Sex talk for people with psychosocial disabilities

This photograph shows a panel discussion under way on the first day of ‘Pleasure, Politics & Pagalpan – National Conference on Sexuality, Rights and Psychosocial Disability’. Seated on the dais (from left to right) are psychiatrist Dr. Ajit Bhide, psychologist Lakshmi Ravikanth, the author – disability rights activist Shampa Sengupta, mental health rights activist Ratnaboli Ray (also the founder of Anjali), and panel moderator Dr. Jai Ranjan Ram. The moderator is speaking with microphone in hand. Low tables with name cards and water bottles are placed in front of the speakers. In the background is a large floor-to-ceiling banner with the conference logo and name, and the names of the organizers printed on it. The conference was co-convened by Anjali Mental Health Rights Organisation, Kolkata and Arrow, Kuala Lumpur with support from CREA, Delhi; Oak Foundation, Kolkata; and media partner Hidden Pockets. It was held on May 13-14, 2017 at The Gateway Hotel in South Kolkata. Photo credit: Sagnik for Anjali.

Insight, Policy Matters, Jun '17
Shampa Sengupta, founder of Sruti Disability Rights Centre, argues that the sexual needs of persons with psychosocial disabilities must be addressed, and that there can be no one-size-fits-all approach to this challenge. Excerpts from a presentation she made at a national conference on sexuality, rights and psychosocial disability held last month in Kolkata.

Inset: What is psychosocial disability? Psychosocial disability implies impairments and restrictions on participation in day-to-day activities because of certain mental health conditions.   As an expression, ‘psychosocial disability’ is considered a more sensitive alternative to ‘mental illness’. The latter symbolizes a narrow medical approach, while the former recognizes that psychological or mental health conditions often have roots in negative social attitudes and social exclusions. This means that social changes are as important as medicines, if not more, in addressing mental health conditions.  Psychosocial disability is one among  several forms of disabilities, the others being physical, intellectual , neurological and blood disorder related – each of these in turn also have different sub-types – Editor.When 31 year old Mr. G contacted us, he said he felt very depressed and wanted to commit suicide. He explained that he met with an accident and lost both his legs. His job in a private company was gone and now he was financially dependent on his family. Unable to bear this, he wanted to commit suicide.

We felt the need for a sensitive and experienced counsellor who could make home-visits. But to avail of a service like this, one needs money which Mr. G did not have, and to find such services within the government system was impossible.

We decided to provide the service pro-bono. So it took umpteen visits to his home, talking to his wife and other family members. Only after four months of my regular interaction with him, he confided that apart from financial dependence, he couldn’t accept the fact that sexual relations with his wife, whom he married two years ago, totally stopped after the accident. He was suspicious his wife was meeting her sexual needs with other partners. He became abusive towards his wife, even violent, and there came a time when the family felt that he should be admitted to a mental health hospital as they could not cope with the situation.

Mr. G’s is not an isolated case. We do get to see a large number of people whose mental illness (psychosocial disability) is caused by suppression of sexual desires. It needs to be noted here that the Mental Healthcare Act, 2017 states that “there shall be no discrimination on any basis including gender, sex, sexual orientation, religion, culture, caste, social or political beliefs, class or disability.” How does this statement appear from the perspective of class and disability?

For Mr. G and his family, it had become difficult to buy regular food day by day. They were more concerned about how to get him a disability certificate, any job for his wife, aids and appliances for him and, of course, how to pay the medical bills. In their two-roomed house, even we found it difficult to initiate talk around sexuality. The issues around his physical disability reined in all our discussions.

We also need to remember that the idea of ‘privacy’ differs from one set of people to another according to social strata as well as physical ability.

Inset: ‘Pleasure, Politics & Pagalpan – National Conference on Sexuality, Rights and Psychosocial Disability’ was co-convened by Anjali Mental Health Rights Organisation, Kolkata and Asia-Pacific Resource and Research Centre for Women (Arrow), Kuala Lumpur. Supporting partners included CREA, Delhi; Oak Foundation, Kolkata; and media partner Hidden Pockets.  The conference held on May 13-14, 2017 attracted around 20 well known speakers from the fields of mental health, disability, queer activism, social research, law and media from all over India. Around 200 mental health professionals, practitioners, activists, students, lawyers and media professionals attended half a dozen panel discussions, musical performances and interactive exercises at The Gateway Hotel in South Kolkata.At Sruti Disability Rights Centre, we have worked with a young woman who lives in a slum near Ballygunge railway station in South Kolkata. It’s difficult to imagine her home, which is just 20 minutes away from the conference room of this five star hotel. It’s a 6 by 8 room where seven members of a family live.

Her neighbours told me that she “lost her sanity” when she was 14 years old. They whispered that her father came home drunk every night and had sex with her mother in front of others. (None of them used the term ‘marital rape’, so I’m also refraining from using it). But her neighbours were sure that viewing sexual acts every night impacted the girl and she became “mad” as a result of this. Now, how do we talk about the concept of privacy when there is a single room where so many people have to live?

The crisis with this young woman began when she started hugging almost all the boys and men in the neighbourhood, asking several of them to marry her. It became a routine. Strangely, or not so strangely, the whole community became protective of her. They tried to find out where they could get free medicines for her. The young men of the slum confided that they moved away when they saw her. At other times they tried to take her back to her home or to the company of other women, to make sure she remained ‘safe’. They were worried that men from other slums might abuse her. Her recovery became the concern of all the neighbours.

How could any kind of sexuality education that we wanted to offer her be disconnected from her class background? My own daughter is exactly the same age as she is. Trying to be a liberal mother of a 19 year old daughter, I try to discuss sexuality with her many times. Our conversations move around whether she should take alcohol if she goes out on a date, or on issues of sexual orientation.

