Io1 incluedusex project course final version

SUPPORTIVE TRAINING COURSE AND SELF-HELP GROUPS OF
PARENTS OF YOUTH WITH PHYSICAL AND LEARNING
DISABILITIES ON SEXUAL EDUCATION, TECHNIQUES AND
APPROPRIATE BEHAVIOUR
INCLUEDUSEX
2018-1-ES01-KA204-050062
IO1 Parental sexual education training course

This is a parental sexual education training course to guide the parents with children
and adolescent with disabilities, providing necessary information, topics and
approaches to be discussed while teaching sex education.

Chapter 1: Sexual Education
Knowledge
1.1 Consequences of lack of sexuality/knowledge
1.2 Sexual unawareness

1.1 Consequences of lack of
sexuality/knowledge
The complete lack of sexual education for teens with disabilities is particularly
alarming given the fact that individuals with disabilities are at a much higher risk of
sexual assault and abuse. In fact, children with disabilities are up to four times
more likely to face abuse and women with disabilities are nearly 40% more
likely to face abuse in adulthood.
 Inappropriate sexual behaviors
- Masturbation in public
- Masturbation Addiction
- Talking about intimate things in public with
strangers
- Internet harassment
- Unhealthy relationships
- Lack of respect for him/herself or the partner
https://www.teenvogue.com/story/disabled-sex-ed

1.2 Sexual unawareness
For a long period, sex education has been considered only as a personal
matter, something that should not be discussed in public. There are
concerns over the appropriateness of sex education in schools and some
teachers are not comfortable to teach it or parents do not want their
children to learn it, leading to issues as:
 Unintended pregnancies
 No pregnancies
 Sexual Assault
 Desexualization
 Diseases (HIV, STDs)
 Lack of hygiene

Types of disabilities to be addressed:
■ Deaf-Blindness
■ Intellectual Disabilities
■ Learning Disabilities
– Autism Spectrum Disorders (ASD)
■ Physical Disabilities
– Spinal Cord Injury
■ Complex disabilities
– Spina Bifida
– Cerebral Palsy (CP)

Chapter 2: What knowledge should I as a
parent have before talking to my child about
Sex Education?
2.1 What Sexuality means?
2.2 What age should I start talking about Sexual Education with my child?
2.2.1 Teaching typical children about Sex Education
2.2.2 Are young people who get sex education more likely to be sexually active?
2.3 How my child’s disability can affect him or she for having a regular sex life?
2.4 Social myths and discrimination about disability and sexuality
2.5 Cultural and Religious beliefs

2.1 What Sexuality means
 Sexuality is much more than body parts
and sex (though it includes these things,
too).
 Sexuality includes our gender identity (the
core sense that we are female or male).
 Sexuality includes gender role (the idea of
how we should behave because we are a
female or male).
 Sexuality includes our sexual orientation
(heterosexual, homosexual, bisexual,
transsexual, etc.).
 Sexuality includes how we feel about our
bodies. We call that “body image”, and
poor body image can have a profound
effect on our ability to have healthy
relationships. A person with poor body
image may not think they deserve a good
partner, and so they may be willing to
settle for someone who will not respect
them or who may even abuse them.
http://www.srcp.org/for_all_parents/definition.html

 Sexuality includes our sexual
experiences, thoughts, ideas,
fantasies.
 Sexuality includes the way in which the
media, family, friends, religion, age, life
goals, and our self-esteem shape our
sexual selves.
 Sexuality includes how we experience
intimacy, touch, love, compassion, joy,
and sorrow.
http://www.autimates.com/autism-sexuality-taboo-broken-yet/
“Anyone knows that the sexuality is an integral part of
life and not merely the presence – or absence – of
orgasm. Sexuality is the energy that motivates you to find
love, contact and intimacy, and expresses the way we
feel, in the way people touch and is touched. Sexuality
influences thoughts, feelings, (inter) actions and both
physical and mental health.” Fatima Kwant, 2017

2.2 What age should I start talking about Sexual
Education with my child?
2.2.1 Teaching typical children about Sex Education
■ From birth to age 2
Incorporating the proper names for genitals into everyday activities like bath time. Because
children need these words to communicate health issues or injuries.
■ From 2 to 5 years old
A major focus it is necessary for this age group is learning about boundaries and what is and
isn’t appropriate when it comes to touching—or being touched—by other people.
When raising a child with disabilities we should always look for the typical development and try
to fill up the gaps that our child might face, with material adaptions and different methods of
education. In that way we always have an education to look for and to provide to our children.

