Disability and the male sex right

Disability and the male sex right
Sheila Jeffreys
School of Social and Political Sciences, University of Melbourne, Victoria 3101, Australia
a r t i c l e i n f o s y n o p s i s
Access to prostituted women is increasingly justified by disability charities and services on the
grounds of the sexual rights of the disabled. In Australia, for example, disabled men form a
niche market for the legalised prostitution industry. Male sexuality is constructed out of male
dominance and is likely to manifest the eroticisation of hierarchy and the idea that males
should have the sexual right to access the female body. This model of sexuality poses problems
for all women in the form of sexual harassment and violence, pornography and prostitution. It
poses particular problems for women with disabilities who are more vulnerable to sexual
assault and harassment from carers and disability fetishists. The sexual rights idea does not
generally take gender into account. Thus sexual rights for men with disabilities can include the
right to pay for or demand sexual servicing from women in prostitution, nursing or caring work.
This article seeks to disaggregate the notion of sexual rights according to gender.
© 2008 Elsevier Ltd. All rights reserved.
Introduction
In this article I will look in an exploratory way at several
issues concerning disability and sexual exploitation that
might seem at first to be distinct. They include the sexual
abuse of women with disabilities and the prostitution of
women with disabilities, the exploitation of prostituted
women by men with disabilities, and men's sexual fetishising
of women with disabilities. The connecting factor is the
sexuality of male dominance. In relation to sexuality, disabled
men may pursue interests that are in stark contradiction to
those of disabled women. Organisations supporting men with
disabilities campaign for their sexual rights which may mean
using pornography and prostituting women. These forms of
sexual exploitation teach and represent an objectifying
sexuality. It is precisely this form of sexuality that disabled
women suffer from, in the form of unwanted sexual contact
and the fetishising of disability. It is important to disaggregate
the interests of men and women when considering the issue
of disability and sexuality.
Feminist disability theorists have been working for three
decades to provide an understanding of disability which takes
gender into account (Morris, 1989; Fine & Asch, 1988;
Matthews, 1983). They have pointed out that women with
disabilities can be seen as at least doubly disadvantaged i.e. by
discrimination on the grounds of gender and disability, and
often by a third form of exclusion and discrimination in the
form of racism as well (Begum, 1992). They have shown that
the model of rehabilitation of people with disabilities that the
medical model of disability promotes, has a male body and
male sexuality in mind. Rehabilitation programmes seek to
cultivate ‘competitive attitudes’ and address ‘concerns about
male sexuality’. They are about ‘enabling men to aspire to
dominance notions of masculinity’ whilst ignoring the needs
of disabled women (Begum, 1992: 72). Feminists have
criticised the understanding of sexuality that is applied to
women with disabilities by doctors, in which they are seen as
functional if they have a usable vagina for a male partner's
satisfaction. This is a very masculine model which does not
countenance women's pleasure, the clitoris, and more
imaginative approaches which do not have to be focused on
penis in vagina sex, or even heterosexual (Titchkosky, 2000).
Feminist approaches to disability have given little attention,
however, with the notable exception of the work of Amy
Elman, to the need to disaggregate the concept of the sexual
rights of the disabled (Elman, 1997).
Feminist theorists have also criticised the limitations of
the ‘social model’ of theorising disability. This article starts
from the understanding that disability is to a large extent
socially constructed (Oliver, 1990), an approach that has been
termed the ‘social model’ of theorising disability (Lloyd,
2001). According to this approach the problems that women
Women's Studies International Forum 31 (2008) 327–335
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with disabilities face are not the sad but inevitable result of a
biological or acquired flaw, and an individual responsibility.
The disabled experience problems such as violence and
penury because the societies in which they live do not
acknowledge persons with disabilities and want them to be
‘out of sight, out of mind’ (DVIRC, 2003). The values of
capitalist societies based on male dominance are dedicated to
warrior values, and a frantic able-bodiedness represented
through aggressive sports and risk-taking activities which do
not make room for those with disabilities. Feminist critics
have pointed out, however, that the social model can
reproduce a form of mind/body split, by downgrading the
lived experience of the body which is not merely a social
construction. It can serve to obscure the very real experiences
of pain, for instance, that women with disabilities face
(Titchkosky, 2000). Women's physical experience of impair-
ment will affect the ways in which they are vulnerable to
men's violence, and the forms that this takes. But sexual
violence against women with disabilities is also a classic
example of how the problems of disability are socially
constructed. This violence is founded on the male sex right,
a construction of male dominance, and enabled by economic,
mobility and emotional factors that women with disabilities
suffer as a result of the obstacles placed in the way of their
integration into an able-bodied world.
The sexuality of male dominance is based upon what the
political theorist, Carole Pateman, calls the ‘male sex right’
(Pateman, 1988). This is the privileged expectation in male
dominant societies that men should have sexual access to the
bodies of women as of right. Such societies organise delivery
of this access to men, and the removal of obstacles, in various
ways. This can be through the provision of legalised
prostitution or the tolerance of illegal prostitution. It can be
through enabling the creation of other aspects of the
prostitution industry such as pornography, strip clubs and
sex phonelines (Jeffreys, in press-a). It can be through child
marriage in traditional societies or the early sexualisation of
children in the west (Moschetti, 2006).
