Why do you help me to get dressed and not to have sex?

If we think about our lives as autonomous people, can we imagine a full life without sexuality? Probably not. And what would welfare be without meaningful relationships with other people? 

Can we imagine a life of meaning and joy without relationships of affection, intimacy and tenderness? 

Do we consider the same about the lives of those dependent people we love or care for? Possibly here there are mixed feelings and reasonable doubts about how to act. The fact is that, whoever has not felt terribly uncomfortable when discovering two people living in the residential centre in which they work caressing each other intimately, should throw the first stone. 

SEXUALITY: NEED, IDENTITY AND RIGHT

Sexuality is more complex than sex. It is how we manifest ourselves as sexual beings, the experience of mixing biology, gender roles, identity, sexual orientation and other cultural components. Sexual behaviour, what we commonly call sex, is also a much more open and complex term than we might imagine. I believe that there is no better definition than that of any activity that is seen as such by the people who participate in it, making them feel sexual.

We are talking about human needs that shape our identity. Moreover, expressing them freely, as well as being a right, is also the source of many of our well-being and vital pleasures.

CULTURAL PREJUDICES

We live in societies where sexuality seems to be intimately linked to an age group, youth, when in reality we are sexual beings from the earliest childhood until the end of our days.

Moreover, this is accompanied by a reductionist vision that links sexuality to the purely genital and coital, linking it to reproduction. Hence, if we understand sexuality exclusively as penetration or genitality, any person who is prevented by their physical conditions or does not enjoy this type of sexuality, is completely out of this story. All of this is accompanied by gender roles, which "encourage" us to assume what the attitudes and desires of men and women should be.

In short, we have been taught that there are some bodies (with specific capacities and characteristics) that are sexual, and can enjoy sexuality, while in others, asexuality must become the norm or it is something perverse or immoral.

Ageism, capacitism, heteronormativity, machismo and many other preconceived and discriminatory ideas are part of our culture and society, so, to a greater or lesser extent, we are all influenced by this, naturalising the cultural and creating an inflexible and unique model of sexuality.

With all these crumbs, how can it be easy to think positively and without prejudice about the sexuality of people in a situation of dependency?

CARING FAMILIES

When someone in the family takes care of a dependent person, it is easy to fall into the trap of not paying attention to their sexuality. It is the great taboo within the family. As caregivers and those responsible for their well-being, they are aware of the risks and sometimes fears: "What if they take advantage?

Fear of assault is logical in a society like ours, but responding to it by denying and nullifying other people's sexuality will not solve things, nor reduce the risks.

On the other hand, when families provide them with tools for self-care, strengthen their own self-concept and naturalise family dialogue about sexuality, they encourage them to live it according to their life plan and their needs for support. Therefore, they will be much more protected against aggressions, being able to set the limits they want and the protection measures they need. In other words, it is through the promotion of sexual autonomy that they will be able to develop it in a healthier, natural and satisfactory way, while being protected.

PROFESSIONALS

Prejudices also affect us professionals, making it easier to forget this part of our being. Negative views and social taboos become apparent when we feel so uncomfortable discovering a person living in the residential centre where they work with an erection or masturbating in their bed. Those of us who work with dependent people can incorporate into their lives safe spaces where they can be free sexual beings, without feeling threatened or exposed, as well as spaces where they can discuss their sexual concerns and needs with us.

To do this, it is necessary and appropriate that we work on our own vision of human sexuality and the prejudices that hang over it.

It would be unfair not to point out that many tools for facilitating autonomy in sexuality are already being put in place at the initiative of both families and professionals, especially in cases of functional diversity. On few occasions have I felt greater integration of the promotion of personal autonomy in a carer than when I heard a 70-year-old man relate how he stripped his daughter with his partner, both with cerebral palsy and moderate dependence, to let them enjoy themselves alone in the room, while he waited, reading in the room, the call to help them with their clothes again.

Will the day come when the promotion of sexual autonomy will become commonplace in the care of dependent elderly people, and will we as a society soon stop putting an expiry date on human sexuality?