What do you get when you mix the taboo nature of discussing sexual intimacy with the social stigma surrounding intellectual and developmental disabilities? The answer: a heck of a lot more problems than you might think. Sexual education in the school setting is already a hot-button issue for non-disabled students. But when students with intellectual and developmental disabilities are introduced into the mix, so too are the ableist stigmas we all hold.

Taboo-Nature

I would like to start this piece with a brief exercise one of the health teachers at my high school conducted at the beginning of sex ed. Repeat after me: Penis. Vagina. Penis. Vagina. Why do you think she would make a room of teenagers yell these words in school? Isn’t that inappropriate? If you think it is, you proved my point from earlier. Sexual intimacy and anything loosely related to sex are currently incredibly taboo topics. To help break down the air of discomfort surrounding such topics, that health teacher did something many are afraid to do: she spoke openly and encouraged others to follow suit.

One could argue these topics are not to be spoken about simply because we are taught to not speak about them. A child can ask why their anatomy is different from their siblings, but they will often be met with shushes or roundabout answers. In many cases, there is no reason for this reaction other than traditional values. Those same values are often times what causes conflict in regard to sexual education in public schools.

My sex ed experience at a public school was mediocre at best. Genitalia, STIs, and contraceptive methods were discussed. Consent was not taught nor were the proper ways to actually engage in sex, just that if we did it we should do it safely. This was not the most educational experience. And if this is what I received, what is the experience of children and adolescents with intellectual and developmental disabilities?

The Institutional Deficit

Working in a behavioral school for boys with emotional, developmental, and intellectual disabilities yields an interesting perspective. These students are taught the same subjects most other students in the country are taught just with more academic and therapeutic support. However, they are not always provided with a health class.

I worry greatly about this institutional deficit, partly due to my own ableism. These students are receiving very little, if any, sexual education during the school year from our faculty and who knows what they see on the Internet and what their families and friends are telling them. As they get older and begin to develop their curiosity, I am worried that they might not always have a reliable source of sexual education. With that, the concept of consent is often discussed but not in the context of intimacy. I don’t know if the connection between consent and sexual activities has been made or if it ever will be in this school setting. I don’t know if some of these students would understand the magnitude of these topics. I’d like to think these kids can do anything, but from what I’ve seen I don’t know if I would feel confident in their understanding. I wish I could feel otherwise.

Deeper Issues

Individuals with an intellectual or developmental disability are seven times more likely to experience sexual assault than non-disabled people. In many cases, the perpetrator is another individual with an intellectual or developmental disability. Ableism likely prevents people from thinking this to be possible. Common stereotypes around this population convince the non-disabled community that these individuals can do no wrong and are by default sweet and innocent. Of course, this is not realistic. Another ableist stereotype, as seen above, is the incapability of this population to understand topics related to sexual education and sexual intimacy. Like the non-disabled community, however, individuals with an intellectual or developmental disability prove that idea wrong.

Why This Matters to Social Workers

So, if people with intellectual and developmental disabilities are able to learn about sexual education, and learning about sexual education dramatically decreases instances of sexual assault, then what is the reason for this population to not receive sexual education? The signs point towards ableism held by those in helping professions, with social workers being a perfect example. While the social work community prides itself on how educated and accepting they are of different identities, very rarely do social workers take the time to reflect upon identities they may not be as familiar with. Race and sexual orientation are examples of identities social workers study extensively, but disability as an identity and the depths of disability culture are rarely examined. To combat this, social workers need to begin the process of confronting personal ableism.

Confronting personal ableism is difficult, but doing so will only benefit social workers and others who choose to do so. It is important and necessary to challenge internal biases. Critically examining personal ableist ideas pushes social workers to gain a different perspective. Through this difficult process, one gains clarity in the issues they may not even know they wrestle with. Understanding how ableism impacts perceptions allows social workers to get a firm grasp on the disability community. They may begin to feel empowered to advocate for a change they never once considered, such as a stronger sexual education program for people with an intellectual or developmental disability. The importance of critically examining personal biases should be emphasized throughout the entirety of the social work community and by every social worker.