In relation to disability this law of the male sex right leads
men and boys to sexually abuse women, girls and boys made
vulnerable to them by virtue of their dependence on male
carers, or through institutionalisation. It leads to the provision of
prostituted women to men with disabilities (see Sullivan, 2007),
the provision of what are euphemistically called ‘sex surrogates’,
or even the requirement that nurses and carers masturbate men
with disabilities, which is called ‘facilitated sex’ (Earle, 2001;
Davies, 2001). It also leads men who fetishise and get sexually
excited by women's disabilities to harass women amputees and
seek sexual access to women with disabilities through various
forms of exploitation and trafficking, the mail order bride
business, prostitution and pornography (Elman, 1997).
The fetishising of disability comes from the way in which,
under male dominance, male sexuality is constructed to
eroticise hierarchy and to objectify. As the radical feminist
legal theorist, Catharine MacKinnon, points out, gender is a
hierarchy, and it is the eroticising of male dominance and
female subordination that forms the foundation of what is
commonly understood as sex in male dominant culture
(MacKinnon, 1989; Jeffreys, 1990). The eroticising of hierarchy
by men is not restricted to gender. Other forms of hierarchy
are eroticised too, such as age in paedophilia, race in relation
to the racist sexual stereotyping that underpins the male
interests of using exotic prostituted women, such as those
who have been trafficked or are available in sex tourism
destinations (Jeffreys, 1997). Disability provides another
hierarchy for eroticisation. Women with disabilities offer the
double delights of gender inequality and disability as sources
of sexual satisfaction to dominant male sexuality. Thus some
men come to fetishise women's disability (Elman, 1997).
Some of those men who sexually fetishise disability seek to
become disabled themselves, usually through amputation of
limbs (Elliott, 2003). This condition is commonly called
amputee identity disorder or BIID (Body Identity Integrity
Disorder). The power and influence of the male sex right is
indicated in the fact that a movement to get amputation of
healthy limbs available to such men is under way with the
support of respected psychiatrists and surgeons, such as the
editor of the US Diagnostic and Statistical Manual, Michael
First (First, 2004).
Despite the rather clear differences in the ways in which
male and female sexuality are constructed under male
dominance, when disability studies have approached the
issue of sexuality they have not usually disaggregated the
interests of women with disabilities from those of men with
disabilities. When sexuality is addressed in the literature this
often fails to mention the problem of sexual exploitation that
women with disabilities face. The definition of sexual
exploitation that I use comes from the United Nations Draft
Convention Against Sexual Exploitation (1991) in Defeis
(2000, p. 335).
Sexual exploitation is a practice by which person(s) achieve
sexual gratification, or financial gain, or advancement,
through the abuse of a person's sexuality by abrogating that
person's human right to dignity, equality, autonomy, and
physical and mental wellbeing. (For discussion of this Draft
Convention and the text see: Defeis, 2000).
Prostitution and pornography are included in this under-
standing as sexually exploitative practices. In this article
sexual exploitation means gaining access to sexual use of a
person's body by means of any form of unequal power e.g.
payment, force or its threat, emotional manipulation by
someone in a position of power, superior age or knowledge. It
is distinguished from wanted sexual interaction with equal
desire and pleasure for both partners, freely entered into.
Unwanted or coercive sex in relationships and from carers
International research suggests that women with disabil-
ities suffer significantly more from sexual violence than other
women (Elman, 2005). In general women with disabilities are
‘assaulted, raped and abused at a rate of at least two times
greater than women without, yet are less likely to receive
assistance or services if they experience violence’ (DVIRC, 2003,
p. 12). Some forms of abuse are unique to women with
disabilities. Sexual abuse of a woman with a disability may
include, for example, forced sterilisation or forced abortion
(DVIRC, 2003: 12). Lack of sex education for girls with
disabilities can contribute to their vulnerability to male sexual
use. Also women with disabilities, ‘face alarming rates of
violence from paid and non-paid carers’ (DVIRC, 2003: 23).
328 S. Jeffreys / Women's Studies International Forum 31 (2008) 327–335

Feminist scholars have paid considerable attention to the
problem of unwanted sex in the relationships of able-bodied
women in the last decade (Jejeebhoy, Shah & Thapa, 2005;
Gavey, 2005; Phillips, 2000). The difficulties for women with
disabilities, however, are likely to be greater than those of
girls and women without for several reasons. These include
self esteem and body image problems which may make them
more easily manipulated emotionally (Hassouneh-Phillips &
McNeff, 2005). Physical or intellectual disabilities, mobility
problems or dependence upon carers, make it more difficult
for them to protect themselves against unwanted touch and
sexual contact. Women with high degrees of physical
impairment, may suffer disproportionately low ‘sexual and
body esteem’ (Hassouneh-Phillips & McNeff, 2005: 227). A
study of women with high degrees of physical impairment
found that they were vulnerable to ‘getting into and staying in
abusive relationships over time’ because they saw themselves
as sexually inadequate and unattractive (Hassouneh-Phillips
& McNeff, 2005: 227). These women are less likely to marry
than other women with disabilities and this may make them
more likely to suffer abuse rather than face loneliness and lose
the person who cares for them ‘For some women, these
disadvantages translate into an increased tolerance of abuse
in intimate partner relationships out of fear that no one else
will want or care for them’ (Hassouneh-Phillips & McNeff,
2005: 229).
