Sexuality and Disabilities

A Guide for Human Service Practitioners

Deborah P Valentine, Romel W Mackelprang

• Publisher: Routledge
• Year: 2013
• Print ISBN: 9781560243755
• eBook ISBN: 9781136614095
• Edition: 1
• Topic: Medizin
• Subtopic: Anästhesiologie & Schmerztherapie

Individuals with disabilities are often "desexualized" in our society, yet they have the same need for intimacy, self-worth, and social belonging as people without disabilities. Sexuality and Disabilities addresses persons with physical, sensory, intellectual, and cognitive disabilities and their concerns in the areas of intimacy, family issues, sexuality, and sexual functioning. It offers suggestions for professionals who work with persons with these disabilities to help them work more competently with disabled persons in the sexuality arena. These concrete ideas are excellent for staff training and education and for enhancing professional development for those working with persons with physical disabilities.The contributing authors create an awareness that all people need individualized consideration and that the special needs of all individuals are important, especially for those who may have previously been left to discover things on their own--usually unsuccessfully. Sexuality and Disabilities focuses on a wide range of disabilities, including physical, developmental, and learning disabilities, mental retardation, and conditions that may have an impact on people later in life such as strokes, heart disease, or other chronic illness. Chapters discuss education and support issues for both practitioners and clients. Some of the topics examined include:

• components of a staff training program on sexuality and disability
• specific recommendations for sexuality education and counseling with people with spinal cord injuries and other acquired severe neurological disabilities
• a program model serving parents with mental retardation and their children
• specific ways educational programming, social work intervention, and policy efforts can address the special learning needs of people with cognitive impairments
• sources of support and stress for families caring for developmentally disabled children
• an analysis of special vulnerabilities and challenges relating to sexual victimization that confront people with disabilitiesAn extremely helpful tool for human service practitioners, Sexuality and Disabilities is also a valuable resource for graduate and undergraduate students who have an interest in working with people with physical, cognitive, or mental disabilities and helping them explore this basic facet of their lives.

Mental Retardation
and Sexual Expression:
An Historical Perspective

Rita Rhodes

SUMMARY. This paper will examine the history of mental retardation within three distinct periods: the pre-Civil War, the turn-of-the-century and the 1960s. In each of these periods, professional and societal perceptions of mental retardation underwent significant revision. Despite changing perceptions, however, the constant feature in the treatment of individuals with mental retardation is society’s resistance or denial of a sexual life for them. This paper will argue that the persistence of this factor in American society continues to present special challenges to advocates for individuals with mental retardation. Implications for social work practice are discussed.

Not unlike other minorities, the experiences permitted persons with mental retardation have been defined by the larger society. For this reason, any investigation into the sexual experience of individuals with mental retardation must take into account changing perceptions by the majority community. In addition, it will be argued that earlier societal views continue to inform what is considered acceptable sexual experience by the citizen with mental retardation.

Societal perceptions of individuals with mental retardation have varied over time. When perceived as harmless, the treatment accorded them could range from tolerance, indifference, amusement or special considerations as the “innocents of God.” When viewed as a threat to the good of the community, however, treatment could extend from persecution to segregation in institutions such as prisons, poorhouses or hospitals. This paper will examine the history of mental retardation within three distinct transitional periods: the pre-Civil War, the turn-of-the-century and the 1960s. In each of these periods, professional and societal perceptions of mental retardation underwent significant revision. Despite changing perceptions, however, the constant feature in the treatment of individuals with mental retardation is society’s resistance or denial of a sexual life for them.

