Volume XIV Number 4 March 1986 ISSN~0091-3995 Sex Information and Education sEaJs REPORT Council of the U S.

SEXUALITY AND : LOOKING BACKWARD AND FORWARD

Pamela 5. Boyle, MS, ACFC Coordinator, Reproductive Health Care and Disability Program Planned Parenthood Board member, Coalition on Sexuality and Disability New York, N.Y.

In the spring of 1978, I found myself walking the streets and had the pleasure of coordinating the Reproductive Health avenues of New York City, resume in hand, trying to decide just Care and Disability Program at Planned Parenthood of New what to call myself. Should l look for a job as a rehabilitation York City. Happily, I’ve come a long way since 1978-although counselor who specialized in sexuality and disability,or should I’ve still not decided exactly what to call myself! I say I was a sexuality and disability counselor-educator who There are now many people working in the field of rehab had a masters degree in rehabilitation counseling? After I fig- to ensure that people with have access to complete, ured out how I would identify myself, where would I seek factual information related to their sexuality. The field of sexu- employment? A hospital? Rehabilitation center? The private ality and disability probably had itsorganized beginnings in the sector? A state funded organization? Would anyone hire an early 70’s, when the first training programs in sexuality and individual with my specific skills? Finding a job seemed impos- disability were being perfected by Theodore and Sandra Cole sible. There were lots of pats on the back, statements about at the University of Minnesota. After more than fifteen years of how interesting I must find my work “Whatwork?” I thoughtto growth and development, now may be the time to examine just myself, “I’m hoping you’ll give me work! !!” About this time, a how this adolescent is doing. meeting was held at United of New York City. I recently spoke with a number of professionals whocould The meeting was attended by numerous professionals from the be considered “pioneers” in the field of sexuality and disability city who were working in rehab and who were interested in and asked them to share their feelings about the progress we doing work in the field of sexuality and disability. Also in have made. We also discussed what we must do to ensure that attendance were Susan Knight and David Bullard from the Sex the field will continue to grow into adulthood and many years and Disability Training Program at the University of California, beyond, into the distant future. Those I spoke with include San Francisco. In 1977, I had been a trainee at UCSF in the first Ciovanna Nigro, United Cerebral Palsy of N.Y.C.; Isabel Robi- training session they had conducted, which followed on the nault, United Cerebral Palsy Associations, Inc.; Sandra Cole, heels of my completion of graduate school. We sat together University of Michigan; Mary Romano, National Rehabilitation and talked about the emerging field of sexuality and disability. Hospital; Simi Linton, private psychologist; Sol Gordon, Syra- We were all in agreement that it had a rightful, important place cuse University; Anne Welbourne-Moglia, SIECUS; and Tuppy in service programs for people with disabilities. Why, if this is Owens, Outsiders Club in London, England. true, I asked, can’t I find a job?!! Each of these individuals felt that we have made significant I was fortunate to be in the right place at the right time. progress in increasing publicand professional awarenessof the Giovanna Nigro of UCP/NYC advised me that UCP of Queens general needs of people with disabilities, including their social was looking for a person to work on sexuality education and sexual needs. People with disabilities, as well as their families, counseling with its clients. “This is too good to be true,” I have become more vocal as a consumer group. This is progress. thought, as I surveyed the blisters on the bottoms of my feet Perhaps it is slow, but an important message is reaching society: and the callouses on my knuckles. It was just about two weeks people with disabilities are more alike than different from the later that I found myself sitting behind a desk at UCP/Queens, able-bodied. organizing my books and thoughts. After a fantastic experience The media has played an important role in exposing the of working with clients who were developmentally disabled for general public to disability and thesocial/sexual needs of those one and a half years, I packed up my skills and moved on to who are disabled. Recently a major morning talk show in New work at UCP/NYC under the supervision of Ciovanna Nigro. I York City invited three individuals to discuss sexuality and worked at the New York City office for about an equal length of disability. The segment lasted some twenty minutes and was time and served a similar client population. Since 1981 I have well received by the public. Now that’s progress! In the mid 1970’s the film Coming Home encouraged consideration of the Gipper” feeling. We must not mistake this as training in its sexuality and the needs of people with disabilities in its presen- truest sense. Because of the lack of staff training time, other tation of a beautiful and sensual love scene between Jane priorities, lack of funding, scheduling problems, etc., we as Fonda and aspinal cord injured,Vietnam veteran played by Jon professionals may find ourselves being cheerleaders for the Voight. Similarly, television has gradually improved its depic- cause. Substantive training requires much more, including tion of people with disabilities. Actors who are disabled are adequate time to return to the agency to offer support and being cast in the roles of the disabled, instead of casting able- guidance of staff. bodied actors in these roles. Television is stepping back from Often mentioned in discussions about training was the the two extreme views of the disabled. The disabled person is lack of training of students at all levels and in all disciplines. no longer portrayed as either the super-hero or the angry Medical students, nurses, social workers, rehab counselors, person with an enormous chip on his shoulder. If you look special ed teachers, physical, occupational and speech thera- closely at a recent television commercial for MacDonald’s, you pists, and psychologists, etc., need to receive adequate expo- will spot a young man in a . This too is progress. sure to issues of sexuality and disability within the context of The professionals I spoke with each felt that progress has their overall training programs. We should be producing a been made in the area of staff training, but that the field may group of professionals who arewell-rounded in their approach have reached its peak in the mid to late 1970s in terms of to the concept of total rehabilitation, who do not omit issuesof securing grants and other monies to finance training for those sexuality and hope that someone else will deal with the topic. working in rehabilitation. There appears to be little money in Interesting discussions were sparked by the question of why so agency budgets allocated for the hiring of consultants to pro- few sexuality professionals-therapists, counselors and vide the groundwork for training programs, or so we are told. educators-have chosen to add to their set of skills by increas- Could it be that issues of socialization and sexuality continue to ing their knowledge of sexuality and disability. Many found be on the bottom of the priority list in rehab centers, in com- that training programs were far moreoften attended by profes- munity residences for the developmentally disabled, and other sionals working in jobs directly related to rehab or special facilities serving people with disabilities? It seems that “line education than by individuals in , counseling, or staff,” those who work on a daily basis with the disabled popu- therapy. It was noted that workshops and round table discus- lation, often identify their need for training in sexuality but do sions on sexuality and disability held at SSSS and AASECT not receive it. All too often, “trainers” show a film on sexuality national conferences have been very poorly attended. and disability and call it “training.” Isabel Robinault describes Throughout the country there are far too few knowledgeable these meetings as “rah-rah”sessions, or as Mary Roman0 says, resources for individuals with disabilities even though in most the gathering of staff which produces the“let’s win this one for metropolitan areas there is no shortage of people working in the field of sexuality. People interested in expanding their expertise in sexuality to include the provision of services to disabled individuals should locate the nearest Sexual Attitude SICCUS REPORT Reassessment Seminar Center (SAR). They are located at some of the major rehabilitation centers throughout the country. Volume XIV, Number 4 March 1986 (Contact SIECUS for the SAR center closest to you.) The S/ECUS Report is published bimonthly and distributed to Two organizations concerned with issues of sexuality and SIECUS members. disability have been developed. Their primary aims are to Annual membership fees: Individual $40; Student (with valida- ensure the continued progress in this field as well as to create tion) $20; Organization $90; Benefactor $150 or over. an atmosphere wherein sexuality and disability is legitimized as Library and Institutional subscriptions: $40 annually. an important issue. The Coalition on Sexuality and Disability, Inc. is an organization committed to advancing the full social Outside U.S.: Canada and Mexico, add $5.00 per year to the above fees; other countries, add $10.00 per year. integration of people with disabilities. It works to increase the availability of accessible, client-responsive sexual health infor- Single copies of back or current issues of theS/ECUSReport may be ordered for $5.00 each, prepaid. Bulk prices available. mation and services. It is a network of people, both disabled and non-disabled, professionals and members of the commu- All inquiries should be directed to the SIECUS Publications Office at the address below. nity. The Coalition provides educational programs and advo- cates the right of people with disabilities to have a social and S/ECUS Report is available on microfilm from University Micro- sexual life. Another organization, the Task Force on Sexuality films, 300 North Zeeb Road, Ann Arbor, MI 48106. and Disability of the American Congress of Rehabilitation Editor-Sharon R. Edwards, MA Medicine, has played a major role in keeping issues of sexuality Editorial Consultants in the forefront among the providers of medical services to Joan S. Benesch disabled individuals. The establishment of the network of SAR Michael Carrera, EdD centers is only one of the many important contributions made Jane Quinn, ACSW by this task force. SIECUS can put you in contact with these Robert Selverstone, PhD Ann Welbourne-Moglia, RN, PhD organizations. Another step forward has been the inclusion, in some Copyright @ 1986 by The Sex Information and Education Council agencies servicing the disabled, of studies of the U.S., Inc. 80 Fifth Avenue, Suite 801-2, New York, NY programs coordinated by skilled individuals. United Cerebral 10011; (212) 929-2300. Palsy of Queens and UCP of New YorkCity serveastwoshining Library of Congress catalog card number 72-627361. examples of agencies that employ full-time professionals to No part of the S/ECUS Report may be reproduced in any form work with clients and staff in sexuality and disability. without written permission from the SIECUS Publications Non-rehabilitation agencies, such as Planned Parenthood Office. of NYC and Planned Parenthood of LA (as well as other affiliates

2 SIECUS REPORT, March 1986 of PPFA), have identified the need of people with disabilitiesto 6. We professionals who are skilled in sexuality and dis- receive the same kinds of reproductive health care services as ability must nurture students and draw them into the field by any other individual. The Margaret Sanger Center of Planned providing internship opportunities. All of us realize that read- Parenthood of NYC sought and received federal monies in the ing books can never provide the kind of education that actual early 1980s. This funding has enabled Planned Parenthood to one-on-one work with a client can offer. By offering these make its clinic accessible to people with disabilities. They pur- opportunities, we will increase the pool of professionals work- chased educational materials, installed hydraulic exam tables, ing in the field who have skills, not only good intentions. lowered the button panels in the elevators, and, in 1981, 7. We must continue networking. Cooperation between opened its architecturally accessible doors to people with dis- people with disabilities and service providers is essential. abilities. After five years, and despite many budget cuts, the Organizations, such as CSD, SIECUS, AASECT, the Task Force Reproductive Health Care and Disability Program is alive and on Sexuality and Disability and SSSS must forge a bond which well, evidence of the agency’s commitment to meeting the will ensure that the needs for sexuality services for all individu- needs of disabled people for sexuality counseling, education, als will be met. and direct medical services. Sadly, the funding needed to open 8. We must continue to advocate issues of sexuality, indi- and sustain this kind of program is for the most part unobtaina- vidual needs, and basic human rights with public officials. This ble given the current fiscal and political climate. As Giovanna is especially needed in the area of mental retardation/develop- Nigro stated, the good intentions of any agency are only real- mental disability where the topic is all too often avoided due to ized when funding is available. fear, misunderstanding and “other priorities”. We must act as One must question why so few positions exist in the field an advocate for this population of consumers. of sexuality and disability compared to those found at Planned Finally, and perhaps most importantly, we must remember Parenthood and the UCP affiliates. Mary Roman0 suggested that almost everyone becomes disabled in some way, to some we must ask if there are so few jobs available because there degree before they die. This fact may help us to avoid the is a limited number of people seeking employment of this “them” and “us” feeling that too often prevents full social and nature or if the number of people specializing in the field of sexual integration of people within our society. sexuality and disability is painfully small because of the scarcity of agencies seeking to employ people with these skills. Many suggestions relating to what professionals in the field of sexuality could do to ensure the future growth of this I DO YOU KNOW THAT.. . 1 field were offered. Some of the suggestions are as follows: 1. We need more research in such areas as sexual abuse, pregnancy, child-birth, parenting, and sexual functioning of Resources to Write for . . . disabled people. 2. We must increase the of information related to sexuality and disability for all-students and profes- Teaching People With Mental Retardation About Sexual Abuse sionals, disabled and non-disabled. According to Anne Welbourne-Moglia, the SIECUS Resource Center finds that Prevention (1982) by Cordelia Anderson of Minneapolis’s renowned Illusion Theater Company is a 24-page guide for sexuality and disability is the third most asked about topic educators working with moderate-to-high functioning men- following sex education and adolescent pregnancy. Essential tally retarded people. It emphasizes role playing, described in publications such as Who Cares!, Sexual Options for Paraple- such sections as “Stranger on the Bus” and “When Touch gics and Quadriplegics, and Sex, Society and the Disabled are Changes From Good to Bad,” as well as the development of just a few examples of books no library should be without. practical skills. This resource, priced at $4.95, plus 15% p/h, may Universities, hospitals, as well as public libraries should be ordered from: Network Publications, 1700 Mission Street, seriously consider increasing their holdings in this very impor- Suite 203, Santa Cruz, CA 95061-8506. tant area. 3. We must find ways to decrease the isolation of people About Sexuality and People With Disabilities, a 1985 addition to with disabilities. This isolation prevents social skills to be devel- the Scriptographic Booklet series, is a 15-page pamphlet oped because of lack of practice. Friendships, which are the encouraging family and friends to accept the sexuality of peo- basis upon which deeper relationships are formed, may not be ple with disabilities, help provide them with accurate informa- initiated. We must not forget that the socialization aspect of tion, and realize that there are many ways to express one’s our sexuality is vital. Finding solutions to the issue of isolation sexuality. Single copies cost 69q, and bulk rates are available. isn’t easy in a society filled by architectural and attitudinal Orders should be sent to: Channing L. Bete Co., 200State Road, barriers. South Deerfield, MA 01373. 4. We must develop new treatment techniques to use in sex therapy and counseling for people who have organic love, Sex, and Birth Control for Mentally Handicapped Peo- impairments of their sexual functioning. ple: A Guide for Parents, by Winifred Kempton, Medora S. 5. We must continue striving to ensure that professionals Bass, and Sol Gordon, has been revised and issued in its seventh in all disciplines working with disabled people have appro- edition (1985). The 38-page guide offers supportive, practical priate training to increase their level of comfort about sexual- suggestions for providing basic sex education in the home and ity. They must become permission-givers who may not have all also for dealing with the sexuality of mentally retarded daugh- the answers but who know when to refer a patient/client to a ters and sons. Topics covered include reproduction, puberty, professional with well-developed skills and knowledge in sex- masturbation, dating, sexual decision-making, contraception, uality counseling, education, and/or therapy. If all helping sexual abuse prevention, marriage, and parenthood. It is avail- professionals could do this, people with disabilities would ben- able for $2.95, plus 45~ p/h, from: Planned Parenthood, 1220 efit more than is imaginable. Sansom Street, Philadelphia, PA 19107.

SIECUS REPORT, March 1986 3 WHERE THE ACTION IS

Confronting the Myth of : The Networking Project for Disabled Women and Girls

Harilyn Rousso, CSW Director The Networking Project for Disabled Women and Girls YWCA of the City of New York New York, N.Y.

