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News: Enhance The UK launch Ground Breaking Disability And Sexual Expression Training

By Disability, Undressing Disability

In what is believed to be a first for the UK, disability awareness charity Enhance The UK has developed a new training programme on the topic of Disability and Sexual Expression.

Aimed at professionals working in caregiving roles such as occupational therapists, care home staff and physiotherapists the course tackles the subject of disability and sexual expression.

Jennie Williams, CEO of Enhance The UK (ETUK) said “Our training programme is for occupational therapists, physios, sex educators, teachers and anyone who works with disabled people. It is designed to build confidence and develop communication skills so that the current barriers around sex and disability can be removed and open conversations about sexual expression can take place with a person in their care.”

Jennie wears a patterned swirly dress, has long blonde hair and dark framed glasses with pink lipstick
ETUK highlight that the training is necessary because sex and disability is still a taboo subject, and even in a medical environment there are barriers due to a professional’s personal level of embarrassment or awkwardness around the topic.

The following scenario puts this in context. A man in his 30s has been in a traffic accident and has acquired a spinal cord injury. His life has changed dramatically and whilst he’s receiving support for his physical and mental health, he’s unsure who to ask about his sex life. A lack of intimacy is causing issues in his marriage and impacting his self esteem.

CEO Jennie Williams explains “Everyone has a right to sexual expression and it’s wrong to assume that disabled people aren’t sexual beings with the same need for intimacy, exploration and expression. Yet in a professional capacity it can be a tricky subject to approach when your employer has no policy in place, or you feel uncomfortable or embarrassed chatting about sexual wellbeing with a patient. Our training course will build confidence and develop communication skills thus enabling open conversations which support the needs of both patients and caregivers. ”

Jennie adds “We have delivered this unique training course to an NHS Trust and to care home staff and the feedback is extremely positive. It’s obvious there is a need for this course for professionals. Our goal as a charity is to change the way society views disability and to raise standards in sexual health and sexual awareness for disabled people. We are delighted to be able to support both professionals and the disabled community with our work.”

Learn more about our Disability and Sexual Expression training by contacting us directly. You can also watch this video and learn the details of the 3.5hours course.

 

A group of young people, at the front are a young couple holding hands one of whom is a wheelchair user

Disability Inclusive Sex Education

By Sex & disability, Undressing Disability

Tips for teachers to create disability inclusive sex education.

When delivering sex education, it is important that everyone can access the session equally and feel that the content speaks to them personally. All sessions should be inclusive, regardless of whether it is known that there is a disabled person or child partaking in the lesson. Here are a few factors to consider to ensure lessons are as inclusive as possible.

Representation

It is crucial that each student feels represented by the content. Often, resources show diversity in terms of race, age, weight, and gender but disabled children can often feel left out. They do not see anyone that is like them included in the sex education material. This feeds into the stigma around sex and disability. With a subtle change of focus in education, showing a disabled person in the images for example, the recognition that disabled people want and indeed do have sex and intimate relationships can become the standard view in our society.

This representation can be valuable for both sides:

• the disabled person to no longer feel that sex and relationship probably aren’t for them, as it’s not talked about with their situation being characterised.
• Other pupils seeing inclusive sex education can help stop perpetuating the notion that they couldn’t or shouldn’t have a relationship with a disabled person.

Accessible Resources

Not everyone will be able to access the lesson material in the same way. When planning your sessions ensure you have differentiated resources. There are some examples of adjustments you can implement:
• Ensure all videos are subtitled. This is useful practice at any time and for anyone, not just if you know of a deaf/hard of hearing pupil.
• Interactive games/exercises – think about whether these are accessible. Sometimes a small adjustment like a large dice or putting people in groups so they can work together and support each other can make a big difference.
• Providing large print worksheets
These should all be offered as standard, in any lesson.

Be Pupil-Led

You will have worked hard on your lesson plan, but you’ll be writing from your frame of reference. It is useful to be open to suggestions or concerns from pupils. Allow space for them to offer their thoughts and raise points that are meaningful for them. Then listen and respond to those points. It may not fit the direction of your lesson plan, but it could be what is needed by them and where the real learning could happen.

