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Many college students experience severe loneliness, anxiety, depression, or chronic illness, or are dealing with past trauma—and most who meet this description would likely not identify as disabled. Yet depression, trauma, and anxiety may be disabling. Among other effects, these conditions can reduce students’ abilities to integrate socially and advocate for their own needs. Like physical and developmental disabilities, emotional health conditions may raise students’ risk of sexual assault and coercion. Sexual assault can happen to anyone—yet it often is not random.

Disability can mean social isolation

That’s why when sexual assault prevention advocates talk about disability, their definition is broad. It covers not only people with physical, developmental, or neurological disabilities, but also those with emotional health conditions. This includes students experiencing anxiety or depression, who may have less social support than their peers, experts say. “These students may be more vulnerable because they tend to be more isolated. They might have trouble connecting with people, but a strong network of friends or family is a protective factor for sexual assault. The isolation makes them more vulnerable,” says Barb MacQuarrie, community director at the Center for Research and Education on Violence Against Women and Children, Ontario.

Disability is variable

Disability can be temporary or lifelong, visible or invisible. It can be emotional or behavioral (e.g., depression, PTSD, addiction), physical (e.g., cerebral palsy, blindness), developmental (e.g., Asperger syndrome, ADHD), related to learning (e.g., dyslexia, language processing disorder), or result from a chronic illness (e.g., cancer, diabetes).

When sexual assault goes under the radar

Studies of sexual assault consistently show a higher rate of victimization of people with disabilities compared to nondisabled people (see the next page popup for stats). Disability is also a barrier to accessing support services and legal justice, advocates say—partly because standard resources may be inaccessible to people with additional needs. Sexual assault and other types of abuse can even cause disabilities—for example, depression and post-traumatic stress disorder—or aggravate existing conditions.

“No one is paying attention; that’s the message we receive,” says J. E., a writer and disability advocate who graduated in 2007 from a private university in the Northeast, where she had been a student athlete. “I was sexually assaulted in college and none of my teammates intervened. I was basically forgotten.” J. E. is autistic and has Ehlers-Danlos syndrome, an inherited condition that can affect mobility. In a recent survey by SH101, more then nine out of ten (92 percent) students who responded agreed that the sexual assault and abuse of disabled people is largely hidden. Only one in three said schools are proactively addressing the issue.

Sexual assault risk is aligned with social status

People with disabilities are often disadvantaged in the social hierarchy, and that disadvantage creates vulnerability, says Dr. Melanie Boyd, assistant dean of student affairs at Yale University. “Community power dynamics have enormous impact: Social status can dictate who gets targeted, who is granted the right to advocate for themselves, who is seen as a legitimate self-advocate.”

This is the same phenomenon that sidelines people of minority races, sexualities, and genders, and less wealthy socioeconomic classes. “Perpetrators of sexual violence often seek out persons who are socially isolated or otherwise marginalized,” says a 2010 report by the California Coalition Against Sexual Assault (CALCASA). For some, that marginalization reflects negative attitudes toward disability and emotional health issues.

Many in our society are uncomfortable with the sexuality of disabled people, disability activists point out. “The idea that disabled people might be sexual destabilizes society’s view of disabled people, who are supposed to remain passive objects, not living, active people,” says S. E. Smith, a disability rights activist and journalist based in California. This bias is reinforced by the idea that disabled people lack the ability to make certain decisions and exercise certain rights.

Many disabled people are denied sex education

“We see this bias arise when people refuse to provide sex education to disabled youth, don’t offer sexual health services to disabled adults, assume that disabled people can’t have sex and don’t want to, and deny the identities of LGBQ disabled people,” says Smith.

Disabled people are less likely than their nondisabled peers to be taught about sexuality, consent, and sexual boundaries, placing them at greater risk of sexual exploitation. “The assumption is that disabled people aren’t sexual and aren’t sexually appealing, so no one would be interested in assaulting them,” says Smith. “That’s a misunderstanding of disabled sexuality, but also of the motivations around rape and sexual assault, which are about power, not sex.”

Sexual aggressors use victims’ mental health and disability against them

Disabled sexual assault survivors may be seen as unreliable witnesses. “Historically, accusations of mental illness have been used to minimize and deflect the voices of disabled people, including those who actually are mentally ill. The notion is that being ‘crazy’ means that someone is unreliable and not able to narrate their own experience,” says Smith. Perpetrators use this by “implying or outright claiming that accusers are making it up—and this carries through in the way that law enforcement and even some sexual assault counselors interact with disabled victims.”

This perceived lack of credibility can be compounded by the communication differences associated with some disabilities, and a lack of disability-specific expertise and resources available to survivors.