There is a pervasive myth in our society that people with dis- stomping grounds-college campusesand theworkplace-are abilities are asexual. This myth is reflected in our associations to often less available to disabled women. disability: dependent, sick, childlike, helpless-not very sexy The myth of asexuality seriously limits the social and sexual images; in our language: paras and quads, the blind, the dis- options and opportunities of disabled women and girls in a abled, rather than women and men who happen to have dis- variety of ways. It may limit their families’ and friends’ social ability as one of their characteristics; and in our media images: expectations for them, which in turn may affect the expecta- telethons and poster children-appealing as fundraisers but tions that disabled women and girls have for themselves. It may lacking in sex appeal. limit disabled women’s access to sex information and sexual Women with disabilities are particularly likely to be per- health care services, because parents, educators, and society ceived as asexual, for several reasons. So much of the traditional may view such information and services as unnecessary. lt view of female sexuality is based on physical appearance, on contributes to the limited accessibility of social and singles’ meeting Madison Avenue standards of beauty and physical activities, often fraught with architectural and transportation perfection. While disabled women are by no means unattrac- barriers. It limits the number of potential partners who are able tive, they often differ from these norms. In contrast, male to recognize the social and sexual capacities of disabled sexuality, which is based less on physical appearance, includes women. Finally,the mythof asexuality may limitthesewomen’s other components, such as income level, status, and type of own identity as desirable, attractive, sexual people and affect work; a disability in a man is thus less likely to detract from his their self esteem. Disabled women pay a high price for this sex appeal. myth. Indeed, statistics suggest that disabled women are less Differences in male and female socialization and gender likely to marry, are more likely to marry late, are more likely to role expectations also reinforce asexuality in disabled women. be divorced post-disability, and are more likely to bealone and To the extent that passivity isstill viewed by families and society left alone in comparison to either disabled men or nondisabled as appropriate female behavior, disabled women and girls are women (Fine and Asch, 1981). not encouraged to challenge the myths about their lives that Yet disabled women are sexual and are entitled to and confront them. The woman’s role in dating and courting con- capable of an active, rich, social and sexual life. How can they tinues to be a passive, waiting role. So that for disabled women, confront the myth of asexuality in themselves, in their families, and indeed all women, feeling sexual is more dependent on and in society? being chosen, which in turn is more dependent on the atti- For all women, disabled or not, access to strong, positive tudes of potential partners and society as a whole. In contrast, role models is one major strategy for confronting limiting disabled men can take a more active role in validating their myths and stereotypes and expanding their range of profes- sexuality by choosing a partner. Also, sex is more readily seen as sional and personal options. Within the women’s movement, a physical need for men than for women, a need which must be strong emphasis has been placed on developing networks and met, disability and all. A further factor is that women are more programs that will provide women with accesstoother women readily seen as nurturers than men are, so that disabled men from whom they can learn and emulate. Through role models may more easily find and expect to find a woman to care for and networks, women have been able to climb further up the them; whereas it is less socially acceptable and hence more corporate ladder, enter nontraditional fields, and explore new difficult to find a man to “tend to” a disabled woman. lifestyles. In comparing disabled women with disabled men, it is Role models, which might help confront the myth of asex- important to note that disabled women may have fewer social uality, are noticeably absent in the lives of most disabled opportunities with which to test out and disprove the myth of women and girls. Disabled women do not usually have dis- asexuality for themselves. Their families are more likely to be abled mothers or other disabled family members with whom overprotective in the social and sexual arena. They do not have they can share their experiences; they are often the only dis- access to “old boys’ networks, ” which often serve to introduce abled person in their community. Also, successful disabled disabled men to the world of sexuality. And, the major social women are quite invisible in our society. While there have

4 SIECUS REPORT, March 1986 been many socially and professionally successful disabled “Having a baby when you are quadriplegic may involve some women historically and currently-women like Harriet Tub- creative problem solving, but it is definitely possible and an man, Elizabeth Barrett Browning, Sara Bernhardt, Kitty O’Neal, experience that I would never have wanted to miss. My own Mary Tyler Moore, and Wilma Rudolph-the fact that these parents thought I was crazy when I decided to have a child, and women have disabilities is rarely known. Because of thestigma I got furious at them. As a woman, I am entitled to make my of disability, when a disabled woman becomes successful, she own choices about having children. Of course, that meantthat is often no longer perceived as disabled. In people’s minds, my husband and I had to take responsibility for figuring out “disability” and “success,” particularly social and sexual suc- ways for me to feed, hold, and care for an infant without the use cess, do not go together. Thus these well-known women do of my arms, and for him to be available for assistance when I not serve as role models for other disabled women and girls. needed it. But there are always ways, if you feel entitled.” One innovative program that seeks to confront the myth Utilizing role models to help young disabled women feel of asexuality and other stereotypes about disabled women by entitled to all aspects of themselves and their lives, including providing highly visible positive role models is the Networking their sexuality, is what the Networking Project is all about. The Project for Disabled Women and Girls, sponsored by the project views sexuality as a broad concept, including all the YWCA of the City of New York. This project seeks to increase ways people think, feel, and act as women or as men; our the social, sexual, educational, and vocational aspirations and sexuality affects how we walk, talk, dress, work, play,feel about options of adolescent girls who have physical and sensory ourselves, and relate to others. It includes but is not limited to disabilities by linking them with successful disabled women in specific social activities, such as dating, or to acts of sex per se. the community who can serve as role models and mentors. Thus many of the activities and events sponsored by the project These disabled women lead diverse life styles and work in a address issues of sexuality, although not necessarily as the main range of occupational areas, from carpentry to medicine, busi- focus; in all cases, the emphasis is on choices and options. For ness to fine arts. These women’s very presence and visibility,as example, many intergenerational discussion groups include well as their willingness to share their experiences and advice, discussion questions on identity and self-esteem as women, enables the girls and their parents to begin questioning the types of relationships, and parenthood, as well as educational numerous myths and stereotypes about being a disabled and career choices. Also, worksite visits, where small groups of female that subtly permeate their lives. girls visit with a role model at her workplace, have included not “How do you flirt when you can’t see?” “Where did you only visits to courtrooms, computer terminals, and neuro- meet your partner. T” “What is it like to have a baby when you chemistry laboratories, but also to cosmetics firms and fashion have no sensation?” “ Do your children feel self-conscious houses, where the girls can experiment with makeovers, new because you look different from other mothers?” “Is it scary to hairstyles, and new looks on the road to self-definition. live on your own? ” “How did you figure out how to ‘do it’?” An example of a project activity is attending a recent These are some of the questions that adolescent girls have been miniconference celebrating the artistic achievements of dis- able to ask their mentors at the conferences, small group dis- abled women that included the performance of a play, “Love cussions, home and worksitevisits, and one-to-oneencounters Letter,” by writer Bobbi Linn. This play describes the first love that the project provides. experiences of an adolescent girl with cerebral palsy. The per- The adult women try to answer these questions as openly formance led to a rich discussion by the more than 30 disabled and realistically as possible, acknowledging the myriad obsta- high school girls attending, who were able to share their own cles to “social success” that disabled women face, while at the anxieties and concerns about first dates and obtain support same time opening new possibilities by offering strategies to from the author and from one another. As one of the girls address the barriers. For example, one of the women shares noted, “This play was the highlight of my day. Dating is a hot some of her experiences with prejudice: “Some partners may issue on my mind. I sometimes wonder if a teenager with a be put off by your disability. It is not fair, but this is the way it is disability can make it out there. It is good to know others have in our prejudicial world. Sometimes you may want to confront survived.” the person, at other times it may be better to let it be. The Dating and the social arena are also “hot topics” for par- important thing to remember, though, is that not everyone will ents of adolescent girls with disabilities, whoareencouraged to be turned off. Some people will recognize that you are indeed participate in the project. Many of the parents involved with desirable, attractive, and sexual. And, after all, you only need the project would like to help their daughters become more one.” Another mentor, who has visual impairment, offers her socially involved with their peers, yet have difficulty letting go. experience with flirting: “While it indeed may be easier to flirt These parents may have great difficulty allowing their disabled if you can make eye contact, this is not essential; a telling smile teenagers to go out without their supervision, to explore trans- or casual touch of the hand can be quite flirtatious, if you wish it portation options, or to obtain much needed independent to be.” Another woman offers some advice on learning about living skills, for fear that their daughters may be victimized sex: “In order to figure out how to ‘do it’, disability and all, you when they are on their own. Suggestions, support, and gentle should first learn as much about your body as possible. A lot of admonitions from adult disabled women enables parents to disabled women know relatively little about their own disabili- provide their daughters with more of the information and ties, and they also know too little about their anatomy as opportunities they need to become independent, successful females. Nondisabled women share our problem-we all know women. One parent stated, “I never realized disabled women too little about our bodies. To enjoy your sexuality as fully as could do so many interestingthings with their lives. Suddenly it possible, you need to know how your body works, what parts seems like we have so many more options. We need more of your body work, and what parts don’t work as well. Get as programs like this one.” much information as you can so you will know rather than have The intent is to create more programs like the Networking to guess about what you can and can’t do sexually; then you Project, since currently this is the only program of its type in the can make good choices.” Another woman, the mother of three country. Over the next year, with funding from the U.S. children, explains having children when you are disabled: Department of Education, The JM Foundation, and the New

SIECUS REPORT, March 1986 5 York Community Trust, the project will be replicated in several per copy; minimum order 25. Order from: Sex Education Coa- sites nationwide, within YWCAs or other types of agency set- lition, 1309 L Street, N.W., Washington, DC 20005. tings. Instructional materials, including a book highlighting the lives of 12successful disabled women and avideotape illustrat- Tips for Parents (1984) is a four-page guide on talking to chil- ing the mentoring process, are being developed to facilitate dren about sexuality. Frequent concerns such as parental dis- replication and increase the number of disabled women, girls, comfort and fear of havingto discuss their personal sex livesare and parents who are reached. addressed. Suggestions for bringing up the subject based on The Networking Project for Disabled Women and Girls is material from television and newspapers are given, along with part of a larger effort to confront the myth of asexuality that ten communication tips. The point emphasized is that only unnecessarily and unjustly restricts the lives of women with parents can conveytheirfamily’svaluestotheirchildren. Avail- disabilities. It is to the advantage of everyone, disabled or able for $1.00 eachforsinglecopiesor$.50eachforordersof25 nondisabled, women or men, to join in this effort. Each of us or more from: Sex Education Coalition, 1309 L Street, N.W., has been restricted by an overly narrow definition of sexuality Washington, DC 20005. that says who is attractive, who is desirable, who is sexual. When we challenge this definition with regard to women with disabilities, we also challenge and expand it for all of us. Papers from a National Policy Conference on legal Reforms in For further information about the Networking Project for Child Sexual Abuse Cases ($20.00) and Evidentiary and Proce- Disabled Women and Girls, contact: Harilyn Rousso, Director, dural Trends and other Emerging legal Issues in Child Sexual Networking Project for Disabled Women and Girls, YWCA of Abuse Cases ($3.50) are two monographs published in 1985 by the City of New York, 610 Lexington Avenue-9th Floor, New the American Bar Association. The first contains results from a York, NY 10022; (212) 735-9767. national invitational conference held in Washington, D.C., in March 1985, where experts from around the country analyzed recent innovations in the legal system’s handling of child sexual References abuse cases. The second analyzes recent legislation, creating a special exception for out-of-court statements of child sexual Fine, M., and Asch, A. “Disabled Women: Sexism Without the Pedes- tal.” lourn. of Sociology and Social We/fare, 1981, 8 (2). abuse victims and allowing the use of video-taping and closed circuit television for children’s testimony. Both are available from: National Legal Resource Center for Child Advocacy and Protection, 1800 M Street, N.W.,Washington, DC 20036. Prices DO YOU KNOW THAT.. . include p/h. La Familia Es Importante is an 8-page Spanish language pam- phlet in comic book format. This 1984 publication is designed Resources to Write for . . . to encourage couples to plan their families, visit clinics and doctor’s offices where birth control services are available, and use contraceptives. Priced at $.27 for a single copy, it is also A Hearing Impaired Woman’s Experience is a % or VI available at $25.00 for 100 from Planned Parenthood of Orange inch (150 mins.) color video tape in sign language with voice- County, 1801 North Broadway, Santa Ana, CA 92706. over. The tape may be rented for $50.00 or purchased for $150 from: Mental Health Hearing Impaired Program, St. Paul- Changing Shapes of the Family (1984), by Robert Sayers and Ramsey Medical Center, 640 Jackson Street, St. Paul, MN 55101. Carla Thornton, is directed toward the adults and children of single-parent, divorced, and blended families. This communi- Spinal Cord Injuries: Psychological, Social and Vocational cation guide, giving practical suggestions to help ease the Adjustment (1980) by Roberta R. Trieschmann is a well-written, tension often found in new family structures, was developed by thorough, state of the art book that covers social and psycho- Heart-to-Heart, a project sponsored by Planned Parenthood of logical treatment of patients with spinal cord injuries. Included Marin and Sonoma and the Family Service Agency of Marin. in this book is a chapter on sexuality and spinal cord injurythat The publication actually contains 2 booklets in one, each sub- states that sexuality cannot be overlooked, but instead, inte- titled: “Guide to Dealing with New Family Forms and Changing grated from the onset of disability. The author advocates focus- Relationships,” with the section for adults starting at the front ing on human needs and providing options for the patient. The and the section for young people at the back. Available for cost of the book is $25.00 and it can be ordered from: Per- $2.95 + 15% p/h from Planned Parenthood, 20 H Street, San gamon Press, Maxwell House, Fairview Park, Elmsford, N.Y. Rafael, CA 94901. 10523. Young, Gay and Proud!, much of which was originally pub- What is SEX ED Really? (1985) is a pamphlet written by Ann lished in Australia by the Gay Teachers and Students Group of Thompson Cook and Mary Lee Tatum for parents, clergy, Melbourne, has now been issued in a second U.S. edition. Both youth workers, and school board members and administrators. the 1980 and 1985 U.S. editions are edited by Sasha Alyson, who Questions about what sexuality is, how children learn about has added much new content, especially on AIDS. Addressed sexuality, what sex education does and does not do, and how to gay high school students, the book also covers meeting sex education helps are answered. Other points made are that other young gays, coming out in schools, telling parents, deal- sex education should be age appropriate, tailored to the needs ing with gay sexuality, and finding one’s identity. Available for of the community and supported by parents. A five-point $4.00 (incl. p/h) from Alyson Publications, 40 Plympton Street, checklist for sex education programs is included. Priced at $.I5 Boston, MA 02118.

6 SIECUS REPORT, March 1986 I 1 IWHERE THE ACTION IS

Sexuality Education in a Psychiatric Day Treatment Setting

Pamela M. Skerker, RN, MS, CS Psychiatric Nurse Practitioner Capital Region Mental Health Center Hartford, Conn.

As part of the rehabilitation curriculum of a long-term psychiatric day frequently to facilitate concreteness. The outline is followed in a flexi- treatment programforthechronical/yil/asexua/ityeducation program ble manner, allowing the patient group the opportunity to progress at a was initiated by the author. It consists of a weekly group session where comfortable pace. Methods are built in to provide the author with a facts are presented and discussions encouraged. Topics covered mechanism for constant evaluation andrevision to meet patient needs. include basic reproductive anatomy and physiology, pregnancy and Sexuality education is necessary and has a definite p/ace along side the fetal development, abortion, contraception, sexually transmitted dis- traditional daily living skills and psychology offered in a psychiatric eases, masturbation, and sexual preference. Audio-visual aids are used rehabilitation setting.