Range of Learning Styles

Ensure each session is delivered in a range of learning styles, so that each pupil gets a chance to learn in the way that works best for them.
Think about Visual, aural, verbal (reading/writing) and kinesthetic ways of learning and share the material in:
• Videos/Images
• Group Discussion
• Activities
If an activity is tricky for someone to do, then ask if there’s a way they think they may like to try it, or check if they’re ok watching someone else do it. For example, someone with poor dexterity may struggle with putting a condom on the demonstrator. They can still learn the right way by watching a peer do it. Also, this could develop into a discussion point for how people would overcome feeling awkward doing this for the first time with a partner if someone struggled.
There is always learning to be had from every situation if the session allows the freedom for discussion.
If every lesson is delivered catering for the different learning styles, then you are already halfway there to being fully inclusive!

Learn More

Keen to make your sex and relationships education lessons inclusive? Then check out our Disability and Sexual Expression training

Contact us directly or you can also follow our Undressing Disability campaign on Instagram and twitter#UndressingDisability

 

A woman holds and red and white megaphone and shouts into it. She has pinned up blonde hair and wears a checked short sleeved blouse

Calling All Occupational Therapists – It’s Time To Talk About Sexual Expression!

By Sex & disability, Undressing Disability

This blog has been written by Katherine Sellors for her fellow Occupational Therapists. The aim is to help break down communication barriers and enable conversations about sex and sexual expression with patients in your care.

Sexual Expression

Occupation is what is meaningful, and it can be argued that nothing is quite as individually meaningful as sexual expression.

Sexual expression is the individual expression of sexual self and interpersonal interactions (emotional and/or physical). It’s a very objective concept but that’s what makes it so great.

It includes:

  • what makes you feel attractive and good about yourself
  • your sexual behaviours and desires
  • incorporates sexual orientation, gender identity and gender expression

Unique to each person it can be such a core part of our identity that it is a protected right under the Human Rights Act. Despite working in a variety of sectors as a profession, OT’s should always be working holistically, meaning we may need to discuss sexual expression no matter where we are working.

a dark haired woman in a red dress holds up a sign that reads Occupational Therapists

Appropriate Practice

Your employer may have policies and procedures in place telling you exactly how to manage these situations when they arise which is great! Unfortunately, if you don’t have these in place, it can muddy the waters on what would be considered appropriate practice. The second place we would look would be our professional standards but unfortunately guidance here is also limited. Fortunately, there is other guidance out there we can use.
One of my favourites is the PLISSIT model or the more recently expanded, or Ex-PLISSIT, model.

PLISSIT / Ex-PLISSIT Model

The premise of this model is that is an acronym of various stages of treatment. First we must give our patients Permission to talk about sexual expression, then we must provide Limited Information meaning we only give them an overview of information that often helps support sexual expression, following this are Specific Suggestions, information for their circumstances and finally Intensive Therapy which is referral to specialist services. Some patients may not need to go through the full cycle and may find their difficulties are resolved after the initial steps, others may need to complete the cycle multiple times for a variety of different needs.

The difference between PLISSIT and Ex-PLISSIT is the concept of permission being expanded through all the stages. So, remember Permission, Limited information, specific suggestions, and intensive therapy.

Recognition Model

A different model is the Recognition Model, the premise of this being we need to recognise our patients as sexual beings and once we have done this, we will be able to feed that recognition into our treatment.

In principle this would be like recognising any occupations our patients may wish to pursue from washing and dressing to writing a novel. We would help them engage in sexual expression using the same clinical reasoning we would to support any engagement. It has been suggested, to do this, we can add the concept of supporting sexual expression to our explanation of OT and what we can help support and then allow the patient to lead from there.

There are other models and guidance for discussing sexual expression in academic journals relating to specific areas of practice such as learning disability, nursing homes and rehab that may be of individual benefit.

This does beg the question “what if I don’t feel comfortable”. It is important we recognise our own comfort levels and areas of knowledge to ensure we give the best care to our patients.

If you truly feel you are not the best person to address this with someone that is ok as the information doesn’t have to come from you. It is important we don’t make our patients feel uncomfortable for raising their issues, so take down whatever information you feel comfortable with and signpost to a more appropriate information source or professional.