 Digital spaces: Discuss how to safely explore, even if your child won’t be using the
internet unsupervised for a few more years. You don’t need to pre-emptively explain
pornography to kids, but be prepared to have them stumble across it and remember
there’s no need to present pornography as something bad, you will want to state that that
these types of websites are just for adults.
 Masturbation: since by age eight most children have begun to explore their bodies.
Frame it as something that, while normal, is done in private, and don’t forget to address
proper hygiene.
 Sexual Abuse: Starting with the basics, such as how no one should be touching them
without their permission, then revisiting the subject a few days later to gauge what they
understood and how they feel.
“It’s crucial that even young children learn to ask before they touch someone else.
Lessons around sharing, touch-based games like tickling, and asserting your own
boundaries, such as telling a child when it is and isn’t OK to climb onto your lap, all help to
create a more intuitive understanding of consent.” Cory Silverberg

 Explaining mechanics of sex to kids: It all depends if your child seems ready for
it, otherwise it’s okay to delay it a bit if you think they won’t comprehend it.
 Puberty: When kids are around age six, this can be a simple discussion about how
bodies change as we grow. For example, you could compare photos of when they
were little with what they look like now. It is also recommended saving the more
detailed puberty talk until just before your child or those in her peer group start
experiencing it.
 Sexism and Sexualisation: Use examples found in the media or even in your own
community—for example, a grandparent who thinks boys should only have short
hair—to spark discussions. These chats can be depressing, but support kids to find
their power, and point out positive examples of individuals who have overcome
stereotypes.
 Changes: This age is full of emotional and social changes, and girls in particular
may struggle with body issues. Learn to explain and to be supportive. Focus also
in the hygiene, sexual and self care.

 Safe sex: By age 11, you want to start having conversations about sexual
choices and safer sex (research shows that teens make better choices when
they know the risks). You should highlight different types of birth control and
explain the basics of how they work.
 Body Change: This age is full of emotional and social changes, and girls in
particular may struggle with body issues. Explain what happens and let them
know it is normal.
 Digital space: Talk frankly about how sharing nude or sexually explicit photos of
themselves or their peers may be illegal. Also how to be respectful to others
online, when high-profile stories on sexting or online bullying are in the news,
use them as jumping-off points to ask your child how they would handle similar
situations.
“Sexuality education recognises the primary role of
parents and the family as a source of information, support
and care in shaping a healthy approach to sexuality and
relationships.” UNESCO, 2009

■ Teenagers: if you’ve been quiet on the subject of sex up till now,
it is recommend sitting down with your teen and stating that
you’re changing your ways.
 You will want to minimize the lectures, teens need real talk
about birth control, you might even want to supply condoms or set
up a doctor’s appointment for hormonal birth control.
 You want to empower your child to be able to evaluate risks and
make good decisions. Help kids to understand that they have a
gut, an inner voice, and they can and should listen to it, because
this is a big part of what sex education is about. And by
discussing the right topics at the right ages, you’re setting your
child up to do just that.
Talking with your kids about sex and sexuality early in life really pays off once they’ve hit
their teens. If you’ve established yourself as open to discussing those topics, “your kids
are probably going to feel more comfortable talking to you and asking you questions,”
says Thornhill.
https://www.todaysparent.com/family/parenting/age-by-age-guide-to-talking-to-kids-about-sex/

2.2.2 Are young people who get sex education more
likely to be sexually active?
A 2009 research review
conducted by UNESCO
provides some hard data on
how sexuality education can
influence behaviour. The
review looked at 87 studies
from around the world and
found:
“Moreover, while the adults are busy
debating how best to approach the
issue, research shows children and
young people are getting information
for themselves from a range of sources
including the internet, magazines, their
friends or television.”
http://www.abc.net.au/health/talkinghealth/factbuster/stories/2013/04/18/3739632.htm
 None of the programs led to earlier sexual activity in young people
 More than a third of programs delayed sexual activity
 One third of programs lead to a decrease in frequency of sex
 A small percentage (3 per cent) were found to increase frequency of
sex
 More than a third of programs lead to a decrease in the number of
sexual partners participants had
 None of the programs led to an increase in number of sexual
partners.

2.3 How my child’s disability can affect him or she for having a
regular sex life?
■ Autism Spectrum
Disorder: People with
Autism are able to have
sex like any other, the
area they usually face
problems is in the
socialization and there is
where you as a parent
will have to most focus
on.
https://cerebralpalsyscotland.org.uk/index.php?/adults/sexual-health
To be able to teach and help your child, you must know what happens in his/hers body,
doesn’t matter the disability, you must try your best to learn everything about it.
Knowledge, understanding and love is what can make teaching successful.
 Cerebral Palsy: Having Cerebral Palsy certainly doesn’t
mean you can’t enjoy an active sex life or go on to have a
family if that’s what you choose to do. Not everyone
experiences problems, but here are some you may encounter
during sex:
 Spasticity, difficulties with positioning
 Stiffness of joint and muscles
 Problems with energy and fatigue
 Balance problems or loss of strength
 Trembling
 Problems with pelvic floor tone.

