in their own words. The study shows that in social health and welfare practices the professional task is to navigate between, on the one hand, the communicative space for the client to provide free recall and, on the other hand, the need to provide help to clients with an intellectual disability to verbalize inner cognitions and emotions.     

The prevalence and correlates of psychological distress following physical and sexual assault in a young adult cohort

Among a birth cohort of New Zealand's 21-year-olds, 41% experienced physical or sexual assault in the previous 12 months. The level of psychological distress experienced by the 374 victims was determined in interviews assessing for symptoms indicative of posttraumatic stress disorder and ratings of impairment in activities of daily living. Of the 141 women victims, 32.6% were identified as experiencing psychological distress as were 9.9% of the 233 men. For men, bivariate analyses showed psychological distress was significantly associated with factors indicative of increased assault severity, and for women an increased likelihood of distress was associated with the location of assault and the relationship to the assailant. Positive indicators of social support were not significantly associated with less adverse psychological outcomes. However, for both men and women, resisting the assailant was associated with a reduced likelihood of psychological distress. Multivariate analyses revealed that for both women and men, unemployment uniquely predicted variance in distress, over and above that accounted for by characteristics of the assault.     

The impact of physical health and socioeconomic factors on sexual activity in middle-aged and elderly Taiwanese men

Sexual activity in older people has become a topic of growing interest. The aim of this study is to investigate the effect of physical health and socioeconomic factors on the sexual activity of middle-aged and elderly Taiwanese men. From August 2007 to April 2008, 744 men older than 40 years were enrolled from a free health screening in Kaohsiung, Taiwan. All participants received detailed physical examination and answered questionnaires that collected demographic and lifestyle information, and medical history as well as answered items from the International Prostate Symptoms Score and five-item version of the International Index of Erectile Function (IIEF-5). Overall, 100 (13.4%) participants reported to be sexually inactive in previous 6 months. Older age, lower education levels, loss of a partner, erectile dysfunction, and increased number of comorbidities were found to be independent predictors for sexual inactivity. In conclusion, most middle-aged and elderly Taiwanese men remain sexually active. In addition to erectile dysfunction and loss of a partner, lower education levels and increased number of comorbidities were found to be predictors for sexual inactivity. Further research would need to elucidate whether improvement of those factors could help to preserve sexual activity.