It is important to note that this article is not advocating working outside of comfort zones or appropriate practice but to highlight an area of practice that we can be involved in. If you are unsure or want clarification before acting then speak with HCPC, RCOT or your workplace for their clarification.You can also enquire about Enhance the UK’s Sexual Expression Training.

Useful Links

Enhance The UK –
The expert team are experienced trainers, enquire about their Disability and Sexual Expression training.
https://enhancetheuk.org/disability-and-sexual-expression-training/

The Health and Care Professionals Council
https://www.hcpc-uk.org/

Royal College of Occupational Therapists
https://www.rcot.co.uk/

The Undressing Disability Hub

Sign up for free to access free resources and network with others working or interested in the field of sex and disability.
https://undressing.enhancetheuk.org/signup

the hashtag Disability Pride Month written in white on a pink background

Disability Pride Month 2021

By Sex & disability, Undressing Disability

A guest blog post by Damian, from the Undressing Disability Team. Damian shares his personal experience of learning to accept and love himself as a disabled person and why he now celebrates Disability Pride Month.

Damian wears a pink tshirt and leans against a brick wall. He is white with short brown hair and dark rimmed glasses and a light beard

When I was diagnosed with Ehlers Danlos Syndrome (EDS) at 14 years old, I found it hard to come to terms with. I wondered what it would mean for my life. It took me a very long time to “own” my disability and not be afraid or ashamed to show it.

I think it was hard when I was first diagnosed as I had to give up a lot of the things that I enjoyed doing, like running and playing football. There was nothing in the way of support or guidance back then.  Looking back now, I think I was affected more than I realise by the fact that I did not get to finish my last year at school. The school decided it wasn’t safe for me to be on the premises after I slipped down a couple of stairs on my crutches. They had no interest in making things more accessible for me so I had to leave and was only allowed to sit a few of my exams. To be honest it was hard getting people to accept that I had a disability. Back then, hardly anyone had heard of Ehlers Danlos Syndrome so the fact I had to leave school and was seeing my friends less made it really hard. I missed out on a lot of the experiences teenagers usually get to enjoy.

“I tried to hide my disability”

Some people thought I was making my condition up as there was nothing to see. That’s possibly one of the main reasons I began to hide my disability as much as I could. I would only tell a small amount of people and that was usually if I absolutely needed to.

I wear support braces on most of my joints and always used to wear clothes that covered them up. If people could see my wrist brace, for example, I would just say that I’d sprained my wrist instead of explaining about my condition.  I would only ever wear shorts on holiday as I did not like people seeing my knee braces. But I was still worried about what strangers would think about seeing me like that.

It took nearly 20 years for me to be more confident about myself and my disability.

Now I am very much of the thinking that if I have to wear braces and supports, I want people to see them.  I quite often wear ones that stand out so it’s not unusual to see me wearing pink wrist supports. It makes me more confident about my disability and I guess it helps others to be more aware of me. Hopefully they can give me more space and not bump into me.

My brightly coloured accessories become quite a conversation starter at times and I am now happy to talk about my disability. It is something I will not hide ever again. It plays a big part in who I am. I wanted to write about this for Disability Pride Month as I know that whilst some people are posting on social media about all the things they are proud of, others will be lacking the confidence to do that. I hope in sharing this it helps in some way. To see what others are sharing search the hashtags #DisabilityPrideMonth or #DisabilityPride. 

I now speak passionately about being disabled and I’m very proud of who I am.  Part of my role here at Enhance The UK is to answer questions for the Love Lounge and by helping to run the Undressing Disability campaign. Joining the team at Enhance the UK has given me both confidence and a platform to talk about my disability and experiences in the hope of helping others realise they do not have to hide their disabilities.

Throughout the month of July we’re sharing posts on our Instagram Stories that relate to #DisabilityPrideMonth with the aim of bringing together the disabled community so we can celebrate, and learn from each other’s experiences. Follow us @UndressingDisability.

 

Stay Connected

Keep up to date with all our latest news, insights and resources by joining us on twitter @ETUKUndressing and Instagram @UndressingDisability.

The Love Lounge is a free service offering advice on questions relating to disability, sex, dating and relationships. Get in touch.

CBD oil a plant and dropper

A Beginner’s Guide to CBD

By Disability, Undressing Disability

Could CBD help when it comes to disability, pain or mental health issues?

