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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. Their stories include the student who was raped 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 disabled survivors 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).

Students talk: “Those Other People Over There”

Students in their student accomodation, enjoying hot drinks and a chat. the male is a quadriplegic and has two prosthetic legs.Reconsidering disability means reconsidering our biases
“The idea that disability rights is a joke and that disabled people are Those Other People Over There increases the rate at which our assaults aren’t taken seriously. I’ve heard college students sincerely profess the belief that people with intellectual disability [ID] are unrapeable since they aren’t ‘fully adults’—but also that people with ID can’t consent either. This was in an ethics class!”
—Student, Portland State University, Oregon

“[This issue] reveals our own biases against mentally challenged people, and our instinctual desire to patrol and criticize other people’s sexuality.”
—Fourth-year undergraduate, University of Alaska Anchorage

“Disabled people have as much right to give consent as anybody else.”
—Third-year undergraduate, Nova Scotia Community College

Young man in deep thoughtEven many progressives don’t understand disability
“I am disabled and mentally ill, and although I have never been sexually assaulted at my university, my experience is that the majority of authority figures in academia feel comfortable minimizing, overlooking, or shutting down the perspective and wishes of various disabled communities—including in schools and departments that market themselves as being socially progressive and supportive of other marginalized groups. The number of times I have been advised to ‘not be so definitive/aggressive/worked up’ or ‘not take an expert role on this issue’ when I have been forced to bring issues on disability rights to professors and TAs is staggering and incredibly alienating.”
—Second-year undergraduate, British Columbia

“I haven’t really given consideration to this issue, which doesn’t make me feel good. Persons with any kind of disability of course deserve full legal protection, as well as a public cognizant of such concerns. I hope the trend toward greater knowledge continues both in colleges and in general.”
—Third-year undergraduate, University of Nebraska–Lincoln

Young asian man in outdoor cafeSocial isolation increases the risk of sexual assault and coercion
“We worked with a student [who had been sexually assaulted] who called herself a ‘shut-in.’ She had not been able to get into campus housing and had been placed in a trailer off-campus. She went into a deep depression and didn’t have a protective social circle. She told us she realized later how vulnerable that made her.”
—Colby Bruno, Esq., senior legal counsel, Victim Rights Law Center, Massachusetts

“I was hanging out with some older people I was trying to be friends with, but was having a hard time getting into the group. The group leader said he would let me be friends with them if I gave him head. Desperate for acceptance, I did it. He kept his word and let me hang out with them, but afterwards all I wanted was to be alone. I could not look in the mirror without wanting to yell, scream, cry, and pull my hair out because I hated myself so much.”
—Second-year undergraduate, University of North Texas

Depressed woman aloneDisability means being misunderstood
“People with disabilities are encouraged to disclose their private medical information in ways other people are not, like it’s relevant to every situation. Then people want to attribute everything to the disability. Disabled people should be empowered to actually not be open when it’s not necessary, and to prioritize their safety and comfort over people’s misinformed intentions.”
—Former student, Catholic university, New England

“When you say a person has a disability, it might not be visible to the human eye.”
—Second-year graduate student, Tarleton State University, Texas

“I think people often misunderstand disabled people who connect and communicate differently with others. I’ve seen many circumstances (outside of college) where disabled people were ridiculed and/or criticized for being overly friendly and flirtatious, when that wasn’t their intention. They just didn’t communicate the same way and, as a result, they were misinterpreted.”
—Third-year undergraduate, University of Wisconsin–Green Bay

Depressed young manSexual assault can cause or aggravate emotional health issues
“I was diagnosed with Generalized Anxiety Disorder with panic attacks and minor depression. I was sexually assaulted five years ago. I tend to overthink and worry about everything. I feel my sexual assault contributes to many anxious feelings I have in my day-to-day life and in my relationship.”
—Third-year undergraduate, Queen’s University, Ontario

“My best friend was assaulted at the first college social event we ever went to. Hardly anyone knows, and few believe it because he’s male. But I helped him through that trauma. I know how hard it was for him to recover.”
—Third-year undergraduate, University of California, Los Angeles

