Paraplegia gay sex-Sexuality and Reproductive Health in Adults with Spinal Cord Injury

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Paraplegia gay sex

Paraplegia gay sex

Paraplegia gay sex

Other suggestions for home modifications Paralegia include arranging furniture to increase accessibility, encouraging transfers to a sofa where the couple may sit together and using remote controls to dim lights, turn off televisions, or turn on romantic music. Evidence based on nonrandomized, controlled, or cohort studies; case series; case-controlled studies; or cross-sectional studies. Inform women with SCI about external devices that are available to enhance genital Paraplegia gay sex and orgasmic potential. From the start he showed interest in me, Paraplegia gay sex me to relax into the moment. Justine provided a negative example when discussing her gqy at sexual activity with her ex-husband. A special thank you goes to Rachel Hoeft, PVA's associate director for Education, for her excellent editing and proofreading skills. The role of health-care providers is to ensure that people with SCI have access to the information they need to make informed decisions. Rationale: Paraplegia gay sex the period of healing after a new spinal cord injury, persons must be carefully monitored for instability at the zone of injury. London: Palgrave McMillan. Thus, we lack knowledge on how women with SCI actually define sexual intimacy or how they determine the possibilities Hardcore real tone ringtones sexual intimacy and satisfaction after SCI.

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Thirty years ago the idea of addressing sexual and fertility issues during rehabilitation was controversial and seldom done.

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“Don’t Think Paralysis Takes Away Your Womanhood”: Sexual Intimacy After Spinal Cord Injury

Heather A. Cathy L. Sexuality and intimacy are important components of health and well-being. Issues surrounding sexuality and intimacy are equally important for men and women living with physical disabilities, including spinal cord injury SCI. This article presents the findings from an in-depth qualitative investigation of the sexual and reproductive health experiences of 20 women with SCI in or around Detroit, MI.

Findings echo existing literature documenting the sexual consequences of life after SCI and suggest new areas of inquiry important for better addressing sexual concerns across the lifespan. Sexuality is a broader term than sexual activity and includes physical, emotional, and sociocultural dimensions; it encompasses intimacy, sex, reproduction, gender identity and roles, reproductive capacities, and sexual orientation World Health Organization, Although various health conditions can affect sexuality, the sexual consequences of suffering a spinal cord injury SCI can be substantial, especially because the majority of SCIs occur during the years when reproductive and sexual capacities are at their peak.

Despite the importance of sexuality to psychological well-being and quality of life, the topic of female sexuality after SCI remains understudied across the disability and rehabilitation literature Cramp et al. Approximately , Americans currently live with SCI, and an estimated 12, new injuries occur each year; however, These issues should be of concern to occupational therapy practitioners, yet research on the topic of sexuality and severe disabilities is scant.

With a few exceptions e. Consequently, a paucity of research examining female sexuality after SCI remains. For example, little is known about how sexuality or sexual intimacy is defined or redefined after injury, how people draw satisfaction from their sexual experiences, the dynamics that affect their decisions to engage or not in sexual experiences after injury, and how they obtain information about sexual function after SCI.

Thus, we lack knowledge on how women with SCI actually define sexual intimacy or how they determine the possibilities for sexual intimacy and satisfaction after SCI. The study was approved by the Wayne State University institutional review board, and all research participants gave their informed consent before data collection.

R01 1HD Inclusion criteria for the women in this study were as follows: diagnosis of SCI, community dwelling, and willing and able to discuss reproductive concerns. We conceptualized reproductive concerns broadly to include diverse reproductive experiences e. Each woman completed a single in-home interview, lasting 2—3 hr on average.

These in-depth ethnographic interviews Spradley, included questions about overall health and physical functioning, accessibility of doctor offices, interactions with health care providers, gynecological health-seeking behaviors, sexuality and sexual behavior, and complementary and alternative medicine use.

Training coupled with familiarity with this study population ensured that key topics discussed during interviews were recognized and pursued with additional probing questions but were also dealt with sensitively.

Study interviews were audiorecorded, and one of the four research team members transcribed them. Analysis began with the authors closely reading all the interview transcripts to identify major patterns and thematic categories. Once agreement was reached on the set of major patterns and themes, each transcript was systematically reviewed and coded by multiple coders with the goal of identifying instances of each pattern and theme and assigning each a descriptive label, or code.

This step involved the traditional method of cutting and pasting from interview transcripts in accordance with each topic and code Creswell, Overall, our work followed a constant-comparison method of analysis Glaser, , which involves comparing and contrasting data with each new section of data and coding and recoding data as patterns and tentative interpretations emerge.

Early findings were shared with 1 woman in the study, and discussions with her helped us finalize our analysis. This member checking is a common method of establishing validity in qualitative research see Creswell, Credibility and dependability are demonstrated by a thorough description of the data collection and analysis process.

Transferability of the findings implies that the insights gained from the work can be beneficial in other contexts. The average age of the sample was 46 yr range: 27—66 yr , and the average time since SCI was Table 1 presents an overview of study participant characteristics. Priscilla age 57, 39 yr after SCI made it clear that being paralyzed does not mean that sexual intimacy is taken away from her and that women with SCI are able to enjoy their womanhood:.

All the women in the sample considered themselves heterosexual; however, ideas widely diverged about what sexual intimacy meant. For instance, Kendra age 31, 14 yr postinjury viewed sexual intimacy as an essential human need and desired behavior that was, in her mind, physiologically necessary for stress relief. Five women reported being satisfied with their current level of sexual intimacy, of which 2 were not sexually active at the time of the study and 2 women had never had sex.