My work in a partial hospitalization rehabilitation setting has standing and identify individual needs. I try to answer all ques- led me to the conclusion that chronically mentally ill people tions that are asked. If the question isn’t directly related to the need sexuality education as much as, if not more than, the gen- topic, I answer briefly and concretely, possibly referring to eral population. Reasons for this include the fact that sex is a another group or an individual therapist for further discussion. readily available form of gratification, there is potential for abuse Although I follow an outline, I avoid a strict time schedule for in this population, and there seems to be a general lack of basic individual topics. The first few minutes of each session are knowledge. My conclusion was based on observations of other devoted to a review of the previous session. Based on this populations-school age children with their parents (as a fam- review, I proceed to a new topic or continue with the same. It ily unit), teenagers, and college students-to whom I have takes approximately four to five months to cover the range of taught the subject. Although there are related articles focusing topics. To facilitate concreteness, I use audio-visual aids, on the sexual activity and education of institutionalized men- including diagrams, models, samples, and films. Also, common tally ill people, I could not find a description of an actual sex slang expressions are interchanged with technical terms (e.g., education group in a psychiatric day treatment program. I “the testicles, which are sometimes called’balls’, arewherethe decided to develop my own sexuality program in the Psychiat- sperm are made and stored”). ric Extended Rehabilitation Program, in the Capital Region Mental Health Center, a community facility ofthe University of Reproductive System Connecticut Health Center. The patients I work with are adult men and women, most The module I developed begins with an explanation of of whom have had several psychiatric hospital admissions. basic male and female reproductive anatomy and physiology. Many have literally been in and out of various institutions their Each patient is offered his or her own copy of simple diagrams entire lives. The intelligence level, educational background, of the male and female reproductive systems. They can label and existing support systems are varied. The average stay in the and keep them if they so desire. Full body diagrams with program is about eighteen months. These people live in var- reproductive areas circled are displayed as a reference for ious community settings (supervised or unsupervised). The perspective. The first week or two, I discuss the male system. diagnoses vary, but most patients have a history of schizophre- This includes information about the scrotum, testicles, sperm, nia and/or an affective illness. The program’s average daily vas deferens, semen, various auxiliary glands, the urethra census is twenty-three. A major goal of this program is rehabili- (including urination and ejaculatory functions), penis, and tation with a return to or progression towards independent erection. The next one or two sessions are spent on the female living. The days are structured with various groups (e.g. cook- system. This includes the ovum, ovaries, Fallopian tubes, uter- ing, budgeting, social skills, psychotherapy). All patients are us, cervix, vagina, clitoris, menstruation, fertilization, and required to attend all groups. menopause. I providesamplesof tampons andsanitary napkins For about three years I have been conducting a weekly during the discussion on menstruation. Each time menstrua- sexuality education group. Each session lasts thirty-five minutes tion has been discussed, at least one group member has asked and is attended by all patients together. Group participation is about Toxic Shock Syndrome. Thus, I decided to include this encouraged in order to help me determine the level of under- subject permanently.

SIECUS REPORT, March 1986 7 Contraception reported positive feelings about the group although some When I sense the group is fairly familiar with this informa- admit to feeling “nervous, dumb, or embarrassed,” even tion, the module continues. Several weeks are spent discussing though they like the group. I encourage exploration of these masturbation, and the fact that it doesn’t cause physical or comments whenever possible. I tell patients that sometimes mental illness; intercourse, including a consideration of physi- people are embarrassed when they don’t understand thingsor cal maturity versus emotional maturity and responsibility; are not used to discussing certain things. Although attendance pregnancy, and fetal development; and abortion, both thera- in the group is a program requirement, no one is forced to peutic and spontaneous. I use large photographs or diagrams participate in the discussions. of the successive stages of pregnancy, describing the weight, Frequently questions or commentswill reflect an individu- length, and developing systems at each stage. At this time I al’s poor self-esteem or personal identity. The patient who asks, generally introduce contraception, unless questions indicate “What’s the usual number of times a man will think about women (in a sexual manner), may really be asking “Am I nor- another topic is more appropriate. I review the various contra- ceptive methods over several weeks. I pass around samples of mal?” In discussing topics that involve personal or religious values or feelings, I consciously try to avoid using words like oral contraceptives, intra-uterine devices, diaphragms, jellies, cremes, foam and condoms for patients to look at. This often normal or abnormal, right or wrong. If I’m giving my personal stimulates questions and sharing of personal experiences. I also opinion, I will say so, for example, “I think that sexual activity is discuss the surgical and rhythm methods of birth control. Fol- a personal decision; we all should be able to decide for our- lowing completion of contraception, I devote at least one selves just what is comfortable for us.” Occasionally, being session to group discussion of how an individual decides when non-judgemental calls for self-control and values clarification and if contraception is appropriate. on my part. When necessary, I discuss this during asupervision session. Diseases Program Revision I then discuss sexually transmitted and related diseases for two or three sessions. I present the general signs, symptoms, I keep a journal documenting patients’ reactions and fre- and implications of the various diseases. I specifically mention quently asked questions. This helps with program revisions. I gonorrhea, syphilis, herpes, trichomonas, monilia, scabies, continually note a group fascination with prenatal develop- veneral warts, and Acquired Immune Deficiency Syndrome ment, heredity, and genetics. Some patients have asked directly, “If I have children, will they get my mental disease?” (AIDS). I cover other diseases if it’s appropriate to the discussion. A mild summertime outbreak of scabies offered an opportunity Multiple births, unusual conditions, and defects are subjects to emphasize the importance of hygiene and personal respon- that generate group interest. Often a theme is initiated by a sibility when coming in close contact (not necessarily in a comment or question. The topic of sexual preference is gener- sexual manner) with others. I stress the local availability of ally addressed by group members in terms of normal versus detection and treatment, the implications of not getting treat- abnormal. As with other emotionally charged subjects,mygoal ment, the responsibility to one’s sexual partner(s) and the fact is to factually explain and clarify, rather than make judgments. that there is no immunity from subsequent infections. Group members are encouraged to discuss personal and reli- gious viewpoints. Patient Response Current events frequently will influence the topic of the week. When there was much media coverage of AIDS, many My program has shown some positive effects. A sexually patients shared concerns about possible symptoms. The group active woman whom I was seeing concurrently in individual also initiated a discussion on the quality of life in response to treatment frequently spoke about wanting to be a mother. local publicity about severely handicapped infants and their After group sessions on reproduction, we discussed the right to treatment. responsibilities involved in caring for a child. In our individual In addition to patients’ comments, I also rely on the feed- work, she acknowledged her fears about responsibility for a back offered by visiting staff and students. Within the mental child. We continued to explore this and she began using a health center, there has been much staff encouragement. I reliable contraceptive method. Patients frequently discuss presented a synopsisof this program at ageneral staff in-service their decision to use contraception. education session. This resulted in requests for consultation Sexual problems are also discussed. One man questioned from the Center’s Outpatient and Acute Day Treatment his medication as the cause of his impotence. This question led departments. Subsequently I received a request for assistance to an evaluation and eventual medication change for him. It in starting a program on an inpatient unit in a state hospital. certainly may not eliminate his impotence, but it gave him The fact that people have a mental illness does not make some knowledge and input into his own treatment. Other them different from other populations in termsof basic interest indirectly related therapeutic benefits include peer support about their bodies. They have heard some of the same myths and communication skills practice. and harbor some of the same fears as others. The positive I was initially surprised at the relatively small amount of response to this program from patients and other mental discomfort or embarrassment that patients displayed. health professionals has confirmed my assumption that sexu- Although this is merely a subjective observation, it has been ality education can be beneficial to chronically mentally ill confirmed by visiting staff members and students. Keeping people. It promotes responsibility rather than promiscuity, general group dynamics in mind, I try to direct potentially therefore it has a place in a rehabilitation program along with uncomfortable questions or situations to the group rather than psychotherapy and daily living skills. to an individual. In response to the man who commented I‘. it’s disgusting to talk about bodies, .” I said to the group, Note: The author would like to acknowledge lane Hardy Davis of the “How do you feel about this?” The majority of the members Human Growth and Development Program.

8 SIECUS REPORT, March 1986 j SPEAKING OUT

Sexual Abuse and Disability

Ronald Moglia EdD Associate Professor New York University, Human Sexuality Program New York, N.Y.

Susan was born with cerebral palsy. She was the first of four him to stop, but he just kept doing it. He then turned herso she children. She and her brothers and sister grew up in a poor was lying on her back. In this position, her disability made it rural neighborhood. Susan’s mother worked nights in a fac- impossible for her to move. Susan’s stepfather then forced her tory. As a young child Susan could get around by walking and to engage in oral and anal sex, followed by coitus. ho/ding onto objects. When she reached the age of nine, Susan wished she would die. For the next two years her crawling was her only means of movement. When Susan stepfather continued to force her to engage in sexual relations. became ten, she got her first wheelchair. In addition, he started to bring his male friends. When they It was at this time that Susan’s mother remarried. On many paid him, they too had sexual relations. Not long after that, occasions, Susan’s stepfather babysat forher. Susan didnot like Susan’s mother started to show Susan sex magazines. She also her stepfather; he was always trying to hug and kiss her when began to invite other male friends over to have sex with Susan. she didnot want him to. Susan’s way of dealing with this was to Susan felt like a prisoner in herhome. She felt there was no stay away from him by going to her room. She frequently one she could tell about this terrible thing she wasdoing. After pretended to be asleep to keep her stepfather away. all, her mother had told her many times that their life was hard One Saturday night when they were alone, Susan’s step- because of Susan’s disability. Susan did not feel she had any father came into her room and started touching her. She told right to complain.

Note: This is a true story. The names and identifying information have been altered.

We are beginning to realize that Susan’s experience of necessary at this time to rely on estimates from professionals sexual abuse is not that unusual. As there has been increasing who work with people who have disabilities. public awareness about the frequency of sexual abuse in our In December, 1985, the Los Angeles Committee on Abuse society, there has also been more discussion and reports about of Disabled Persons sponsored the First Annual Conferenceon the incidence of sexual abuse among the disabled. Unfortu- Abuse of Disabled Persons. At this meeting, it was estimated nately, the amount of data available documenting these cases is that 99% of disabled children experience at least one incident significantly lower for the disabled population than for the able of abuse by the time they are 18. Abuse included incest, fond- bodied. ling, exposure, rape, physical injury, and financial harm. While A 15-month study conducted in Minneapolis uncovered this figure may seem high, it is corroborated by research con- 60 cases of physical and sexual abuse (Center for Women’s ducted on a blind population (Welbourne, Lipschitz, Selvin, Studies, 1984). The Seattle Rape Relief Disabilities Project and and Green, 1980) in which over 50% of the women who were Center reported over 700 cases of sexual exploi- blind from birth reported one or more forced sexual experien- tation involving disabled children and adults in the period from ces. This frequency was significantly greater from their sighted 1977 to 1983. The Developmental Disabilities Project considers counterparts, who were also interviewed. this figure to be low because of the many factors that cause the Another estimate of the incidence of sexual abuse among low reporting rate of sexual abuse cases among the disabled. the disabled is based upon applying the ratio of disabled to They estimate that over 3,500 cases of sexual abuse have actu- nondisabled to the incidence of all reported rape in this coun- ally occurred during this period in the Seattle-King County try. Using this method, the estimate would be 100,000 cases of area (Ryerson, 1984). Because of inaccurate reporting, it is sexual abuse a year (Center for Women Policy Studies, 1984).

SIECUS REPORT, March 1986 9 Some experts, such as Barbara Rawn, a counselor at Deaf with disabilities adds to this lack of adequate information about Community Counseling Services in Richmond, Virginia, and sexual abuse. Many of the facilities designed for the able- Howard Dickman, director of the rylental Health Hearing bodied population are not accessible or adequately staffed for Impaired Program at St. Paul-Ramsey Medical Center, believe the disabled. On the other hand, those medical facilities specif- that the high rate of family violence among the deaf may be ically designed for the disabled often lack the resources to help related to the additional frustrations encountered in their lives with the sexuality concerns of their clients. Thus, the abused (Center for Women’s Studies, 1984). One might postulate that if client who is also disabled is often faced with no place to turn. the rate of family violence is higher, then the rate of sexual As a result the rate of unreported incidents of abuse in- abuse might also be higher. creases. Today a large portion of our society recognizes sexuality as The first and most important step that can be taken to an integral part of human life. When we deny or aredenied that prevent the sexual abuse of the disabled is to change attitudes aspect of life, an important part of our identity suffers. This through education. We must explore our own attitudestoward same society is constantly denying the disabled the right to the disabled. Once we have accepted the sexual rights of the their sexuality. The disabled are identified by society in terms of disabled, we can act as catalysts to help the disabled, their their disabilities. Their right to express their sexuality is bound parents, and the institutions serving them to understand and to this social perception, and they suffer from the resulting take responsibility for their sexuality. A holistic approach deal- myths (Worthington, 1985). ing with the physical, social, and emotional aspects is necessary Growing up disabled is particularly difficult. Susan’s his- to assist people with disabilities to reclaim their sexual selves tory of the abused disabled person is typical, in fact it contains (Ryerson, 1984). all the characteristics common to these cases. The circumstan- After coming to terms with our own feelings, the next step ces, the abusers, the evolution of the victimization, and the is to provide education in the institutions serving the disabled. feelings and frustrations of the victim are apparently classic Sexuality education should be a mandatory part ofthecurricu- according to the information available to us to date. lum of every disabled child. The disabled have as much right to Parents of all children have difficulty coming to terms with healthy sexual development as the able bodied. their children’s sexuality. Parents of disabled children rarely Our health care institutions must examine their facilities in recognize their children’s sexuality at all. When it is recog- relation to attending to the sexuality needs of the disabled. nized, it is often ranked below other health concerns of the Those institutions giving direct services to abused individuals child. There is strong evidence that healthy sexuality is depend- should eliminate the physical barriers that prevent the disabled ent on a healthy self image. But the disabled population is from using their facilities. Even if the institution is physically denied the opportunity to structure healthy self images accessible, there may be social barriers caused by inadequately because they have little or no contact with their peers, one of trained staff that restrict their services to the disabled. The the greatest sources of information. Disabled children miss institutions that deal with the health concerns of the disabled important cues to social and sexual feelings because they are must incorporate sexual health information as an integral part isolated, either physically or emotionally, from their able- of the client’s medical evaluation (Worthington, 1985). bodied peers. Although their normal biological sexual pro- in conclusion, most of us are disabled in one form or cesses exist, lack of learning experiences and social another, and, because many of us have experienced some form experimentation can result in deficits in self esteem, body of sexual abuse or neglect, this challenge affects us all. image, social skills and knowledge on which to base social and sexual skills as an adult (Glass, 1984; Knuth and Smith, 1984). Postscript: Susan was able to make wonderful changes in her By the time disabled children reach adolescence, they life through the guidance of a we//-trained therapist who have learned that passivity and cooperation are the keys to helped her learn about her sexual self. Unfortunately, during independence and survival (Center for Women’s Studies, 1984). treatment, Susan’s therapist was forced to find another office The same traits that are necessary for survival make the child because the institution where the therapist was practicing was vulnerable to exploitation and sexual abuse. Ellen Ryerson not “comfortable” with disabled clients. states that in the majority of abuse cases of the disabled in which the offender is a member of the family or care provider, the victim is either confused about the appropriateness of the behavior or unaware of his/her victimization (Ryerson, 1984). References The offender has an additional advantage if the physically handicapped child has restricted mobility. These children are Center for Women’s Studies. “Wife Abuse in the Deaf Community.” Response to Violence in the Family and Sexual Assault, January/ taught to comply with the instructions of family and care givers February 1984,7 (I), 1-12. and may not be able to distinguish between handling done for Center for Women’s Studies. “Sexual Exploitation and Abuse of People care and handling for the sexual pleasure of the offender. with Disabilities.” Response to Violence in the FamilyandSexual If the offender is a family member, it is easy for the abuser Assault, March/April 1984, 7 (2), 7-8. Glass, D.D. “Sexuality and Visual Impairment.” S/ECUS Report, May to create a reality that allows for the victimization to occur. The 1984, 12 (5), l-3. victim is taught that affection is connected to the sexual activity Ryerson, E. “Sexual Abuse and Self-Protection Education for Develop- and that their relationship is “a special secret.” These same mentally Disabled Youth: A Priority Need.” SIECUS Report, Sep- behaviors are found in sexual abuse cases of normal children. tember 1984, 13 (I), l-3. The difference is that the disabled population is much more Welbourne, A., Lipschitz, S., Selvin, H., and Green, R. “A Comparison of the Sexual Learning Experiences of Visually Impaired and isolated from non-abused friends and non-abusive individuals. Sighted Women.” lournal of Visual Impairment, 1983, 256-259. Therefore, the ability to learn or compare appropriate behav- Worthington, C. M. Coming to Light: issues Regarding the Physical ior is limited. and Emotional Women with Disabilities. New York: George Mar- The lack of sexual health care facilities available to people shall Worthington, 1985, 1-13.