How many college students have a disability?

“Disability” is a much broader concept than the ubiquitous wheelchair logo implies, and students with disabilities are not a defined community.

Two million undergraduates (11 percent of the undergrad population) say they have a disability, according to the US Department of Education (2012 data). This number excludes students who do not identify as disabled; this is likely the case for some who have an emotional health condition or learning issue.

Here’s how many students said they had a disability in a national, anonymous survey (2015):

Psychiatric condition7.5%
ADHD7%
Chronic illness5%
Learning disability4%
Deaf/hard of hearing2%
Blind/limited vision2%
Mobility/dexterity1%
Speech or language1%
Other2.5%

Here’s how many students said they were diagnosed with or treated for the following conditions within the past 12 months:

Anxiety17%
Depression14%
Panic attacks8%

Source: National College Health Assessment, Fall 2015

How commonly do disabled people experience sexual violence?

Studies of sexual assault consistently show a higher rate of victimization of people with disabilities compared to nondisabled people. For example:

  • Women with disabilities are more than four times as likely as women without disabilities to experience sexual assault, in a study of women in North Carolina (Violence Against Women, 2006).
  • Men with disabilities were more than four times as likely as men without disabilities to have experienced sexual violence, in a 2011 study in Massachusetts (American Journal of Preventive Medicine).
  • Women with disabilities are significantly more likely than women without disabilities to experience intimate partner violence, which can include rape and sexual assault, according to a 2015 study in the Annals of Epidemiology.

Some studies examine sexual assault victimization and specific types of disability. For example:

  • Among people with developmental disabilities, 83 percent of women and 32 percent of men are sexually assaulted in their lifetime, according to a 1991 Canadian study that is still widely cited.
  • In a small study, more than three out of four (78 percent) of adults with autism had experienced sexual victimization; they were more than twice as likely as their nondisabled peers to say they had been raped, according to the Journal of Autism and Developmental Disorders (2014). The adults with autism had less sexual knowledge than their typically developing peers.
  • Students who were deaf or hard of hearing report unwanted sexual contact at nearly double the rate reported by the general student population, according to a 2009 study by researchers at the University of Maryland.
  • Disabled children are more likely to be abused than nondisabled children. The risk of sexual abuse appears to be particularly high for children with communication disorders, behavioral disorders, intellectual disability, and multiple disabilities (Sullivan & Knutson, 2000).

How to help prevent the sexual assault of people with disabilities and emotional health issues

1.  Reconsider how you think about disability and emotional illness

We can all help build a culture in which everyone’s bodily autonomy and communication is respected. This includes recognizing that every adult has the right to consensual sex and the right to be heard and presumed competent. Negative attitudes toward disability and emotional health issues are everywhere, and this places people with those conditions at greater risk. Here’s how not to be part of the problem.

As with any stereotype, it’s on us to catch ourselves in the act. That woman with speech issues may have a lot to say. The man with PTSD is almost certainly a reliable reporter of his own experience. When we applaud a nondisabled student for inviting the autistic student to the prom, or describe a disabled person’s ordinary activities and achievements as “inspirational,” we’re doing it wrong. Disabled activists point out that these responses are condescending.

Our assumptions about disability—what it is, what it means, and what it’s like to live it—are often wrong, research shows. For example, nondisabled people assume people with disabilities have a low quality of life, while disabled people rate their own quality of life as high—a contrast known as the “disability paradox” (Social Science and Medicine, 1999).

Many of us will experience disability in our lifetimes

The numbers vary, depending in part on how disability is defined, but try these:

  • One in five adults in the US currently has a disability, says the Centers for Disease Control and Prevention (CDC).
  • Around one in three people born in 1995 will become disabled to the point that they can’t work before reaching retirement age, according to the Social Security Administration (2015) (using a relatively narrow definition of disability).
Students’ instincts are promising

A recent survey by SH101 (with 970 respondents) suggests that students are aware of certain key issues:

  • Two out of three students who responded (68 percent) felt that society is uncomfortable with disabled people’s sexuality.
  • Four out of five respondents (80 percent) believed that almost every adult is capable of learning what they need to know about sexuality and sexual choices.
  • Only 7 percent said they were “very familiar” with disability advocacy issues; many students expressed willingness to learn.

2.  Rethink your social norms and rituals. Ask: Who wouldn’t these work for? How can we broaden social accessibility?

Being inclusive is not only more ethical; it is also more rewarding, says Dr. Boyd, who oversees Yale University’s Consent and Communication Educators program. “Inclusive groups work—and play—better because everyone is engaged.” This calls for you to think constructively about social experiences you may take for granted. Here’s how to approach it.