NINETEENTH-CENTURY AMERICA

Mainstream Beliefs

In nineteenth-century America, individuals with mental retardation were not regarded as dangerous but more a nuisance factor in a society which valued individualism and competition. Society was largely indifferent to their condition except insofar as public assistance was required for their support. For those without resources, the almshouse became the last resort for persons with mental retardation and for other vulnerable populations. After describing conditions in one almshouse in 1838 in which “two married men and their wives, and one aged colored woman, two male idiots, a very old man, and eleven children” occupied one room with ten beds, the institutional officials reported their frustrations to the New York legislature: “the law compelled us to receive them [the insane and feebleminded], but neither the law nor any authority under it provided us the place to keep them in a proper manner” (Deutsch, 1949 p. 130). The plight of similar inhabitants was described by Dorothea Dix in her crusade to ameliorate the conditions of persons with mental illness and retardation that they encountered in jails and almshouses. Her immediate attention, however, was directed at providing asylums for those with mental illness.

Antebellum Reforms

Others, however, began to take an interest in the conditions of individuals with mental retardation. The origin of this attentiveness came from France. Edourd Seguin opened the first school for children with mental retardation in Paris in 1838. He interpreted “idiocy” as arrested development and set about developing educational methods to counter mental disabilities through the development of the body and training of the senses. French methods as well as the optimism they generated crossed the Atlantic, and a movement was begun in the United States to serve the educational needs of citizens with mental retardation. The timing for such efforts was propitious as antebellum America was an environment where social problems were thought surmountable by moral fervor and philanthropy. The expression of these latter was the founding of seven public training schools for children with mental retardation between 1848–1865.

American reformers believed that their interventions were best confined to work with children. An article published in the American Journal of Education in 1856 described their reasoning:

In the countries where cretinism prevails, pupils over seven years are not considered as capable of successful instruction, but in other countries idiots are received up to the age of fifteen or sixteen, and in the English schools up to twenty-five or thirty, even. There is, however, far less hope of material progress in adults than in children—and it is hardly desirable that those beyond fourteen or fifteen should be placed under instruction. (Brockett, 1976, p. 81)

The purpose of instruction was to return these children to the community where they would hopefully support themselves. Even if unsuccessful in that endeavor, however, the moral training that children received would eradicate “bad and vicious habits” (Pirn, 1976, p. 100).

One of the “vicious habits” that was of most concern to reformers was “self-abuse” or masturbation. Masturbation was thought to violate “natural law” and so contribute to the growth of mental retardation both in its performers and in their progeny. In his report to the Massachusetts Legislature in 1848, Samuel Howe, superintendent of the first training school for citizens with mental retardation, noted that ten cases of the “idiocy of the children” could be “manifestly attributable to this sin of the parent” (Howe, 1976, p. 56). For other “self-abusers,” the consequences could be exhibited in their own lives:

There are among those enumerated in this report some who not long ago were considered young gentlemen and ladies, but who are now moping idiots,-idiots of the lowest kind; lost to all reason, to all moral sense, to all shame-idiots who have but one thought, one wish, one passion,-and that is, the further indulgence in the habit which has loosed the silver cord even in their early youth, which has already wasted, and, as it were, dissolved, the fibrous part of their bodies, and utterly extinguished their minds. (Howe, 1976, p. 54)

Convinced of the etiology of “idiocy,” professionals who worked with these children took pains to ensure that their clients would undergo no further mental decline because of their sexual habits. Howe was pleased to note that in his experience:

There is one remarkable and valuable fact to be learned respecting this vice, from observation of idiots, and that is, that some of them, though they have no idea of right and wrong, no sense of shame, and no moral restraint, are nevertheless entirely free from it. They could never have been in the practice of it, else they never would have abandoned it. (Howe, 1976, p. 56)

Howe further concluded that “it is handed from one to another like contagion; and that those who are not exposed to the contagion are not likely to contact the dreadful habit of it” (Howe, 1976, p. 57). With an understanding of masturbation as both contagious and habit-forming, Howe recommended vigilance as the primary method of dealing with sexual explorations. Howe made the same recommendations for the parents of children with and without disabilities: “It behooves every parent, especially those whose children (of either sex) are obliged to board and sleep with other children… to have a constant and watchful eye over them, with a view to this insidious and pernicious habit. The symptoms of it are easily learned, and, if once seen, should be immediately noticed” (Howe, 1976, p. 55). Howe and his contemporaries did not differ from other educators in both their warnings and their vigilance against sexual activity among their charges.