10 SIECUS REPORT, March 1986 RESEARCH NOTES

“Research Notes” is prepared by Elizabeth Rice Allgeier, PhD, Psychology Department, Bowling Green State University, Bowling Green, Ohio.

Ethical Guidelines for Ethics Committees

Elizabeth Rice AIlgeier, PhD

Among people who do sex research, a sure-fire topic likely to our most eminent researchers. His sex guilt scale, developed elicit a spirited “I can top that!” response is “Ethics Committee a dissertation project, and published in 1966, has been ex- Objections to My Sex Research Proposal.” At my own institu- tensively used ever since then. Most recently, he and his tion, my students and I have never been prevented, ultimately, students have been studying variables related to sexual assault from doing any proposed research for which we have perse- and have developed a measure of the macho personality vered. On the other hand, I have had many dialogues involving (Mosher and Sirkin, 1984). Mahoney, Shively, and Traw (1986) negotiations about various projects, and there have been a few have just published fascinating data showing that macho males instances in which I have simply given up on a particular pro- (using the Mosher and Sirkin scale) report more sexually coer- ject out of exhaustion. This problem has been compounded by cive behaviors than do non-macho males, and sexually coerced the fact that some new faculty members rotate onto the com- females report being attracted to macho males more than do non- mittee every year, changing the constituency of the ethics victimized females. Mosher and his students are currently con- committee. I’ve noticed that the first few proposals with new ducting (or attempting to conduct) research involving guided members involve considerably more discussion of projects imagery of rape and the role of the macho personality in than do subsequent proposals with those same members after marital rape. However, Mosher, too, has been suffering the they’ve been on the committee for awhile. In fact, after numer- “chilling effect” of extensive scrutiny of research by him and ous visits to my office by one of the incoming members of our his students. departmental ethics committee last year over proposals sub- In November, 1985, Mosher was invited to a meeting of his mitted by my students, I finally said jokingly tothe EC member, Ethics Committee, ostensibly to answer two questions about “You don’t have to keep using these proposals as an excuse to their informed consent and debriefing procedures. This meet- spend time with me; we could just go out to lunch together!” ing, however, involved considerably more questioning than Much to my surprise, he took me up on it, we spent an hour Mosher had been led to believe, including: and a half talking about sex research, and the amount of dia- 1. Does participation in a study involving guided imagery logue and hassle with him over my students’ proposals has of rape increase the probability that subjects will com- decreased. After that experience, I thought that maybe we sex mit aggressive or illegal acts? researchers could use a bumper sticker that says”Make friends 2. Is it appropriate to ask subjects to fantasize committing with an ethics committee member today!” However, in this illegal acts or to imagine actions contrary to their moral instance, I happened to bedealingwith a relatively rational and code? well-meaning person who was having his first experience with 3. Are researchers directly speaking to the unconscious proposals involving research on human sexuality. and instructing subjects to commit rape by using indi- As may be suggested by the foregoing, I have tended to rect suggestion? accept (if with some irritation) delays in the beginnings of data 4. How are psychologists viewed by the public when we collection for our studies as part of what goes on with the ask people to fantasize illegal acts? process of doing research on sexuality. Further, my present 5. Is their debriefing too judgmental and might it induce situation is a great improvement over that in a former job, in shame or guilt in subjects who responded with sexual which I was personally required to run all subjects, and at one arousal to realistic guided imagery of rape? point, one member of the ethics committee even recom- 6. Will Mosher’s sex research pose a threat to the con- mended that I wear a white lab coat while administering anon- tinued existence of the subject pool? ymous, voluntary, confidential, questionnaires on contracep- 7. Can Mosher defend the “appropriateness” of his tive behavior (to reduce my sexual stimulus value)! My initial research program in general? response wasastonishment,followed by laughter. At the time, I Mosher described his response to each of these specific perceived the difficulties I was having with the Ethics Commit- lines of questioning in the 17-page documentthat I mentioned tee as isolated incidents. However, my consciousness has above, and he will be discussing the whole issue of human begun to be raised by some informal comments/complaints subject review board procedures at the annual meeting of the about similar difficulties experienced by colleagues at other Eastern Region of The Society for the Scientific Study schools. of Sex in Philadelphia, April 11-13, 1986. Mosher (1985) has Most recently, I was reminded of the issue after receiving written a document that I think many of you who may be faced an eloquent 17-page document from Donald Mosher, a psy- with similar problems from your ethics committee may find chologist at the University of Connecticut. Mosher is one of useful. I’m including it here with Mosher’s permission.

SIECUS REPORT, March 1986 11 Ten Ethical Principles for Human Subject Committees press cannot be restrained because someone judges it as likely to damage without meeting stringent criteria. Awards of libel Principle I: Humility takes precedence over hubris in against the press and awards for damage to human subjects making ethical judgments. If absolute power corrupts abso- under civil tort law aresufficient means of redress. Principlesof lutely, bureaucratic power breeds conservatism. Appointment freedom of inquiry and freedom of expression share much in to a Human Subjects Committee is, in itself, not a preparation common as basic civil liberties. This principle is to be applied in for making ethical judgments. The appropriate model is colle- conjunction with the one above related to scientific evidence gial communication on ethical matters, not a hierarchical and the one below suggesting appropriate criteria. board of review. The HSC is not one-up; the investigator is not Principle 8: The following three criteria must be met one-down. before prior restraint (or censorship) of research is justified: (a) Principle 2: The Belmont Principles and the Disciplines’ There must be strong evidence (with a priority given to scien- Principles of Ethics are the same for every topical area of tific evidence) of a very likely and serious harm; (b) the harms research. Socially sensitive and ‘nonsensitive topics are to be must be closely and direct/y linked (i.e. a causal connection) judged by the identical principles. The Belmont Principles dis- with participation in the research study; and (c) it must be avow concerns with public policy and public reactions as rele- unlikely that furtherspeech or expression (e.g., debriefingand vant to a decision about a specific research proposal. counseling) can be used to effectively minimize the harm. Principle 3: Human Subject Committees areasaccounta- These principles are adapted from the philosopher Fred b/e to the ethical principles as are investigators. To ensure fair Berger’s suggested criteria for permissible censorship of application of principles, specific problems in a proposal expressions such as pornography. Because free inquiry is basic should be related to specific principles or subprinciples in the to a democratic society and to science itself, the burden of ethical codes. This will prevent the use of excessively vague evidence for prior restraint should fall upon those institutions charges of “inappropriateness” and problems will be related to that seek to limit these freedoms. It is not enough merely to principles. This is directly parallel to the method used by the speculate on possible risks and harms and to deny approval for American Psychological Association in formulating its proposed research without creating a chilling effect on free principles. inquiry. Principle 4: The Be/mont Principle of respect forpersons Principle 9: The Belmont principle of justice not only applies to both human subjects and investigators. The issue for applies to protecting human subjects in vulnerable states and an HSC is to find the proper balance in concern for human certain classes of persons, it a/so implies that justice is served by dignity and individual, societal, and scientific welfare. Both research designed to promote the welfare of vulnerable human subjects and scientists should be regarded as autono- c/asses. Many so-called socially sensitive research topics are mous persons capable of making informed choices. Much of concerned with reducing power inequities in the society. The the effort of HSCs should focus on this issue by examining the U.S. Constitution with its Bill of Rights is designed to protect procedure used to obtain an informed consent. The principle the rights of a minority from the majority in our democratic of respecting the autonomy of informed individual choice nation. These rights extend to gender, race, ethnic group, age, specifically prohibits legal moralism and legal paternalism. The religion, physical and mental handicaps, prisoners, and, in- HSC is not there to prevent, out of paternalistic moral concern, creasingly, to sexual minorities. The Fourteenth Amendment’s subjects from having the opportunity to make an informed clause on equal protection under the laws should serve as an choice to participate or not participate in a particular ethical principle that favors research into discrimination and investigation. promotes the rights of such vulnerable classes. Socially sensitive Principle 5: The principle of beneficence is based upon research is exactly that research which expresses a sensitive an assessment of risk in which priority is given to scientific appreciation of these issues that so profoundly affect human evidence. In attempting to maximize benefits and minimize welfare. Human Subject Committees have an affirmative duty risks, scientific methods remain the best source for obtaining to promote, rather than to hinder, such research to ensure that and evaluating evidence. The concept of risk combines a con- justice is served. cern with the probability and seriousness of harm or danger. Principle 70: Procedural justice in the conduct of a Principle 6: Whether dealing with socially sensitive or Human Subject Committee’s mission is basic to equity in jus- nonsocial/y sensitive proposals, caution should be direct/y pro- tice. As the seriousness of ethical concerns increases, there portional to known probabilities and seriousness of risk. Cau- should be a proportionate increase in the use of due process tion should neither be abandoned nor the likelihood of procedures. The due process clause in the Fifth and Fourteenth dangers and harms exaggerated. It is as reasonable to ask any Amendments ensures procedural justice in the American sys- scientist serving on an HSC about scientific evidence for proba- tem of laws. When administrative social controls begin to serve bility and seriousness of potential risks as it is to ask the princi- the same functions of social control as the judicial system, pal investigator. Both the principal investigator and concerned institutions need to adopt corresponding protections of scien- HSC members are accountable to evidence to support alleged tific investigators to ensure procedural justice. Although the risks and benefits. vast majority of HSC actions will be collegial consultations to Principle 7: Prior restraint of research, in the absence of increase mutual awareness of ethical issues designed to protect strong evidence meetingspecific criteria given below, is incon- human subjects, more draconian interventions by HSCs sistent with First and Fourteenth Amendment protections of require formalities modeled after due process protections, the U.S. Constitution. In the landmark case of Near v. Minne- including information in advance on specific principles sota, the principle of no prior restraint of the press to prevent believed to be violated or potentially violated in order to libel was advanced by the U.S. Supreme Court. Damages can be prepare a defense, right to legal counsel, formal records of the recovered after injury has indeed occurred in the press; a free appearance, an appeal process, and so on.

12 SIECUS REPORT, March 1986 Mosher offered these ten principles for consideration by Guelph Human Sexuality Conference the Ethics Committee of his own department, but I hope that ethics committees at other universities will discuss them. I The University of Guelph’s 8th Annual Sexuality Conference would like to hear from any of you who have experienced will examine current issues in Human sexuality, teaching difficulties in obtaining support from your ethics committee approaches in sex education, and counseling methods for sex- regarding the kind of research questions you are studying and ual problems on June 9-11, 1986 at the University of Guelph, the bases for their objections. Specifically, I am wondering Guelph, Ontario. For further information write: Continuing about the extent to which sex researchers are experiencing Education Division, University of Guelph, Guelph Ontario, unusual levels of scrutiny that go beyond the specific task of NlG2W1, or call: (519) 824-4120, ext. 3957. protecting the rights of subjects to informed consent and free- dom from coercion.

References Teacher Training Workshops on Disabled Adolescents Mahoney, E. R., Shively, M.D., and Traw, M. “Sexual Coercion and As- sault: Male Socialization and Female Risk.” Sexual Coercion and Assault, 1986, 1, 2-8. Joan Davies Associates offers teacher training workshops and Mosher, D. L. “The Development and Multitrait-Multimethod Matrix parent group lectures concerning students, Analysis of Three Meaiures of Three Aspects of Guilt.“)ourna/ of including topics such as Socio-Sexual Development of Special Consulting and Clinical Psychology, 1966, 30,25-29. Students, Child Abuse Prevention for Special Students, and Musher, D. L. Letter to Ethics Committee Chair, Department of Psychology, University of Connecticut, November 27,1985. other concerns of disabled students. For further information Mosher, D. L. and Sirkin, M. “Measuring a Macho Personality Constel- write or phone: Joan Davies Associates, 98 Southview Terrace, lation.” journal of Research in Personality, 1984, 18, 150-163. Middletown, NJ 07748, (201) 671-5490.

Editor’s Note: I accepted the editorship of “Research Notes”in 7981, and with the completion of the column for this issue, I haveresigned. If I hear from a number of you regarding difficulties with your ethics Women’s Health Conference committees over sex research proposals, however, I will write a des- cription and submit it to the SIECUS Report. Planned Parenthood Centers of West Michigan will hold a In the years that I have been involved with this column, I havehad helpful advice, ideas, criticism, and support from a number of people, Women’s Health Conference on April 11,1986. Workshops will but there are three people in particular that I want to thank. Mary include such topics as sexual wellness and chlamydia as well as Calderone has been an inspiration and a model for me, and/ think that other health and social issues. For further information call: we all owe her a huge debt of gratitude for founding SIECUS in the first (616) 774-7005. place. I have had numerous conversations with Bobbie Whitney; she has been direct and forthright in her disagreements with me, warm in hersupport,anddelightfulinhersenseofhumor. Mostofall, I willmiss the monthly telephone and letter interactions with Anne Backman. Juvenile Sexual Abuse Conference She is the best editor I have ever experienced: talented, conscientious, and thorough. I want to acknowledge the large debt I owe her, andthe larger amount of affection that I fee/ toward her. On April 27-30 the University of Minnesota Human Sexuality Program will sponsor a national training conference entitled “Treating the Juvenile Sexual Abuse Perpetrator.“This confer- ence will bring together researchers and clinicians in the field of sexual abuse to examine issues relevant to the assessment -DO YOU KNOW THAT.. . and treatment of juvenile sexual abuse perpetrators. For further information contact: Workshop Coordinator, Program in Human Sexuality, 2630 University Ave. SE, University of Min- nesota, Minneapolis, MN 55414 or call: (612) 376-7520. Conscience Seeking Articles Forensic Mental Health Seminars Conscience, a newsjournal of pro-choice Catholics, is soliciting articles for publication in 1986 on a variety of topics related to reproductive rights. For writer’s guidelines send a SASE to: Forensic Mental Health Associates will present two-day semi- Conscience, Catholics for a Free Choice, 2008 17th St. NW, nars on the following topics: Washington, DC 20009. “Child Sexual Abuse Assessment and Treatment: Victims and Offenders” on April 23-24 in Buffalo, N.Y., and on May 8-9 in Minneapolis, MN. Call for Journal Articles “Assessment and Treatment of Juvenile and Adult Sex Offenders: A Medico-Legal Approach” on March 27-28 in The Colombia Sexological Society is preparing the first Latino- Seattle, WA, and on May 22-23 in Rapid City, SD. american lournal of Sexology (Rev&a Latinoamericana de Sex- “Child Sexual Assault: Rape, Incest, and Molestation: The ologia) to be published twice a year initially. The journal will Psychology of the Offender on April IO-II in Nashville, TN, and consist of research, sex therapy, sex education, and book on June 26-27 in Atlantic City, NJ reviews. Send article correspondence to: Octavia Giraldo- For further information contact: Dorothy Molis, Forensic Neira, Editor, Revista Latinoamericana de Sexologia, Apartado Mental HealthAssoc.,29LinwoodSt.,Webster,MA01570,(617) Aereo 3441, Cali, Columbia, South America. 943-3581.

SIECUS REPORT, March 1986 13 I SUMMER 1986 GRADUATE STUDIES IN HUMAN SEXUALITY AND SEX EDUCATION

Programs are listed alphabetically by state. Announcements arriving too late for this listing will be published in the May 1986 S/ECUS Report.

