Sexuality and Disability Flashcards
List five ways that disability can affect sexuality.
- Self-esteem (view themselves as less lovable, appealing, attractive)
- Can impact fertility
- May need to take medication in order to have sex
- Can cause changes in sexual relationships
- Have more precautions, things to think about during sex (e.g. positioning, warm-up, medication)
List four general roles an OT can play in helping a person with a disability manage her/his sexuality
-Sexual activity as an ADL
OT role related to physical performance
-Engaging in sexual activity requires awareness of the role of sex: OT educating client on these factors
-Social participation
-Intimacy, physical contact, expression of feelings
For parenting
List a therapist’s rights related to sexuality
- Protect yourself from sexual advances (physically, mentally)
- Have & maintain personal values/beliefs about sexuality
- Set limits and confront sexual harassment
List a therapist’s responsibilities related to sexuality.
- Respect clients’ values/beliefs about sexuality
- Know your biases & level of comfort
- Report sexual abuse
- Provide evaluations & treatments as needed
- Make appropriate referrals
What is the (EX)-PLISSIT model?
- Explicitly give Permission (first level) - give pt. permission to speak about it; create safe, therapeutic environment & initiate that discussion
- Limited Information
- Specific Suggestions - e.g. meds, positioning
- Intensive Therapy (most intense level) - refer for more intensive therapy (e.g. sex therapy surrogacy, couples counseling)
List three skills an OT may assess in considering a cognitively impaired client’s capacity to consent to sexual activity.
- Ability to express choices/consent.
What are your wishes via relationship? Do you enjoy sexual contact? - Ability to appreciate sexual activity.
Do you know what it means to have sex? What does it mean to your partner? - Personal Quality of life choices in the here & now.
Was and is intimacy important in your life?
What spinal cord injury levels are involved in the ability of men to have psychogenic erections? Reflex erections?
Psychogenic erections: T10-L2
Higher chance of being able to have psychogenic erection if it is an incomplete lower-level SCI
What spinal cord injury levels are involved in the ability of men to have Reflex erections?
Reflex erections: S2-4
Most men with SCI are able to have a reflex erection as long as S2-4 nerves are intact (and they usually are)
What are the issues related directly to fertility for men with spinal cord injuries? Describe two mechanical strategies for helping men with spinal cord injuries ejaculate sperm
- Issues: anejaculation, retrograde ejaculation, & reduced sperm motility
- Mechanical strategies: penile injections, penile vibratory stimulation?
List medications and other tools used to help men with spinal cord injuries attain and maintain an erection.
- Oral medications: Viagra, Levitra, Ciallis
- Other tools: penile injection (use with caution - increases scar tissue), vacuum pumps, surgical implants, MUSE (Medical Urethral System Erection; inserted into urethra to create erection)
How does spinal cord injury impact a woman’s sexuality?
- Limited lubrication
- Muscle weakness
- UTI’s
- Potential for autonomic dysreflexia
What are recommendations an OT can make to help with these issues related to female spinal cord injury?
- Take Viagra (for lubrication)
- Strengthen muscles
- Help with positioning, suggest certain positions or positioning aid
- Refer to physician for recurring UTI’s, autonomic dysreflexia
What is a “phantom orgasm”?
- Mentally intensifying an existing sensation from one portion of their body and reassigning the sensation to the genitals
- Vivid orgasm imagery with total lack of somesthetic sensation from, and paralysis of, the genital area
List three pregnancy complications women with spinal cord injuries may experience
-Pressure ulcers are more likely to occur as pressure relief/transfers become more difficult
-Neurogenic bowel and bladder programs can be affected
Constipations
- UTIs are more frequent
- Women with injury above T10 will not have sensation of uterine contractions