It seems like CBD is everywhere and in everything at the moment. But what is it, and what does it actually do? We’ve prepared your ultimate guide to all things CBD.

WHAT IS CBD?

CBD stands for cannabidiol. CBD is an active compound found in the cannabis plant. It can be extracted from the plant and made into oils, topicals, vape e-liquids or added to food or drink. It is non-intoxicating and it is thought to have potential health and wellness benefits.

HOW DOES IT WORK?

The endocannabinoid system is a biological system in our body. It impacts several major processes which include appetite, sleep, mood, and memory. It is thought that CBD interacts with the endocannabinoid system and binds to CB1 and CB2 receptors. CB1 receptors are found in the brain and body. CB2 are located mainly in the immune and gastrointestinal systems.

A jar of CBD oil with a plant leaf sitting on a wooden worktop

HOW COULD CBD HELP ME?

Inflammation

Inflammation is caused by your body’s white blood cells responding to infection, leading to redness, pain, and swelling. CBD could potentially function as an anti-inflammatory which would help to reduce swelling and inflammation. One of the ways that CBD is thought to reduce inflammation is by inhibiting an eicosanoid enzyme called COX2. One study in 2013 which explored the anti-inflammatory properties of CBD found that cannabinoid may protect against the harmful effects of inflammation in a mouse model of Multiple Sclerosis.

(Link to study : https://www.sciencedirect.com/science/article/pii/S0969996113001939)
(Link to Mind statistic: https://www.mind.org.uk/information-support/types-of-mental-health-problems/statistics-and-facts-about-mental-health/how-common-are-mental-health-problems/#:~:text=1%20in%204%20people%20will,week%20in%20England%20%5B2%5D. )

Anxiety

Anxiety - a dark haired beared man holds his fingers to his temple and closes his eyes with scribbles to represent noise coming from his head

Struggling with your physical or mental health can lead to added anxiety. Mind.org estimated that 1 in 5 people have a mental health problem such as anxiety or depression. CBD may help to reduce anxiety. In a study, positive interaction between CBD and a crucial neuro-receptor linked to anxiety was noted. An evidence review published in the British Journal of Pharmacology found that full-spectrum CBD could have therapeutic benefits for both anxiety and pain.

(Link to study: https://bpspubs.onlinelibrary.wiley.com/doi/epdf/10.1111/j.1476-5381.2011.01238.x/)

Sleep

It can be difficult to get to sleep if you are suffering from physical discomfort or your mental health is causing you distress. A case study from 2019 revealed that CBD could potentially help while tackling anxiety.
It involved 72 participants with 47 of those experiencing anxiety and 25 suffering from poor sleep. They were given 25mg of CBD daily then recorded their feelings. The researchers noted that 79.2% recorded their anxiety felt lower and 66.7% said their sleep had improved after just the first month.

(Link to study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6326553/)

WHAT’S THE DIFFERENCE BETWEEN MEDICAL CANNIBAS AND CBD?

CBD stands for cannabidiol and THC is tetrahydrocannabinol. Both could offer therapeutic benefits for a number of different conditions. In the UK, CBD is available over the counter legally but THC is not. You need a prescription for medical cannabis in the UK from a licensed clinic.

CBD could potentially help with nausea, migraines, sleep, anxiety, inflammation (skin conditions, arthritis), pain, epilepsy and seizures. THC is often associated with the treatment of glaucoma, insomnia, nausea caused by cancer treatments, appetite problems, pain and muscle spasticity, anxiety and multiple sclerosis.

Speaking to your doctor and doing research when it comes to starting CBD is important.

HOW DO I TAKE CBD?

There are a lot of different ways to take CBD. You may find that you prefer some more to others or some methods may suit different needs. It’s best to try different products and keep a journal so you can chart the benefits or differences you feel.

Here is a brief guide to the four most common ways to take CBD

Oils or Tinctures:

Tinctures or oils are an easier way to take CBD by simply popping a small amount under the tongue and allowing them to absorb before swallowing.
The molecules are absorbed through the lining of the wall of the mouth, which is particularly sensitive, and beneath the tongue. It is worth noting that there is alcohol in a tincture if you are trying to avoid it.