■ Deaf-Blindness: People that are Deaf-Blind can
experience sex like any other person, but there is a huge
need to start teaching since very small, so this person can
enjoy sexuality, learn sexual standards and value.
■ Intellectual Disabilities: People with intellectual
disability experience the same range of sexual thoughts,
attitudes, feelings, desires, fantasies and activities as
anyone else. To understand and enjoy sexuality, everyone
needs adequate information and support from a young
age. Most people with intellectual disability can have
rewarding personal relationships. However, some may
need additional support to develop relationships, explore
and express their sexuality, and access sexual health
information and services.
■ Learning Disabilities: If they are given sufficient social
support and accessible sex and relationships education,
many people with a learning disability are able to engage in
safe, healthy and happy personal and sexual
relationships (Sinclair et al. 2015; Eastgate 2008)
https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/intellectual-disability-and-sexuality

■ Physical Disabilities: A person with disability may enjoy sex with
the help of sex toys and physical aids (such as bed modifications), by
finding suitable sex positions, or through the services provided by a
qualified sex worker. Largely depends on the functional abilities.
■ Spina Bifida:
 Musculoskeletal issues: Due to limited mobility or orthopaedic
constraints not all sexual positions are possible;
 Exhaustion: Extra energy may be required to get through the day due
to mobility limitations or level of pain. Time for sexual activities may
need to be arranged on a day where the partner with Spina Bifida has
more time to devote to the sexual activity - meaning that afterwards
the person has the flexibility in his or her schedule to relax and
recover.
 Latex Allergy: Latex allergies are more common in those with Spina
bifida so latex free condoms or another form of birth control other than
condoms may be needed.

 Delayed or Inability to
Orgasm: A decrease in
sensation, typically due to
nerve damage (which also
impacts bladder and bowel
control), may cause some
with Spina bifida to
experience difficulty reaching
orgasm, at least compared to
what is shown as the norm.
 Erectile Dysfunction: Nerve
damage or loss of sensation
may cause some males with
Spina bifida to experience
significant loss in their ability
to get or maintain an erection
— never mind orgasm.
 Vaginal Sensation: Some women
with Spina bifida experience different
sensation than their peers without
Spina bifida due to nerve damage.
 Body Image: Someone with Spina
bifida has likely had to struggle with
their body image, as they might not fit
the “norm” of what is desired
sexually.
 Being Desexualized: A person with
Spina bifida may have had their
sexuality denied or ignored by their
parents, peers and society as a
whole.
 Trauma: Children who are disabled
are more likely to be physically or
sexually abused as, as they are
considered easier targets by
perpetrators.
https://www.sextherapyinphiladelphia.com/spina-bifida-and-sex/

■ Spinal Cord Injury:
 The Physical Changes: For women, their sensation and ability to lubricate
changes the most. For the men, they have to deal with a bit more: Erection
issues, ejaculation issues (many cannot ejaculate) and a lack of sensation.
 Erogenous Zones: Learn where they are (scars, the face, neck, the line on
body where injury stops/begins) so physical orgasms from new areas can be
achieved.
 Self love: Learn to use positive psychology and focus on your positive
attributes.
 Positioning: Teach trying experimenting with different pillows, propping up in
bed or even staying in your wheelchair while having sex to stabilize your
balance.
https://www.spinalcord.com/blog/sex-sci-and-why-its-still-important

2.4 Social myths and discrimination about disability and
sexuality
“Disabled people don’t want or need sex”
The truth is that disabled people are just like everybody else. We have all the same wants and
needs, dreams and desires, lusts and fantasies.
“Disabled people can’t have sex”
The truth is the majority of disabled people have sex just like everybody else; they work just like
everyone else. There are a few people that might have issues like pain, and that gets in the way
of feeling sexy. There are some people who have impairments that mean they can’t move very
easily, and sometimes getting into some of the positions that mean sex is possible is quite
difficult. But all of those people still function totally normally, and they have sex just the same as
the rest of the world.