California l Values in Sexuality, June 9-24, 3 credits. l Sexual Health, July 7-22, 3 credits. National Sex Forum, San Francisco, CA. Write to: Dr. Efrem Rosen, c/o New College, Hofstra University, l SAR XXV/ (Sexual Attitude Restructuring), June 28-11~1~ 5,60 hours. Hempstead, NY 11550. l /nrroductory Course in Human Sexuality #IO’/, June 7-June 8,15 hours. New York University, New York, NY l The Sexology of AIDS, August 2-3,15 hours. l NYU-/nternationa/ Graduate Program in Human Sexuality: South Write to: Don Nesland, National Sex Forum, 1523 Franklin St., San America, July 7-Aug. 22, 12 credits. Francisco, CA 94109. l NYU-S/ECUS Professional Co//oquium, Aug. 2-17. Write to: Dr. Ronald Moglia, New York University, Human Sexuality Program, 715 Broadway, 2nd Floor, New York, NY 10003. Indiana

The Kinsey Institute for Research in Sex, Gender, and Reproduction, Oregon Bloomington, IL. l Summer lnsrirute /-Human Sexuality: Emerging Perspectives, Oregon State University, Corvallis, OR. July 26-31. l Sexuality Education, June 23-July 17, 3 credits. l Summer Institute //-Values Attitude Reassessment(VAR), August Write to: Dr. Margaret Smith, Dept. of Health, Waldo 321, Oregon 1-3. State University, Corvallis, OR 97331-6406. l Summer fnsritute ///--The Human Male: Sex, Gender, and Repro- duction, August 3-8. Pennsylvania Write to: Dr. June Reinisch, Kinsey Institute for Research in Sex, Gender, and Reproduction, Morrison Hall,Third Floor, Bloomington, Indiana University of Pennsylvania, Indiana, PA. IL 47405. l Psychology of Teaching Sex Education for Disabled People, June 9-13, 3 credits. New Jersey l Psychology of Teaching Sex Education, July Z&August I,3 credits. Write to: Leonard B. DeFabo, 246 Stouffer Hall, I.U.P., Indiana, PA Kean College of New Jersey, Union, NJ. 15705. l Advocacy for Family Life Education, June 30-July 17, 3 units. l Parenting Education, June 30-July 17, 3 units. University of Pennsylvania, Philadelphia, PA. l Contemporary issues in Human Sexuality, June 30-July 17,3 units. l Concepts in Human Sexuality, May 12-16,3 semester hours. l Family Life Through Media and Literature for Young Children, l Concepts in Human Sexuality, May 19-23, 3 semester hours. June 30-July 17, 3 units. l Behavioral Foundations of Human Sexuality, June 2-6,3 semester These courses are part of the 6th Annual Family Life Institute. hours. Write to: Dr. Russ A. Mahan, Dept. Early Childhood/Family Studies, l Concepts in Human Sexuality, August 11-15, 3 semester hours. Kean College, Union, NJ 07083. Write to: Dr. Kenneth George, University of Pennsylvania,Craduate School of Education, Human Sexuality Program, Philadelphia, PA UMDNJ-Rutgers Medical School, Piscataway, NJ 19104. l Sexuality Today: A Summer Institute for Educators and Counse- lors, June 23-27, 1 or 3 credits. Vermont *Write to: Marcia Kosofsky, MSW, Rutgers Medical School, Environ- mental and Community Medicine, P.O. Box 101, Piscataway, NJ 08854. University of Vermont, Burlington, VT. l Sexuality Counseling and Therapy, July 7-18, 3 credits. Write to: Kay Frances Schepp, UVM Counseling and Testing Center, New York Burlington, VT 05405. l Contemporary /ssues in Human Sexuality: focus on Social Policy Adelphi University, Garden City, NY. and Practice, June 16-July 4, 3 credits. l Changing Views of Masculinity and Femininity, June 30-July 11,3 Write to: Dr. James R. Barbour, Dept. of Human Development Stu- credits. dies, University of Vermont, Burlington, VT 05405. Write to: Dr. Richard Eberst, Adelphi University, Garden City, NY 11530. Wisconsin Cornell University, Ithaca, NY l Sexual Abuse, Assault, and Prevention. July 7-11, 2 credits. University of Wisconsin-Madison, Madison, WI. Write to: Dr. Andrea Parrot, N134 MVR Hall, Cornell University, l Child, Adolescent and Family Psychotherapy, June 16-August IO,3 Ithaca, NY 14853. credits. l Education and Sex Role Socialization, July 14-August 10,3 credits. Hofstra University, Hempstead, NY. Write to: Susan Disch or Nancy Cebert, UW-Madison Division of l Sexuality Counseling, May 26-June 5, 3 credits. Summer Sessions, 433 North Murray St., Madison, WI 53706.

14 SIECUS REPORT, March 1986 SEXUALITY AND DISABILITY A Bibliography of Resources Available for Purchase

This annotated listing of sexuality and disability materials was otherwise indicated, the prices do not include postage and handling. prepared by Leigh Hallingby, MSW, MS, Manager,SIECUS information Single copies of this bibliography are available from SIECUS on Service and Mary S. Calderone Library, and Marianne Glasel, RN, MS, receipt of $2.00 and a stamped, self-addressed, business-size envelope. intern, Mary S. Calderone Library. Almost all of these resources are In bulk they are: $1.50 each for 5-49 copies; $1.00 each (plus $2.00 p/h) available for use at the Mary S. Calderone Library, 715 Broadway, Room for 50 copies or more. 213, New York University, New York, NY 10003; (212) 673-3850. All are Please note that, except for the items published by SIECUS itself, available for purchase from the sources listed after each entry. Unless SIECUS does not sell or distribute any of these publications.

GENERAL WORKS

Books and Journals Off Our Backs (1981), 1847 Columbia Road, SEXUALITY AND DISABILITY NW, Washington, DC 20009; $2.00 (incl. p/h) Arnold Me/man, ed. HUMAN SEXUALITY A quarterly journal presenting clinical and SEX AND DISABILITY RESOURCE MANUAL IN HEALTH AND ILLNESS Denise Sherer jacobson, ed. research developments in the area of sexual- Third Edition ity as they relate to a wide range of physical Nancy Fugate Woods Includes national and international listings and mental illnesses and disabling conditions. of sex and disability educators, counselors, Human Sciences Press, 72 Fifth Avenue, New Examines the biophysical nature of human and consultants; methods for updating York, NY 70011; annual subscription, $30.00 sexuality, sexual health, and health care resource information; publications, organi- individual, $75.00 institutional (including preventive and restorative inter- zations, and audio-visuals; and information vention and sexual dysfunction), and clinical on speakers bureaus. TEACHER WORKBOOK FOR aspects of human sexuality in such concerns United Cerebra/ Palsy of San Francisco (1983), FAMILY LIFE EDUCATION as chronic illness, paraplegia, and adaptation Go/den Gate Theater Building, 25 Taylor Susan E. Knight and Car/a E. Thornton to changed body image. Street, Fifth Floor, San Francisco, CA 94702; C. V. Mosby (l984), 11830 Westline industrial Helpful for teachers developing curricula $9.00 (incl. p/h) for people with disabilities. Provides informa- Drive, St. Louis, MO 63146; $18.95 tion on needs assessment, approaching par- SEX EDUCATION AND COUNSELING ents and administrators, developing objec- OF SPECIAL GROUPS: INCURABLY ROMANTIC tives, course content, and resources. THE MENTALLY AND PHYSICALLY Bernard F. Stehle ER/C Document Reproduction Service (?983), HANDICAPPED, ILL, AND ELDERLY 3900 Wheeler Avenue, Alexandria, VA 22304- This beautiful book of photographs is Second Edition 5170; $7.40 (to order, specify Document No. about love relationships where one or both Warren R. lohnson and Winifred Kempton ED 229 685) members of the couple is severely physically Deals with problem areas in sex education disabled. Text represents their tape-recorded WHO CARES? A HANDBOOK ON and counseling of handicapped persons, and statements. SEX EDUCATION AND COUNSELING points out danger of losing the individual Temple University Press (7985), Broad and SERVICES FOR DISABLED PEOPLE behind group labels. Offers suggestions for OxfordStreets, Philadelphia, PA 19122; $29.95 Second Edition dealing with sex-related topics from mastur- + $2.00 p/h Sex and Disability Project bation to abortion. Char/es C Thomas (1981), 2600 South First Unique, outstanding, and comprehensive INTIMACY AND DISABILITY Stieet, P.O. Box 4709 Springfield, IL 62708- resource containing excellent listings ofavail- Barbara F. Waxman, ]udi Levin, and june 4709; $24.75 able services and materials. Highly recom- lsaacson G/es mended. SEX, SOCIETY, AND THE DISABLED: PRO-ED (?982), 5347 Industrial Oaks Boule- The authors, who are themselves disabled, A DEVELOPMENTAL INQUIRY INTO ROLES, vard, Austin, TX 78735; $17.00 (incl. p/h) havewrittenwhattheycalla“working”guide REACTIONS, AND RESPONSIBILITIES for people with disabilities to assist them in lsabel P. Robinault Booklets and Pamphlets overcoming barriers to develop intimate rela- tionships. Topics include: self-image, body An excellent resource, presenting a chro- ABOUT SEXUALITY AND PEOPLE image, sexuality, dating, intimacy, contracep- nological discussion of the sexuality of peo- WITH DISABILITIES tion, and avoiding sexual abuse. Contains a ple with physical disabilities. George Marshall Worthington list of resourcesfor obtaining additional help. Harper & Row (19781, Medical Department, National Rehabilitation information Center 2350 Virginia Avenue, Hagersfown, MD A 15-page Scriptographic booklet covering (7982), 4407 8th Street, NE, Washington, DC 21740; $22.75 + $7.50 p/h what sexuality is, why disabled people need 20017; $71.00 (for a photocopy) sex education, barriers to disabled people SEXUALITY AND LIFE-THREATENING expressing their sexuality, special considera- ILLNESS tions for people who acquire a disability, the OFF OUR BACKS-SPECIAL ISSUE: Margot Jallmer et al, eds. role of information in bolstering self-esteem WOMEN WITH DISABILITIES This Foundation of Thanatology text is a and confidence and the role of family,friends Vol. 11, No. 5, May 1981 collection of 20 articles, many by noted and professionals. A number ofthe20articlesarewrittenfrom experts in the field, addressing issues of sexu- George Marshall Worthington (1985), 345 a feminist and/or lesbian perspective. Dis- ality and long-term disability and/or death. West 27st Street, Suite 30, New York, NY abilities covered include stroke, visual and Char/es C Thomas (1984), 2600 South First 10077; $7.18 each for 25 (minimum order)-49 hearing impairment, and mastectomy. Street, Springfield, IL 62717; $24.75 copies + $3.00 p/h; bulk rates available

SIECUS REPORT, March 1986 15 CHOICES: A SEXUAL GUIDE FOR THE Bibliographies ALCOHOLISM AND SEXUAL DYSFUNCHON PHYSICALLY DISABLED ISSUES IN CLINICAL MANAGEMENT Maureen Neistadt and Maureen Freda Baker BIBLIOGRAPHIES OF HOLDINGS David J. Powell, ed. OF THE SIECUS INFORMATION SERVICE Makes suggestions for dealing with each of AND LIBRARY: Originally published in the fall of 1984 as a number of physical problems (such as AGING, DISABILITY, OR ILLNESS AND Volume 1, Number 3 of Alcoholism Jreat- tremor and loss of mobility) that impede sexual SEXUALITY ment Quarterly. Covers sexual function and functioning. Recommended positions for Leigh Hallingby, camp. dysfunctionrelated to alcoholism, including intercourse illustrated. recovery, assessment, sex therapy, andsexual Spaulding Rehabilitation Hospital (1979), Bibliographies on 35 separate illnesses or dynamics of the therapeutic relationship. Occupational Therapy Department, 725 disabilities as they relate to sexuality. The 600 Haworth Press(1984),28 East 22ndStreet, New Nashua Street, Boston, MA 02714; $3.00 (inc/. unannotated citations include periodical arti- York, NY 10010; $17.95 cles and chapters in edited books. Annual p/h) updating planned. Order blank available to those wishing to purchase individual bibliog- ALCOHOLISM IN THE LESBIAN/GAY GETTING TOGETHER raphies. COMMUNITY: Debra Cornelius, Elaine Makas, and Sophia S/ECUS (1985) 80 Fifth Avenue, Suite 801, COMING TO TERMS WITH AN EPIDEMIC Chipouras New York, NY 10011; $30.70 + 20% p/h A pamphlet describing psychosocial rea- Tenth in a series on attitudinal barriers fac- sons for alcoholism in the homosexual com- ing disabled people, this booklet deals with SEX EDUCATION FOR DISABLED PEOPLE: munity. Offers suggestions for locating myths about the sexuality of the disabled and A RESOURCE GUIDE counseling and treatment. steps that can be taken to overcome them. D.I.N. Publications, P.O. Box 21726, Phoenix, RRRI (1987), George Washington University, An annotated bibliography of books, pam- AZ 85036; $25 pamphlet, $7.00 booklet Academic Center, Suite T-605, Washington, phlets, articles, and tactile materials concern- ing sexualityanddisability.Contains informa- DC 20052, $7.70 (incl. p/h) A COUNSELOR’S GUIDE TO THE SPECIAL tion for both younger and older consumers, as well as for health care professionals. Easy to NEEDS OF SEXUAL MINORITY CLIENTS IN SEX EDUCATION FOR read and very usefully laid out. ALCOHOLISM AND DRUG TREATMENT DISABLED PERSONS Planned Parenthood Alameda/San Francisco Chemical Dependency Program Public Affairs Pamphlet tt531 (1987), 1660 Bush Street, San Francisco, CA Written to help counselors recognize the lrving Dickman 94109; $12.50 + $2.25 p/h; 1982 supplement, problems alcoholic homosexuals have in The pamphlet alerts professional people $6.25 + $2.25 p/h coming out to counselors, seekingtreatment, working with physically and mentally dis- and finding alternatives to gay bars. Empha- abled persons to the importance of providing SEXUALITY AND THE DISABLED: sizes that a unique treatment is necessary. them with sex education and of helping their AN ANNOTATED BIBLIOGRAPHY Chemical Dependency Program (7980), 7207 parents to do so. Pine Street, Seattle, WA 98701; $2.50 t g.50 Public Affairs Committee (1975), 387 Park Includes 200 citations to books, periodical p/h Avenue South, New York, NY 10016; $1.00 articles, curricula, conference papers, and (incl. p/h) dissertations. Katharine Dexter McCormick Library, De- NALGAP BIBLIOGRAPHY: RESOURCES ON partment of Education, (7981), Planned Par- ALCOHOLISM AND LESBIANS/ TABLE MANNERS: A GUIDE TO THE enthood Federation of America, 810 Seventh Revised Edition PELVIC EXAMINATION FOR Avenue, New York, NY 10019; $4.00 (incf DISABLED WOMEN AND A three-part bibliography including re- HEALTH CARE PROVIDERS p/h) sources for alcoholic lesbians and gay men, information about the homosexual commu- Susan Ferreyra and Katrine Hughes nity, and resources on alcoholism. Information for clinicians and clients about National Association of Lesbian and Gay a cooperative approach to a comfortable and Alcoholism Professionals (1986) 204 W. 20th thorough pelvic examination. ALCOHOL ABUSE Street, New York, NY 10011; $5.00 (incl. p/h) Planned Parenthood Alameda/San Francisco (1982), 482 West MacArthur Boulevard, Oak- SEX AFTER SOBRIETY: land, CA 94609; $4.00 + 2.25 p/h ALCOHOL AND SEXUALITY: A WOMAN’S GUIDE AN ANNOTATED BIBLIOGRAPHY ON Cay/e Roselfini TOWARD INTIMACY: ALCOHOL USE, ALCOHOLISM, AND An 8-page pamphlet for women, with or FAMILY PLANNING AND SEXUALITY HUMAN SEXUAL BEHAVIOR without partners, covering meeting sexual CONCERNS OF PHYSICALLY DISABLED Timothy!. O’farrell, Carolyn A. Weyland, and needs, recovering self-esteem, rebuilding WOMEN Diane Logan relationships, and sexual healing. Task force on the Concerns of Physically Dis- A bibliography of sources published from D.I.N. Publications (1983), P.O. Box 21126, abled Women 1900 to 1982 covering effects of alcohol on Phoenix, AZ 85036; 8.25 A discussion of various relationships within sexual functioning, treatment of sexual prob- a disabled woman’s life, aimed at promoting lems of alcoholics, social and cultural issues, communication and understanding. and a review of the literature. Planned Parenthood S.E. PA (1977), 7220 San- Oryx Press (1983), 2214 North Central at CANCER som Street, Philadelphia, PA 19107; $3.50 + Encanto, Phoenix, AZ 85004; $55.00 75% p/h ALCOHOLISM AND HOMOSEXUALITY WITHIN REACH: PROVIDING FAMILY Thomas 0. i’iebold and John E. Mongeon, BODY IMAGE, SELF-ESTEEM, PLANNING SERVICES TO eds. AND SEXUALITY IN CANCER PATIENTS PHYSICALLY DISABLED WOMEN J. M. Vaeth, R. C. Blomberg, An anthology on alcoholism in the homo- Task force on Concerns of Physically and L. Adler, eds. sexual community, including treatment, Disabled Women counseling techniques, and prevention. The conference on which this outstanding Helpful for family planning providers serv- Originally published as Volume 7, Number 4 book is based was a first in the specificarea of ing disabled women. of the Journal of Homosexuality. cancer and its possible effects on sexuality Planned Parenthood 5.E. PA (1977), 7220 San- Haworth Press(l982),28 tast22ndStreet, New and self-esteem in patients of all ages. som Street, Philadelphia, PA 79707; $3.50 + York, NY 10070; $24.95 hc, $17.95 pb + $2.00 S. Karger (1980), 79 fifth Avenue, 77th f/oor, 15% p/h P/h New York, NY 10003; $47.00 (incl. p/h)

