Gill, M. (2015). Already Doing It: Intellectual Disability and Sexual Agency. Minneapolis: University of Minnesota Press. ISBN 978-0-8166-8298-0.

Reviewed by Sandra Smele
Doctoral Candidate, Sociology, York University
ssmele [at] yorku [dot] ca

Michael Gill prefaces his book Already Doing It: Intellectual Disability and Sexual Agency with accounts of his past professional interventions in the sexual lives of individuals labelled with intellectual disabilities. His critique of these practices helps lay the foundation for what follows: a book he ambitiously describes as the beginnings of “a sustained and comprehensive critical disability studies discussion about sexuality and intellectual disability” (xvi). Drawing upon almost a decade of research, the objective of Already Doing It is to both contribute to and intervene in disability studies by engaging others in questions about intellectual disability, sexuality, and reproduction. Gill’s analyses demonstrate his deep commitment to challenging dominant ideas and practices concerning intellectual disability, sexuality, and reproduction, and readers of this book will certainly experience this intended disruption, no matter their familiarity or scholarly commitment to addressing the questions he raises.

Opening the book with a chapter on consent, competence, and sexual abuse, Gill uses the case of Kalie McArthur to problematize legal and journalistic framings of intellectual disability and sexuality, particularly those framings invoking pity. Building on Sherene Razack’s insights to advance his critique of pity, Gill argues that the gendered and racialized “virgin/whore dichotomy” often informs these framings, thereby denying attendance to unequal power dynamics that produce conditions conducive to abuse, and denying the very possibility of sexual pleasure among people identified as intellectually disabled. Gill’s analysis of this case is informed by his desire to introduce an approach to sexuality and intellectual disability that recognizes, but is not reduced to, the high prevalence of sexual abuse experienced by this group. He advances this approach by calling for a displacement of preoccupations with competence evaluation and its replacement with an emphasis on the right to sexual agency.

Gill turns his focus toward sex education in the following two chapters. Chapter Two addresses sex education at a broad level, and Chapter Three specifically focuses on masturbation training. These chapters offer critiques of the orientation of sex education toward harm and risk reduction that extend beyond advocating for greater exposure and access to sex education. Indeed, Gill’s analyses demonstrate how the promotion of patriarchal heteronormativity informs these sex education materials and how they position masturbation as the only appropriate form of sexual expression for people with intellectual disabilities. He also addresses how both “street language” approaches to sex education and the use of visual images are not panaceas for the deficiencies in current approaches because they are also potentially oppressive, depending on the language used and the bodies represented in the images. Though not flatly opposed to sex education or masturbation training, in these chapters Gill argues that there is need for creative approaches that support sexual agency outside of professional oversight, behaviour management, and normative sexualities and practices.

The following two chapters focus on reproduction in relation to sterilization (Chapter Four) and parenting (Chapter Five). Through a combination of court case and media analyses in these chapters, Gill advances the argument that assumptions about the inability to parent restrict both the reproductive rights of people labelled with intellectual disabilities and the exploration of the subjugated knowledge of those among this group who are parenting. Of particular note in these chapters is Gill’s assertion that “disabled people, as parents and reproductive beings, warrant deeper analysis in reproductive justice and critical disability studies” (130), and his identification of further coalition possibilities between the two political projects. These chapters also include a provocative discussion about the need for support of alternatives to the productive, heteronormative nuclear family model and the possibilities opened up by putting access to parental supports “on the same level as physical access” (124).

The final two substantive chapters of Already Doing It address popular and new media representations of the sexuality of individuals labelled with intellectual disability. In these chapters, Gill analyses several movies (e.g. I am Sam, The Other Sister, The Idiots), the radio program The Howard Stern Show, and the reality show The Specials. Intended to be read together, the former chapter outlines failings of most movie and radio representations of the sexuality of those labelled with intellectual disability as animalistic, scornful, and a catalyst for others’ family unification or benefit, all at the expense of representing sexual agency and pleasure of those with intellectual disability. In the latter chapter on The Specials, Gill juxtaposes these representations through his crip/queer reading of the desires the show members express in relation to attending a kathoey/“third gender” Lady Boys performance. Cognizant and critical of the colonial relations underpinning the performance, Gill’s assertions about the potential of these desires to queer gender and crip assumptions about the sexuality of people with intellectual disabilities are more tentative than absolute.