Edibles:

Edibles are foods and drinks that have been infused with CBD. Edibles range from gummy bears to brownies to bars of chocolate and bottles of water.
CBD is extracted from a plant using a solvent before forming a concentrated substance. This is then added to the food or drink. The big difference with edibles is that they take longer to work and some of the CBD is ultimately lost due to the metabolic process. This varies from person-to-person with variables such as height or weight.

Vape:

Vaping is a fast way to absorb cannabinoids into your bloodstream.
E-liquid vaporises at approximately 200°C, producing a vapour which is then inhaled. The CBD then enters the bloodstream through the lining of the mouth, throat and lungs, allowing for rapid uptake. Legal CBD e-liquids come in a variety of flavours but will not get you high as they do not contain Tetrahydrocannabinol (THC). THC is a Class B controlled drug in the UK and is illegal.

Topicals:

Topicals are great for relief from aching muscles and for treating skin conditions. The healing compounds are absorbed directly through the skin, allowing them to target a specific sore area for faster and more focused relief. Apply a balm, lotion or oil to the affected area of the skin after a hot shower and allow it to sink in.
Read more: https://cannavistmag.com/cbd101/ways-to-take-cbd/

WANT TO LEARN MORE?

The Cannavist Magazine is your essential guide to all things CBD and medical cannabis. It is available in-store at WHSmith, McColls and Easons. It can be found online at cannavistmag.com and Readly.com

Keep up to date with all of our latest podcasts, news and insights by connecting with @ETUKUndressing on twitter or follow @UndressingDisability on Instagram.

Sign up for free to our Undressing Disability Hub to access free resources on a host of topics relating to sex and disability.

Stress Impacts Your Libido - a face covered with hands and another two hands pressing down on the side of the head

How Stress Impacts Your Libido and General Health

By Disability, Undressing Disability

This article is about how stress impacts your libido and general health.

What is stress?

When we’re feeling stressed, our body has a physical reaction which triggers the release of cortisol and adrenalin. These stress hormones send us into what is known as ‘fight or flight’ mode. Instead of being relaxed we are on edge, worried or overwhelmed. Everyone has different things that trigger stress but for the majority of people stress impacts your libido, your mental health, and your physical wellbeing.

Physical Symptoms of Stress

Stress is exhausting and lowers our tolerance for many things. Some symptoms of stress are:
• Sweaty palms
• Foggy mind and/or irrational thinking
• Irritability and/or low mood
• Rapid heartbeat
• Shallow breathing
• Insomnia

When stressed, we just don’t have the capacity to be thinking about others, only focussing on ourselves. A lack of tolerance for others, irrational thinking and even aggression can impact our relationships by pushing your partner away. In turn, the lack of closeness can lead to more worry about your relationship and perhaps lead to low self-esteem.

Stress and Libido

Stress can affect both men’s and women’s libido. The stress hormone cortisol disrupts your testosterone levels, which is responsible for men and women’s sex drives. It can also:

• Narrow your arteries, meaning men may experience erectile dysfunction
• Take you longer to become aroused and reach orgasm

When you’re stressed and have worries and thoughts running through your head it’s not surprising that your libido might decrease.
If stress is impacting your libido, trust that this can change. It doesn’t mean your sex drive will be low forever. It can fluctuate at any time and for many reasons. Intimacy may help reduce your stress too. So kisses, a loving cuddle or massage can alleviate your tension and stress. And with time, this may help your libido increase.
Masturbation can be a big stress reliever too, so it’s not just a partner that can make you feel good!

What can we do to manage stress?

When you feel stressed and are aware of the physiological changes, try and take control back by refocusing your thoughts. Ask yourself:

1. What is really going on in this moment?
2. How can I reasonably respond to the situation?

This isn’t easy and will take much practice to regain control of your thoughts.

Here are some tips:
• Slow down your breathing and breathe through your nose, deep into your belly, expanding your diaphragm. Release the breath slowly and forcefully, emptying the lungs.
• You can use mindfulness with your breathing too. Notice the air flowing through your nostrils and how your chest and belly rises. How does it feel? This exercise of thought focus will divert the panic response of fight or flight.

Managing relationships whilst stressed

If you recognise that you’re being snappy and impatient with your loved ones, don’t be too proud to admit it’s happening.
When you’ve got time to collect your thoughts, be honest with them. Say

‘I’m stressed at the moment and know I’m being irritable. Bear with me’.

