JournalTOCs

Sexuality and Disability
Journal Prestige (SJR): 0.477

Citation Impact (citeScore): 1
Number of Followers: 18

Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1573-6717 - ISSN (Online) 0146-1044
Published by Springer-Verlag

[2656 journals]

From the Editor of Sexuality and Disability: 2021…A Year of
Acknowledging What We Have Known to Different Degrees….the Fundamental
Importance of Inclusiveness, Diversity, Equity, Accessibility, Fairness
and Respect
- PubDate: 2021-06-01
Professional Educational Opportunities
- PubDate: 2021-06-01
Sexual Education of Persons with Autistic Spectrum Disorders: Use of the
Technique: ‘Social Stories
- Abstract: The difficulty in the area of social skills for persons with Autism Spectrum Disorders (ASD) is particularly visible in the area of sexuality and intimate relationships. Therefore, it is important to create a curriculum including information about sexuality and to address the individual and specific needs of persons with ASD. For this purpose we designed a study using Social Stories for conducting sexuality education following the criteria of Carol Gray. The main goal of our study was to assess the effects of the use of Social Stories to implement sexuality education with three participants with ASD. The individual sessions lasted for 45 min and they continued for a period of 6 months. The participants were tested and their parents interviewed before starting and after finishing 6 months of sexual education, and this allowed us to assess knowledge and behavioral changes regarding sexuality. The most significant changes were determined through assessment of the following areas: the private and reproductive parts of the body; changes occurring during the period of puberty; distinguishing pleasant and unpleasant touch; sexual relations and contraception. Our conclusion after analyzing results were that a period of 6 months implementing sexuality education through Social Stories was sufficient to upgrade and expand knowledge, but definitely was insufficient for noticing visible behavioral changes.
  PubDate: 2021-06-01
Sexual Education: A Case Study of an Adolescent with a Diagnosis of
Pervasive Developmental Disorder-Not Otherwise Specified and Intellectual
Disability
- Abstract: The transition from adolescence to adulthood may be a challenging period for all young people, yet, for youth with autistic spectrum disorder (ASD) it may present some additional challenges. Developing a more coherent sense of the self, defining one’s values and having a sexual awakening are all important processes for the passage from youth to an adult life. People with ASD have difficulties in the aforementioned areas and also face additional risks for sexual exploitation or even abuse. Those challenges underline the importance of sexual education for individuals with ASD. The aim of this case study is to systematically investigate the effectiveness of a behavior analytic intervention in helping an adolescent with Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) improve in the area of sexual behavior and at the same time minimize his inappropriate behavior. Specifically: (a) to develop a verbal repertoire pertaining to adolescence and sexuality, (b) to improve personal hygiene skills, (c) to develop or improve self-satisfaction related to sexual expression, (d) to decrease inappropriate behavior pertaining to sexuality, and (e) to train the father to undertake a part of the intervention that would be unethical for the researcher to contact—monitor the participant’s masturbation practices. Using a multiple-baseline-across-response-categories experimental design, it was demonstrated that the majority of the aforementioned goals were attained, yet, one goal—the decrease of inappropriate behavior—was only temporarily reached.
  PubDate: 2021-06-01
Public Opinion on the Sexuality of People with Intellectual Disabilities:
A Review of the Literature
- Abstract: People with intellectual disabilities (PID) experience the same range of sexual thoughts, feelings, desires, and activities as anyone else. However, the public’s view, especially about stereotypes, is noticeable to have an impact on sexuality and people with disabilities, thereby influencing the population which includes the families of PID, healthcare professionals, and policymakers. This review aims to analyze the opinions of public, family of PID or care staff on the sexuality of PID and the methodology applied. Eleven quantitative peer-reviewed papers were identified. Participants’ attitude could be evaluated as a binary classification of either “Restrictive” or “Acceptance” in four aspects. Demographic background and the conditions of the PID were found to have an influence on people’s attitudes. People acknowledge that PID are not asexual but generally the public holds a more accepting attitude towards the sexuality of PID when compare with family of PID or care staff. Further research on this attitude gap is particularly essential, as this will contribute valuable information and provide insight to policymakers on handling the social, legal and ethical concerns about the sexuality of PID.
  PubDate: 2021-06-01
The Experience of Indonesian Men Living with Type-2 Diabetes Mellitus and
Erectile Dysfunction: A Semi-structured Interview Study