Research shows that 40–72% of women with physical
disabilities ‘have been abused by an intimate partner, family
member, caregiver, health care provider, or other service
provider’ (Hassouneh-Phillips & McNeff, 2005: 229). These
statistics cover abuse in general and make no special mention
of sexual abuse, for which figures are difficult to obtain. But
one particularly poignant quote from the 2005 study suggests
that women with disabilities might allow men to engage in
abusive sexual behaviours towards them out of a desperate
desire to hold onto the relationship, ‘my main thing that I
think my relationship with my men is to please my man... and
so I do everything that I can do to please. Because it's
constantly in my head — am I pleasing him sexually?’
(Hassouneh-Phillips & McNeff, 2005: 237). The prolonged
exposure to abuse that some women with disabilities suffer
because of the restrictions to mobility and lack of alternatives
they suffer in a society which is not organised to ensure their
integration, leads to increased risk for ‘negative health
outcomes including injury, chronic pain, depression, post-
traumatic stress disorder, substance abuse, homicide and
suicide’ (Hassouneh-Phillips & McNeff, 2005: 237).
Douglas Brownridge's study in Violence Against Women on
partner violence against women with disabilities found that
the women had a 1.4 to 1.9 times greater likelihood of physical
violence than other women over the previous 5 years, with
the greatest disparity in relation to ‘more severe forms of
violence’ (Brownridge, 2006: 812). But sexual violence was
much the most common form of violence they experienced.
Women with disabilities were three times more likely to
report ‘being forced into sexual activity by being threatened,
held down, or hurt in some way’ (Brownridge, 2006:812). The
research found that the male partners of women with
disabilities were 1.5 times more likely to ‘engage in
proprietary behaviors’ than those of other women (Brown-
ridge, 2006: 818). The increased risk of violence suffered by
the women with disabilities in this study is attributed to
‘ideologies of patriarchy and male sexual proprietariness
which were particularly strong in these relationships’
(Brownridge, 2006: 818). Brownridge's research focused on
partner violence and the researcher was careful to point out
that women with ‘developmental disabilities’ and the most
severe forms of disability, were less likely to be partnered,
though research suggests that they receive a particularly
severe degree of violence. As Amy Elman, whose earlier work
was the first to examine the issue of men's sexual fetishising
of women with disabilities (Elman, 1997) has commented in
her more recent work, it is important to pay attention to
distinguish the ways in which women and girls are sexually
exploited in relation to different forms of physical, mental
health and intellectual disability (Elman, 2005).
Another recent study echoed Brownridge's conclusions,
finding a high rate of sexual assault amongst women with
disabilities (Martin et al., 2006). This study, too, found that
there was a considerable discrepancy between the rates of
physical violence, which were not significantly more than for
women without disabilities, and the rate of sexual assault,
which was 4 times the rate of other women. It found that
young and non-white women, unmarried women and
employed women were more likely to be assaulted.
The sexual abuse of women with psychiatric disorders or
intellectual impairment, however, is not just perpetrated by
carers or other residents in care homes or institutions. It can
take the form of sexual exploitation in the prostitution industry.
The feminist movement has been split in recent years between
those who see prostitution as violence against women (Barry,
1995; Jeffreys, 1997; Stark & Whisnant, 2004), and those who
use the language of neo-liberalism to normalise that form of
men's behaviour by defining prostitution as ‘sex work’, speak-
ing of women's choice and agency in entering prostitution, and
describing prostituted women as entrepreneurs (Pattaniak,
2002; Lisborg, 2002). My perspective is that prostitution is
harmful to all women. But prostitution depends upon the
exploitation of the most vulnerable and marginalized of
women, indigenous women, trafficked women, as the business
can find it difficult to attract women who have other
opportunities to earn a living. As a result, women with mental
health problems and intellectual impairment are vulnerable to
exploitation in the industry.
The prostitution of women with disabilities
In legalised prostitution systems, such as those in most
states of Australia, women with psychiatric disorders or
intellectual disabilities are exploited in brothel prostitution. In
Australia the legal brothel and strip club industry was worth
2 billion Australian dollars in 2006 according to an industry
report (IBIS World, 2007, p. 4), though the illegal industry, much
of it in the grip of organised crime, still makes up around 80% of
the industry (Sullivan, 2007, p. 202). There is no evidence to
suggest that women with disabilities are being deliberately
employed in prostitution but there are indications that women
suffering intellectual impairment are particularly vulnerable to
being exploited in the industry. Prostitution may offer the only
form of ‘work’ that a woman with a disability is able to access,
especially if a woman is subject to periods of psychological
wellness and periods of illness and unable to hold down regular
329S. Jeffreys / Women's Studies International Forum 31 (2008) 327–335