This will help dissipate their bad feelings towards you, rather than you not admitting it, feeling guilty yet still displaying the unhelpful behaviours! Also just being open and chatting the problem over with them may help you. The old adage ‘a problem shared is a problem halved’ is so true.
• Always remember – talk, reach out, use techniques, seek support! It’s out there.
• Speak to your doctor if stress is impacting your day to day life.

Useful Resources

The Stress Management Society – 30 Day Challenge

Mental Health Foundation – How to Manage Stress

NHS – 10 Stress Busters

 

Keep up to date with all our Undressing Disability chat by joining us on twitter @ETUKUndressing or on Instagram @UndressingDisability.

A starry sky

My Vagina is The Star – Kiruna’s First Smear Test

By Disability, Undressing Disability

A guest blog by Kiruna Stamell.

I am a dwarf woman, a little person, person of restricted growth, person of short stature. That is my ‘thing’. Or the ‘thing’ people focus on.

As a result, I had this long-held belief that I had received my ‘lot’ in life. You know, I had my ‘thing’. I been served my life’s challenge. Somehow this made me arrogantly believe I was superior to getting cancer, herpes, murdered by a serial killer or being struck by lightning. I was simply too unique to be touched by common problems.

I am not alone as a disabled person in this thinking. It seems to be a common idea amongst us disabled folk and reinforced by non-disabled people that we already ‘carry our burden’. We are externally defined by our impairments so often, we too subconsciously internalise the belief, that our impairments are our [winces] ‘thing’.

So, a vaginal or cervical cancer thing was not on the list of things to worry about.

The ‘woman’ part of my identity felt flimsy, secondary to the desexualised label of ‘dwarf’, but she’s always been there. And one day, I woke up to the reality that my health isn’t just about my impairment.

I don’t know what happened, but I think it was a desire to feel like every other woman. All my average height and non-disabled friends were having their vaginas looked at and I wanted someone to look at mine.

Also, I had had a period refuse to stop and thought this was weird. So did my doctor.

My First Smear Test

The first challenge was that I was a virgin, and the doctors were funny about putting a speculum inside a virgin. I think, this is why I got sent to a proper gynaecologist straight away.

I was not so precious. I liked that my vagina was getting a lot of attention and being taken seriously. It took the medical focus off my height. All eyes were on my foof, and my foof was equalising!

At my first smear, lubricant was liberally applied. This was really helpful.

There were a couple of challenges:

  • The building was an old hospital, so door handles were too high for me to open, so I had to be escorted through the building.
  • Getting onto the bed was a challenge. Doing it gracefully and with no knickers on more so, as for me it was a literal climb. They made a step up onto it out of a chair and a smaller step stool.

I discovered that my cervix sits very high up and to the front. I’ve remembered this detail for all subsequent smears, telling the nurse saves so much time!

I find the weirdest bit is when the speculum parts. It feels a bit like when the dentist pulls your cheeks apart. Sometimes, my vagina creaks. Not audibly but like a sound you feel in your body. On a good cervical smear day, it just opens up and if to say ‘wow’. These occasions are rarer, and I only really remember that happening with the lube.

I find it reassuring getting a smear. I find it a really good reminder that being a ‘dwarf’ isn’t my only ‘thing’. I feel connected to humanity knowing I need to look after my sexual health as much as anyone else does.

When I am on that bed getting a smear, my vagina is the star. In that moment it is the most unique thing about me.

Cervical Screening Campaign

Learn more about our Cervical Cancer Red Tape campaign. which aims to remove the barriers that many disabled women face when accessing cervical screening and sexual health services. Search hashtag #CervicalScreeningRedTape to join the conversation and follow us on Instagram and Twitter.

We hope our tips for improving access to cervical screening make a difference. If you work in the healthcare sector please feel free to share them with your network.

 

Cervical Screening and Deaf Awareness

By Disability, Undressing Disability

Cervical screening saves lives and its so important that women have regular check-ups. So why did a survey by Jo’s Cervical Cancer Trust highlight that 88% of disabled women found accessing a smear test more difficult because of their impairment? Claire, our Deputy CEO shares her experience of cervical screening as a deaf woman.