1870–1890

Transition

While the generation of professionals who confined their work to children was still in the field, the emergence of others emphasized the needs of adult clients who were considered inappropriate for lives in the community. The professional literature of the period suggested that institutional life would not only better accommodate the needs of these adults but also successfully shelter them from the dangers of the larger community. The president of the American Association on Mental Deficiency (AAMD), A. C. Rogers, emphasized at the annual meeting in 1890 “the necessity of retaining our pupils and wards for life, not as prisoners, but as pupils, patients, members of a great family living a life of usefulness amid cheerful and happy surroundings” (Sloan & Stevens, 1976, p. 19).

In response to this change in institutional direction, was a corresponding change in the perception and treatment of clients. Inhabitants were increasingly perceived as needing care and protection rather than training and education. At the AAMD in 1890, Rogers summarized the declining expectations: “Once feebleminded, always feebleminded, only in a less degree” (Sloan & Stevens, 1976, p. 19). Reflecting the professional paternalism that came to predominate, Isaac N. Kerlin, superintendent of the Pennsylvania Training School, articulated his vision for the future in a report to the National Conference on Charities and Corrections in 1885:

… here and there scattered over the country, may be‘villages of the simple,’ made up of the warped, twisted, and incorrigible, happily contributing to their own and the support of those more lowly,—‘cities of refuge,’ in truth; havens in which all shall live contentedly, because no longer misunderstood nor taxed with exactions beyond their mental or moral capacity. They‘shall go out no more,’ and‘they shall neither marry nor be given in marriage,’ in those havens dedicated to incompetency. (White and Wolfensberger, 1969, p. 7)

Implicit in this view was an understanding that a sexual life that might enlarge this population was not to be encouraged.

Social Darwinism and the Eugenic Movement

Interspersed with the ideas on the need for protection of persons with mental retardation was an increasingly articulated concern about the danger that such individuals represented to society itself. This latter perception was shaped by an intellectual climate that sought a social application for the concepts of evolution and natural selection that had been described in Charles Darwin’s Origin of the Species. Francis Galton, a cousin of Darwin’s, used the term “eugenics” (from the Greek for “well-born”) in 1883 to describe “the study of the agencies under social control that may improve or impair the racial qualities of future generations either physically or mentally” (Deutsch, 1949, p. 358). The movement emphasized the dominance of heredity and sought to encourage the reproduction of socially desirable individuals (positive eugenics) and discourage the reproduction of the undesirable (negative eugenics).

The hereditary transmission of social problems was an ideal way for both professionals and the general public to understand the changing and often frightening environment of industrial America. Numbers of “scientific” genealogical works were produced which demonstrated the social effects of “degenerate” families over time. The most influential of these was a reported history of the Kallikak Family published in 1912 by Henry H. Goddard, director of the research laboratory at the Vineland Training School in New Jersey, which traced the descendants of the great-great grandmother of one of the patients at Vineland. Goddard concluded that of 480 descendants, 143 were persons with mental retardation. Importantly, almost three quarters of the descendants were judged to be “degenerates” of one kind or other (Farber, 1968, p. 31).

The most telling of these genealogical works, however, was that of the Jukes Family originally published by Richard L. Dugdale in 1877. Dugdale traced the criminal activities of the Jukes family and concluded that bad environmental conditions produced such behavior in generations of family members. In 1915, however, Arthur H. Estabrook re-examined Dugdale’s original work and concluded in a re-published study of the family that one half of the Jukes were individuals with mental retardation and that all the criminal members of the family were. According to one student of the period, “what was regarded in 1877 as primarily a problem in criminal degeneracy, became in 1915, mainly a problem of mental deficiency” (Rosen, Clark, & Kivitz, 1976, pp. 145–6).