“Disabled people only have kinky sex”
There is no correlation between being disabled and being kinky. Another issue is that
people think you must be kinky to want to have sex with someone who is disabled –
and this is really troubling, because it really insults all the people that go out with
disabled people who are not doing it because they’re disabled; they’re doing it
because they like them and they fancy them, just like everybody else.
“Disabled people only have sex with each other”
That is usually the case because they share similar experiences and an
understanding of each other’s life experiences, but they just want to be with someone
they fancy and love, like anybody else.
“Disabled people aren’t sexy”
They are not seen as sexy because they aren’t thought of as sexy, but there’s a
whole new generation of young disabled models coming up who are gorgeous. It’s
again the society “saying disability is not sexy”.

“Disabled people can’t have kids”
Most disabled people can have children just like everybody else. There are a very
small number of disabilities that do impact on fertility, but if you can’t have kids, even
with the help of modern science, you can adopt or foster.
“Isn’t it wrong for disabled people to have children as they will pass on
their disability to their kids?”
No, it’s not wrong, mainly because the majority of disabilities are not inherited, so they
won’t be passed on. But even those that could be passed on, who says it’s wrong to
be disabled?
“If I have sex with a disabled person, will I catch what they’ve got?”
No, for most of them their disabilities are not catching; they’re not sexually
transmitted. There are of course a few conditions that are, but we live in a world
where safe sex should be what we’re all having.

“Disabled people have to pay to have sex”
The truth is that most disabled people will go out and meet people, have a relationship,
just like anyone else. But there are some people who feel they haven’t got the skills or
the social skills, and so they want to go out and pay for sex or even the parents and
institutions will also pay to provide this type of service for them.
“Disabled people are a burden on their partners”
The majority of disabled people do not need much, or any, care at all. There are a very
small number that do need quite a high level of care, but surely won’t they have it in
place already?
https://mosaicscience.com/story/ten-myths-about-sex-and-disability/

2.5 Cultural and Religious beliefs
Accordingly, most religions have seen a need to address the question of a "proper"
role for sexuality in human interactions. Different religions have different codes
of sexual morality, which regulate sexual activity or assign normative values to
certain sexually charged actions or thoughts. Each major religion has
developed moral codes covering issues of sexuality, morality, ethics etc. These
moral codes seek to regulate the situations which can give rise to sexual interest
and to influence people's sexual activities and practices.
 The views of religions and religious believers range widely, from giving sex
and sexuality a rather negative connotation to believing that sex is the highest
expression of the divine. Some religions distinguish between sexual activities
that are practiced for biological reproduction (sometimes allowed only when in
formal marital status and at a certain age), and other activities practiced for
sexual pleasure, as immoral.
https://en.wikipedia.org/wiki/Religion_and_sexuality

Chapter 3: Let’s talk
3.1 When and How to disclose the topic to my child?
3.2 How to set-up an appropriate atmosphere to talk with my
child/teen with disability?
3.3 What topics should I talk about?
3.3.1 Strategies to educate your child/teen

3.1 When and How to disclose the topic
to my child?
As soon as kids start learning to talk, you can teach them the names of the parts of their
body. As soon as they start being around other kids, you can teach them about
respecting other people and talking about their feelings. These things lay the groundwork
for healthy sexuality and relationships later on.
Talking with your kid about sex, relationships, and their health is a lifelong conversation.
Doing a little bit at a time instead of having “the talk” takes pressure off you, and helps your kid
process your values and information over time.
BUT if you haven’t done it and your child is already a teenager going through puberty, then
you should start focusing on these topics…

1. Start with the most important notion:
Adolescents and young adults should clearly understand that the choice to engage in
conduct involving touching of a sexual or intimate nature is ultimately theirs and that
no one has the right to touch them in private places without their permission or in
ways that make them uncomfortable. Teach your values; but teach the facts too.
2. Explain different types of touch:
Children and adolescents with special needs have often been told not to let strangers
or people they barely know touch them, so they may be confused when certain
community workers need to touch them as part of an exam or to help aid them in
some way. Therefore, students should be made aware that medical personnel,
therapists, aides, etc., may need to touch their bodies for purposes tied in with their
jobs, but that this touch is business-like and is not sexually gratifying for them.
Students should know that they can also ask questions as to why they are being
touched. Teens who are unable to ask about or understand the reasons for
being touched, should probably be accompanied by a caregiver who can
explain these situations to them.