I was a freshman in college when I was raped in a closet at a party. My ex-boyfriend and his roommates blamed me. I started having panic attacks. My heart would race and I would hyperventilate with no cause. I was diagnosed with PTSD and Generalized Anxiety Disorder, put on anxiety medication, and underwent counseling.”
—Graduate student, California Lutheran University

Two women friends at the barPeople with high support needs are at high risk
“I have a sister with severe cerebral palsy and noticed how she would come from high school with certain marks on her body. The doctor didn’t confirm any sexual abuse, but recommended having my sister on birth control. The lack of support and understanding from the doctor was scary.”
—Student, City College of San Francisco, California

“My brother is autistic. I grew up in Alaska and heard horror stories of sexual assault experienced by disabled Native Alaskans in rural communities and in the city.”
—First-year graduate student, Portland State University, Oregon

“My sister has Down syndrome, and one of her friends was sexually assaulted a few years ago. You really don’t think about someone taking advantage of disabled students until someone does. It’s sickening, and more attention should be geared toward this topic.”
—Third-year undergraduate, Kutztown University of Pennsylvania

Cropped shot of a young couple sitting in a coffee shopSexual assault and disability is a hidden issue
“Unfortunately, this topic is not one that has ever crossed my mind as more than a passing negative thought. I have a lot of experience with children and adults with disabilities and I have never been educated on this issue or thought much about it.”
—Third-year undergraduate, Gonzaga University, Washington

“As someone who works with nonverbal teens with autism, knowing how to respond to their sexuality has been difficult. There is not a lot of guidance from [disability] agencies. And do all teens/young adults with autism stay forcibly celibate? How does the state decide who is capable of giving consent?”
—Fourth-year undergraduate, Notre Dame of Maryland University

“Abuse can happen to anyone, young, old, or disabled. Unfortunately, I feel like our society focuses more on the young and physically able and others are ignored or at least not given the focus they need.”
—Fourth-year undergraduate, Utah State University

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 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.

How we view disabled people’s sexuality and why this raises their risk of being sexually assaulted
How is the sexuality of people with physical or developmental disabilities presented in popular culture? If you’re struggling to think of examples, that’s because they are scarce. Disabled people are commonly presented as nonsexual beings. This assumption has far-reaching, negative consequences. It exposes people with disabilities to sexual exploitation and reduces their access to support services and legal justice.

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 sexual 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 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 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

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 notto 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.

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) 

Students’ guide to reconsidering a social ritual: A sample exercise

A group that you’re in is planning a celebration for new members. You volunteer to be on the planning committee. You enjoyed the event last year; it introduced you to some of your favorite group traditions, and it was fun to spend time with the older members. There were other parts that made you uncomfortable.

At one point in last year’s event, all of the members drew a series of challenges from a bowl and competed against one another to complete the most challenges. Some of the challenges were sexual; for example, kissing an older member, or talking about sexual experiences. At the end of the night, the person who won the most challenges was awarded a title.

At your first meeting, the other members of the planning committee say they are looking forward to keeping the existing traditions going. The person who won the challenges last year is particularly excited about the challenge bowl, and says that having the title has been one of their favorite parts of being in the group.

What dynamics are at play here?

  • What is fun about this game? Why might some people enjoy it?
  • What are some problems with this game? Which members of the group might feel particularly uncomfortable?

How might the planning committee decide to make change?

  • What kinds of questions might you ask other people on the planning committee to get the conversation about making a change started?
    • What Elephant tactics would you use? Rider tactics? Path tactics?
    • What resistance are you likely to encounter? How would you respond to it?
  • What kinds of changes might the planning committee decide to make?
    • Generally, how could they preserve the fun elements while avoiding the uncomfortable ones?
    • What Elephant tactics could they use? Rider tactics? Path tactics?

Source: Consent and Communication Educators, Yale University

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, and make it sound interesting.” Alternatively, acknowledge the specific issue (rather than the diagnosis), as in the example above.

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

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, 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. (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
  • 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 a health writer, editor, and communications manager. 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.