6 Monthly Check Ups

A few years ago, I had to go for cervical screening tests every 6 months. It definitely wasn’t my favourite way to pass the time, but I know first-hand how essential it is. You see a smear test showed that I had moderate to severe abnormal cells caused by the HPV virus. Luckily for me it was picked up and I had laser therapy to destroy the abnormal cells. Now that’s resolved I go for a smear test every 3 years and hope for a positive experience. Unfortunately, a lack of deaf awareness frequently creates problems. As a result, I battle with feelings of anxiety before, during and after the test takes place. And I’m not alone. A study by Jo’s Cervical Cancer Trust found that 88% of disabled women found cervical screening tests difficult because of their impairments. Something needs to change!

My First Smear Test

The first time I had a smear test I didn’t really understand what was going on. I’m sure that’s common for many women but when you’re deaf there’s extra things to feel anxious about. For example, at my doctor’s surgery the examination room is right next to the busy waiting room. Before my smear test the nurse left the room for me to get undressed. She said she’d knock to make sure I was behind the cubicle curtain before coming back in. As I can’t hear the knock on the door, I felt panicked that I’d be exposed.

I explained that I was deaf, but unfortunately the nurse didn’t adapt her behaviour to ensure I was properly briefed. When preparing for the test she kept turning her head away to organise the equipment. This made it impossible to lipread, so I lay there with my anxiety growing by the second.

Once my knees were up and a sheet covering me, I couldn’t see what was about to happen. I knew she was talking to me, but I couldn’t hear what she was saying. I said “I can’t hear you” and instead of moving her head so I could lipread, she just stopped talking.

When she inserted the speculum there was no warning, so I tensed my body, and it was really painful. (I’m told by hearing friends that the nurse tells you when it’s about to be inserted and whilst it may be uncomfortable it usually doesn’t hurt.)

I also left the test with no idea of when to expect the results and went home upset and worried.

Deaf Awareness

My next experience of cervical screening was much more positive. The nurse told me her cousin was deaf, so she had great deaf awareness. Here’s what she did to make the smear test a much easier experience for me.

1. She explained the procedure from start to finish before asking me to get ready and lie on the bed.
2. Whilst explaining she maintained eye contact, used gestures, and demonstrated with the speculum what would happen. When I didn’t understand one part, she got a pen and paper and wrote it down.
3. When leaving the room for me to get undressed she said she’d be back in 5 minutes, rather than saying ‘she’d knock’. I looked at the time on my phone, got ready and waited.
4. We agreed that she would tap my leg as a sign that she was about to insert the speculum, giving me a moment to relax and prepare.
5. She understood that I was very anxious because of my previous experience and reassured me.

Make Appointments, Not Assumptions

If you are deaf and have never had a smear test, then please don’t be put off by my initial experience. Cervical Screening saves lives. My aim of sharing such a personal insight is that it will help bring about change, and help the disabled community have equal access to the services others access easily.

For medical professionals reading this hopefully my tips will be useful and improve deaf awareness within your surgery or clinic. Find more insight on our campaign page. 
#CervicalScreeningRedTape

Follow Our Campaign

Read more about our #CervicalScreeningRedTape campaign and follow us on twitter @ETUKUndressing and Instagram @UndressingDisability.

 

Worried about Cervical Screening?

Visit the Jo’s Cervical Cancer Trust website where you’ll find lots of practical information, advice and a forum where you can pose questions and share experiences.

#CervicalScreeningRedTape campaign

By Disability, Undressing Disability

Our #CervicalScreeningRedTape campaign aims to highlight the fact that many disabled women are finding it difficult to access cervical screening.

The Issues

Common barriers to accessing cervical screening are:

  • Disabled women not being offered a smear test as it is often assumed that they are not sexually active and are less likely to need a test.
  • Physical barriers such as a lack of non-adjustable beds in GP surgeries.
  • Fear. Due to a previously negative experience. Or a self-consciousness as their body may differ to what they believe medical staff are used to seeing.
  • Expense. Often disabled women have to travel further than their local surgery to attend an accessible clinic.

Potential Solutions

What can be done to improve access to smear tests for disabled women? Below are four potential solutions.

