How people with disabilities navigate sexual health and reproduction in SA

JOHANNESBURG - Conversations around sexual and reproductive health services largely exclude the needs of people with disabilities.

Eyewitness News spoke to different people from this group to underscore their realities.

The treatment of people from this cohort of society can make it uncomfortable or discourage them from seeking the necessary help or information to attend to their sexual health needs.

“There are some healthcare workers but very few that love their work, have compassion and respect you as a person. The majority are cold, heartless, insensitive, judgmental, discriminate, and clearly don't know what Batho Pele taught them," said Lisakhanya Zenzile-Nyweba, a senior administrator at Disabled People South Africa.

Human beings are sexual beings with sexual thoughts, attitudes, feelings desires and fantasies.

According to the World Health Organization sexuality is a basic need and aspect of being human that cannot be separated from other aspects of life.

But buying condoms, asking a doctor about contraceptive options, having infections checked out, and discussing your menstrual cycle, erections or their absence is difficult for most people - especially people with disabilities.

"I remember going to request information in terms of checking myself with regards to having more babies, especially tests, to make sure I am good to go, and I was so humiliated by two nurses laughing, saying: 'how does a cripple think she can have sex, let alone a child?' I was so angry, and chose to leave before losing my temper as they were not worth it,” Zenzile-Nyweba said.

Senior administrative assistant at Wits Disability Rights Unit Mx Tish Morpheus Geddes pointed out a misconception that people with disabilities were asexual, a sexual orientation comprising 1% of the population.

Asexuality is defined as showing or having no sexual attraction for other people despite their sex or gender identity, they added.

"This leads to people with disabilities being placed into an incorrect assumption of our sexual orientations. This placement is furthered by the denial of agency, based on a notion that people with disabilities need to be protected, which in itself is condescending and denies sexual agency between consenting adult partners,” they said.

Mbalenhle Nkhumeleni is a T-4 paraplegic, which means she has a complete injury of her spinal nerves at the T-4 bone, echoed Geddes' view saying: “There is this stigma attached to people with disabilities that if you are sexually active then you are promiscuous, that we actually can't have healthy sexual relationships just like everyone else.

“Or that you should actually get contraception because you should not have any children, you can't be a good parent because of a mere disability,” said Mbalenhle Nkhumeleni.

Geddes also touched on the fact that safe abortion facilities should by default be accessible to those with mobility disabilities, but that many invisible disabilities are not factored into accessibility planning.

"Someone may experience a nonverbal episode. How do practitioners ensure that their teams are trained to navigate this? A deaf teenager may face similar barriers, for example, in the case of trauma incurred from a stillbirth. Who takes accountability to ensure that these patients don’t fall through the cracks in ensuring access to trauma counselling?"

A software designer Sandile Mkhize - who is a T5 paraplegic - said that he did not engage in conventional sex.

“My experience has been a positive one over the years. As a T-5 paraplegic, I do not have conventional sex, so no need for condoms as I take other sexual health measures. I plan to see a reproductive doctor soon and I will most definitely share my experience then.”

Meanwhile, Thabiso Mabelane who has spina bifida - a condition that also affects the spine - recounted his encounter with a nurse when he sought an HIV test.

“I remember when I went for an HIV test, the nurse who was helping me was nice and not rude to me," he recalled.