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Sexuality and Disability
Journal Prestige (SJR): 0.477  Citation Impact (citeScore): 1 Number of Followers: 19  Hybrid journal (It can contain Open Access articles)ISSN (Print) 1573-6717 - ISSN (Online) 0146-1044 Published by Springer-Verlag  [2468 journals]
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- Romantic Relationships and Adults with IDD in Inclusive Supported Living:
Considerations, Complexities, and Opportunities-
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Abstract: The love and companionship provided from romantic relationships is a right for all adults, yet many adults with intellectual and developmental disabilities (IDD) have been unable to experience these forms of relationship. This study investigates the experiences and perspectives on romantic relationships regarding adults with IDD involved in an inclusive supported living program. We asked residents with IDD, their parents, graduate student residents (without disabilities), and organization staff for their insights into the romantic relationships of adults with IDD and how the organization could better support those relationships. The residents with IDD described romantic relationships in various ways, but all emphasized their importance. Participants discussed an array of challenges in this area, including difficulty meeting people to date, challenges with social skills, and a lack of comprehensive sexual education. Likewise, the study noted a number of tensions that arise when supporting adults with IDD to pursue romantic relationships, including their comfort addressing this area, navigating dignity of risk, and acceptance from family members. The residents, parents, and staff members also provided helpful recommendations for how supported living organizations can most effectively support individuals with IDD in romantic relationships.
PubDate: 2023-06-01
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- Decoding Neurodiverse Couples Therapy: A Solution-Focused Approach
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Abstract: The rising prevalence of autism spectrum disorder (ASD) in the United States is projected to increase annually. Despite this increase, romantic relationships among neurodiverse couples is not well represented in the current literature. This study incorporated both conversational analysis (CA) and observational behavioral coding (OBC) to distinguish “problem talk” and “solution talk” among a neurodiverse couple participating in Solution Focused Brief Therapy. Results indicated increased “problem talk” and lower levels of both types of reinforcement in the partner with ASD versus the neurotypical partner. These findings have clinical implications for and highlight the benefits of CA and OBC among neurodiverse couples.
PubDate: 2023-06-01
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- ‘More than just the Curriculum to Deal with’: Experiences of Teachers
Delivering Sex and Relationship Education to People with Intellectual
Disabilities-
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Abstract: Interviews with fifteen teachers and educators delivering sex and relationships education to people with intellectual disabilities were conducted. The aim of the study was to investigate their experiences and views. Thematic analysis was used to look for patterns and themes in the verbatim transcripts. Three main themes were identified: challenges when delivering sex education, how to overcome these difficulties, and important topics for sex and relationships education. Implications for delivering sex and relationships education for people with intellectual disabilities and support needed for teachers are discussed.
PubDate: 2023-06-01
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- The Effect of Sexual Counseling Based on EX‑PLISSIT Model on Improving
the Sexual Function of Married Women with Systemic Lupus Erythematosus: A
Randomized Controlled Trial-
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Abstract: Systemic Lupus erythematosus (SLE) is a multisystem autoimmune disease. This disease triggers sexual dysfunction due to physiological, cognitive and mental effects. Since sexual function is often ignored in these patients, this study aimed to investigate the effect of sexual counseling based on EX‑PLISSIT model on improving the sexual function of married women with SLE. This clinical trial was conducted on 101 married women suffering from SLE (18–49 years) residing in Tehran. Randomization was performed by random block allocation with six blocks in a rheumatology clinic. A demographic questionnaire, the Depression, Anxiety, Stress Scales-21 Items (DASS-21), and the female sexual function index were used to collect the data. The intervention group received counselling sessions every week while the control group (n = 55) received routine care for the disease. Eight and twelve weeks after completion of counselling sessions, outcomes compared between the intervention and control groups, using independent ttest, paired t-test, repeated measures and Chi-squared test. The scores of sexual function in both groups did not differ significantly before the intervention (p > 0.05). At the first follow-up session, the score of all sexual function domains except sexual pain increased significantly in the intervention group while a significant reduction was observed in all domains of sexual function in the control group (p < 0.05). In the second follow-up, sexual function significantly increased in the intervention group whereas it significantly decreased in the control group (p < 0.05). According to the findings of this study, counseling based on EX-PLISSIT model positively affected the sexual function of women with SLE. Therefore, this model can be used as a cost-effective and simple counseling method to improve the sexual functions.
