The American Academy of Pediatrics offers guidance on discussing and promoting sexual health for children and teenagers with disabilities in a newly published clinical report.
The report, "Promoting Healthy Sexuality for Children and Adolescents With Disabilities," published in the July 2021 Pediatric updates a 2006 report and recognizes the need for pediatricians to help families begin discussing sexuality early in the patient's life.
Understanding changes & promoting safety
"It's so important to help all children and youth, including those with disabilities, gain a healthy and accurate understanding of their changing bodies and feelings." said Amy Joy Houtrow, MD, PhD, MPH, FAAP, lead author of the report, developed by AAP Council on Children with Disabilities.
"Research tells us that many children learn about sexuality through the media rather than from a trusted family member or doctor," Dr. Houtrow sad. "We offer pediatricians guidance that promotes the autonomy of children and youth with disabilities while helping to reduce their risk of sexual violence, abuse, exploitation, and coercion."
Pediatricians are ideally positioned to promote safer sex practices and education on how to achieve a healthy sexuality regardless of physical, cognitive, or socioemotional limitations, the report states. The report urges pediatricians to examine their own beliefs and attitudes about disability and sexuality to ensure their own counseling reflects inclusivity and willingness to provide anticipatory guidance, problem-solving and referrals if needed.
The AAP also recommends:
Pediatric health care providers are encouraged to discuss appropriate "private" versus "public" behaviors from an early age, such as preschool.
When a child reaches age 8 or 9, pediatricians should begin to discuss puberty and may need to do so sooner if the child is at risk for precocious puberty. This is especially important for children who are discovering their
nonbinary gender identity or nonheterosexual sexual orientation.
Pediatricians are encouraged to partner with families who may feel uncomfortable addressing sexual health. They can do this through a shared decision-making process that is culturally responsive and elevates the rights of children with disabilities to gain knowledge and understanding regarding their developing sexuality.
Pediatricians are ideally suited to counsel youth with disabilities on prevention of sexually transmitted diseases and unwanted pregnancy, as well as the benefits of HPV vaccination. They can help teens obtain contraception confidentially with adherence to informed consent rules.
Pediatricians may partner with schools to ensure children with disabilities have access to developmentally appropriate sexual education. This should include information on sexual victimization, safe sex practices, consent and respect.
"Sexuality is a reflection of the natural human desire for a feeling of connectedness and intimacy," Dr. Houtrow said. "The pediatrician is great resource to help families with questions they have about their children with disabilities as they grow and develop into young adults."