How School-Based OTs Should Address Masturbation & Sexuality

Navigating the complex landscape of sexual development and education in school settings, especially for students with disabilities, presents a unique set of challenges. Addressing behaviors such as masturbation openly and sensitively can be particularly daunting for school-based occupational therapists. However, by employing thoughtful strategies and prioritizing a curriculum inclusive of sex education, it’s possible to manage these situations with care and respect for the students’ developmental needs.

Understanding and Overcoming Personal Biases

First and foremost, it’s crucial to examine and address our own personal biases and discomfort surrounding the topic of masturbation. Many school-based OTs have been “tagged in” on this situation, and the instinct is often to run for the hills and say it doesn’t fall under our scope. But here’s the thing: sex is an ADL. ADLs are our bread and butter as OTs, even in a setting like school where we’re focusing more on the occupation of education. To ignore sexuality development in our students would be to shirk our role as occupational therapists. 

Instead, we need to rise to this challenge, as uncomfortable as it may be. Recognizing that such behavior is a part of typical human development is essential. The goal is to approach these situations without shame, ensuring we don’t inadvertently pass on feelings of guilt or embarrassment to the child. This requires a level of comfort and understanding that can only be achieved through self-reflection and education on your part as the OT. Remember: even typically developing children experiment with masturbation, often at younger ages than you would expect. 

Implementing a Specialized Sex Ed Curriculum

The implementation of a sex education curriculum designed for students with disabilities is a proactive measure that cannot be overstated in its importance. Such a curriculum should be a standard part of every school’s approach to handling situations involving sexual development. If your school has yet to adopt this strategy, it becomes imperative to advocate for its inclusion. This is especially important as children with disabilities are at a greater risk of sexual assault than their typical peers, and they typically receive less education in this area. 

Education around topics of consent, privacy, and safety should be accessible to all students, tailored to their level of understanding and intellectual abilities. If you’re not sure how your school approaches sex ed, ask around at your district 1) if there’s a specific sex ed curriculum that is used and 2) if it’s inclusive to students with disabilities.

Need resources here? This list is a great place to start. 

masturbation school-based OT

The Role of Consent and Safety

A significant aspect of teaching about appropriate behaviors involves framing the conversation around consent and safety. This is particularly challenging when working with students who have intellectual disabilities, requiring curriculums and educational materials that are adaptable to various levels of comprehension. Persistence is key, as the concepts of where and when masturbation is appropriate may need to be reiterated over an extended period. The goal is to foster understanding and respect for personal and public boundaries. Masturbating at school is a consent issue at its core. This situation requires the student masturbating in public to learn that others aren’t consenting to them doing this activity in front of them. But it’s also helpful to teach potential observers that they can advocate for their boundaries and stand up for themselves. 

Utilizing Social Stories and Private Spaces

Social stories can be an effective tool in illustrating complex concepts in a digestible format for children. By using personalized narratives, educators can delineate the contexts in which masturbation is acceptable and those in which it is not. Additionally, guiding students towards appropriate private areas for masturbation, such as their bedroom or a private bathroom, respects their privacy and autonomy while maintaining public spaces as safe. Work closely with your student’s teachers and family to determine what those appropriate spaces might be for your student. The goal should never be to stop or shame masturbation – just to teach the student where it’s appropriate to do it. 

Strategies to Avoid When Addressing Public Masturbation

While navigating these waters, certain approaches are advisable to avoid. For instance, enforcing the wearing of tight clothing like leotards or overalls to restrict access to one’s genitals infringes on the student’s bodily autonomy and can be considered a form of restraint. 

Similarly, redirecting the behavior with other sensory activities overlooks the fundamental human need for sexual expression. If someone prompted you to do an obstacle course the next time you were planning to masturbate/have sex, would you find that an okay substitution? I know I wouldn’t, and our students likely aren’t okay with it either. Having a sensory-rich day is totally fine and beneficial for other reasons, but all the fun sensory activities in the world aren’t a substitute for a basic human need like masturbation/sex. Equating masturbation or sexual activity with a sensory-seeking behavior fails to acknowledge its place in human development and can invalidate the student’s experiences and needs.

masturbation school-based OT

Lastly, it’s important to keep in mind that while learning to masturbate is a typical part of development for kids with disabilities and without, it’s still key to keep an eye out for red flags that could be indicative of further concerns. Public masturbation in and of itself isn’t a red flag, especially for kids with disabilities that impact social norms. But it’s important to listen for any reports of sexual abuse and watch out for other behavior, like attempting to engage peers or adults in inappropriate sexual and physical contact.

Additionally, it’s important to accurately identify that a child is masturbating, and not scratching at their genitals, which can be a sign of an infection or other medical issue, whether due to sexual abuse or otherwise. It’s important to work collaboratively here with your school nurse and tag in the student’s pediatrician if you need to. And remember, if you do suspect child abuse, sexual or otherwise, you must report it as a school-based OT. 

Addressing Masturbation as a School-Based OT: A Delicate Balance

The conversation around masturbation, particularly in school settings, requires a nuanced approach that balances respect for the child’s developmental stage with the need for appropriate public behavior. By fostering an environment of openness and education, free from shame and stigma, educators and occupational therapists can support students in their sexual development in a healthy and respectful manner.

Understanding that masturbation is a normal part of human development and ensuring that our approach is both respectful and educational is paramount. We must strive to create a supportive environment that acknowledges the complexities of sexual development, especially for students with disabilities. This involves tailored educational strategies and a commitment to continuous learning and adaptation on the part of the professionals involved.

Want more support with how to address tricky topics like these as a school-based OT? You should consider enrolling in The Dynamic School OT Course. It’s full of frank discussions like these and practical and actionable strategies for you to implement into your practice. Click here to read more! 

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