PubDate: 2023-06-01
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- It’s a Taboo: Women with Disabilities Applying for Psychological
Counseling Due to Romantic Relationship and Sexual Problems-
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Abstract: The aim of this research was to explore the experiences of a sample of disabled women about problems with romantic relationships/sexual life. For the study, eight disabled women between the ages of 20 and 38 years were contacted. One theme to emerge was "sexuality as taboo" related to the family. It also seemed that these taboos led to women not receiving health information during adolescence. A second theme to emerge was "forbidden before marriage", which means that women with disabilities were prevented from dating and having sexual intercourse before marriage. A third theme to emerge was "disabled people are targets of sexual abuse" related to the overprotection of disabled women by their families. The final theme was "ableism is the biggest obstacle to the romantic/sexual relationships of disabled women". Participants emphasized the importance of obtaining information regarding disability and sexual life.
PubDate: 2023-06-01
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- Sexual Rehabilitation After a Stroke: A Multi-site Qualitative Study About
Influencing Factors and Strategies to Improve Services-
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Abstract: This study aimed to better understand the factors influencing the provision of sexuality-related post-stroke rehabilitation services by clinicians on different sites and to explore strategies to improve post-stroke rehabilitation services with stakeholders. A qualitative study with co-design methods was conducted with 20 clinicians from five post-stroke rehabilitation centers in Canada, 1 manager and 1 patient-partner. Participants either took part in a focus group or in sessions of an adapted version of the LEGO Serious Play method to explore influencing factors and strategies of improvement in relation to post-stroke sexual rehabilitation services. Thematic analysis was conducted semi-deductively using the Theoretical Domains Framework (TDF), the Capability, Opportunity, Motivation and Behaviour (COM-B) system and the Behaviour Change Wheel (BCW). A total of twenty factors pertaining either to the categories of Capability (n = 8; e.g., Sexual rehabilitation procedural knowledge), Motivation (n = 4; e.g., Professional boundaries) or Opportunity (n = 8; e.g., Workload) were perceived as influencing provision of sexual rehabilitation services by participants. A theoretical model was conceptualized. Strategies (n = 10) were categorized in concordance with the BCW as Training (n = 1), Enablement (n = 5) or Environmental restructuring (n = 4). This study showed that factors influencing provision of post-stroke rehabilitation services were numerous and interrelated, and that various strategies aiming either clinicians or the rehabilitation environment would be relevant to improve services. This study will help guide the design and implementation of future interventions studies aiming at improving post-stroke sexual rehabilitation services.
PubDate: 2023-05-24
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- Life Experiences of Married Women with Visual and Orthopedic Disabilities
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Abstract: The study aims to determine the life experiences of married women with visual and orthopedicdisabilities concerning sexuality and sexual health with the grounded theory method and develop a theory revealing the concepts and processes that affect these experiences with an explanatory framework. The study was implemented with a constructivist grounded theory design and method. The data were collected and analyzed by performing profound interviews with 12 visually disabled women and 13 orthopedically disabled women and recording the data, taking notes with observation, taking analytic notes (mnemonic notes), using secondary data sources and continuous comparison method until attaining satisfaction and using analysis stages (open, axial and selective coding) of the grounded theory synchronously with analysis stage of the data. Focus categories defining the life experiences of married women with visual and orthopedic disabilities concerning sexuality and sexual health were determined as; “Social Perception”, “Immediate Environmental Perception”, “Familial Perception”, “Partner Perception” and “Disabled Individual’s Perception”, “Coping Mechanisms” and “Solution Offers”. Focus categories were under the influence of the categories of; disability, sexuality, disabled sexuality, marriage and starting a family, the intention of having a child and were explained accordingly. Every stage of the grounded theory is affected by the characteristics of married women with visual and orthopedic disabilities, the relationship of their life experiences concerning sexuality and sexual health with each other, contextual and comparative factors, as well as a complex structure that varies according to time and experience.