3. Take your time:
Adolescents with special needs, like most young adults, can be overwhelmed if given
too much information about a subject all at once, especially a sensitive subject such
as this. Be prepared to cut it short when he or she indicates a sense of being
overwhelmed. You can always return to the conversation later.
4. Emphasize the power of saying NO!
Our teens need to be told that they have the absolute right to say “no” to any
touching or activity that they don’t feel comfortable with, or don’t really wish to
participate in, and that no one should be allowed to pressure them into doing things
that they don’t want to do. Emphasizing the power of saying “no” empowers kids to
advocate for their own sexual safety.
5. Illustrate the appropriate time/place for intimacy:
At the same time, teens should also be told that it is not “bad” to be affectionate or
ultimately sexual with the right person at the appropriate time, as long as it reflects
both people’s feelings and is based on mutual respect, consent, and love. What is
important to stress here is the appropriate time, person, and place.
https://stanfield.com/6-tips-for-talking-about-sex-with-special-needs-teens/

3.2 How to set-up an appropriate atmosphere
to talk with my child/teen with a disability?
■ It will depend on your child’s disability and the intellectual level, but if your child has a
typical intellectual development you can:
- Choose the right time, like something happen with somebody else (someone got
pregnant, someone close to the family started dating someone, your child came with
questions, etc.)
- Ask questions and provide answers
- Give sex education in appropriate occasions (at home, when it is a private time, when
both of you are free and can take the time to talk about it)
- Seize opportunities such as relevant TV programs to induce children to think and ask
questions voluntarily of what they think (couple kissing, being aggressive to the
partner, asking someone for a date)
- Avoid discussing sex with children in the presence of other people, in case they feel
embarrassed or disrespected.
https://www.studenthealth.gov.hk/english/resources/resources_bl/files/lf_se_fse.pdf

■ If your child has atypical intellectual development then you will need to have
knowledge of the mental age of the child (using the mental age test). Suggested
approach:
- Put in his/hers visual routine schedule (if you do have one at home) that will
have a “teaching time” and put the title of what will be taught on the day
(example “hygiene” or “body parts”), or if you do not have one, just start telling to
your child the day before, that tomorrow at a certain time of the day you will have
the “teaching time”
- Do not try to teach everything at once
- Pick a room in your house with not much information, sounds and distractions
- Pick a time after your child has had a snack and it is comfortable, where no
physical needs can become a problem in the middle of the teaching moment
- Have your material ready before starting, so you can keep the flow of the
explanation
- Be excited, prepared, do your studying before presenting the subjects. Show
your child that you are okay with explaining those things and that you are open
to any questions. Be comfortable with it, so your child can also be
- After you have those “teaching times” you can use examples from the daily life to
remind the child of what you taught (example ask the name of body parts, ask
the hygiene steps of daily life, etc.).

3.3 What topics should I talk about?
American Academy of Pediatrics & NICHCY suggests the following topics
for children aged 5-8:
– Body parts
– Similarities and differences between boys and girls
– Elementals of reproduction and pregnancy
– Qualities of good relationships (friendship, love, communication, respect)
– Decision making skills & that decisions have consequences
– Beginnings of social responsibility, values and morals
– Masturbation can be pleasurable but should be done in private
– Avoiding and reporting sexual abuse/exploitation

American Academy of Pediatrics & NICHCY suggests the following
topics for children aged 8-11:
– Pubertal changes (menstruation, wet dreams, masturbation)
– Sexuality as part of total self
– Reproduction and pregnancy
– Importance of values in decision-making
– Communication within family about sexuality
– Personal care and hygiene, diet, exercise,
– Body image /self-esteem
– Contraception strategies
– Rights and responsibilities of sexual behavior
– Fashionable clothes & Inappropriate dress code
– Abstinence/restraint
– Avoiding and reporting sexual abuse
– Sexually transmitted diseases including HIV/AIDS

American Academy of Pediatrics & NICHCY suggests the following
topics for children ages 12-18:
– Health care, health promoting behaviors such as regular check-ups,
breast and testicular self-exam
– Sexuality as part of the total self
– Communication, dating, love, intimacy (Qualities of good relationships
such as friendship, love, communication, respect, decision making,
and knowing there are consequences)
– Abstinence/restraint
– Importance of values in guiding ones behavior
– How alcohol and drug use influence decision making
– Sexual intercourse and other ways to express sexuality
– Birth control and responsibilities of child-bearing
– Reproduction and pregnancy
– Condoms and disease prevention
– Discussing issues of abuse (signs, prevention, what to do if it is
suspected)
– Healthy diet, body weight, good grooming, exercise

3.3.1 Strategies to educate your child/teen
 Learn as much about the disabilities as possible;
 Before starting a conversation, make sure you know your own values and beliefs;
 Be ready to assert your personal privacy boundaries;
 Use accurate language for body parts and bodily functions;
 Identify times to talk and communication strategies that work best for you and your
child;
 Avoid times and strategies that do not work well for your child and your situation;
 Be clear when discussing relationships (mother father vs, Paul and Carol);
 Use teachable moments that arise in daily life (e.g., friends pregnancy, marriage,
adoption);
 Be honest when children ask you questions;
 Always acknowledge and value your child’s feelings and experience;
 Be willing to repeat information over time – don’t expect your child to remember
everything you said.

