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Many college students experience loneliness, anxiety, depression, or chronic illness, or are dealing with past trauma—and most who meet this description would likely not identify as having a disability. 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. Their stories include the student who was assaulted in her senior year of high school, a trauma that increased her vulnerability to further abuse later. “When she went to college, she was so afraid, understandably so, that she stayed in her room. That’s a vulnerability, because she had no social circle to rely on,” says Colby Bruno, senior legal counsel at the Victim Rights Law Center, a legal service in Massachusetts meeting the needs of sexual assault victims.

“Seventy-five percent of our cases involve a survivor with a disability,” says Bruno. That’s a stunning proportion, especially because the organization does not target survivors with disabilities specifically. A relatively small number of cases involve people who have a physical disability, says Bruno. More typically, the survivor is “someone who is not in the social mainstream, who has experienced trauma, who looks lost or depressed. Or students in their first year who are lonely, sometimes to a clinical degree. That makes them more vulnerable to assault.”

Disability is variable

Disability comes in many forms, which helps explain why students with disabilities are not an organized group on campus. 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 those without. 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 people with disabilities is largely hidden. Only one in three said colleges are proactively addressing the issue.

Sexual assault risk is aligned with social status

People with disabilities (including emotional health conditions) 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 people with disabilities, activists point out. “The idea that people with disabilities might be sexual destabilizes society’s view of [them], 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 people with disabilities lack the ability to make certain decisions and exercise certain rights.

Many people with disabilities are denied sex education

People with disabilities are less likely than their peers to be taught about sexuality, consent, and sexual boundaries, placing them at greater risk of sexual exploitation. “The assumption is that people with disabilities 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 disabilities' against them

Sexual assault survivors with disabilities may be seen as unreliable witnesses. “Historically, accusations of mental illness have been used to minimize and deflect the voices of people with disabilities, 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 victims who have disabilities.”

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.

Who has a disability in college?

“Disability” is a much broader concept than the ubiquitous wheelchair logo implies, and students with disabilities are not a defined campus 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 having a disability, which may be 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 people with disabilities experience sexual violence?

Studies of sexual assault consistently show a higher rate of victimization of people with disabilities compared to those without. 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.
  • 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.
  • Children with disabilities are more likely to be abused than those without. 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 a reliable reporter of his own experience. When we applaud a nondisabled student for inviting the autistic student to the prom, or describe the ordinary activities and achievements of a person with disabilities 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 people with disabilities 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 experience disability 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 the sexuality of people with disabilities.
  • 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, such as half-time at the big game, the annual dance, and initiation rituals. 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 annual dance. As a group, what you can do to demonstrate cohesion?

“Ask: What are we taking for granted about our group members that allows them to participate? For whom would this feel different? Who gets marginalized or excluded? By getting rid of those status-enforcing elements, you’ll make the occasion more inclusive and also more powerful; the group will form deeper bonds once everyone can fully participate.”

Why you need Riders and Elephants

To help you think about how to change social norms, use this metaphor developed by Dr. Jonathan Haidt, a psychologist, in his book The Happiness Hypothesis (Basic Books, 2006). To put this into practice, check out the sample exercise on the next slide.

Picture someone riding an elephant along a path. The Rider represents our rational side, the Elephant our emotional side. The Path represents the situation and surrounding environment. The Rider holds the reins and seems to be the leader. But the Rider’s control is precarious because the Rider is so small relative to the Elephant. If the Elephant and the Rider disagree about where to head, the Rider loses.

If you want to change things, you’ve got to appeal to both. The Rider provides the planning and direction, and the Elephant provides the energy and drive. When Elephants and Riders move together, change can come easily. In addition, changing the Path (environment) makes other changes more likely.

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

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 minority of people (including those with social communication issues or autism) can have 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 students with disabilities need more disability-informed allies, mentors, and advocates. Ideally, colleges 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. 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 RA you can most comfortably talk to. “Most students have ‘that’ professor,” says J. E. “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
  • Specific office hours and spaces for confidential support
  • Victim advocacy and counseling services with professionals who have expertise in disability
  • Organized representation in student government to help advocate for appropriate programming, awareness, and acceptance

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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.