As the above summary demonstrates, Already Doing It addresses the topic of intellectual disability and sexuality rather extensively, and the arguments presented within it are challenging. Whereas critical disability scholars will be familiar with some of these arguments, particularly those who engage with the scholarship of Robert McRuer, Tobin Siebers, Margrit Shildrick, Michel Desjardins, and Alison Carey, the questions Gill raises regarding support for parenting within alternative family arrangements certainly points to the need for further exploration and imagination in critical disability studies. His assertions about consent and pleasure also require our engagement in light of the recent sexual assault conviction of Professor Anna Stubblefield and the impassioned, divergent reactions to this case by members of disability communities.1 In sum, with regards to breadth and provocation, Already Doing It clearly succeeds in contributing to the sustained discussion about intellectual disability, sexuality and reproduction that is needed among critical disability studies scholars. There are, however, aspects of Already Doing It that diminish the book’s contribution to this laudable project.

These include the “inconsistencies and seemingly contradictory logics and argumentation” (8) that Gill recognizes are apparent in his book. His response to these problems is insufficient, however, because “resist[ing] simple narratives” does not need to involve the “purposeful confusion” of one’s readers (192). Though one of his definitional inconsistencies was intentional and partly constructive,2 it is important to express and develop ideas in a manner that allows for clear understanding and, on that basis, the possibility of debate and careful consideration of one’s ideas. This would have been particularly helpful with regards to the contradiction between the author’s critiques of liberal rights-based approaches yet his fundamental reliance on them for advancing his main arguments. Indeed, Gill repeatedly incorporates feminist, anti-racist, postcolonial, and queer insights into his critical disability analyses, but he does not attempt the much more difficult task of producing a conceptual framework for disability justice outside of liberal rights approaches. As a result, his arguments remain grounded in the liberal “unnecessary opposition of rights” (216) logics that he purportedly eschews,3 and the key concept informing his arguments, sexual ableism, ends up reducing different systems of oppression to a singular system of sexual exclusion, instead of grappling with the specific ways in which systems of oppression interlock, but are not reducible to one another.4

Of less direct import to advancing the project of sexual and reproductive justice for individuals labelled as intellectually disabled, the scholarship drawn upon to advance the author’s ideas is not consistently incorporated in a substantive manner. This is most unfortunate with regards to the author’s engagement with Foucault’s insights given their direct pertinence to critiques of sexual and reproductive regulation. Weaknesses aside, however, Already Doing It is certainly a book that all who are committed to pursuing sexual and reproductive justice for those with intellectual disabilities should read. Members of critical disability studies communities need to continue to engage with the project of imagining how this justice can be achieved, and Gill’s work certainly places these important issues on the agenda.



  1. For perspectives on the Stubblefield case from disability studies and community, see Liebowitz, 2015; Tremain & Aldred, 2015; Tremain & St. Pierre, 2015.

  2. Gill intentionally avoids using a consistent definition of “intellectual disability” in order to disrupt the reification of this category (see p. 11). Yet the population he generally focuses on, particularly in the early chapters of the book, consists of those who would be labelled as intellectually and developmentally disabled according to the American Association on Intellectual and Developmental Disabilities’ definition that he includes in footnote 6 on p. 204. Further incorporation of populations that more commonly fall under other diagnoses/categorizations (e.g. Alzheimer’s) would have strengthened this approach to disrupting the category of intellectual disability.

  3. The reliance on liberal oppositional arguments is most evident in the chapter on sterilization wherein Gill rejects the prioritization of children’s rights, but then reverses this prioritization to privilege the reproductive rights of individuals with intellectual disabilities (who are of reproductive maturity and capacity) instead of conceptualizing reproductive justice in a manner that moves beyond oppositional rights arguments.

  4. Gill defines sexual ableism as “the system of imbuing sexuality with determinations of qualification to be sexual based on criteria of ability, intellectual, morality, physicality, appearance, age, race, social acceptability and gender conformity” (106).