Sexuality in people who need help to communicate

Sexual liberalism, in other words, liberalism has increased and continues to increase in our society moment by moment. There is more and more talk about sex, sexuality, gender, relationships and their diversity. Sexuality is made on podcasts, blogs, and it is talked about on various social media channels such as TikTok and Instagram. Nowadays many are arranging courses on sexuality that can help people become more aware of their own sexual power. A consensual approach is called for in all interaction, but especially in sexual interaction and quite rightly so. So, we live in a certain way a new sexual revolution that is definitely in place. As well as for example, sex education has long been based on a very narrow perspective about sex and sexuality and has mainly touched only Cis-heterosexuals. People are now interested in training in the field of sexology and passing their knowledge to wider audiences. We have to talk about sex, sexual habits, and we have to talk about sexuality. We need to talk about the diversity of sexuality and talk about sex and sexuality in relationships and learn to express our wishes and need.

What if you can’t be able to talk?

Speaking is encouraged, but not speaking is not always one’s own choice. It is better to talk about communication, because there are several means of communication, speech is just only one way. Indeed, speech impaired people often remain underdogs in sex talk as others rush toward the finish line, toward sexual freedom, autonomy, and sex positivity.

If there are challenges in communication, the person often uses a supportive or substitute method of communication, such as picture communication. Pictures can be a visual aid in receiving a message, or they can be used as a method for supporting one’s own speech.

There are about 65,000 people in Finland who has the varying degrees of speech and communication difficulties. As many as 30,000 of them need speech-supported communication methods, such as clear pictures and communication pictures. Up to 10% of the population benefits from plain language as part of communication. Increasingly, health care professionals recognize sexual health as an important part of a client’s care. However, there are many challenges associated with addressing sexuality and talking about it, which means that sexuality is still an overlooked topic of conversation, especially when there are challenges in communication, or it would require aids for. Sexuality belongs to everyone, and all customer groups should have the opportunity to discuss it. The right to communicate is guaranteed in particular in Article 19 of the UN Declaration of Human Rights, which states that everyone has the right to the freedom of opinion and to the freedom of expression.


SelkoSeks conducted an open online survey which was titled: The human sexuality that needs support in communication and communicating about it.

The main purpose of this survey is to facilitate communication about sexuality and increase knowledge about the topic. The survey is related to the development of SelkoSeks´s picture bank’s products and services and is part of a project in which, with the support of the Finnish state (Business Finland), a sexuality-related product and service package is to be built in where users could also be acquired from abroad. Mikko Pesonen from Oulu Business Networks Oy was responsible for the technical implementation of the research.

A total of 47 responses were received to the survey. The responses came anonymously, and no identity information was collected from the respondents.


79.1% of the respondents were social and health professionals, 18.6% were close and 2.3% of the respondents were people who needed support themselves. Among the social and health professionals, the range of professions was wide — sexual workers, practical nurses, service housing unit instructors, midwives, teachers, social workers, and interpreters of the speech impaired. There were also sexual counsellors among the respondents. 


How important do you consider sexual education? On a scale of 1 to 10. Average rating 7.3. 59.1 % of the respondents had defined the value as 10.

How important do you consider the possibilities of realizing sexuality? On a scale of 1 to 10. Average rating 7.36. 57.8 % of the respondents had defined a value of 10.

How important do you consider the opportunity to communicate about sexuality? On a scale of 1 to 10. Average rating 7.48. 63% of the respondents had defined the value as 10.

What prevents the realization of sexual education?

Many things were named as barriers to sex education, but as many as 19 respondents recorded the prejudices and attitudes as the barriers in their responses. The second biggest obstacle was perceived lack of knowledge and skills related to the topic area (15 respondents). Other barriers were lack of material (7 respondents), lack of resources (3 respondents), the importance of prioritization (3), and lack of interest (1). Only one respondent reported that sexual education and counselling were well implemented in the work units.

“Often, issues related to sexuality are awkward for loved ones of special people. It can seem embarrassing to discuss the topics with your own child, for example. For example, the use of pictures in that topic may seem more intimate than a non-picture supported conversation. If, for example, a person has developmental disability, it is not necessary to think that the need for the realization or awareness of sexuality even exists, and they are left unaddressed.”

“One´s don’t even know how to talk about the subject with neuronormative, let alone then with clients with intellectual disabilities and / or autism spectrum disorders.”

“It is a lack of vocational training, because in many caring industries training doesn’t address sexuality issues at all.”

“Sexual education is left at the feet of the other parts, and it is not valued or seen as equally important.”

“There is no appreciation or awareness of the holistic importance of human rights, well-being and security in sexual education.”

“There are still ideas about that people with disabilities don’t need, even if they do, because violence and its threat is more prevalent than other people´s experiencing violence and its threat. The risk of developmental disabilities in particular is 10 to 13 times higher.”

“The attitude towards people with disabilities. Although sexuality is no longer so taboo today.”

“Sexuality and its safe implementation are not considered a key part of a person’s overall well-being (especially if the person has a disability that impairs their ability to function).”

What prevents the possibility of realizing sexuality?

The prejudices and attitude became the biggest obstacle to the realization of sexuality (11 respondents). The second biggest obstacle was identified as a lack of concrete assistance and materials (10 respondents). Respondents also cited lack of knowledge and skills (5), lack of a partner (3), and lack of sexual education (2).

“Many communication aids support well in other areas of life but may be deficient in content in terms of sexuality (for example from vocabulary or pictures).”

“Also, not all speech-impaired people have sexuality-related images in their communication folders, for example, so that they can talk about the topic at all. Family prejudices or fears may also hinder the realization of sexuality, as they usually affect, for example, whether there are the right images in the folder. The lack of sexuality education also hinders the realization of sexuality.”