16 SIECUS REPORT, March 1986 SEXUAL ADJUSTMENT TO CANCER HUMAN SEXUALITY CURRICULUM: SURGERY IN THE VAGINAL AREA SELF-AWARENESS AND MENTALLY HANDICAPPED M. Edward C/ark and lavier Magrina INTERPERSONAL RELATIONSHIPS Pennsylvania School for the Deaf Describes vaginal cancer, the types of surgery involved, sex following surgery, sex- This curriculum for hearing-impaired stu- ual arousaLand partner involvement. Written dents in elementary, junior, and senior high for clients and medical practitioners. schools provides courseoutlinesfor stages of Student Union Bookstore, University of Kan- development, emotional involvement, family For Parents and Professionals sas Medical Center (7983), Rainbow Boule- and social relationships, sexual behaviors, vard and 39th, Kansas City, KS 66103; $9.75 + reproduction and parenthood, and lifestyles. $2.00 p/h Divided for each grade into beginning, inter- mediate, and advanced levels. AN EASY GUIDE FOR CARING PARENTS: Pennsylvania School for the Deaf (7977), 700 SEXUALITY AND SOCIALIZATION- SEXUALITY AND CANCER West School House Lane, Philadelphia, PA A BOOK FOR PARENTS OF PEOPLE WITH lean M. Stoklosa et al. 79144, $70.00 (inch. p/h) MENTAL HANDICAPS Sensitively written discussion with useful Lyn McKee and Virginia Blacklidge sections on ostomy, laryngectomy, and mas- SIGNS FOR SEXUALITY: An honest, upbeat book about the social tectomy. A RESOURCE MANUAL and sexual needs of people with mental han- Bull Publishing (1979), Box 208, Palo Alto, CA Susan D. Doughten, Marlyn 6. Minkin, and dicaps. Valuable aid to both parents and 94302; $2.95 + $7.00 p/h Laurie E. Rosen educators. P1annedParenthoodS.E. PA (1987), 7220Sam- Contains over 600 photographs illustrating som Street, Philadelphia, PA 79707; $5.95 + 300 signed words and phrases associated with 75% p/h HEARING AND VISUALLY human sexuality. Bound to lie flat, leaving IMPAIRED hands free for communication. Planned Parenthood of Seattle/King County LOVE, SEX, AND BIRTH CONTROL (7978), 2271 East Madison, Seattle, WA 98722; FOR THE MENTALLY RETARDED: $17.95 + B.50 p/h A GUIDE FOR PARENTS FEELING FREE: A SOCIAL/SEXUAL Seventh Edition TRAINING GUIDE FOR THOSE WHO Winifred Kempton, Medora Bass, and SIGNS OF SEXUAL BEHAVIOR WORK WITH THE HEARING AND Sol Gordon lames Woodward VISUALLY IMPAIRED Thoughtful guide covering sex education lean Edwards et al. Each sign, along with its etymology, is and sexual responsibility. Spanish edition also explained. Author also discusses deaf culture A guide for teaching responsible decision available. as it relates to the ever-changing signs. making to all ages with thegoal of increasing Planned ParenthoodSI. PA (7985), 7220 San- T. /. Publishers (1979), 877 Silver Spring appropriate social and sexual behavior. som Street, Philadelphia, PA 79707; $2.95 + Avenue, Room 206, Silver Spring, MD 20970; Includes curriculum preparation, lesson 8.44 p/h $7.95 + $7.50 p/h plans, and appendices of resources. Ednick Communications, Inc. (1982), P.O. Box VIEWPOINTS: A SELECTED BIBLIOGRAPHY ON 3612, Portland, OR 97208; $30.00 + $2.50 p/h SEX EDUCATION AND DEAFNESS SEXUALITY, SEX EDUCATION AND FAMILY Della fitz-Gerald and Max Fitr-Gerald, eds. PLANNING FOR USE IN MENTAL SEX EDUCATION FOR RETARDATION PROGRAMS A compilation of ten articles by the Fitz- DEAF-BLIND STUDENTS Phyllis Cooksey and Pamela Brown Ceralds and others. Deals with the need for Ellen Cadigan and Roslye Roberts Ceuss and methods of sexuality education for hear- Bibliography includes materials for both Contains six units on: self-identity, anat- ing impaired children and adolescents. professional and patient/client education. omy of the reproductive system, human Gallaudet College Bookstore (7985), Out- Topics covered are sexuality, sex education, reproduction, growth from infancy through reach Products, P.O. Box 70-D, Kendall reproduction, birth control, and sterilization. puberty, adolescence, and personal health Green, Washington, DC 72002; $72.95 + $2.50 Planned Parenthood of Minnesota (7987), 7965FordParkway,St,Paul, MN55776;$3.50+ care and hygiene. Within each unit is a series p/h of skills to be learned and under each skill is a 8.35 p/h series of objectives. Perkins School for the Blind (7987), Office of KIDNEY DISEASE SEX AND THE MENTALLY HANDICAPPED Public Relations and Publications, 775 North Michael Craft and Ann Craft Beacon Street, Watertown, MA 02772; $70.00 + $7.00 p/h SEX AND DIALYSIS Written for professionals and parents car- Barbara Ulery ing for the mentally handicapped, this British book looks at many of the questions, anxie- A valuable resource in this special area of ties, and fears raised by the sexuality of this HEARING IMPAIRED concern. group. Offers guidelines to those wishing to Barbara Ufery (7979), P.O. Box2349, Durango, plan sex education programs. CO 87307; $3.75 (incl. p/h) Rout/edge & Kegan Paul (7978), 9 Park Street, GROWING UP SEXUALLY Boston, MA 02708; $8.95 (incl. p/h) Angela M. Bednarcryk SEX AND INTIMACY FOR DIALYSIS AND TRANSPLANT PATIENTS Includes a 138-page teacher’s manual, a SEX EDUCATION AND COUNSELING FOR Revised Edition student text divided into seven chapters MENTALLY HANDICAPPED PEOPLE Norman 5. Levy (each packaged as a separate booklet), and a Ann Craft and Michael Craft, eds. booklet for parents. Student chapters are This booket for patients and health profes- Written for professionals to enable them to arranged according to comfort-level criteria, sionals covers: the nature and causes of sex- educate and counsel parents, staff and the andeach includesan introduction, discussion ual dysfunctions, sexual ability and interest, mentally handicapped on sexuality issues. questions and activities, and review ques- contraception, and treatment for sexual dys- Practical suggestions aregiven for developing tions. functions in the patient with kidney disease seminars, workshops and programs. Contrib- Kendall Demonstration Elementary School or transplant. utors include American and British pro- (7982), Callaudet College, Kendall Green, Virgil Smirnow Associates (7984), Health and fessionals. Washington, DC 20002; teacher’s manua/, Public Affairs, 8507 Burdette Road, P.O. Box University Park Press (7983) 300 North Char- $78.95; student manual, $26.95 + $3.50 p/h 34425, Bethesda, MD 20877; $7.50 (inc. p/h) les Street, BaItimore, MD 27201; $79.95

SIECUS REPORT, March 1986 17 SEX EDUCATION AND THE Looseleaf format enables educators to EDUCATION FOR ADULTHOOD INTELLECTUALLY HANDICAPPED remove and add pages. Madeline Creenbaum and Sandra No// Wendy McCarthy and Lydia Fegan Division for Disorders of Development and Designed to help mentally retarded adoles- Learning (7984), BSRC 220H, University of This book, originally published in Australia, cents and adults reach an understanding of North Carolina, Chapel Hill, NC27574; $18.50 is designed to help parents and other caretak- being sexual, aging, dealing with death and + $1.50 p/h ers understand the many aspects of the sexu- dying, being disabled, expressing feelings, ality of mentally handicapped children. developing relationships, and keeping fit. /ohn Wright (1984), PSC Inc., Littleton, MA A SPECIAL BOOK: Includes training program for those who will 01460; $12.50 SEX EDUCATION FOR THE teach this curriculum. Accompanying each DEVELOPMENTALLY DISABLED unit are worksheets, discussion questions, Nancy Cenn and lists of additional activitiesand resources. SEX EDUCATION FOR PERSONS WITH Staten Island Mental Health Society (?982), DISABILITIES THAT HINDER LEARNING: Meant to be read to or by the developmen- Elizabeth W. Pouch Center for Soecial Peo- tally disabled teenager. Drawings and text A TEACHER’S GUIDE ple, 657 Castleton Avenue, Staten Island, NY Winifred Kempton and Rose Foreman address gender and sex differences, sexual 10301, $28.00 (incl. p/h) anatomy and functioning, sexual develop- This invaluable resource for instructors ment, reproduction, friendships, intimacy, stresses the need to integrate sexuality with and love. Birth control briefly covered. ESSENTIAL ADULT SEX EDUCATION FOR every facet of human experience. Nancy Cenn (7983), Association for Retarded THE MENTALLY RETARDED: Planned Parenthood5.E. PA (7975), 7220San- Citizens of Greater NewHaven, 1 StateStreet, E.A.S.E. SEQUENTIAL CURRICULUM GUIDE som Street, Philadelphia, PA 191b7; $7.95 + New Haven, CT 06511; $70.00 + $.69 p/h David B. Zelman and Kathie M. Tyser 15% p/h Sequenced set of objectives, procedures, For Teachers: Curricula and materials grouped into four instructional SEXUALITY, LAW, AND THE units: biological data, sexual behavior, DEVELOPMENTALLY DISABLED PERSON: and Tests health, and relationships. Pre/post tests and LEGAL AND CLINICAL ASPECTS OF teaching picture cards are included in curric- BECOMING ME: MARRIAGE, PARENTHOOD, AND ulum guide. Total E.A.S.E. package also STERILIZATION A PERSONAL ADJUSTMENT GUIDE FOR includes two introductory cassettes, 100 Diag- Sarah F. Haavik and Karl A. Menninger SECONDARY STUDENTS nostic Pupil Profile sheets, a color filmstrip, Teresa Jhrockmorton Presents research data, legal analysis, and and a menstruation and birth control pro- programmatic recommendations concerning Includes units on personal and social ducts kit. sexuality, marriage and reproduction for per- development, health and self-care, and Stanfield Film Associates (l979), P.O. BOX sons with developmental disabilities. human growth and development, all focused 1983, Santa Monica, CA 90406; total curricu- Paul H. Brookes Publishing Co. (1981) Box on nurturing the practical skills needed for fum package, $l99.00+$2O.OOp/h; sequential 10624, Baltimore, MD 21285; $15.95 + $1.69 everyday life. For each topic, a content out- curriculum guide on/y, $50.00 + $7.00 p/h p/h line, behavior objectives, learning activities, and suggested resources are presented. FEELING GOOD ABOUT YOURSELF: Grand Rapids Public Schools (1980), 743 Bost- A GUIDE FOR PEOPLE WORKING WITH For the Mentally Handicapped wick, NE, Grand Rapids, MI 49503; $12.00 PEOPLE WHO HAVE DISABILITIES (inch. p/h) Second Edition Gloria B/urn and Barry B/urn AN EASY GUIDE TO LOVING CAREFULLY FOR MEN AND WOMEN BEING ME.. . Covers socialization and decision-making Lyn McKee, Winifred Kempton, and Lynne lean Edwards and Suzan Wapnick skills and a wide variety of sexual topics. The St&a// continuing focus ison self-esteem asessential Subtitle: A Social/Sexual Training Guide in preparation for adulthood. Basic information about sexual anatomy, for Those Who Work With the Developmen- Ed-U Press (1987), P.O. Box 583, Fayetteville, reproduction, and contraception, presented tally Disabled. Includes examples of curricula NY 13066; $9.95 + 15% p/h in large print with many illustrations. Suitable and lesson plans from a variety of sources for higher functioning mentally handicapped approaching a broad student population FULLY HUMAN people to read on their own or with a parent from mildly to severely disabled, from age 6 Nancy Howes or professional. up to young adults and older persons. Planned Parenthood: Shasta-Diablo (1980), Designed both to supplement existing train- In lesson plan format this comprehensive 1291 Oakland Boulevard, Walnut Creek, CA ing and to serve as a complete new program. curriculum covers twelve sequential topics 94596; $6.95 (incl. p/h) Ednick Communications (1987) Box 3612, from sexual identity through parenting at Portland, OR 97208; teacher’s guide, $30.00; four progressive levels of ability. Includes teacher training information, activity pages GETTING IN TOUCH WITH YOURSELF assessment scale andphoto cards, $40.00; sex education slides, $40.00, + $2.50 p/h and drawings, and specific teaching tech- Sally 5. Miller niques for each lesson. Guide for mentally disabled to bodyexplo- Nancy Howes (in press for 1986) Box 2107, CIRCLES ration, including looking at their genitals with Hanover, MA 02339; price unavailable at Mark/en Champagne and a mirror and masturbating. press time Synergy Book Service (1984), 210 Main Street, Leslie Walker-Hirsch A GUIDE FOR TEACHING HUMAN Flemington, N) 08822; $6.00 + $1.50 p/h Subtitle: A Multimedia Package to Aid in SEXUALITY TO THE MENTALLY the Development of Appropriate Social/Sex- HANDICAPPED ual Behavior in the Developmentally Dis- GROWING UP: Third Edition A SOCIAL AND SEXUAL EDUCATION abled Individual. The Circles Concept is used to teach appropriate social distancing, Phyllis Cooksey and Pamela Brown PICTURE BOOK FOR YOUNG PEOPLE including individuals with whom various WITH MENTAL RETARDATION This curriculum guide contains nine cate- kinds of touch are and are not acceptable, as Victoria Shea and Betty Cordon gories, such as contraception and interper- well as many other sex and family life educa- sonal relations. Under each category are Designed to be read to moderately through tion topics. Includes curriculum, two slide listed topics to cover, points to make, and severely mentally handicapped students aged programs, a teaching drop cloth, and a set of suggested activities and resources. A simple I2 and up, although many parts may be suita- 10 photographs. but very practical approach to teaching the ble for younger students with mild learning StanfieId Film Associates (7983), P.O. Box mentally handicapped about sexuality. problems. Basic information and illustrations 7983, Santa Monica, CA 90406; $399 + $25.00 Planned Parenthood of Minnesota (1981), are on right hand pages, and ideas for discus- p/h; curriculum guide only, $25.00 + $5.00 1965 Ford Parkway, St. Paul, MN 55116; $3.50+ sion and further learning activities on left. p/h 8.35 p/h