PubDate: 2023-05-18
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- Racial and Ethnic Differences in the Severity of Sexual Dysfunction
Symptoms in Patients with Multiple Sclerosis-
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Abstract: Sexual dysfunction (SD) is a common symptom for many with multiple sclerosis (MS). However, most studies researching this topic have predominantly White samples. While this matches epidemiological estimates, research has shown that those of other ethnic groups, such as African Americans/Blacks and Hispanics/Latinos, tend to exhibit more symptomology. This study aimed to determine if this greater symptomology in other ethnic groups with MS holds for SD. Study participants were recruited from the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry. Participants completed the MSISQ-19 and the PDDS and provided demographic information. Study participants were 5445 respondents (Mage = 51 years, SD = 9.56, 75% female, 93% White). White, African American/Black, and Hispanic/Latino groups were compared on sexual dysfunction. Linear mixed effects modeling revealed that the MSISQ-19 subscale scores were significantly different for the African American/Black group (t = − 2.48, p < 0.013) and all female participants (t = − 2.58, p < 0.010). African American/Black participants had the least amount of primary SD (M = 10.56, 95% CI [9.09, 12.03]). African American/Black participants had the highest amount of secondary SD (M = 18.62, 95% CI [17.15, 20.09]), though the result was not statistically significant. Additionally, African American/Black females scored higher in all subscale scores when compared to African American/Black males, with a 3-point and 2-point difference in primary and tertiary symptoms. Our study has highlighted the importance of clinicians assessing for SD within their patients and to consider potential differences in symptom presentations of racial groups.
PubDate: 2023-05-11
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- Using Concept Mapping to Explore the Perspectives of People with Mild to
Borderline Intellectual Disabilities Toward Sexual Health-
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Abstract: People with mild to borderline intellectual disabilities face many barriers toward their sexual health. To promote sexual health and overcome these barriers, they need individualized forms of sexuality support and education. To align sexuality support and education insight is needed on their understanding of sexual health. The current paper aims to provide greater insight in what sexual health consists of according to people with mild to borderline intellectual disabilities. Nine people with a mild to borderline intellectual disability participated in a concept mapping procedure, consisting of brainstorming, sorting, and ranking the statements. The resulting clusters and concept map were interpreted by an expert group. Analysis resulted in five clusters which participants considered important for their sexual health. According to people with mild to borderline intellectual disability cluster pertaining to romantic relationships and sexual socialization were the most important. These were followed by clusters on sexual health and lastly sexual selfhood. These results have implications for the development of sexuality support and education, as well as further research.
PubDate: 2023-05-09
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- From the Editor of Sexuality and Disability: Artificial Intelligence and
Sexuality: Who is Programming Whom'-
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PubDate: 2023-05-04
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- The Effect of Ex-PLISSIT Model on Sexual Satisfaction in Women with
Multiple Sclerosis-
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Abstract: Aim This study aimed to examine the effect of sexual counseling based on Extended Permission, Limited Information, Specific Suggestions, and Intensive Therapy (Ex-PLISSIT) model on sexual satisfaction in women with Multiple Sclerosis (MS). Methods 73 married women with definite MS and FSFI score ≤ 28, aged between 15 and 49 years were randomized as experimental group [n = 37] and control group [n = 37]. Sexual counseling based on the Ex-PLISSIT model were performed in four weekly sessions in the experimental group. Sexual satisfaction and sexual distress were measured before the intervention, 4 and 12 weeks after intervention using Larson Sexual Satisfaction Questionnaire and Female Sexual Distress Scale-Revised. Data were analyzed by using SPSS Software version 16, and t-test, Chi-square, GLM Repeated Measures were used for data analysis. Results There was statistically significant increase in SS score when data were compared through 3 phases of evaluation in experimental group [P < 0.001] versus there was no statistical difference in control group. Also, SD score significantly decreased in experimental group through 3 phases of evaluation [P < 0.001] versus no statistical differences were seen in control group. Conclusion According to this study, sexual counseling based on Ex-PLISSIT model can alter SS and SD of married women with MS in good manner.
PubDate: 2023-04-26
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- Revealing Strategies for Sexual Adjustments Among Ostomates in Indonesia
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Abstract: As the fourth highest cancer in Indonesia, colorectal cancer (CRC) is one paramount cancer issue that requires urgent healthcare management. Most CRC survivors must undergo ostomy surgery to prevent malignancy and death. The stoma formation negatively impacts the ostomates’ quality of life as it predominantly affects these people’s sexual function, satisfaction, and social life. This study explores in-depth sexual experiences and perspectives of people living with a stoma and their physical, psychological, and cultural influences. This phenomenological qualitative study involved 12 female and male ostomates recruited purposively from the National Cancer Centre Hospital in Indonesia. Qualitative data were collected through semi-structured interviews, managed using Nvivo 12, and analysed thematically. The contextual findings highlighted four significant themes: sexual disruptions, revealing strategies for sexual adjustments, support from the marital partner, and limited support from the healthcare professionals. An interdisciplinary team supporting the sexual needs of the ostomates is necessary to improve strategies for adjusting to the sexual disruptions after CRC therapy. Pre- and post-stoma surgery counselling is recommended for CRC patients and their partners.
