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Fulfilling Sex Lives: Understanding People with Disabilities and Sexual 

Desire in Denmark and Sweden 

Review by John A. Carranza 

 

Loneliness and Its Opposite: Sex, Disability, and the Ethics of Engagement.  

by Don Kulick and Jens Rydström, eds 

Duke University Press, 2015 

 

 Human sexuality has been considered by a variety of scholars across disciplines that focus on 

differing time periods and social contexts. These studies have yielded a wealth of information from 

which we can better understand the diversity of sexualities. However, the available literature on 

sexuality frequently focuses on the able-bodied. Don Kulick and Jens Rydström add to this literature 

with their monograph Loneliness and Its Opposite: Sex, Disability, and the Ethics of Engagement. In 

this book, Denmark and Sweden are the sites in which the authors consider people with disabilities’ 

desires for sexual activity and to what extent policymakers, social workers, and caregivers allow or 

disallow such desires.  

 Kulick and Rydström combine their experiences as an anthropologist and historian, respectively, 

to present an ethnography that uses fieldwork, interviews, and archival materials to discuss the place of 

sexuality and disability in Denmark and Sweden. While each of the countries are welfare states and are 

within proximity to one another, the reader learns that policies and attitudes about sex and people with 

disabilities are in contrast. The authors highlight the differences by presenting points of view from 

caregivers, governmental policies, and the voices of people with disabilities.   

 The first chapter positions sexuality within the larger disability rights movement, which 

frequently sees it as one of the last items on the list of objectives to be attained by activists. This study 

was rooted in Kulick and Rydström’s work on queer theory, which led them to embrace crip theory (the 

amalgamation of queer theory and disabilities studies). Although the authors embrace crip theory, they 



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question whether anything new can be learned in the approach to and the understanding of the lived 

experiences of people with disabilities. Another concern presented by the authors is disability studies’ 

insistence that people with disabilities teach nondisabled persons about disability. Instead, the authors 

offer the concept of “ethical engagement and responsibility,” (17) where they question the actions of 

the Danish and Swedish states in facilitating sex for people with disabilities by focusing on what both 

countries do socially and relationally for people with disabilities. Therefore, this study relies on the 

examination of how nondisabled people engage with disabled people and their sexual desires. 

 Chapter 2 gives the reader the historical foundation from which the discussion—or lack 

thereof—of sexuality and people with disabilities began to take shape in Denmark and Sweden. 

Beginning in the 1960s, governmental agencies in both countries began to question forced sterilization 

and large institutions that violated the human rights of people with disabilities. These issues combined 

with the sexual revolution of the time led to the acknowledgement that people with disabilities had a 

right to a fulfilling sex life. This chapter also focuses on the Scandinavian political and theoretical 

framework called the normalization principle, which was coined by the Danish reformer Niels Erik 

Bank-Mikkelson that moves away from the medical model of disability and focuses on reshaping 

society to make it more inclusive. The normalization principle is slightly similar to the social model of 

disability, but was in use nearly twenty years before the social model.  

 The third chapter considers the precarious position in which caregivers are placed when 

assisting people with disabilities and ensuring that they are sexually fulfilled. Using interviews with 

caregivers in Sweden and Denmark, the authors present diverse perspectives for why a caregiver would 

not (i.e. accusations of sexual abuse) or would (wanting people with disabilities to fulfill basic needs) 

facilitate sex.  

 In chapter four, Kulick and Rydström explore what boundaries mean when examining sex and 

people with disabilities. This chapter is thought provoking because it considers sex and people with 

disabilities and the complicated personal and social boundaries around these issues. Taken together, the 

authors question the extent to which caregivers should facilitate sexual interactions for people with 

disabilities without being complicit in a crime (hiring prostitutes where it is illegal), dictating a person’s 

sex life (when and where a person can have sex), or instructing them about sexual techniques such as 

masturbation (which could border on sexual abuse in some locations). However, they also consider 

boundaries between people with disabilities who have sex with one another by again questioning how 

caregivers might provide sex positive education about their bodies and what feels pleasurable.  

Chapter 5 can be viewed as an extension of chapter four and its discussions of boundaries, but fleshes 



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out the ethics of allowing people with disabilities to purchase sex from sex workers. The authors 

consider whether caregivers should facilitate appointments with sex workers and whether those same 

employees should transport the individuals to those appointments. The legality of sex work in Denmark 

and Sweden and the debate about whether government funds disbursed to people with disabilities 

should be used to purchase sex workers.  

 The sixth chapter veers slightly away from people with disabilities and sex by digging deeper 

into the history of Denmark and Sweden to trace their political trajectories that led them to diverge in 

their treatment of sexuality and people with disabilities. This divergence results in Denmark being more 

progressive in allowing people with disabilities to have sex lives and the matter is discussed openly. 

Sweden is more conservative in that the matter is rarely discussed among caregivers, social workers, 

and politicians and usually focuses on negative aspects of sexuality such as abuse and rehabilitation. 

 The final chapter explores why the reader should care about sexuality and disability. A 

significant part of the chapter discusses sex and disability from a social justice and capabilities 

standpoint. The authors use John Rawls’s work on social justice, which conveys the idea that a just 

society is one in which everyone desires an equal position, and so everyone must work together to 

create a society that one would expect to have access to if they were introduced to it with a 

disadvantage. Another viewpoint comes from a focus on capabilities as outlined by Martha Nussbaum. 

Nussbaum’s view is that a just society helps a person expand their capabilities to the greatest extent. 

Nussbaum’s capabilities approach provides for very basic entitlements for all people, capabilities are 

intertwined and a lack in one capability is not immediately fulfilled by an abundance in another, and 

each person is worthy of living a life with dignity. Rawls’s and Nussbaum’s works mesh well to give us 

a framework for understanding human rights. This discussion about human rights, disability, and 

sexuality is particularly useful because of the history that people with disabilities have had fighting for 

visibility and demanding a society that can be accessed by everyone. When sex is added, it contributes 

a new dimension to consider human rights and who should have access to one of the most basic of 

needs.  

 Loneliness and Its Opposite: Sex, Disability, and the Ethics of Engagement is a significant 

contribution to the body of literature on disability studies because it shows how sex and disability are 

contested or accepted in a given society by using Denmark and Sweden as examples of how welfare 

states handle both issues. Kulick and Rydström are straightforward with their intent of making this 

monograph accessible for all readers, which is evident as the reader moves through the book 

unencumbered with excessive jargon and lofty theoretical ideas that the reader might skip over. In all 



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instances, the actors speak for themselves and the theory used is presented in a comprehensible manner. 

The lessons to be learned from the authors’ work would be useful in affecting policy in the United 

States. Consequently, it also helps us to reconsider sexuality from a different perspective and how 

expressions of that sexuality vary from one person to another. This book is beneficial not only for 

students of anthropology, gender and sexuality studies, and disabilities studies, but also for students and 

general readers of history, public policy, and public health because of the added dimensions of thought, 

analysis, and consideration given to people with disabilities by the authors. 

 

John A. Carranza is currently completing coursework towards his PhD in history at the University of 

Texas at Austin. His current research interests include the history of medicine, disability studies, and 

gender and sexuality. 

 

 

 

© 2017 John A. Carranza 


