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All people are sexual beings and sexual expression is a natural and important part of life. What is sexuality? One's sexuality includes one's personality, thoughts, values, feelings. How we communicate and express ourselves in our relationships with others, as well as our individual sex drive and sexual activities are also an expression of our sexuality.
In today's society, sex is often associated with youth and physical fitness; therefore, society often views a person with a disability as non-sexual. Of course, this simply is no so -- a person with a disability is also a sexual being, regardless of their mental or physical limitations. However, persons with disabilities have to overcome uninformed attitudes, as well as their own misconceptions and personal barriers regarding sexuality. It is important that everyone, including persons with disabilities, be able to make conscious decisions about their sexuality from a position of information and understanding.
Disability may result in many changes: movement problems, loss of sensation, communication problems, impaired bowel and bladder control, pain, fatigue, changes in behavior and thinking, changes in sexual functioning (erection, ejaculation, lubrication, orgasm) as well as role changes, and a change in body image. Each of these changes may impact one's sexuality. Stress, fatigue, depression, pain and fear, which are often associated with the early stages of disability, may impact sexual desire. Prescribed medications may affect sex drive and sexual function. Of course, self- esteem (how one feels about themselves) is going to affect one's sexuality and sexual behavior.
As with other activities of daily living (ADL's) adaptations may have to be made. For a person with a disability, sexual activity may be a less spontaneous, more planned activity in order to address issues of fatigue, pain and bowel and bladder routines. Other changes may include trying different positions, or a partner may play a more active role than previously. Other forms of sexual expression may be used. This may call for experimentation and alternative methods of pleasuring. Assistive devices may be used.
Communication is important in all relationships. When a disability exists, it is very important for partners to discuss their thoughts, feelings, needs, wants and how they can mutually satisfy each other.
Persons with disabilities must also be responsible for their sexual health. Healthy behaviors include: acting within one's own value system to prevent unplanned pregnancies, seeking early prenatal care, avoiding contracting or transmitting sexually transmitted disease, and avoiding sexual abuse. Health promoting behaviors such as self breast and testicular exam and regular check- ups are responsible ways to identify potential problems.
Sexuality is often a very intimate, personal area of our lives which we usually only discuss with those to whom we are very close. Please, if you have concerns or questions regarding sexuality issues related to a disability ask your rehabilitation professional.
Thanks to Lisa Peck RN, BS, CRRN from MossRehab Hospital for providing this information.
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