Chapter 4: Materials
4.1 Puberty
4.1.1 Physical Changes
in Boys
4.1.2 Physical Changes
in Girls
4.2 Private and Public
4.3 Menstruation
4.4 Masturbation
4.5 Hygiene
4.5.1 Hygiene for Girls
4.5.2 Hygiene for Boys
4.6 Touch
4.7 Relationships
4.8 Sexual abuse
To have access to the reference material access:
https://incluedusex.eu/outputs-downloads/

4.1 Puberty
The average age for girls to begin puberty is 11, while for boys the average age is 12.
But it's completely normal for puberty to begin at any point from the ages of 8 to 14.
The process can take up to 4 years.
4.1.1 Physical Changes in Boys
■ From 9 to 19 years old:
- Broadening of chest and shoulders
- Deepening of voice and appearance of facial hair
- Appearance of body hair and pubic hair
- Increase in size of genitals
- Growth spurt
- Ability to ejaculate.
www.menstrupedia.com/articles/puberty/physical-changes-boys

4.1.2 Physical Changes in Girls
■ From 7 to 19 years old:
- Development of breasts
- Appearance of hair in the armpit
- Widening of hips and appearance of pubic hair
- Growth spurt
- Onset of menstruation.
https://www.menstrupedia.com/articles/puberty/physical-changes-girls

4.2 Private and Public
■ Some young people need to learn about:
• Private body parts (when it is ok to touch yourself, others);
• Private and public places and appropriate behaviour;
• Sharing private information (e.g. telling the bus driver about having a period).
- Input generally starts at home with very young children identifying private body
parts.
- If children start to touch other people (particularly private body parts), this
needs to be addressed by the school and parent in a co-ordinated way.
- Aspects of Private and Public need to be taught from early childhood through
puberty and into young adulthood.
- Prior to puberty, children should learn who they can talk to about body changes
and other private things.
http://www.autismtoolbox.co.uk/supporting-wellbeing/sexual-health/public-private

4.3 Menstruation
■ An introduction to female
Reproductive System:
- Pituitary gland
- Uterus
- Vagina
- Cervix
- Ovaries
- Fallopian tubes
■ What is menstruation?
■ When does menstruation
start and stop?
https://www.menstrupedia.com/quickguide/girls#physiology
 How long does menstruation last?
 What is the length of a menstrual
cycle?
 Phases of Menstrual cycle:
- Menstrual phase (From day 1 to 5)
- Follicular phase (From day 1 to 13)
- Ovulation phase (Day 14)
- Luteal phase (From day 15 to 28)
 Methods of Contraception
https://www.nhs.uk/conditions/contraception/

4.4 Masturbation
■ Take the opportunity to educate yourself first about:
- Health and cleanliness
- Common misconceptions
- Moderation
■ Temper your cultural or religious concerns, don’t treat it as a taboo;
■ Consider giving your teen a book as a gift;
■ Set aside some time to talk in private;
The most common mistake that parents make is to try to eliminate masturbation
completely. This leads to a power struggle which the parents inevitably lose. Children
should not be physically punished for masturbation, nor yelled at or lectured about
it. Do not label masturbation as bad, dirty, evil, or sinful, and do not tie your child's
hands or use any kind of restraints. All of these approaches lead only to resistance
and possibly later to sexual inhibitions.
https://www.wikihow.com/Talk-to-Your-Teenager-about-Masturbation

■ Be as straightforward as possible;
■ Use a gentle tone of voice;
■ Reassure your teenager, so he or she can feel comfortable and safe about the
situation;
■ Talk about cleanliness and safety;
■ Encourage moderation;
■ Be available for questions;
■ Don't "look for evidence”, give your child privacy;
■ Don't punish masturbation;
■ Don't overdo the talking.
www.wikihow.com/Talk-to-Your-Teenager-about-Masturbation

4.5 Hygiene
4.5.1 Hygiene for Girls
■ Showers
■ Genital care
■ Skin
■ Hair Care
■ Shaving
■ Sweat, Odor care
■ Teeth and Breath
■ Nails
■ Clothing
https://buband.com/blogs/news/personal-hygiene-tips-for-teenage-girls