18 SIECUS REPORT, March 1986 GUIDELINES FOR TRAINING IN SEXUALITY Benhaven Press (1979), Maple Street, East AND THE MENTALLY HANDICAPPED Haven, CT 06512; $21.00 (incl. p/h) Winifred Kempton and Rose Foreman SEXUAL ABUSE PREVENTION

Not a textbook, but a proposed training SOCIO-SEXUAL KNOWLEDGE AND program for those working with staff, aides, ATTITUDE TEST (SSKAT) or parents involved with the mentally loel R. Wish, Katherine Fiechtl McCombs, ARE CHILDREN WITH DISABILITIES handicapped. and Barbara Edmonson Planned Parenthood S.E. PA (1976), 1220San- VULNERABLE TO SEXUAL ABUSE? Can be used with mentally retarded per- som Street, Philadelphia, PA 19707; $9.14 sons and others whose language is limited. This five-page booklet acquaints parents of (incl. p/h) disabled children with the problem of sexual Responses to most questions consist of the subject’s pointing to a choice of pictures and abuse and outlines steps to take to protect HUMAN SEXUALITY: indicating “yes” or “no.” There are 13 sub- their children. A PORTFOLIO FOR THE tests, which can determine both sex knowl- Minnesota State Documents Division (7983), DEVELOPMENTALLY DISABLED edge and attitudes. Manual presents data 117 University Avenue, St. Paul, MN 55155; 50 Victoria Livingston and Mary E. Knapp from use of SSKAT with 200 retarded adults for $7.00 + $1.50 p/h Consists of IO separate drawings on stiff- ranging in age from 18-42. ened paper, with discussion suggestions for Stoelting Co. (1976), 1350 South Koster CHOICES: SEXUAL ASSAULT the teacher printed on the backof each plate. Avenue, Chicago, IL 60623; $100.00 + $4.00 PREVENTION WORKBOOKS Content areas include male and female geni- p/h Three different workbooks available. talia, girl to woman, boy to man, masturba- Those for the physically disabled and deaf- tion, and . hearing impaired are in standard print. The Planned Parenthood of Seattle-King County one for the visually impaired is available in (1974) 2211 East Madison, Seattle, WA 98712, MULTIPLE SCLEROSIS braille and large print and on cassette. They $23.00 (incl. p/h) cover topics such as safety at home, on street, in workplace, and on public transportation, THE JOAN DAVIES FAMILY LIFE UPDATE as well as assertiveness training. loan Davies, ed. Seattle Rape Relief Disabilities Project (in This newsletter, published nine times per GUIDE TO PROGRAM PLANNING ON press for 1986), 7825 South lackson, #702, Seattle, WA 98178; prices unavailable at press year-September through June-contains SEXUALITY AND MULTIPLE SCLEROSIS time. tips, materials, games, lesson plans, etc. for Ann Barrett and Michael Barrett teaching family life education to special Includes well-devised exercises for groups students. dealing with sexuality and multiple sclerosis. PREVENTING SEXUAL ABUSE OF PERSONS loan Davies Associates, 98Southview Terrace Multiple Sclerosis Society of Canada (1978), WITH DISABILITIES: North, Middletown, NJ 07748; annual sub- A CURRICULUM FOR HEARING 250 Bloor Street East, Suite 820, Toronto, scription, $19.95 Ontario M4W 3P9, Canada; $3.00 (incl. p/h) IMPAIRED, PHYSICALLY DISABLED, BLIND AND MENTALLY RETARDED STUDENTS PERSONAL DEVELOPMENT AND Bonnie O’Day SEXUALITY: SEXUALITY AND MULTIPLE SCLEROSIS This 175-page curriculum includesseparate A CURRICULUM GUIDE FOR Revised Edition lesson plans for each of four populations DEVELOPMENTALLY DISABLED Michael Barrett Lenore Morrey et a/. named in title. Topics covered include posi- Useful booklet for people with multiple tive and negative touch, vocabulary, myths Presents general statements, behavioral sclerosis and the professionals working with and facts about sexual abuse, avoidance tech- objectives, activities, and resources for a ser- them. niques, and assertive behavior. ies of topics such as self-actualization, per- National Multiple Sclerosis Society(l982), 205 Network Publications (?984), 7700 Mission sonal hygiene, and human sexual response. East 42nd Street, New York, NY 10077; single Street, Suite 203, P.O. Box 7830, Santa Cruz, Also gives guidance about how to be a facili- copies free of charge CA 95061-1830; $19.95 + $2.99 p/h tator and how to plan and evaluate sex educa- tion programs. PROVIDING COUNSELING AND Planned Parenthood of Pierce County (I 978), ADVOCACY FOR DISABLED PERSONS 873 South K Street, #200, Tacoma, WA 98405, WHO HAVE BEEN SEXUALLY ABUSED: $25.00 (id. p/h) OSTOMY A TRAINING MANUAL FOR RAPE CRISIS CENTER VOLUNTEERS PRACTICAL APPROACHES TO SEXUALITY EDUCATION PROGRAMS This manual includes basic information Ann Thompson Cook and about mental, physical, and sensory disabili- ties. Also provides directions and guidelines Pamela M. Wilson, eds. SEX AND THE FEMALE OSTOMATE (1982) for organizing training sessions concerning A guidebook for sex education programs SEX AND THE MALE OSTOMATE (1982) sexual abuse counseling and advocacy with for preadolescents, adolescents, parents, and SEX, COURTSHIP AND THE SINGLE persons who have disabilities. All necessary mentally retarded persons, giving course out- OSTOMATE (1981) handouts for trainees included. lines and materials, questions students may Well-written booklets for ostomates and Seattle Rape Relief Disabilities Project (1981), ask, selected resources, and sample lessons those working with them. 1825 South Jackson, Suite #102, Seattle, WA for the four groups. United Ostomy Association, 2001 West Bev- 98718; $22.00 (incl. p/h) Sex Education Coalition (1982), 2001 OStreet, erly Boulevard, Los Angeles, CA 90057; $?.OO N.W., Washington, D.C. 20036; $5.50 (incl. each + 8.30 p/h each p/h) SEXUALITY AND SEXUAL ASSAULT: DISABLED PERSPECTIVES SEXUALITY AND SOCIAL AWARENESS: SEXUAL COUNSELING FOR OSTOMATES Revised Edition A CURRICULUM FOR MODERATELY Ellen A. Shipes and Sally T. Lehr Char/es K. Stuart and Virginia Stuart AUTISTIC AND/OR NEUROLOCICALLY A commonsense approach to sexual coun- Curriculum guide for development of IMPAIRED INDIVIDUALS seling of ostomates, covering easy-to- workshops for professionals on incest, rape, Dawn A. Lieberman andMary Bonyai Me/one understand techniques. and sexual abuse of disabled people. Valuable for sex educators working with Char/es C Thomas (1980), 2600 South First Learning Resources (1983), BA246,Southwest lower functioning mentally handicapped Street, P.O. Box 4709, Springfield, IL 62708- State University, Marshall, MN 56258; $7.94 individuals, aged 12 and older. 4709; $14.75 (incl. p/h)

SIECUS REPORT, March 1986 19 SPECIAL EDUCATION CURRICULUM ON SEX AND THE SPINAL CORD INJURED: INTIMACY AND CHRONIC LUNG DISEASE SEXUAL EXPLOITATION SOME QUESTIONS AND ANSWERS Carol J. Hossler and Sandra 5. Co/e Seattle Rape Relief Disabilities Project M. G. Eisenberg and L. C. Rustad Presents effective ways to deal with lung Designed for teaching mentally and physi- Questions discussed include areas such as disease, including relaxation and breathing cally handicapped students to be aware of physical attractiveness, aging, drugs, cathe- exercises, diet, medication, and energy con- sexual exploitation and to protect them- ters, divorce, adoption, and alternative servation. Intimacy, sexual anatomy and phy- selves. Two self-contained kits (elementary methods of sexual expression. siology, and positions for intercourse arealso and secondary levels) provide a variety of Superintendent of Documents, U.S. Govern- covered. educational materialssuch as teacher’s guide, ment Printing Office, Washington, DC 20402 Department of Physical Medicine and Reha- body maps, slide series, and pamphlets. (1975); $2.00 (to order, useStock No. O51-OOO- bilitation (7983), 7405 East Ann Street, Ann Audio tape supplements are available. 00087-7) Arbor, MI 48709-0010; 5.00 Comprehensive Health Education Founda- tion (7981), 20832 Pacific Highway South, SEXUALITY AND THE SPINAL CORD THE SENSUOUS HEART: Seattle, WA 98188; Level 7, $125; Leve/2, $495; INJURED WOMAN GUIDELINES FOR SEX AFTER A HEART Teacher’s Guide with written narratives, $35 Sue Bregman ATTACK per level. Suzanne Cambre Booklet providing guidelines concerning A cartoon-style booklet covering concerns TEACHER TRAINER MANUAL: social and sexual adjustment for spinal cord about depression, sexual activity, physical TECHNIQUES FOR PLANNING AND injured women and health professionals who exercise, medications, sexual positions, eat- IMPLEMENTING A SELF-PROTECTION work with them. Sister Kenny /nstitute (7975), Publicatfons ing, and drinking. PROGRAM Department, 800 East 28th Street at Chicago Pritchett and Hull Associates, Inc. (7978), 3440 Provides a systematic approach to develop- Avenue, Minneapolis, MN 55407; $6.00 + Oakcliff Road, NE, Suite 770, Atlanta, GA ing a special education program concerning $3.00 p/h 30340; $2.60+$2.00 p/h sexual exploitation within a school system. Manual includes guidelines for training of SEXUAL DYSFUNCTION IN special education personnel, counselors, NEUROLOGICAL DISORDERS: nurses, other professionals, and parents con- VISUALLY IMPAIRED DIAGNOSIS, MANAGEMENT, AND cerning awareness about sexual exploitation REHABILITATION of disabled individuals. Francois Boiler and Ellen Frank Seattle Rape Relief Disabilities Project (7983), FOR BOYS: A BOOK ABOUT GIRLS Reviews etiology, symptoms, and practical 1825 South Jackson, Suite 702, Seattle, WA Braille booklet explaining menstruation. management of impairments of sexual func- 98178; $28.00 (incl. p/h) Includes braille diagrams of female repro- tion in patients with such disordersasdiabetes, ductive system. spinal cord lesions, strokes, and Parkinson’s TEACHING PEOPLE WITH MENTAL Persona/ Products Co. (1985), Milltown, NJ disease. RETARDATION ABOUT SEXUAL ABUSE 08850; $1.50; one comp/imentary copy per Raven Press (1982),1140 Avenue of the Amer- PREVENTION school system icas, New York, NY 70036; $16.50 (incl. p/h) Cordelia Anderson and Walter Brea Particularly geared toward staff of residen- GROWING UP AND LIKING IT SEXUAL HEALTH AND DIABETES tial facilities, but the concepts and role plays Booklet explaining menstruation to girls; Linda K. Strodtman and Ralph F. Knopf may also be used by parents andother educa- available in braille. This booklet is written for diabetics, but is tors in their homes and classrooms. Personal Products Co. (7985), Milltown, NJ useful for health professionals, as well. It Network Publications (1982). 1700 Mission QS850; $2.00 (one complimentary copy per addresses pregnancy, contraception, and Street, Suite 203, P.O. Box 1830, Santa Cruz, school system) sexual function and dysfuncfion. CA 95061-1830; $4.95 + $0.74 p/h Media Library, University of Michigan Medi- SEX EDUCATION FOR THE VISUALLY cal Center (1983), R4440 Kresge I, Ann Arbor, WHAT PARENTS OF HANDICAPPED HANDICAPPED IN SCHOOLS AND MI 48709; $18.50 for 70 copies (incl. p/h) PERSONS SHOULD KNOW: AGENCIES: PARENT BROCHURE SELECTED PAPERS SEXUALITY AND NEUROMUSCULAR This brochure is designed to inform parents Sound advice on the development and DISEASE of developmentally disabled persons about implementation of sex education programs Frances Anderson, Joan Bardach, and sexual ab&e. for the visually impaired from professionals in Joseph Coodgold Seattle Raoe Relief Disabilities Project (1983), a variety of settings. This monograph’s recommendations for 1825 so&h Jackson, Suite 102, Seatt/k, WA American Foundation for the Blind (1975), 15 helping disabled individuals with neuromus- 98718; $1.25 (inc/. p/h) West 16th Street, New York, NY70077; $5.00+ cular disease achieve sexual fulfillment are $2.50 p/h derived from interviews with patients, their families, and physical therapists, as well as from literature surveys. OTHER DISABILITIES New York University Medical Center (1979), SPINAL CORD INJURED Publications Office, 530 first Avenue, New York, NY 10076; $2.00 (includes p/h)

SEXUALITY AND HANDICAP: CROWING UP WITH SPINA BIFADA: PROBLEMS OF MOTOR A BOOK ABOUT PUBERTY, HANDICAPPED PEOPLE INDEPENDENCE, AND CARING B. H. H. Duchesne, C. Pons, and THE SENSUOUS WHEELER: M. C. Treadwell and R. L. Patrias SEXUAL ADJUSTMENT FOR THE SPINAL A. M. C. M. Schellen, eds. A booklet with detailed diagrams, provid- CORD INJURED This book, originally published in Holland, ing information on body parts, puberty, body Barry J. Rabin has been translated into English by Robert image, hygiene, and sexuality. Includes Lyng. It is divided into three parts dealing with Informal, positive treatment of the subject, resource list for more information, and a the medical, psycho-social, and ethical as- stressing the sharing of sexual responsibilities glossary. pects of sexuality and motor disabilities. The and vulnerabilities. Mason Barr, MD (1981), University Hospital, medical section is strongest. BarryJ. Rabin (1980), 5595 East 7th Street, Suite K2027 Holden, Box 07, Ann Arbor, MI 48709; Charles C. Thomas (l986), 2600 South First 353, Long Beach, CA 90804; $11.45 (incl. p/h) $1.00 (incl. p/h) Street, Springfield, IL 62777; 834.75 pb

