Sexuality and Diabilities

Question 1

Sexually Elite

Answer 1

those whose activity does not violate reproductive bias and could lead to socially sanction conception and pregnancy (heterosexual married couple)

Question 2

Sexually Oppressed

Answer 2

those who are perceived as not conforming to the reproductive bias and who tend to be systematically a-sexualized (elderly, ugly, or disabled)

Question 3

Sexually Unusual

Answer 3

those who society view as deviant, weird, sick, or criminal (pedophiles, exhibitionist, transvestites, etc…)

Question 4

Impairment

Answer 4

organic condition/diagnosis e.g.. R.A., S.C.I., C.V.A., glaucome, Down’s Syndrome

Question 5

Handicap

Answer 5

environmental & attitudinal barriers, e.g. stairs, mountains, small print, public & personal attitudes, beliefs, values, etc.

Question 6

Disability

Answer 6

functional limitations e.g, unable to walk, see, hear, move hands, comprehend, etc.

Question 7

Factors that affect adjustment

Answer 7

• 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)

Question 8

Cerebral Palsy

Answer 8

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

Question 9

Sensory Deficits

Answer 9

• 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

Question 10

Spinal Cord Injury

Answer 10

bruising, tearing, cutting of the special cord resulting in partial or total loss of voluntary movement and sensation below injury

Question 11

Quadriplegia

Answer 11

neck injuries — arms, trunk and legs affected

Question 12

Paraplegia

Answer 12

upper/lower back injuries — trunk and legs affects

Question 13

Quads

Answer 13

wheelchair — semi independent

Question 14

Paras

Answer 14

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

Question 15

Arousal:

Answer 15

ability to have psychogenic arousal gone, reflex erection for men & women still talk about having relief and pleasure

Question 16

Arthritis

Answer 16

• 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

Question 17

Amputees

Answer 17

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

Question 18

Intellectually Impaired

Answer 18

inadequate development of the brain — varying degrees of severity and often physical as well as intellectual limitations.

Question 19

Brain Injury

Answer 19

injury to brain at any age — varying degrees of mental and physical limitations.

Question 20

Mental Illness

Answer 20

psychiatric conditions — such as depression, anxiety, schizophrenia, etc…
- Mild to Severe

Question 21

Psychoneurosis

Answer 21

disturbances in thought, feelings, attitudes and behaviour; in touch with reality
- characterized by predominant symptom, e.g., anxiety, depression, obsessional, phobias

Question 22

Psychosis

Answer 22

disorder that include the disintegration of personality and loss of contact with reality and usually require hospitalization e.g., schizophrenia

Question 23

Sexuality Issues Include:

Answer 23

• 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

Question 24

Intellectual Impairment and Sexuality

Answer 24

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

Question 25

Guidelines When Working with Individual with A Mental Disability

Answer 25

1. Masturbation is normal sexual expression no matter how frequently and at what age it occurs
2. All sexual activity involving the genital should occur in privacy
3. Any time a sexually mature girl and boy have intercourse they risk pregnancy
4. Unless a couple clearly wants a baby they need to understand and practice effective birth control
5. 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
6. Adults must never use children sexually
7. with appropriate safeguards, sexual expression may be encouraged
8. Private sexual activity is acceptable between consenting adults.
9. Nobody is allowed to touch you in any way without your permission

Question 26

“Consensual Ability” = Capability to give informed consent to sexual contact

Answer 26

• 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.

Question 27

situational competency

Answer 27

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.

Question 28

Competency To Make Decisions Is Highly Contextual.

Answer 28

Competency To Make Decisions Is Highly Contextual.

Question 29

Sexuality Intervention Guidelines

Answer 29

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.

Question 30

Accurate Age-Appropriate Information

Answer 30

topics should be tailored to the chronological age of the person.

Question 31

Teach to express physical affection that is appropriate to their…

Answer 31

apparent ages.

Question 32

The teaching methods/tools should be at their intellectual abilities

Answer 32

• concrete vs abstract

- remember that Context is Everything

Question 33

Sexuality Health Intervention for Individuals with Disabilities

Answer 33

• 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