When Two Worlds Connect
Blog by Lorraine Stanley, Founder & CEO of SWAD. Originally published on 25 November 2022 by BASHH to mark the BASHH centenary and Disability History Month The British Association for Sexual Health and HIV (BASHH), is the UK's leading professional organisation dealing will all aspects of sexual health care.
As part of Disability History Month, I took a look back at how disabled people have experienced access to sexual health services and contraception over the same time period.
Timeline – 8 key events in the UK & the wider world:
1922
The UK’s Mental Deficiency Act had already been in place for 9 years. This categorised people with learning disabilities and mental health issues as “idiots” or “moral defectives”. Unmarried mothers begin to be placed in this ‘moral defective’ category too. Many people acquire their diagnosis of mental deficiency because of extreme childhood adversity or institutional care. The Act leads to many more people with learning difficulties being incarcerated.
1941
Disabled people were viewed as being “defective” by the Nazis. A Catholic bishop, Clemens von Galen, delivers a sermon in Munster Cathedral calling the Nazi euthanasia program ‘plain murder.’ Hitler suspends his Aktion T4 programme, which had already accounted for nearly 100,000 deaths of disabled people. However, the euthanasia program quietly continues using drugs and starvation instead of gassings.
1995
Protests by disabled people lead to the landmark introduction of the UK’s Disability Discrimination Act. This makes it illegal to discriminate against disabled people in connection with employment, the provision of goods, facilities and services or the disposal or management of premises. Service providers must now make reasonable adjustments to enable disabled people to access their services.
2004
The legal requirement to make reasonable adjustments to make buildings accessible comes into effect.
2005
The Disability Discrimination (Amendment) Act extends protection to land, transport, small employers and private clubs, extends the definition of disability and introduces a duty for public bodies to promote disabled people’s equality and ‘involve’ them in the design of services and policies.
2010
The Equality Act is passed by Parliament days before the general election. It outlaws direct or indirect discrimination and harassment in employment, vocational education and the provision of goods and services, for a total of nine protected characteristics including disability. It also outlawed discrimination because of association with a disabled person or because of the perception that someone is disabled.
2015
Judge authorises sterilisation of mother-of-six with learning disabilities. This is rare now, but enforced sterilisation was a frequent happening up until the 1950s. It happened, but less frequently, into the 1990s.
2020
The Department for Education introduced compulsory Relationships Education for primary pupils and Relationships and Sex Education (RSE) for secondary pupils from September 2020. Up until then, students at Special Educational Needs (SEN) Schools, would only receive this vital information if their school was quite progressive.
Where are we now?
In 1995, there were massive protests by disabled people. The protests helped pressure the UK government into making it illegal to discriminate against someone because of their disability. From my own lived experience, and the hundreds of disabled people I have supported through my work – there are still many barriers to disabled people in accessing sexual and reproductive healthcare. When we know better, we do better……so to start the ball rolling, I have a few questions for you!
- Is there at least one hoist in your sexual health clinic? Some disabled people need a hoist to transfer onto an examination couch.
- If there is a hoist, do you feel confident in using it?
- Does your examination couch have arm rests/grab handles? This helps people to get onto, and adjust their position safely while on the couch. It’s unnerving to be above ground height, on what is essentially an island, with cliff drops all around you. It could be arm rests were provided with the couch, but ended up in a cupboard somewhere. (Have a treasure hunt before you order new ones.)
- Do your examination couches have leg supports? Imagine you have a condition that involves muscle tremors, muscle weakness, or you have a spinal cord injury. How confident would you feel in being able to maintain the necessary positions?
The above questions all assume that you have managed to access the building/the sexual health unit/the reception area/the examination room. My wheelchair is fab, but it can’t fly or magically go through walls – which leads to my next questions….
- If you have a lift, can it accommodate a large electric wheelchair?
- If you have an accessible loo, is there a wall or structural pillar hindering my ability to manoeuvre into it? Is the door itself light enough to open with one hand? Once I drive in, can I shut the door behind me and lock it?
The above applies equally to GP surgeries that offer cervical cytology, and long-acting contraception such as implants and coils.
The bottom line
My health and my life are just as important to me, as a non-disabled person’s life is to them. There are over 14 million disabled people in the UK at the moment. If even a quarter of those people are sexually active, but can’t access the professional services provided by BASHH members, I see that as being an unacceptable situation.
The non-judgmental attitude of sexual health staff is something I really admire. The pressures that Covid and Monkey Pox have put on your services is tremendous. I (almost) feel guilty about asserting my right to equal healthcare, but the situation won’t change unless you’re made aware of it.
I want to be part of the solution, because improvements will happen sooner if we work together. It would be great to lighten the fight load for other disabled people in accessing health care that other, non-disabled, users of your services can access freely.
BASHH have welcomed me with open arms onto the Public Panel; REALLY listened to my input on the disability side of life; provided reasonable adjustments to accommodate my disabilities; and even let me present at the Annual Conference last year (!). If you missed my presentation, you may like to view a pre-recorded interview with Alex Sparrowhawk. Alex is a fellow public panel member who invited me to present at the HPE Conference. It’s under 20 minutes long, and is really relevant content to this blog. You can find it here: https://www.swaddorset.org/resources/ .