20 SIECUS REPORT, March 1986 IA~DI~-VI~UAL REVIEWS I

Members of the S/ECUS Audio-Visual articulate. It is obvious that they love “profound” to describe this video, Review Panel for this issue were: Peggy each other in a unique way, and David which is highly recommended for Brick, MEd, Director of Education, speaks of how he wishes he could have audiences from late teens up. It presents Planned Parenthood of Bergen County, such close relationships with other men, a beautiful model of male-to-male inti- Hackensack, IV); Patti B&ton, Depart- especially those with whom he served in macy and also brings up issues of love, ment of Education, Planned Parenthood Vietnam. The last part of the video touch, physical dependence, disability, Federation of America; Martha Calder- reveals another side of Rik’s life: his love friendship, commitment, trust, and sex- wood, MA, University of Medicine and for Jean Schuster, a young woman with uality. LT, A, P, PR Dentistry of New lersey; Rita Cotter/y, cerebral palsy. They explain how their Men Who Molest/Children Who Sur- Graduate Assistant, S/ECUS Information relationship developed and how their vive. 1985, 16mm or video, 52 min. Pur- Service and Mary 5. Calderone iibrary, dreams and desires are similar to those chase, $750 (16mm), $450 (video); rental, and doctoral candidate in Human Sexu- of other young couples. $80. Filmakers Library, 133 East 58th ality Program, New York University; One panel member summed up many Street, New York, NY 10022; (212) 355- Leigh Hallingby, MSW, MS, Manager, of our feelings about The Attendant (the 6545. S/ECUS information Service and Mary S. title of which unfortunately reflects only Calderone Library; lean Levitan, PhD, part of the content) when she described This potent documentary opens with Assistant Professor, William Paterson it as “a dichotomous film that works Alan, who began sexually abusing his College, Wayne, N); Valerie Pinhas, beautifully in the end. It demonstrates daughter Amy when she was eighteen PhD, CSW, CAC, Associate Professor of two remarkable relationships.. Each of months old and did not stop until he was Health Education, Nassau Community the halves is quite special.” Other panel caught five years later. Alan and his wife College, Garden City, NY; AlexSareyan, members used adjectives such as “pow- are still together trying to salvage their President, Mental Health Materials Cen- erful, ” “beautiful,” “moving,” and marriage and family. Next, we meet ter; Linda Schwarz, Department of Edu- Dawn, a young adolescent who took the cation, Planned Parenthood Federation unusual step of reporting her father of Ainerica; Ian Sola, PhD, Program Wayne to the Harborview Sexual Assault Consultant, National Board of YWCA of Center in Seattle, Washington, after he the USA; /ill Tabbutt, information Spe- had been molesting her for two years. cialist, S/ECUS information Service and Lia, at age seven, is introduced during a Mary S. Calderone Library, andgraduate (16 mm & Video/Color/60 M&s.) therapy session in which she uses rag student, HumanSexualityProgram, New dolls to reenact her uncle David’s moles- Produced for: York University. The reviews were writ- Institute of Rehabilitation Medicine tation of her at age 4. Subsequently, in a ten by Leigh Hallingby. New York University Medical Center powerful scene, she shows how a victim Joan L. Bardach Ph.D., Project Director can become a survivor when she con- The Attendant. 1984, video, 30 min. Pur- Frank Padrone Ph.D., CeDirector fronts her unclein prison. Finally,wesee chase, $300; rental, $55. Filmakers Jim, who unlike the other three men, is Library, 133 East 58th Street, New York, Choices is a film which can be used not related to any of the more than 30 NY 10022; (212) 355-6545. time and time again in rehabilitation boys and girls whom he has molested. facilities human sexuality programs and Other scenes in this film include The first two thirds of this video in any group where issues of sexual in- explores the relationship between Rik teraction and adjustment.to a disability group therapy sessions with male sex Berkenpass, a severely disabled young are being discussed. If both parts cannot offenders and separate sessions with man, and his attendant David Harlan, be purchased, Part 1 is a tremendously women who are wives of molesters who goes through two hours of strenu- good discussion starter and should not and/or mothers of abused children. This ous work every morning to get Rik out of be missed. video also includes interviews with ther- bed, toileted, washed, dressed, into his Pam Boy/e, Coordinator: Reproductive Health apists and a judge who discusses the and Disabilities Program of the Margaret wheelchair, and ready for work. It is a approach of the criminal justice system Sanger Center of Planned Parenthood. NYC. symbiotic relationship, which enables to child sexual abusers. Rik to function as a whole, dignified Some of the messages of Men Who human being, and gives David the satis- Molest/Children Who Survive are that faction of doing a job that is almost a men engage in this offensive behavior matter of life and death. Beyond this, because they derive sexual pleasure however, lies an even deeper dimen- Vercury Productions from it; that they are addicted to it, sion, which is the physical (but not sex- 7 7 West 45 Street, NYC 70036 much the way an alcoholic is addicted to ual) and emotional intimacy that these ‘2 12) 869-4073 drinking; that relatively little is known men have developed and are able to about the phenomenon of child sexual

Audience Level Indicators: C-Children (elementary grades), ET-Early teens (junior high), LT-Lateteens (senior high), A-College, general adult public, P-Parents, PR-Professionals.

SIECUS REPORT, March 1986 21 abuse; and that there are no easy messages-get to know yourself, ques- game is a knowledge test pitting the ado answers and perhaps no answers at all tion physicians, and consider alterna- scent against the computer. When the for some offenders as far as treatment tives-raise consciousness and cannot user correctly answers one of the ques- and cure are concerned. The panel be heard too often by consumers or tions about reproduction, sexually trans found this to be an interesting, intense, professionals. A, PR itted diseases, contraception, or human and rather pessimistic film, which would anatomy, she/he gains two points. An be most useful for therapists, child sex- incorrect answer gives BARN two points. BARN, the Body Awareness Resource ual abusers and their family members, “Dear Barny” letters, generated from Network. 1985. A 5-part computer pro- and college and adult audiences inter- questions submitted by adolescents, gram for adolescent health education. ested in this complex problem. A, P, PR provide more in-depth information Purchase, $1,195; human sexuality about topics introduced in the “Skunk Sudden Changes: Post Hysterectomy module only, $499. Encyclopedia Britan- Barny” game. Decisions teens must Syndrome. 1984, video, 29 min. Pur- nica Educational Corporation,425 North make about first dates, peer pressure, chase, $295; rental, $50. Cinema Guild, Michigan Avenue, Chicago, IL 60611; and pregnancy are explored in “Soap 1697 Broadway, New York, NY 10019; (800) 621-3900. Operas.” ” Am I Pregnant?” provides (212) 246-5522. BARN is a friendly, spunky computer information about pregnancy symp- If present trends continue, by the program that provides teens with infor- toms, testing, and counseling. The same year 2000 at least half of all American mation, resources, and decision-making kinds of information regarding sexually women will have their uteruses removed aids about alcohol and drugs, human transmitted diseases are provided in at some time in their lives. Sudden sexuality, smoking, stress management, “Do I Have VD?” Changes tells the stories of an important and body management. It was devel- The panel subcommittee was im- and generally previously unheard-from oped by the Center for Health Systems pressed with BARN for many reasons. minority of women who experience sig- Research and Analysis at the University Besides being user-friendly and provid- nificant negative after-effects from their of Wisconsin in Madison. A subcommit- ing a wealth of information, it gives surgery. The filmmakers admit that their tee of the Audio-visual Review Panel teens permission to be sexual persons. intention is not to be objective, but to (Patti Britton, Leigh Hallingby, and Linda Masturbation, for instance, is viewed present an alternative view to the com- Schwarz) reviewed the human sexuality not just as an activity that will not hurt mon one that hysterectomies generally portion. teens, but as a potentially positive activ- do not cause unpleasant after-effects. As The human sexuality program uses a ity. Homosexuality is another controver- part of this process, they raise questions non-threatening and often humorous sial topic that is dealt with forthrightly. such as: When is such surgery neces- format. For instance, the”Skunk Barny” The program does not talk down to ado- sary? Why is the rate so high? What alter- lescents, nor is it sexist. It helps to build natives are viable? The video includes self-esteem and motivate teens not to interviews with women who have expe- “The most comprehenswe film collectton get pregnant. In field tests, students said rienced such post-hysterectomy com- available to the professional. ” they like BARN because it is confiden- v&&l 8 Pomero”, co a”fhOr. khsey fteparrs plications as lack of sexual drive, joint tial, fun, and nonjudgmental. Further- pains, hot flashes, and vaginal dryness. it more, they pointed out that it is not also includes a visit to a self-help group Sex Education embarrassing to ask questions of BARN for women who have undergone the and that they get more accurate answers operation, an interview with a couple than they do from their peers. who discuss the impact of the surgery We did find some disappointments. on their marriage, and the stories of For instance, the developers of BARN two women who have chosen alterna- seem to have gone along with the socie- tives to hysterectomy, such as having tal tabu against showing an erect penis, fibroid tumors removed from the and there were a few situations-such as womb. Many of the women who appear discussions of ejaculation, condoms, in the video are of premenopausal age. and fertilization-where this was obvi- Graphics are used to explain some of the ously missing. The option of abortion anatomy and physiology involved. was not mentioned in the pregnancy Generally, the panel reacted well to section. There were places like the sec- Sudden Changes, feeling that it is an tions on testicular self-examination, audio-visual with a unique and impor- breast self-examination, and birth con- tant viewpoint that needs to be aired. A trol methods where more graphics were couple of members raised the question needed. Finally, the “Skunk Barny” of whether it crossed over the line from questions about males and females were educational to alarmist, and there was all aimed at girls avoiding pregnancy. agreement that statistics comparing the Despite these drawbacks, BARN is an situation of hysterectomies and women’s exciting new approach to sex education gynecological health in the U.S. to other LrnUlTI-FOCW 1nc.l and deserves wide distribution wher- countries would have been an excellent ever computer terminals are available to addition. But the consensus was that it is teens. Currently, BARN is designed for important for women and physicians to use with the Apple II computer, but see Sudden Changes and that it would compatibility with other popular for- be an excellent discussion starter. Its L mats is in the works. ET, LT, P, PR

22 SIECUS REPORT, March 1986 1BOOK REVIEWS

Sexuality and Handicap: Problems of On the other hand, if your interests problem objectively and who is con- Motor Handicapped People. B.H.H. are focused more on the social and emo- scientious about finding the most Dechesne, C. Pons and A.M.C.M. tional aspects of sexuality and disability, appropriate solution. It provides guide- Schellen, eds. Springfield, Illinois: Char- the book is less developed and insuffi- lines for initiating behavioral changes. les C Thomas (234 pp.; $34.75). cient. The authors tend to discuss the What is quite special about this book is “problems” of disability, while offering that it treats sexual behavior in the same Reviewed by Ann Welbourne-Moglia, minimal suggestions or reasons for hope professional manner as other behaviors Ph.D., Executive Director, Sex Informa- in this area. Also, the research cited is of mentally handicapped persons by sys- tion and Education Council of the U.S. not as current as it could be. tematically observing, reporting, and One of the first books written to In sum, Sexuality and Handicap pro- recording, and analyzing when prob- address the topic of sexuality and dis- vides a basic overview of some of the key lems arise. This is progress. ability was a book entitled Not Made of issues affecting the sexual satisfaction of Interest in the beginning chapters will Stone. It contributed significantly by individuals with motor disabilities. The probably vary according to the back- increasing awareness and information book would be a good introductory text ground of the readers. For example, the about the sexual needs of motor dis- for someone not very familiar with this material on sexuality, such as sexual abled people. Over ten years have topic area, particularly the physical and rights, myths, social skills, and sex edu- passed since that time. The authors of reproductive aspects. The editors and cation for the handicapped will already Sexuality and Handicap begin their text authors are to be commended for their be familiar to those who are involved in by saying that what is needed now is a attempt to “escape the Chatterley syn- the field. The explanations on how book with a morescientificcharacterfor drome” of impotent and infertile para- behavior is learned and changed will a professional audience. They base this plegic and quadriplegic women and seem elementary to behavioral scien- approach on the premisethatthere is no men. PR tists. However, it is important that readers longer a need for a book providing basic who plan to utilize the following chap- sex education for disabled consumers. ters clearly understand all of this basic While this reviewer has some disagree- background information. In describing ment with this belief,Sexua/ityandHan- Behavioral Intervention in the Sexual the process of learning, the author dicap does deliver what the authors Problems of Mentally Handicapped states, “Behaviors are motivated and promise. Individuals in Residential and Home Set- maintained by our expectation that we The book is divided into three parts. tings. Lynda K. Mitchell. Springfield, III.: will receive some form of reinforcement Part One covers medical aspects, such as Charles C. Thomas, 1985 (106 pp.; for engaging in them, either positive or fertility, reproduction, sexual problems $19.75). negative. In order to decide whether or and neurological injuries, heredity and not we are likely to be reinforced, we Reviewed by Winifred K. Kempton, contraception. Part Two focuses on look for cues in the environment to Consultant, Sexuality and the Develop- psycho-social aspects; rehabilitation guide our behavior. We also learn from mentally Disabled; author, Sex Educa- and relationship issues are the principle observing others.” tion for Persons With Disabilities That topics covered. The final section of the Mitchell’s procedures for changing Hinder Learning: A Teacher’s Guide. book is concerned with the ethical behavior, succinctly outlined in the issues of what is normal thought and When people indulge in sexual activities third chapter, emphasize the need to behavior when one is disabled. in public, reactions to this behavior analyze individual patterns before set- The strength of this book is in the first depend largely on thesituation involved. ting up such procedures. Sample base- section. Comprehensive and very useful For example, if they are on the street and line charts are presented for this information and resources are pre- a policeman is nearby, they may land in purpose-to record what the behavior sented when discussing the medical jail. If, however, they are mentally handi- is, what triggers it, and what reinforce- aspectsof motor disability. In addition to capped and with people they know, what ments, if any, are being used. From this discussion of assessment steps and happens usually depends on their care- data, intervention procedures for chang- procedures, illustrations of treatments, takers’ attitudes about sexuality: One ing the patterns can be set up for staff to medical procedures, and sexual devices individual may overreact and randomly follow. The case cited in this chapter are very helpful. If one is looking for a punish; another may ignore out of dis- concerns helping a client overcome a basic overview of the physical/medical comfort; a third may ridicule the activ- masturbatory problem. issues of motor disability, this book pro- ity. This book is for the caretaker who Most of the remaining chapters are vides it. recognizes the need to approach the devoted to applying these theories to

Audience 1 eve/ Indicators: C-Children (elementary grades), ET-Early teens (junior high), LT--Late teens (senior high), A-College, general adult public, P-Parents, PR-Professionals.

SIECUS REPORT, March 1986 23 the main problematic sexual activities person prefers a homosexual lifestyle seemingly incorrigible sexual acts, or characteristic of mentally handicapped because he (or she, I assume, although women raped, impregnated, and used persons. The chapter on self-stimulation lesbianism is not mentioned) is exhibit- as prostitutes after repeated failure to is especially important for those in- ing one, and she cites considerations to correct their blatant seductive behavior. volved with the very severely disabled. be explored before drawing conclu- In fact, more case presentations through- However, Mitchell does not discuss here sions. Mitchell believes that, whatever out would have strengthened the book, how she defines masturbation. Does it the sexual orientations, the behavior perhaps taking the space allocated to the include such behaviors as rocking, head must be changed if it is publically unac- last chapter’s outline of a training course. banging, rubbing other than the sexual ceptable, since otherwise clients cannot This is not to minimize the crucial role a parts of the body, and various bizarre become free-moving members of soci- trained staff plays in successfully imple- habits? Nor does she address a question ety. Some readers, however, may join menting the book’s guidelines, but it is caretakers often ask: When can self- me in taking issue with Mitchell’s view true that the information given is availa- stimulation be considered satisfying and that intervention in private homosexual ble in other resources. Mitchell no doubt what should be done if it isn’t? The activities is an infringement of a client’s included this chapter because she is rea- author does wisely recommend check- privacy. There are many documented listically aware that the effectiveness of ing such items as physical causes, cases of physical harm and sexual exploi- the implementation depends upon full extreme boredom, and ignorance of the tation occurring unchecked because the cooperation among the staff members unacceptability of public self-stimula- victims were ignorant of their rights or and their consistency in following the tion before applying theories for chang- because their disabilities made it impos- procedures. Unfortunately, doubt and ing behavior, and she points out the sible for them to report or complain- dissension about sexual matters still exists problem involved in deciding what can too many such cases for us to support among professionals as well as parents. be considered private behavior in some her opinion. Thesame argument extends The serious omissions in the book are group-living situations. Included in this to private heterosexual activity. footnoted references to specific sources. chapter are two case histories illustrating The two case presentations using Though the annotated bibliography is the use of behavioral techniques in intervention for overly aggressive and fairly comprehensive, textual references affecting masturbatory habits. Prob- seductive behavior both have happy are too casually made for sound docu- lems of public disrobing are also endings, which are encouraging to read. mentation of the experts cited. Overall, addressed. One wishes there had also been exam- however, the author has provided many In her discussions of sexual orienta- ples of intervention in some not-so- useful suggestions for dealing with the tion, the author wisely cautions against easily solved situations, such as in those sexual problems of mentally handi- assuming that a mentally handicapped involving men arrested because of their capped individuals. PR

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March 1986

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