In 2020, the population of homeless people grew for the fourth year in a row, and a single night count in January of that year revealed 580,000 people were experiencing homelessness. But while the homelessness crisis is widely acknowledged, a problem that is less recognized is how (and why) LGBTQ+ youth are disproportionately represented among the homeless. Moreover, the problem is not only the overly high representation of LGBTQ+ youth without homes but the increased risks and challenges they face while they are living homeless. And if they are also Black, Indigenous and People of Color (BIPOC), then there are even further risks yet. Mitigating the problem will therefore require a broad, multifaceted, and holistic approach that addresses the multiplicity and intersectionality of these challenges, some of which have been exacerbated by the pandemic.

Causes, Risks, and Minority Stress

At the deepest level, generalized homophobia and transphobia are foundational causes of the high percentage of homeless LGBTQ+ youth. Both homophobia and transphobia underlie family rejection, which is a primary cause of the higher rates of LGBTQ+ youth homelessness. Among LGBTQ+ youth without housing, around 46 percent run away due to family rejection and 43 percent are forced to leave home by their parents.

Once homeless, LGBTQ+ youth also face higher risks of mental health challenges, substance use, sex trafficking, sexual assault, and becoming victims of hate crimes compared to their cisgender, heterosexual counterparts. And when we probe deeper into any one of these risks, we find them inevitably linked with numerous forms of discrimination. For example, one of the reasons unstably housed LGBTQ+ youth are at higher risk of sex trafficking is that many of them are pressured into alternative forms of making money to survive due to discrimination against sexual and gender minorities in the job market.

In addition to the job market, there is discrimination against the LGBTQ+ community when it comes to housing and accessing homeless services as well. Minority stress theory is used to describe this kind of intertwining of discrimination in multiple, overlapping dimensions in a way that compounds stress and increases risk factors for minority groups.

Racism is also a major factor. While LGBTQ+ youth in general are disproportionately represented among the homeless, so too are Black people. Because of this, there are even more risks for Black LGBTQ+ youth experiencing homelessness since they lie at the intersections of sexual, gender, and racial identities and are thus exposed to all of the discriminations these minority groups face.

Tragically, many of these preexisting disadvantages faced by homeless LGBTQ+ and Black LGBTQ+ youth were exacerbated by the pandemic, which caused numerous programs and services designed specifically for these communities to reduce hours or shut down entirely.

Minority Strengths, Resilience, and Action

A newer framework that can be seen as complementary to minority stress is minority strengths.  That is, even as racial and sexual minority statuses come with increased stresses and risks, they can also be sources of strength when members of these minority groups can identify with, and experience camaraderie with, other members of their respective minority group(s). Here as well, however, there are complexities since not every minority may have equal access to social support. Even within the LGBTQ+ community, for example, there can be transphobia and/or racism. A Black trans youth may therefore experience multiple forms of discrimination from within the very community they look to for strength. Still, it is useful to consider the minority strengths model alongside minority stress so that neither the positive nor negative aspects are overemphasized.

Speaking of overemphasizing, the tendency to focus on resilience in the context of LGBTQ+ youth homelessness has become a double-edged sword. While, on one hand, resilience should certainly be acknowledged, its role as a solution should not be exaggerated. The fact of the matter is that there are many ways to reduce LGBTQ+ youth homelessness and the risks associated with it.

We can work to address homophobia, transphobia, and racism in the culture at large, for instance, and to reduce discrimination in the job and housing markets which would help reduce the rate of homelessness among LGBTQ+ youth in the first place. We can also work to implement protections for the LGBTQ+ community more widely within homeless services so that those who do end up homeless can safely access these services. Social workers and providers of social services can also be trained to better recognize and address the unique challenges that unstably housed LGBTQ+ youth face. Relying too much on resilience creates a danger of neglecting concrete actions such as these which can and should be taken as preventative measures.

Finally, a word needs to be said about research which, like resilience, is sometimes overemphasized. As a researcher myself, I know that research can certainly help play a mitigating role, but we need to be mindful of the tendency to put the onus on more research when we already know enough to get to work and make a sizable difference. Research and advocacy can complement each other. There will always be more to learn, but if we wait until we know everything we will never act. With rates of homelessness increasing, and the pandemic having amplified the causes and risks of LGBTQ+ youth homelessness, the time to act is now.