Serving Survivors with Disabilities on Campus

Defining Disability

Disability status is one aspect of an individual’s identity that intersects with many others, such as race, ethnicity, sex, gender identity, sexual orientation, and socioeconomic status. Disability is a common experience; approximately 1 in 4 adults in the United States has at least one disability, a significant portion of whom experience multiple disabilities throughout their lifespans. Individuals experience disability differently based on the intersections of their identities, the nature of their disabilities, and other individual- and community-level factors.

Disability is traditionally defined through a medical model, which views disability as requiring treatment and rehabilitation. This model does not acknowledge the social construction of disability and places all responsibility on the individual whose body and/or mind is considered disabled. The Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act of 1973 use the medical model to define disability as physical or mental impairments which limit major life activities; these categories are pertinent for use in higher education settings because of the ADA’s relevance to freedom from discrimination in education on the basis of disability status

In contrast, the social model of disability views disability as socially constructed; disability is not an individual problem related to a particular diagnosis or impairment, but rather is created from constructed environments that are inaccessible and thus disabling (e.g., buildings without access ramps or elevators). The pervasiveness of environments’ “disabling barriers, attitudes, and cultures” make medical diagnosis and treatment insufficient in supporting people with disabilities. Therefore, this guide utilizes the definition provided by the United Nations Convention on the Rights of People with Disabilities (2006), which defines disability as any “long term physical, mental, intellectual, or sensory impairment” which interacts with societal and other barriers that limit an individual’s full participation (authors’ emphasis) in the community” (p. 9). This definition acknowledges that disability is both biological and socially constructed. Victim/survivor service providers have a responsibility to dismantle factors in their own environment that disable those in need of their services.

Risk Factors for Interpersonal Violence

Like students without disabilities, students with disabilities are vulnerable to sexual, physical, emotional, and economic abuse. However, people with disabilities experience certain risk factors for interpersonal violence at higher rates than the general population. Psychological risk factors for abuse such as low self-esteem, feelings of powerlessness, socialized passivity, dependency, and socialization to accept mistreatment more commonly impact people with disabilities than those without (Glover-Graf & Reed, 2006). Often, social isolation, lack of appropriate sexual education, and the perceived asexuality of people with disabilities also increase vulnerability to abuse (Nosek et al., 2001). These risk factors ultimately relate to increased perpetration of interpersonal violence against people with disabilities.

Prevalence of Interpersonal Violence Victimization Among People with Disabilities

Several studies document IPV and sexual violence among people with disabilities. These studies report that people with physical or mental disabilities experienced IPV and sexual violence at higher rates than those without. For example:

• Son and colleagues (2020) found that college students with disabilities experienced higher rates of IPV than students without disabilities (70% compared to 58%, respectively), and this was strongly correlated with higher rates of adverse childhood experiences for students with disabilities.
• Brown et al. (2017) document that women and nonbinary college students with disabilities experienced higher rates of unwanted sexual contact than men and people without disabilities, and women and nonbinary students with autism spectrum disorder were at increased risk compared to those with other disabilities.
• In one study, college students with mental disabilities reported the highest rates of stalking victimization (Reyns & Scherer, 2018).
• Research shows that disparities in experiences of abuse among those with and without disabilities widens as the violence becomes more severe (Brownridge, 2006), and victims/survivors with disabilities experience abuse for longer periods of time than those without (Plummer & Findley, 2012).
• Some studies suggest that people who are at higher risk for abuse include those with voice or speech disabilities, chronic psychosis, and intellectual disabilities (Lin et al., 2010).

It is important to note that the definition of disability varied across these studies. Further research is needed to understand the frequency of violence perpetration against individuals with certain types and severities of disability. Regardless, understanding differences in prevalence of IPV, stalking, and sexual violence for students with disabilities can inform programming on violence prevention and response.

Disability-Specific Violence

It is critical to examine forms of abuse which uniquely impact people with disabilities. For example, students with disabilities may be at risk for abuse by caregivers; isolation and dependence on caregivers increase vulnerability to violence. Caregivers, including paid personal assistants, intimate partners, and family members could threaten to or actually leave the victim/survivor unattended in dangerous situations, damage or withhold assistive equipment, give the wrong dosage of medication, or handle victims/survivors roughly or inappropriately (Nosek et al., 2001; Powers et al., 2008). Financial exploitation by family members, intimate partners, or other caregivers is another abusive, controlling behavior that limits victims’/survivors’ access to vital resources. Research by Kutin and colleagues (2017) demonstrated that financial exploitation in the context of intimate relationships is more commonly perpetrated against people with disabilities, especially women. Disability-specific abuse can be physically and psychologically damaging, and often is not defined as a criminal act, which can prevent victims/survivors from seeking legal recourse (Plummer & Findley, 2012). Victims/survivors of abuse with disabilities are also more likely to be disbelieved and perceived as unreliable witnesses, which prolong and exacerbate experiences of abuse (Nosek et al., 2001). These forms of abuse are harmful and more difficult to detect, demonstrating the need for targeted intervention and screening for students with disabilities.

Consent in Disability Communities

The concept of sexual consent is based on 1) a person’s developmental capacity to understand sexual activities and their consequences and 2) a person’s willingness to perform sexual acts in the absence of coercion (Lyden, 2007). Sexual consent has both legal and social definitions (Indiana Coalition to End Sexual Assault, 2019). Sexual consent capacity and reproductive agency of individuals with intellectual, developmental, and psychiatric disabilities has a complicated history in the United States. In Buck v. Bell, the Supreme Court determined that involuntary sterilization of people with mental disabilities was not only legally permissible, but also preferable to codifying their full reproductive rights (Buck v. Bell, 1927).

This was due to widely-held, inaccurate beliefs about the heritability of mental disabilities and negative societal attitudes about dependence and the parenting abilities of people with mental disabilities (Eisenberg, 2013). Buck v. Bell was never explicitly overturned, and although the right to privacy has since been invoked by the Supreme Court regarding individuals’ sexual and reproductive rights, and state-level standards determining incapacity to make reproductive health decisions have since become much stricter, myths about the sexual, reproductive, and parenting capabilities of individuals with disabilities persist legally and socially (Eisenberg, 2013; Mutcherson, 2017). Myths surrounding the asexuality, or conversely hypersexuality, of people with mental disabilities are widespread and damaging; lack of appropriate sexual education for individuals with intellectual disabilities is related to significant knowledge deficits and increased vulnerability to abuse and exploitation (Borawska-Charko et al., 2017; Mutcherson, 2017; Monasterio, 2018).

Furthermore, adults with disabilities under legal guardianship often lack agency over their sexual and reproductive lives afforded to most other adult members of the population (Indiana Coalition to End Sexual Assault, 2019). Individuals with intellectual and developmental disabilities can acquire skills and knowledge regarding healthy sexual relationships and power dynamics which can lessen vulnerability to coercion and abuse when this education is tailored to their learning needs (Borawska-Charko et al., 2017; Monasterio, 2018). Therefore, simultaneously focusing on empowering individuals with disabilities’ healthy sexual expression and reducing vulnerability to abuse is crucial for service providers.

In recent years, many colleges and universities have applied affirmative sexual consent standards to their student conduct policies. These standards typically place more value on verbal, vocal communication (i.e., saying “Yes”) than nonverbal communication (e.g., body language) or non-vocal communication (e.g., American Sign Language) and presuppose that communication can be standardized and unambiguous across cultural groups, including those with disabilities (Lockwood Harris, 2018).

Because communication abilities and styles are variable, universities should consider how definitions of sexual consent may unintentionally marginalize and dismiss the sexual agency of students with disabilities.