PubDate: 2023-04-24
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- Professional Educational Opportunities
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PubDate: 2023-04-24
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- Who is Delivering Sexual Health Education Content to Young Adults with
Intellectual or Developmental Disability': A Survey of US-Based
School-Based Professionals and Parents-
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Abstract: Limited access to sexual health information is a significant problem faced by young adults with intellectual and developmental disabilities. In a survey of family members and school-based professionals, we assessed which sexual health topics are covered by whom, as well as from whom survey respondents believe young adults with intellectual and developmental disabilities should be getting information. Participants report providing some sexual health information but that more information should be provided, especially on topics such as sexual orientation and gender identity. Results demonstrate medical providers are being expected to provide more sexual health information, and that the internet is a non-preferred source of education. These findings should inform recommendations about who should be providing sexual health education for young adults with intellectual and developmental disabilities.
PubDate: 2023-04-18
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- Unmet Need for Sexual Rehabilitation after Acquired Brain Injury (ABI): A
Cross-Sectional Study Concerning Sexual Activity, Sexual Relationships,
and Sexual Rehabilitation after ABI-
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Abstract: In relation to brain injury rehabilitation, research has stressed the importance of including sexuality issues due to increased risk for sexual dysfunctions after Acquired Brain Injury (ABI). This study aims to explore experiences after non-stroke ABI concerning individual and relational aspects of sexuality, received information about sexuality at rehabilitation, and gender differences. A postal nationwide survey was conducted in Sweden, 2018–2019. The sample included individuals who had participated in brain injury rehabilitation 2014–2016, response rate 40% (250/624). Among all participants 78% had resumed sexual activity, and there was a significant difference between males (84%, 118/140) and females (69%, 76/110, p = 0.004). Among all participants, 95% reported physical intimacy as important, 80% considered sex as important on an individual level, and 91% stated sexuality as important for the relationship (no gender differences). Significantly more females (52%) than males (22%) reported that they had tried sexual aids (p = 0.000), and more males (29%) than females (16%) reported that professionals addressed sexuality issues during brain injury rehabilitation (p = 0.024). However, only a few participants were offered specific sexual counseling during brain injury rehabilitation, such as individual counseling (3%), couples counseling (2%), and group counseling (3%). To conclude, the vast majority valued both individual and relational aspects of sex and sexuality highly, and more males than females had resumed sexual activity. Few had received information about sexuality after ABI, and even fewer females compared to males reported that the issue was raised during rehabilitation. Clinical implications are discussed in relation to sexual rehabilitation.
PubDate: 2023-04-03
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- Evaluation of Comprehensive Sexuality Education and Support Workshops for
Parents and Carers of Children and Young People with Intellectual
Disability and/or Autism Spectrum Disorders-
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Abstract: Parents and carers often have limited knowledge and confidence in providing comprehensive sexuality education (CSE) and support to children and young people with intellectual disability (ID) and/or autism spectrum disorder (ASD). To address this need, six workshops were delivered and evaluated in New South Wales (NSW), Australia in 2018. Pre/post-workshop surveys were completed (n = 145) along with three-month follow-up surveys and interviews (n = 34) to evaluate the perceived effectiveness of the workshops in improving parents’ and carers’ knowledge and confidence in providing CSE and support to their child or young person. The evaluation also sought to understand additional barriers for parents and carers in providing CSE and support to people with ID and/or ASD. Significant improvements in self-reported knowledge and confidence were identified following the completion of the workshop, which were retained at the three-month follow-up. Barriers to the provision of CSE and support included feelings of isolation and stigma, a preference for reactive approaches to CSE, and a lack of accessible information and resources. Findings suggest that while the provision of workshops to parents and carers can increase their knowledge and confidence in providing CSE and support, significant barriers persist. This evaluation provides insight into how the parent and carer approach to CSE and support for children and young people with ID and/or ASD can be improved.
PubDate: 2023-04-01
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- Sexual Rehabilitation and Relational Satisfaction in People with Multiple
Sclerosis and their Partners-
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Abstract: Sexuality is an integral part of our existence. Multiple Sclerosis (MS) can complicate the lifelong course of sexual development and the ways in which one defines and expresses sexuality. Unfortunately, these issues are not adequately addressed by the health professionals involved in the rehabilitation process. Present research attempts to study the effect that can arise on the sexual and relational satisfaction of couples having a partner with MS after the implementation of a sexual rehabilitation program. 60 couples where one partner has MS and the other does not, were divided into three groups and accepted the PLISSIT (PLISSIT stands for Permission, Limited Information, Specific Suggestions, Intensive Therapy) sexual rehabilitation program as follows: Group a (n = 40, control group) completed self-referencing questionnaires at three times (initial measurement, after 10 weeks and 6 months later), group b (n = 40) did 10 weeks of sexual counselling and completed the same questionnaires at the same times and group c (n = 40) followed the PLISSIT programme and was evaluated in the same way at the same times. The implementation of PLISSIT improved Sexual Dysfunction (SD) levels, increased sexual satisfaction between partners along with general relational satisfaction. PLISSIT can be used by professionals involved in the management of the disease as a comprehensive psychosexual rehabilitation program for MS patients and their partners.
