Sexuality and Diabilities Flashcards
Sexually Elite
those whose activity does not violate reproductive bias and could lead to socially sanction conception and pregnancy (heterosexual married couple)
Sexually Oppressed
those who are perceived as not conforming to the reproductive bias and who tend to be systematically a-sexualized (elderly, ugly, or disabled)
Sexually Unusual
those who society view as deviant, weird, sick, or criminal (pedophiles, exhibitionist, transvestites, etc…)
Impairment
organic condition/diagnosis e.g.. R.A., S.C.I., C.V.A., glaucome, Down’s Syndrome
Handicap
environmental & attitudinal barriers, e.g. stairs, mountains, small print, public & personal attitudes, beliefs, values, etc.
Disability
functional limitations e.g, unable to walk, see, hear, move hands, comprehend, etc.
Factors that affect adjustment
- Congenital vs. Acquired (age)
- Mild/Localized vs. Severe/Systemic (perception)
- Stable vs. Progressive (rapidity)
- Visible vs. Invisible (to public)
- Degree and Constancy of Pain (medications)
- Degree control and/or effective management of bladder and bowel function
- Currently in vs. Committed Relationship
- looking for relationship(s)
- Attitudes/Acceptance of Significant Others (partner, family, friends)
Cerebral Palsy
damage to the brain and/or central nervous system before or during birth resulting in some degree of spastic paralysis and speech difficulties
- most normal intelligence
Sensory Deficits
- Blindness and Deafness
- can affect any age group & varies in severity
- many live independent, satisfactory lives, however individuals vary in their ability to adapt
- much depends on the age of onset, family support, and the self esteem confidence of the individual
- they may have decreased socialization and educational opportunities
Spinal Cord Injury
bruising, tearing, cutting of the special cord resulting in partial or total loss of voluntary movement and sensation below injury
Quadriplegia
neck injuries — arms, trunk and legs affected
Paraplegia
upper/lower back injuries — trunk and legs affects
Quads
wheelchair — semi independent
Paras
wheelchair, crutches, canes — independent
- Majority young males, all ages male and female potential
- Approx. 50% vehicle accidents
- Other: sports, work related, assault, etc…
- In USA 6-10 thousand per year
- Relatively normal life expectancy
- Advent of computers, sophisticated devices and electro myography changing potential for independent living and employment
Arousal:
ability to have psychogenic arousal gone, reflex erection for men & women still talk about having relief and pleasure
Arthritis
- conditions that affect the small and large joints of the body causing pain, swelling, stiffness, and immobility — progressive
- more women — can occur at any age & different types affect different age groups
- ranges from mild pain in some joint to sever limitation of movement and use of crutches or a wheelchair
- female superior positions
Amputees
loss of limb(s) from trauma or illness
- usually non-progressive but complications may change status later
- more males — all ages — often vehicle and work related
- level of independence, self esteem, ability to work depends on the personality of the individual, the support of family or friends, and the severity of injury or progression of disease
Intellectually Impaired
inadequate development of the brain — varying degrees of severity and often physical as well as intellectual limitations.
Brain Injury
injury to brain at any age — varying degrees of mental and physical limitations.
Mental Illness
psychiatric conditions — such as depression, anxiety, schizophrenia, etc…
- Mild to Severe
Psychoneurosis
disturbances in thought, feelings, attitudes and behaviour; in touch with reality
- characterized by predominant symptom, e.g., anxiety, depression, obsessional, phobias
Psychosis
disorder that include the disintegration of personality and loss of contact with reality and usually require hospitalization e.g., schizophrenia
Sexuality Issues Include:
- self esteem & body image
- sexual identity & male/female roles
attitudes of others — especially partners - reduced sex drive
- sexual dysfunctions — - erectile/lubrication
- poor judgment/impulsive/vulnerable
- unsafe sex practices — forget/can’t be bothered
- drug side effects
- too few sexuality education program in mental health care facilities
- limited social life — lack of partners
Intellectual Impairment and Sexuality
IQ less than 70 Mild IQ: 50-70 Moderate IQ: 35-49 Severe IQ: 20-34 Profound IQ: below 20
- mature sexually in normal way (may have normal sex drive)
- often receive little training regarding their bodies and sexuality
- sex drives similar to those of other people, socialization and learning patters are different
- have to teach sexual expression based on functional age
Guidelines When Working with Individual with A Mental Disability
- Masturbation is normal sexual expression no matter how frequently and at what age it occurs
- All sexual activity involving the genital should occur in privacy
- Any time a sexually mature girl and boy have intercourse they risk pregnancy
- Unless a couple clearly wants a baby they need to understand and practice effective birth control
- Society decrees that one one should have intercourse until about age eighteen. At which age men and women are ready to make such a decision for themselves
- Adults must never use children sexually
- with appropriate safeguards, sexual expression may be encouraged
- Private sexual activity is acceptable between consenting adults.
- Nobody is allowed to touch you in any way without your permission
“Consensual Ability” = Capability to give informed consent to sexual contact
- Evaluating an individual’s consensual ability should address the person’s ability to make a decision based on:
- knowledge of the nature of the sexual contact,
- its possible consequences,
- the social and moral context in which it occurs.
- Contact where one or both parties lack consensual ability may be considered a crime
- It is expected that Staff are required to report all sexual contact between non-consenting individuals to the appropriate authorities.
situational competency
allows argument that an individual may be capable of consenting to some forms of sexual contact. With a certain individual in a particular setting but not to other forms of sexual contact with the same or other individuals in other settings.
Competency To Make Decisions Is Highly Contextual.
Competency To Make Decisions Is Highly Contextual.
Sexuality Intervention Guidelines
Treating this population as asexual or as children is ingrained in much of society that it creates a vicious circle. They are treated like children and then — surprise! — they sometimes behave like children.
Accurate Age-Appropriate Information
topics should be tailored to the chronological age of the person.
Teach to express physical affection that is appropriate to their…
apparent ages.
The teaching methods/tools should be at their intellectual abilities
- concrete vs abstract
- remember that Context is Everything
Sexuality Health Intervention for Individuals with Disabilities
- Removing Barriers
- Education
- Attitudinal - giving permission
- Skill training
- Environmental Adaptation
- Dealing with social environment
- Assistive devices – lubricant, -vibrators, pumps etc.
- Medication management
- Behaviour modification
- Provide sex therapy
