Sexuality and Access Project (SAP) 2023

The aim of the Sexuality and Access Project 2023 is to promote crucial conversations around sexuality supports and sexual health within the attendant care service dynamic for both attendant service users (any individual who uses personal care services) and service providers (personal support workers, facility providers, family members).

Online surveys were conducted with both attendant service users and providers across Canada from January 2023 to December 2023 and focused on experiences accessing sexual health support, attitudes towards sexual health support, and barriers to sexual health support within the attendant service dynamic. Following the survey, 90-minute virtual interviews were conducted with 6 attendant care users to gain deeper understanding of the connections and nuances of sexuality and disability alongside other intersecting identities and experiences.

Most service users and providers reported that sexual support is excluded from service agreements and formal training and education, contributing to ongoing gaps, though informal discussions on the topic still occur within attendant care. Interview participants highlighted experiencing internalized stigma and shame, discomfort and dissociation with one’s body, and challenges with heteronormative notions of intimacy and pleasure. To challenge these barriers, participants shared: (1) using humour as an icebreaker when discussing disability and sexuality; (2) co-constructing sexual support when negotiating one’s care; (3) centering diverse voices within discourse on disability and sexuality; and (4) expanding abled ideas of sexuality using knowledge produced from individuals with disabilities (IWD). Users suggested that attendants could improve comfort by building rapport, setting clear boundaries, and normalizing these discussions as part of their role. Attendants suggested that employers could improve support by offering more education on sexual support, inclusion in service agreements, and clarifying rights and responsibilities.