“Tools for the realization of sexuality are hard to get by, and they are expensive to buy.”

“It is hard to find helpers who would help with sex.”

“Lack of assisted sex services and the negative attitude towards from assisting in sex.”

Numerous responses also highlighted the lack of privacy and individuality (8 respondents).

“The reasons mentioned above, as well as the lack of privacy and individuality of the clients of the housing services units.”

“For example, a customer cannot bring dating partners, a girlfriend / boyfriend or a sex worker to sleepover.”

“Several places ban it outright or make it considerably more difficult.”

“Lack of privacy, and difficult organization of situations in some cases.”

“Housing arrangements that do not allow couples to live together or overnight guests.”

“Service housing routines that do not make possible, for example, sex when a person or persons want to.”

What prevents us from communicating about sexuality? Is there something tricky about it?

Once again, attitudes became the biggest barrier here as well (9 responses), but the lack of material also rose alongside it to be an equal barrier (9 responses).

“When we have educated the staff in the workplaces, they have shown much attitude behaviours and sometimes even aggression. Aggression is shown in a manner similar to hate speech, in which customers are annulled, and sexuality is seen as repulsive and talking about it is seen as coercion.”

“The subject is still a taboo. There are no concepts or words.”

“It can be a difficult and too personal topic for many, so you may not want to discuss it.”

“A professional does not always invite communicating or some tools are missing which could be used to communicate.”

“Many communication aids support well in other areas of life but may be deficient in content in terms of sexuality (for example from vocabulary or pictures).”

“There is no vocabulary or illustration or symbols on the subject in the communication aid.”

“There are not enough contents of the aids or if there would be any content, it wouldn’t be allowed to be included in the content”.

“I have come across situations where sexuality-related imagery, for example, is not available to support the discussion. Alternatively, the images may exist, for example, in the communication folder, but the person does not use them because they are not familiar to him.”

“Nursing staff don’t want to talk about things with clients. For them, it is awkward, inappropriate or completely unnecessary.”

The difficulties and challenges of interaction became the second biggest obstacle and inconvenience (8 responses).

“It is when you don’t know what a person with a mental disability understands. It is difficult to know how much information a person with developmental disability can understand and absorb and how to tell things to an adult who is in a childlike state.”

“How to know what the other person likes if you can’t directly ask or get an answer?”

“Sexuality may never have necessarily been handled in an understandable and open way with a person with speech disability.”

Other impediments included lack of sexual education (3), challenges created by an environment (4), and lack of resources (1).


Do you need more information on sexuality? Yes 31.1%, No 55.6%, I can’t say 13.3%.


What communication tools do you use?

Communication pictures (Clear pictures) 85.2%

Communication boards 70.4%

Sign language 77.8%

Image tool (e.g., Boardmaker) 70.4%

Something else, what? 51.9%

Other means of communication were commonly named by respondents as: pictures, quick drawing, interpreter, plain language, alphabet, newspaper clippings, social stories, and communication devices.

How important are visual support such as communication pictures as part of communication? On a scale of 1 to 10. The average was 7,25. 51.2% of the respondents had defined a value of 10.’

What things are important in sexual communication pictures?

Clarity and neutrality emerged as the most important things in the communication pictures of sexuality. Concreteness and realism were hoped for in the pictures, but also a neutral tone. It was also seen as an important part that the images are designed for adults and are therefore of the right kind, and not too “childish”. A clear hope for in the images also became possibility to see diversity and versatility, such as different sex habits, issues related to orientation and identity, and to enable enjoyment through aids or assisted sex.

“A material bank is definitely a sensible idea.”

“It is great that something is done about it.”

“You are on good cause, there is definitely a need for this. From the point of view of the work of the interpreter, I am grateful that you have made a material that can be utilized if necessary. Thank you!”

“Thank you all, you are doing a great work <3”

“The teaching materials in upper comprehensive schools would need to be reformed in part in this subject.”


This survey brought us implementers with more information, ideas, and confirmation that there is a need for the material. In the answers, one can see and hear the same ideas that we, the developers of SelkoSeks, have had. The challenge, however, is not that the person may have speech disability, but that there is no real footage from sexuality to communicate about it. And the most mind-boggling, one doesn’t want to use them.

In disability work, it is still regrettably often encountered the notion that sexuality is not a part of human life and everyday life, for example in housing service units. Sexual needs and their satisfaction can be horrified and restricted arbitrarily. If a person asks for information or help on a topic related to sexuality, he or she can be shamefully silenced even completely. Part of the reason can be the lack of training, as it is obvious that social, health and educational staff is not adequately trained on sexuality and therefore it can be difficult to face the issue in practice. With a help of education can also break harmful prejudices and stereotypes that prevent sexual encounters. However, one does not have to cross one’s own boundaries and there is no need to talk about things that one is not ready to talk about. One may wonder, however, whether an ethically sustainable solution to respecting one’s own boundaries is to leave a person alone with his or her needs and questions. As we contribute to increasing sexual liberalism, communication about sex, sexuality and its diversity, we must remember and consider all people and adhere to accessibility and that there are no obstacles. All human beings are sexual beings from birth to death and everyone should have equal rights as well as opportunities for self-realization.

We would also like to point out that the importance of sexual education and communication is enormous when considering the prevention of sexual violence. Studies show that vulnerable children and young people have more risk factors for various forms of violence in their lives and thus more experiences of mental and physical violence. Special children and young people often receive less sexual education but are over-represented in experiences of sexual violence. Every child, regardless of their background, has an equal right to comprehensive and high-quality sexual education.

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