■ What is menstrual management?
■ Why is menstrual hygiene and management essential for girls and women?
■ Why should a girl know about menstrual hygiene and management even before she
starts to menstruate?
■ What are the different ways to manage menstrual flow?
- Disposable sanitary pad
- Reusable cloth pad
- Tampon
- Menstrual cup
■ What is a sanitary pad and how to use it?
■ What is a tampon and how to use it?
■ How to dispose a used sanitary pad or a tampon?
■ What is a menstrual cup and how to use it?
■ What should a girl do when she gets her first menstruation?
■ What are general hygiene measures necessary during menstruation?
https://www.menstrupedia.com/quickguide/girls#hygiene

4.5.2 Hygiene for Boys
■ How to Shave Effectively
■ Genital care
■ How to Shower Properly
■ How to Brush Your Teeth Correctly
■ Essential products:
- Deodorant
- Mouth wash
- Perfume/cologne
■ Clothing
https://lifehacker.com/an-adults-guide-to-hygiene-for-those-who-werent-taught-1689160558

4.6 Touch
■ Use the bathing suit rule: It is also known as the “underwear rule.” Teach your
children that anything covered by a bathing suit or underwear is a private, personal
area. Make sure children are aware that if they feel uncomfortable when someone
touches them near their bathing suit area, then it’s not okay.
■ Use the right language
■ Teach them the difference between good and bad touch
■ Remind them that secrets are bad
■ Strategize with them
■ Make them feel safe.
https://www.northshore.org/healthy-you/teaching-your-kids-appropriate-touching

4.7 Relationships
■ Define a healthy relationship;
■ Define an unhealthy relationship,
describe the different types of abuse
and associated warning signs:
- Physical abuse
- Emotional abuse
- Sexual abuse
- Financial abuse
- Digital abuse
- Stalking
■ Explain the differences between lust,
infatuation, and love
■ Talk realistically about sex
■ Set expectations and boundaries
■ Offer your support
■ Use gender-inclusive language
■ Remain neutral to sexual orientation
■ Sexually transmitted diseases
(STDs).
https://www.goodtherapy.org/blog/9-tips-for-talking-to-teens-about-dating-and-relationships-0227157
https://kidshealth.org/en/parents/talk-child-stds.html

4.8 Sexual abuse
■ Among children, the warning
signs of sexual abuse, asserts
the U.S. Department of Justice’s
National Sex Offender Public
Website (NSOPW) include the
following:
 Nightmares or other sleep
problems
 Inability to focus
 Changes in eating habits or
refusing to eat
 Experiencing trouble swallowing
or an unusual fear of objects near
the mouth
 Unusual changes in mood
 New fear of specific places or
people
 Refusal to discuss events with
others
 Expresses sexual actions or
images through varying media,
such as drawings
 “Bribery-like” gifts, such as
money or toys that are out of the
ordinary
 Negative view of his or her body,
especially the genital area.
https://www.relias.com/blog/how-to-recognize-the-signs-of-sexual-abuse-among-people-with-disabilities

- Up to 14 per cent of children with disabilities are 'likely to be sexually abused'
- Unsupervised care makes these children vulnerable to sexual predators
- Children with a disability are regarded as less likely to report their abusers (Llewellyn,
G, Wayland, S, Hindmarsh, G (2016) Disability and child sexual abuse in institutional
contests, Royal Commission into Institutional Responses to Child Sexual Abuse,
Sydney.)
■ Warning signs of sexual abuse among teens may include the
following:
 Depression or anxiety
 Drug or alcohol abuse
 Improper hygiene
 Self-injurious behaviours, such as cutting, burning or otherwise
harming oneself
 Suicide attempts
 Changes in eating habits.
■ Adolescents may also exhibit any of the signs of sexual abuse in
children. Yet, all of signs of sexual abuse may appear in adults as
well.
https://www.relias.com/blog/how-to-recognize-the-signs-of-sexual-abuse-among-people-with-disabilities

Chapter 5: Case studies
■ 30 years old men who is deaf and becoming blind, talking about relationships
and sex life: www.junkee.com/out-of-the-darkness-the-sexuality-of-deafness-
and-blindness/52513
■ Debbie, Thomas, Carolyn, Sam and James (Intellectual disability) Story
about sexual assault and how they felt:
www.npr.org/2018/01/18/578956859/in-their-words-adults-with-intellectual-
disabilities-tell-their-sexual-assault-s
■ Katie’s (Intellectual disability) Story about her first time and Lisa Shevin
mother of Chani, who has Down Syndrome, explaining how she explain
about sex to her daughter: www.refinery29.com/en-
us/2016/12/131205/intellectual-disabilities-sexual-assault-statistics-sex-
education
■ Linda’s (Learning disability) Story: 19 years old daughter with special needs
has sex for the first time: www.lindaatwell.com/yikes-my-special-needs-
daughter-had-sex/