PubDate: 2023-03-16
DOI: 10.1007/s11195-023-09785-z
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- Disabled Sexuality and Negotiations with Sexual Partners
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Abstract: Past research, media and pop culture, and the medical field have largely overlooked the sexual lives and stories of disabled adults. This research used a long-response survey methodology to collect the stories of over 300 physically disabled adults regarding the interaction between their disability and sexuality, and their experiences navigating sexual partnerships. Data showed there were a variety of challenges sexually active disabled adults faced, but numerous benefits were also described. Additionally, participants discussed the process of choosing a sexual partner, experiences of rejection and “coming out” as disabled, and the experience of communicating with partners about sexuality. This research sheds light on the nuances of disabled sex and sexuality, contributing to a growing body of literature which highlights the interpersonal and emotional aspects of navigating sex as a disabled person.
PubDate: 2023-03-07
DOI: 10.1007/s11195-023-09784-0
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- Female Sexual Dysfunction in Subjects with Type 2 Diabetes Mellitus
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Abstract: The correlation of female sexual dysfunction (FSD) with the degree of glycemic control, the duration and complications of diabetic disease and cardiovascular risk factors are not so clear. The aim of this study was to assess the prevalence of FSD in a sample of females with type 2 diabetes mellitus (T2DM), and to identify factors involved in its pathogenesis. We enrolled 81 females who have T2DM. We administered the female sexual function index (FSFI), self-rating anxiety scale (SAS) and self-rating depression scale (SDS) questionnaires. We also estimated anthropometric parameters, glyco-metabolic control, comorbidities, autonomic nervous system assessment, some adipocytokines and ongoing therapy. 87% of participants were affected by FSD. There was evidence of an inverse correlation between the total score of the FSFI questionnaire and the mean of the values of HbA1c in the previous years. There was an inverse correlation with the duration of diabetes and homeostasis model assessment of insulin resistance index in participants not affected by FSD. Participants with FSD have a higher prevalence of anxiety (p = 0.043) and participants with depression and ischemic heart disease scored less on the FSFI questionnaire (p = 0.005 and p = 0.010, respectively). Homocysteine and E-selectin values were higher in participants with FSFI (p = 0.002, and p = 0.017, respectively). Most of the enrolled females with T2DM had FSD. Glycemic control, ischemic heart disease, endothelial dysfunction, autonomic neuropathy, and psychological conditions, such as anxiety and depression, seem to have a close correlation with FSD. An early diagnosis of FSD can help to improve not only participants’ quality of life, but also to early identify and treat risk factors related not only to FSD, but also to cardiovascular risk. Therefore, we highly recommend that clinicians have a high index of suspicion for FSD in females with T2DM.
PubDate: 2023-03-06
DOI: 10.1007/s11195-023-09781-3
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- Experiences, Barriers, and Facilitators to Sexual and Reproductive Health
Care Access of People with Sensory Impairments: A Scoping Review-
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Abstract: Disability is a varied experience resulting from the interaction of multiple factors: health conditions, personal, and environmental factors. People with Disabilities face various forms of discrimination within the healthcare sector, including the lack of accessible and appropriate services; information in accessible formats; coverage of communication needs; and access to information and communication technologies. Another area of hindrance is accessing sexual and reproductive health (SRH) services. This scoping review aims to identify facilitators and barriers related to accessing SRH services and the experiences of people with sensory impairment (PwSI) in them. The review includes 37 articles reporting on facilitators and barriers to SRH services. Findings include less access to SRH and awareness in how to access SRH services, mainly among young people, and less comprehensive knowledge about modern contraceptive methods possibly determined by the lack of adequate and inclusive sexual information. These results support the idea of including accessible SRH materials, training providers on the needs of people with sensory disabilities, removing barriers to sexuality education and health services, to address the disadvantages faced by PwSI and provide them with access to health care which is a basic right.
PubDate: 2023-03-03
DOI: 10.1007/s11195-023-09778-y
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