Social cohesion benefits all students

Social isolation (resulting from disability or another reason) can make some students more vulnerable to sexual assault. Developing social inclusion norms and practices can help. This means welcoming students who may not otherwise be able to join in, and ensuring that events and rituals do not expose students to demands they may find unduly difficult or even intolerable. Here’s how to approach it, says Dr. Melanie Boyd:

“Instead of directing energy into social hierarchies, put it instead into making sure everyone feels included and is watching out for each other. For example, consider your social and cultural norms that feel ordinary: half-time at the big game, or the grad student mixer. As a group, what you can do to demonstrate cohesion?

 

How to bring about change in a group (Chip and Dan Heath) 

Source: Consent and Communication Educators, Yale University

3.  Hold yourself and others to the standard of enthusiastic mutual sexual consent

Mutual desire is key to any great sexual encounter. This standard applies across the board, regardless of who’s involved. When your sexual experiences are based around what both (or all) of you truly want, and the goal is quality, not quantity, they become more like the sex of your fantasies. All partners deserve respect and open communication. Here’s how disability may play into that.

When one or more of the people involved is disabled, sexual communication may require accommodations. For example:

  • While most people are adept at reading nonverbal signals, a student with autism or a social communication disorder may need verbally explicit communications (see below).
  • A student who has speech issues may use an adaptive communication device (e.g., a tablet computer) that needs to be on hand throughout.
  • A student with mobility issues (e.g., cerebral palsy, a broken leg) may need help getting physically comfortable.
What if nonverbal communication doesn’t come easily?

A small minority of people (including those with social communication issues or autism) has difficulty interpreting nonverbal language and social cues. This has implications for establishing mutual sexual consent. In these situations, be verbally explicit.

What to say to your partner if understanding body language is hard for you “I don’t always pick up on body language, so if I misunderstand you, it’s not intentional. Please tell me directly what you want and what you don’t want.”

What to say if understanding body language is hard for your partner
“Let’s be direct, so we’re sure to understand each other. I’ll tell you what I want and what I don’t want. What do you want?”

How misunderstandings can happen “This issue is mainly about the ability to read other people’s intentions and thoughts,” says Dr. Isabelle Hénault, a sexologist and psychologist based in Montreal, Quebec. “Especially with individuals with Asperger syndrome or other autism conditions, they rarely act out with a negative intention. Any problems are most likely about misreading situations.”

How to communicate clearly “With consent, you have to be very concrete, very explicit, very clear,” says Michael Glenn, a clinical social worker and sex educator based in Massachusetts. He recommends that students consider disclosing a diagnosis that affects social communication. “I really believe that at this point in time, enough is known about Asperger’s. You may as well label it and discuss it more openly.” Alternatively, acknowledge the specific issue (rather than the diagnosis), as in the example above.

Referrals for guidance with intimate communication (Asperger/Autism Network)

4.  Support efforts to build networks for students with disabilities

In a recent survey by SH101, 97 percent of students who responded agreed that disabled students need more disability-informed allies, mentors, and advocates. Ideally, schools will work toward establishing those networks of support. In the meantime, students with disabilities likely need to be proactive in finding mentors and allies on campus and in their communities. Peers, staff, and faculty can provide a supportive community. Here’s how to approach it.

Support efforts to build networks for students with disabilities

If you have a disability or ongoing health condition, think about which faculty, staff member, or advisor you can most comfortably talk to. “Most students have ‘that’ professor,” says J. E. (the sexual assault survivor quoted on the page). “That’s a good start for discussion. There is a reason for that connection. It may not be disability, it may be other things, but ‘that’ professor is already a mentor.” All students can support each other’s efforts to build connections (e.g., by encouraging their peers to reach out, or offering to accompany them to meetings that may feel intimidating).

What a supportive network looks like We can all support efforts to establish networks for students with disabilities, including:

  • Designated faculty and staff, preferably including some with lived experience of disability
  • Victim advocacy and support services with professionals who have expertise in disability

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Article sources

Melanie Boyd, PhD, assistant dean in student affairs; lecturer in women’s, gender, and sexuality studies, Yale University, Connecticut.

Colby Bruno, Esq., JD, senior legal counsel, Victim Rights Law Center, Massachusetts.

Michael Glenn, LICSW, clinical social worker and sex educator, Massachusetts.

Isabelle Hénault, PhD, director, Clinique Autisme et Asperger de Montréal, Quebec.

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Lucy Berrington is the editor of Student Health 101. Her work has been published in numerous publications in the US and UK. She has an MS in health communication from Tufts University School of Medicine, Massachusetts, and a BA from the University of Oxford, UK.