- Abstract: Background Erectile dysfunction (ED) in men living with Type-2 Diabetes Mellitus (T2DM) in Indonesia is rarely discussed. This study explored the lived experiences of young- to middle-aged Indonesian men living with T2DM and ED to identify the related healthcare support they received from their local public health center. Methods A qualitative-descriptive approach was used to elicit the experiences of twelve men with T2DM who were recruited from a public health center in Surabaya. Using guiding questions, individual interviews were audio recorded, transcribed verbatim, translated to English and then thematically analyzed. Results Most men in this study experienced ED, with participants’ responses to ED ranging from acceptance to feeling afraid to acknowledge ED to their wife or displaying anger towards their wife. Despite reporting they needed information about ED related to T2DM, participants reported an absence of discussion about ED with health professionals during regular T2DM appointments. Men reported not raising the issue themselves as they felt ashamed or embarrassed. Some men engaged in high-risk self-management behaviors, such as using off-street medications to try and fix their ED while others sought other forms of intimacy with their wife. Conclusion This study’s findings present previously unreported healthcare experiences of Indonesian men with T2DM and ED. Although routinely visiting healthcare professionals in public health settings for T2DM management, the men in this study did not receive assessment or healthcare around ED. The men would have appreciated the opportunity to discuss their ED and explore treatment options. Future studies are recommended to explore how men with T2DM and ED, and their wives, can be supported by healthcare professionals to improve health and wellbeing outcomes.
  PubDate: 2021-06-01
The Complexities of Sexual Health Among Adolescents Living with Autism
Spectrum Disorder
- Abstract: The complexities of living with Autism Spectrum Disorder (ASD) can derail an adolescent’s opportunity to engage in healthy sexual relationships. Social connection, a large component of healthy sexual relationships, is often a major obstacle for adolescents diagnosed with ASD. Sexual health goes beyond the physical component and relies on emotional and social skillsets that directly influence appropriate sexual behaviors and connection with others. The concept of appropriate psychosexual norms is quite important and can be adopted by exposing adolescents with ASD to social environments that form healthy interactions with others. The sexual behavior of adolescents with ASD is often observed from a problem-based perspective rather than a strength-based approach. There is a lack of evidence-based sexual education curriculums geared towards the needs of adolescents with ASD which bring closer together the dynamical relationship between sexual socialization and sexual behavior. Therefore, the purpose of this conceptual paper is to describe that dynamic relationship and how inadequate sexual socialization often leads to socially “inappropriate” sexual behaviors of adolescents with ASD.
  PubDate: 2021-06-01
“It tingled as if we had gone through an anthill.” Young People with
Intellectual Disability and Their Experiences with Relationship, Sexuality
and Contraception
- Abstract: In summary, literature shows that people with intellectual disability tend to have less and later sexual experience than persons without disability. They have limited opportunities to meet potential partners but the same human need for intimate romantic relationships. The sample included 42 people with mild to moderate intellectual disability between 14 and 25 years. Face-to-face interviews were conducted in schools and sheltered workshops. The interview guide was translated in easy to read language. The interviews were evaluated with the qualitative content analysis. Most of the respondents have had a relationship and met their partners in professional and school context. Their contacts are reduced to the encounters there. One third have had intercourse experience. Difficulty existed in the search for an undisturbed place and partner selection. A large part of women take hormonal long-acting reversible contraception. The sexual lives of young people with intellectual disability are still partly restricted due to a lack of access. More inclusive activities should be offered and provided with an appropriate retreat for togetherness. Applicable graphic informational material and sex education on sexuality, relationship and contraception is required in easy language.
  PubDate: 2021-06-01
Sexual Behaviors and Sexual Perceptions of Portuguese Adults with Physical
Disabilities
- Abstract: The primary goal of this study was to shed light on the sexual behaviors and sexual perceptions of people with physical disabilities living in Portugal. As a result, we adopted a mixed methods study, which utilized a descriptive approach to describe participants’ sexual behaviors and a qualitative approach to assess their sexual perceptions. This study surveyed 36 people (mean age = 40.25 years, SD = 10.45), of whom 58.3% (n = 21) were male, almost 70% (n = 25) were single, and the vast majority self-identified as heterosexual. 58.3% (n = 21) of participants did not report partaking in any sexual interactions over the previous 6 months, and 27.8% (n = 10) of study participants claimed to have never had sex. Among those who had engaged in sexual activity during the previous six months, kissing, touching, and caressing (38.9%, n = 6), receiving erogenous zone stimulation (33.3%, n = 5) and performing oral sex (33.3%, n = 5) were the most frequently reported activities. Among sexually active participants who reported not having had sex in the previous 6 months (58.3%, n = 21), only 2 (9.5%) mentioned that they did not have sex because of personal attributes, such as not feeling attractive. The remaining 19 (90.5%) systematically reported a lack of opportunity or a lack of a partner to justify not engaging in any sexual activity. Results from the content analysis of 36 participants’ responses revealed the following 9 recurring themes regarding sexual perceptions: the definitions of human sexuality, the positive and negative impact of sexuality on emotional well-being, sexual problems, obstacles to sexual expression, sexual expectations, positive coping/resilience and interactions with society. Finally, it is important to highlight this study’s contributions to the demands of people with physical disabilities in Portugal to be seen as sexual citizens.