Dissatisfaction with level of sexual activity was noted in interviews with married as well as unmarried women; therefore, having an established partner did not always ease these feelings.

Especially us women, OK? Some women were also dissatisfied with their sexual lives because of the lack of a partner. For example, Cora age 27, 10 yr postinjury expressed wanting to have a husband and children but had not had a partner since injury partially because of the nature of her high-level injury. Justine age 48, 5 yr postinjury also described being married before and at the time of injury but then going through a divorce after her SCI.

Ultimately, however, relationship dissolution led to a lack of sexual intimacy and sexual dissatisfaction at the time of interview. The lack of bowel and bladder control was especially problematic for women who were developing new intimate relationships. We use lack of bowel and bladder control as an example here because participants explained that penetration, or simply orgasm, could result in embarrassing bowel and bladder accidents.

It was 8 years later before [I had sex again], and I really wrestled with that. And that happened even during the course of my sexual activity, and that was very painful. Does that make sense? Aging bodies could also hinder sexual intimacy; thus, the impact of physical disability on sexual intimacy sometimes changed over time for women in our sample.

In the face of these challenges, some participants coped with reduced sexual intimacy by revising their expectations and redefining what intimacy meant to them. For example, Damita explained that physical penetration during sex became less important to her over time and that she and her partner focused instead on alternative ways to show their affection:.

Lack of support and education about sexual activity also contributed to the challenges faced by participants in our study. The women discussed their difficulties learning what sexual positions would be feasible with their particular level of injury and how to adapt positions to accommodate functional declines across their lives. For example, Stacie age 48, 17 yr postinjury was afraid that she would not be able to maintain a sexual relationship because of her inability to manipulate her body.

Idell, fortunate that her physician was prepared to address her questions regarding sexual activity, stated,. I know those things [about how] to satisfy your husband and all this other stuff. Thus, women and their partners were left to engage in trial and error as they attempted to develop sexual intimacy after injury. Although this approach worked for some of the women, it resulted in negative experiences for others. Justine provided a negative example when discussing her attempt at sexual activity with her ex-husband.

Justine received no information regarding sexual intercourse; consequently, she and her spouse were uncertain whether it would be safe to have sex. I think that was the first and last time [having sex before the divorce]. Her husband was also concerned, which jointly limited their incentive to engage in intimate behavior.

They lacked basic information about how to maneuver a body with SCI, and sexual education would have helped this situation. Women in the study also reported that education about how to deal with very particular SCI-related conditions during sexual activity is also needed.

Damita said she had always had questions about how to broach the topic of possible bowel and bladder accidents with a new partner or how to modify the environment to accommodate these physical issues during sex. She suggested that these questions have been left unanswered by medical providers. Directly after their injuries, the majority of study participants were informed that they could still become pregnant. Nonetheless, they had many reasons why they were not ready to process such information.

I was in a nursing home. Why would I [have sex]? Some participants were injured at even younger ages; thus, addressing sexual education in the initial rehabilitation phases did not make sense for them.

However, sexual education would have been useful later, after they became an adult with SCI and learned to live with their disability. Again, in her case, sexual education at a later date, after adjustment to the injury, would have helped.

For many of the women in our study, experiencing an SCI during peak reproductive years created challenges to childbearing. Therefore, developing intimate relationships and being engaged in sexual activity were associated with starting or expanding a family. Three women were pregnant at the time of their SCI, and 2 lost their unborn children as a result of the injury.

Damita explained,. And I think that would be another interesting study. For women such as Damita, sexual intimacy was not separate from her desire for motherhood. Other women, such as Justine, Idell, and Terry, were finished having children at the time of injury; therefore, sexual intimacy after injury had nothing to do with reproduction. Women in our study who were not sexually active or did not have a committed partner before their injury provided examples of how they faced additional challenges to developing a sexual identity and sexual confidence and participating in meaningful sexual relationships.

Becoming confident and learning to see oneself as a person worthy of love and intimacy were precursors to developing a healthy sexual self after injury. However, becoming accepting of oneself involved coming to terms with the physical changes caused by SCI and having the confidence to try to engage in intimate relationships and sexual behavior.

And finding somebody who is sensitive enough to be there for the need is a challenge. And you have to have enough confidence to allow yourself to go there, too, so I have to be all right with me in order for people to be all right with me. You develop ways, I mean.

You know, because when people see, especially guys, guys are visual, so they see you, they are curious. So I talk, you know? Unfortunately, many women in the study faced societal perceptions of women with disabilities as asexual beings every day and struggled to resist internalizing such perceptions. Damita stated,. In another part of her interview, Damita also discussed how unfeeling and uncomfortable American society is in thinking about physical intimacy and disability.

Several women in the study discussed how physical interactions that are common in social interactions with able-bodied women general touching, a hug, or a pat on the shoulder are extremely uncommon for women with SCI. But that emotional deprivation is a problem because of the lack of touch, the lack of feel.

Yet, as cases such as Priscilla, Damita, and Stacie show, these challenges are not insurmountable. However, to appropriately address the concerns women in this study raise, occupational therapy practitioners must take into account the diversity of sexual experiences and meanings associated with sexual intimacy.

Findings from this study demonstrate that sexuality remains important after SCI and draw attention to the widely divergent and evolving sexual education and support needs of women after injury. Occupational therapy practitioners are uniquely suited to support a client-centered approach to sexual education MacRae, However, although studies have indicated that practitioners realize that their clients are sexual beings, few actively pursue addressing sexual concerns Anderson et al. One possible reason for not offering sexual education to clients with SCI is that some clinicians may be uncomfortable broaching the topic of sexuality with their clients Couldrick, ,

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