■ Grace : “He wanted (and got) sex at least twice a day every day. Sometimes
we had sex more than twice a day – even up to five times a day. It didn’t
matter if I had my period or if I felt unwell or was pregnant. He wanted sex. If I
refused, he made my life a misery, sulking and getting angry and taunting me.
It was easier to do as he wanted. I seldom ever enjoyed it. And there was my
deafness. I had left school with no qualifications, no career [her education
was inaccessible]. A dead end job and an early marriage and children meant I
had hardly any skills outside the home. He isolated me from my friends. He
could not cope with me being deaf; as my deafness increased, he found it
harder. He did not want a deaf wife. He hit me a few times.”
■ Helen: “When I was younger I remember this one guy at school said “Can you
have sex?” I was like “Yeah!”… Getting people to see past the chair… it’s
difficult.”

■ Lucille: “I can’t feel any sensation that one would normally have but the way I feel
does change in a way I can’t describe. Teamed with my imagination it can be very
pleasant, makes me feel sexy.”
■ Rhona: “Although I knew that he adored me, I also always felt slightly as though I
didn’t deserve him. I am a logical person, and I know that disability puts you further
down the relationship league table.”
■ Jane: “I am unhappy [in the relationship] a lot. But I’m scared no one else would
accept me. I just think people don’t accept people who are different.”

■ Sally: “Who would want to have sex with me when there are plenty of normal girls more
than willing?”
■ Lucille: “I felt so bad about not wanting sex [after injury] that I kept telling him to have
an affair”.
■ Jenny: [After a date] “His father came out to my car and told me to fuck off. He
[boyfriend] didn’t have any disability… He said “fuck off you cripple and leave my son
alone””.
http://shamelessmag.com/blog/entry/storying-disabled-womens-sexual-and-intimate-lives

■ Graham: “It was the first time I realised a woman’s body was warm, with no clothes
on, naked, she was warm and that was a shock to me.”
■ Rhona: “Sex was brilliant, and we both enjoyed each other immensely: Intimacy,
proximity, sensations, comedy, lack of control, feeling desired, being treated roughly
and not as though I might break.”
■ Grace: “His physical limitations meant that he used fingers and tongue to very best
effect. Also, he took time, lots and lots of time. One hour was minimum, more often
two or more. Foreplay was everything and he always, always made sure I came first
– more than once.”ugh I might break.”
■ Sally: “Up until recently I never doubted I’d someday have sex, but now, I’m really
not so sure. It depresses me that I might never have that experience. I am 21 after
all!”
■ Pete: “I’d ask for doors to be locked while I was showering. It never was locked… the
door was always wide open.”
http://www.disabilityhorizons.com/2012/05/reclaiming-our-sexual-stories/

■ Upon becoming a wheelchair user, according to society I am suddenly asexual and
“agender”. Young men don’t even see me. Men my age won’t look me in the eye. And
older men smile sympathetically at me. It’s as if I’ve become unviable as a potential
partner. If I am seen as a sexual object, it is as a fetish. There are hundreds of images
and clips of women using their amputations in unpleasant ways, or women trapped
and helpless in their wheelchairs while their partner performs various sexual acts. I
have heard more stories of kinky sexual propositions than of genuine romantic
connections. Fortunately, I am happily married and don’t have to suffer the dating
scene. But that doesn’t mean I don’t appreciate being complimented or being found
attractive. My husband and I still have a healthy attraction to one another, but intimacy
in this body is much different than it was in my able body. This body is softer and
looser. It sags in places it didn’t before. It’s not as flexible and graceful as it used to
be. It doesn’t feel as sexy. Intimacy — even loving, mutually respectful intimacy, can be
intimidating and uncomfortable when you don’t feel sexy. It doesn’t help that society
tells us every day that we are unattractive and unviable unless we are fetishized.
https://themighty.com/2018/12/people-with-disabilities-sexual-beings/

Disclaimer
For further information, related to the INCLUEDUSEX project, please visit the project’s website at
https://incluedusex.eu/elearning/ or visit us at https://www.facebook.com/Incluedusex/.
Download our mobile app at https://play.google.com/store/apps/details?id=com.incluedusex.mobile&hl=en_US.
This project (INCLUEDUSEX project - 2018-1-ES01-KA204-050062) has been funded with support from the European
Commission (Erasmus+ Programme). The European Commission support for the production of this publication does not
constitute an endorsement of the contents which reflects the views only of the authors, and the Commission cannot be held
responsible for any use which may be made of the information contained therein.

Io1 incluedusex project course final version

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