These works contributed to the public and professional belief that mental retardation was both inherited and associated with social problems. Demographic evidence was gathered to bolster both of these beliefs. The federal census in its 1890 report disclosed that persons with mental retardation were more likely to have insane or “feebleminded” relatives than either the deaf or the blind. Other studies were produced that “proved” that a large proportion of prisoners, alcoholics and prostitutes were “mentally retarded” (Farber, 1968, p. 27). Together, the impression upon professionals and the general public was that the larger community needed to be protected from a menacing and dangerous population. Walter E. Fernald, superintendent of the Massachusetts School for the Feeble-Minded, warned his colleagues at the 1912 AAMD annual meeting: “It has been truly said that feeblemindedness is the mother of crime, pauperism and degeneracy. It is certain that the feebleminded and the progeny of the feebleminded constitute one of the great social and economic burdens of modern times” (Sloan & Stevens, 1976, p. 76). For professionals as well as the general public, this population had become “the most potent, if not the sole, source of all social evils” (Vecoli, 1960, p. 191).

Given the overwhelming “scientific” evidence of the period that nominated mental retardation as a source of a plethora of social problems, those who had concerned themselves with such problems were left with an unsure role. The National Conference of Charities and Corrections struggled with the issue beginning in the 1890s and eventually advocated prevention as the significant role for its members. The keynote address of the 1915 meeting, for example, featured Marvin Barr, of the Pennsylvania Training School at Elwyn, who declared “that the prevention of the transmission of mental defect is the paramount duty of the hour” (Deutsch, 1949, p. 361). Edward T. Devine of the New York Charity Organization Society, also advised that “there is much of this eugenics program with which social workers may sympathize and in which they should clearly cooperate. The permanent segregation, during the reproductive years of life, of the feeble-minded, the insane, the incorrigibly criminal, and the hopelessly ineffective… would enormously reduce the total social burden” (Devine, 1912, pp. 44–45).

1890–1920

Institutional Segregation

Public and professional perception alike were increasingly likely to view individuals with mental retardation as a dangerous class from whom society needed protection. Segregation was the first eugenic measure to win widespread support. Professionals, unlike their predecessors, regularly advocated for the permanent institutionalization of those with mild forms of mental retardation. In an address to the AAMD in 1902, Martin Barr described the professional consensus: “Without formal expression emanating from our association as a body there is yet, I believe, a consensus that abandons the hope long cherished of a return of the imbecile to the world” (Barr, 1976, p. 101). With the victory of this viewpoint, training schools were converted to custodial institutions while other institutions were enlarged or created. The numbers of institutionalized reflected this new mandate and institutionalized individuals with mental retardation increased from 14,000 in 1910 to nearly 43,000 in 1923 (Rosen, Clark & Kivitz, 1976, p. 146). The possibility of a segregated solution appealed to an editorialist in the Journal of Psycho-Asthenics, the official publication of the AAMD, in 1899:

If the day ever comes-let us say bravely when the day comes-that all or nearly all, the degenerates are gathered into industrial, celibate communities, how rapidly the‘White Man’s Burden’ of distress, pauperism, and disease, which he must be taxed to support, begins to diminish. (Tyor & Bell, 1984, p. 104)

According to this vision, a segregated, celibate population of the mentally retarded was a viable solution to the social problems of turn-of-the-century America.

Institutional Life

The professionals who were charged with the care of this “dangerous” minority took their responsibility seriously. Within institutional life itself, the sexes were segregated to prevent any occasion for sex...

Table of contents

• Cover
• Half Title
• Full Title
• Copyright
• Dedication
• Contents
• Contributors
• Foreword
• Mental Retardation and Sexual Expression: An Historical Perspective
• Responding to the Sexual Concerns of Persons with Disabilities
• Training in Sexuality and Disability: Preparing Social Workers to Provide Services to Individuals with Disabilities
• A Holistic Social Work Approach to Providing Sexuality Education and Counseling for Persons with Severe Disabilities
• Cognitive Impairments: Psychosocial and Sexual Implications and Strategies for Social Work Intervention
• Children with Special Needs: Sources of Support and Stress for Families
• The Parent with Mental Retardation: Rights, Responsibilities and Issues
• Sexual Assault and People with Disabilities