  1. Recognise that disabled adults can enjoy an active sex life and offer as standard cervical screening and sexual health tests.
  2. Ask what an individual’s needs are. If your surgery does not have accessible facilities that meet the needs of a disabled patient, then have a procedure in place where you can offer an alternative location. This saves both you and the disabled woman a lot of time and effort phoning around. Read Emily’s blog for a real-life example. 
  3. Realise that standard procedures won’t work for everyone. For example, due to physicality it may be easier for a woman to have a smear lying on her side rather than on her back. We are all different, and often know our bodies well. So if it’s feasible to do things differently, be willing to give it a try.
  4. Most women are apprehensive about having a smear test but for many disabled women there is an extra layer of nervousness. Reassurance prior to the test being booked can help alleviate this fear.

We fully appreciate the challenges our NHS is facing during the pandemic and know that wait times may be longer than usual, however we hope our solutions can become best practice.

Useful Resources

Undressing Disability Podcast

Dr Larisa Corda OBGYN and presenter Sam Renke are guests on Episode 2 of our Undressing Disability podcast. Joined by our CEO Jennie Williams they share personal experiences of the issues around accessing cervical screening raised in this #CervicalScreeningRedTape campaign.

 

Blog

Emily wrote about her experience as a wheelchair user of trying to access her first ever smear test in this blog article.

The Undressing Disability Hub

Last year we launched our Undressing Disability Hub which is free to join. It is full of free resources on topics relating to sex and disability. Members include professionals working in the fields of medicine, psychology, and care homes. As well as sex educators and those searching for a safe network to learn and share information on the topic of sex and disability.

Sign up for free today.

Worried about Cervical Screening?

Jo’s Cervical Cancer Trust is a charity which provides information and support on the topic of cervical cancer. Their website https://www.jostrust.org.uk/ is full of valuable insight and they do an incredible job raising awareness and saving lives with their work.

#CervicalScreeningRedTape 

Stay Up To Date

Follow our campaign on social media on twitter @ETUKUndressing and Instagram @UndressingDisability. #CervicalScreeningRedTape

 

Bedroom Adventures Logo is a black lacy eye mask with the brand name in curvy black writing below

Win A Decor Heart Wedge From Bedroom Adventures

By Disability, Undressing Disability

This competition is now closed. Congratulations to winner Rosie Glen.

A graphic of a crown with the word WINNER written on it and the name Rosie Glen below. The background is bright blue

It’s competition time!

Thanks to Bedroom Adventures we have a Décor Heart Wedge to give away to one lucky winner. Perfectly contoured for the derriere, the Décor Heart Wedge provides a sweet incline for deeper penetration and G-spot positioning during lovemaking. This compact version of the Wedge combines passion with fashion as a positioning aid that doubles as a decorative pillow.

A merlot red coloured heart shaped cushion

Prize:

1 x The Décor Wedge, gifted by Bedroom Adventures.

How to Enter:

Simply sign up to the Undressing Disability hub, complete your profile and a profile photo and you’ll automatically be entered.

Competition Ends:

Thursday 26th November at 12 noon

Winner Announced:

Tuesday 1st December at 12 noon.

Terms & Conditions: All new and existing hub members who have completed a profile, including uploading an image as a profile picture, will be entered into the competition. The winner will be contacted by email and also messaged on the hub. The winner must respond within 24 hours to confirm they wish to receive the prize, if not a new winner will be selected. Your prize will then be posted directly to you.

A lady in black basque and knickers poses on a bed holding the heart wedge

More Product Details

  • Compact version of the Wedge provides lift and angles for deeper penetration.
  • Perfectly contoured for the derriere.
  • Ultra soft velvish material in designer colours to match your bedding.
  • Removable, machine-washable cover.
  • Moisture-proof liner prevents moisture from penetrating the foam interior.
  • Measurement in inches: 18L x 14W x 7H

Bedroom Adventures

Thank you to Bedroom Adventures for the generous gift of this prize. Damian, owner of Bedroom Adventures is one of our Love Lounge sexperts, offering practical advice on getting the most from your sexual relationships. If we can help solve a dating dilemma or relationship question contact us in confidence.

Follow our Undressing Disability campaign on social media. Find us on Instagram and twitter, or search hashtag #UndressingDisability.

 

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