Inset: From the ‘Pleasure, Politics & Pagalpan’ conference brochure: In the context of India, sex and sexuality has conventionally been accepted as a subject of shame and silence . . . However, that does not change the reality, where the society comprises of individuals, who are inherently sexual beings, with their needs to express and be satisfied.  When an already tabooed theme gets clubbed with another one, it is bound to usher in vehement opposition . . . The notion that people with psychosocial disabilities can have sexual needs is considered nothing less than being blasphemous. Such a reaction is not unnatural in a society that lacks the element of ‘sexual citizenship’.  Sexual citizenship is about intimate pleasures, desires, and ways of being in the world . . . The vision is to have a society in which diverse people can take responsibility for their own sexual lives; and the ‘diverse’ population does include people with psychosocial disabilities.

I also learnt a lot of new information from my daughter. For example, I was not aware about a specific app to track the dates of one’s periods. Though my daughter and this young woman live just a five- minute walk from each other, I don’t think we can offer the same sexuality education to both. The young woman is a school dropout, her mother works as a domestic maid and her father as a mason. The whole background is so different that one can’t say that the same strategy of sexuality education will work in both cases.

There can’t be a fixed strategy even for people within the same group. In 26 years of working with persons with intellectual disabilities, I have learnt how sexuality education has to be part and parcel of special school systems. Though some people claim that sexuality issues are never discussed in the context of disability, I clearly remember that we used to talk about it even in the 1990s. Maybe in a hushed tone, but definitely discussions were there.

I remember that from 2001 onwards, at the special school level, we started talking about how to teach masturbation and we actually implemented those teachings in a few schools in Bengal. One of the major hassles faced was that the majority of special educators were female (for obvious gender reasons as special educators till now don’t get enough salary and men can’t afford a low income). So dealing with sexual arousals of adolescent boys in special schools at the sight or touch of female teachers was an issue we kept deliberating on.

Quote: The Rehabilitation Council of India till now has not incorporated sexuality as a compulsory component of the trainings imparted. So the special educators and counsellors trained by them don’t have proper knowledge and bring in their own mental barriers against diversity in gender and sexuality. As a result, sexual oppression becomes a double-edged sword leading to and resulting from psychosocial disabilities.As far as my understanding goes, there are few special school set-ups that are ready to discuss same-sex relationships though a beginning has been made. We do get requests from special educators to train them on various LGBTIQ issues.

As far as psychologists or other mental health professionals are concerned, there is still a huge gap in their understanding of gender identity or sexual orientation issues. So organisations like ours make a separate list of counsellors who can be consulted by LGBTIQ persons as societal pressure very often makes them depressed. We need many more mental health professionals who believe that having a different gender identity or sexual orientation is not an illness and that such persons have similar mental health needs as anyone else.

Herein comes one of the main challenges – lack of trained and sensitive personnel. Our laws (unfortunately even the newly passed Mental Healthcare Act, 2017) say that professionals who deal will special education or counsel persons with disabilities should be registered with the Rehabilitation Council of India (RCI).

But the RCI till now has not incorporated sexuality as a compulsory component of the trainings imparted. So the special educators and counsellors don’t have proper knowledge and bring in their own mental barriers against diversity in gender and sexuality. As a result, sexual oppression becomes a double-edged sword leading to and resulting from psychosocial disabilities.

It is not the job of a few NGOs to change this situation. State intervention is required and advocacy towards a change in the RCI’s training curriculum should start from today.

This second photograph shows installation art put up in one corner of the conference room during the ‘Pleasure, Politics & Pagalpan’ conference. The installation consists of a double bed in white with two pillows on the far side of the bed – the photograph is taken from the foot of the bed. The left side of the bed sheet and the pillow to the left are all tousled up, and only the left side of the bed seems to have been slept in. A grey blanket lies thrown on the left corner of the bed, and an open packet of Japani Oil at the centre of the bed (the oil container itself is not there anywhere). The far right corner of the bed is lit up with bright light, while the surroundings are more dimly lit. Close to the right side of the bed is a low round table with a TV set on it. The TV set has a handy red and black table lamp atop it with the light on. There are two boxes of what look like medicines – one on top of the TV and another right in front of it on the round table. The installation seems to display elements of pleasure, passion but also loneliness, and can be open to several interpretations. Photo credit: Sagnik for Anjali.

Installation art at the ‘Pleasure, Politics & Pagalpan’ conference

For more details on the ‘Pleasure, Politics & Pagalpan’ conference, please click here.

About the main photo: Panel discussion under way on the first day of the ‘Pleasure, Politics & Pagalpan’ conference at The Gateway Hotel, Kolkata. Seated on the dais – from left to right – are psychiatrist Dr. Ajit Bhide, psychologist Lakshmi Ravikanth, the author – disability rights activist Shampa Sengupta, mental health rights activist Ratnaboli Ray (also the founder of Anjali), and panel moderator Dr. Jai Ranjan Ram (all photo credits: Sagnik for Anjali).

Author Photo

Shampa Sengupta

Shampa Sengupta is a Kolkata-based activist working on gender and disability issues for more than 25 years. She is the founder of an advocacy group called Sruti Disability Rights Centre and is Executive Committee Member, National Platform for Rights of the Disabled. She will be happy to answer your queries on disability and related issues. Write in your queries to vartablog@gmail.com, and they will be answered with due respect to confidentiality.

Comments So Far

    No Comments so far
Leave a Comment
captcha img

Refresh Captcha

Back to Top