  PubDate: 2021-06-01
Perceptions of Dating Behaviors Among Individuals in the General
Population with High and Low Autistic Traits
- Abstract: While many individuals with Autism Spectrum Disorder (ASD) desire a romantic relationship, they often report anxiety and uncertainty about what behaviors are expected in a dating context. The goal of the current study was to determine how individuals in the general population respond to dating behaviors that may be perceived as unexpected, confusing, inappropriate, or unattractive. Participants responded to fifty behaviors on the Dating Behaviors Questionnaire (e.g., “asks too many questions about you”), indicating their willingness to continue dating someone showing each behavior. Participants also completed the Short Autism Spectrum Quotient to index the degree to which they personally experienced autistic traits. A principal components analysis supported a four-factor structure for this questionnaire: Rude and Unattractive, Intrusive, Distant, and Idiosyncratic Behaviors. Gender significantly predicted variability across the four factors, such that women perceived the dating behaviors more negatively than men, especially Intrusive Behaviors. This result suggests that men may maximize romantic interest from a female partner by proceeding moderately in demonstrations of their own attraction. Compared to those with low autistic traits, participants with elevated autistic traits were significantly more willing to date others with Rude and Unattractive Behaviors and Idiosyncratic Behaviors and marginally more willing to date others showing Distant Behaviors. As such, individuals who are autistic or have elevated autistic traits may be more receptive to romantic relationships with other autistic individuals. However, individuals with autistic traits may have difficulty recognizing rude or inappropriate behaviors in a dating context, potentially leading to a heightened risk of sexual victimization.
  PubDate: 2021-06-01
Parents’ Plans to Communicate About Sexuality and Child Sexual Abuse
with Their Children with Autism Spectrum Disorder
- Abstract: The current study examined intended plans of parents of children (3–18 years) with autism spectrum disorder (ASD) to communicate with them about sexuality topics including sexual abuse. Participants included 87 parents/guardians who completed an online survey. Results revealed that parents are concerned about the sexual victimization of their children with ASD. While many have spoken to their children about some aspects of sexuality education, most feel ill-equipped to handle such discussions. Characteristics of ASD may make prevention programming difficult, and parents worry about ways to teach their children about sexuality issues. Limitations and implications of the findings are discussed. Recommendations for sexuality education programming, including child sexual abuse prevention, for this population are provided.
  PubDate: 2021-06-01
Not Doing it Properly' (Re)producing and Resisting Knowledge Through
Narratives of Autistic Sexualities
- Abstract: Autism is conceptualized in much scientific literature as being associated with restricted and repetitive interests, characterized by an ‘empathy deficit’, and negatively impacting social communication. Meanwhile, ‘good and healthy’ sexuality is largely considered to be a social endeavor: asexuality and sexualities defined by acts rather than by partner gender—for example kink or BDSM—are broadly pathologized. Perhaps, therefore, first-hand autistic experiences of sexuality challenge existing assumptions about ‘good and healthy’ sexualities within couplehood. As a theoretical starting point to explore this potential, we revisit Gayle Rubin’s notion of ‘sex within the charmed circle’ to ask whether autistic sexuality can ever truly ‘fit’ within this (neurotypically defined) virtuous sexual arena. We further consider the ways in which the intersection of autism and sexuality is understood and experienced in first-hand autistic accounts of sexuality within a specific context, through analysis of a Swedish online discussion forum in which autistic people discuss sexuality. In doing so we seek both to better understand autistic sexual experience, and to track and deconstruct potentially restrictive assumptions of (non-autistic) couple sexuality more generally. We also consider ways in which assumptions of deficit concerning both non-normative sexualities and autism may have a deleterious effect on autistic people and on research more broadly, limiting theoretical and conceptual understandings of autism and autistic ways of (sexual) being by a default comparison to sexual and neurological norms.
  PubDate: 2021-06-01
Evaluation of a Web-Based Sexual Health Education Program for Individuals
with Visual Impairments
- Abstract: Individuals with visual impairments often do not receive adequate sexual health care. In order to improve their health, they need to be better informed. The purpose of this study was to assess the web-based sexual health education prepared for individuals with visual impairments regarding quality, content and usability. Views of 16 experts were taken to assess the web content and quality of the study. Of them, eight were nurses in sexuality and sexual health and eight were experts in education of individuals with visual impairments and Web Accessibility Criteria. In order to evaluate usability, the sample comprised 35 individuals with visual impairments who met the inclusion criteria. Data were collected using a Personal Information Form, the DISCERN Guide, Web-Based Sexual Health Education Web Content Evaluation Form, System Availability Scale and Website Evaluation Form for Individuals with Visual Impairments. The quality and content of the website were found appropriate (Respectively: Kendall’s W = 0.899, p = 0.000; Kendall’s W = 0.441, p = 0.000). The usability of the website was determined as high (x̄ ± SD = 97.00 ± 2.8). The most useful modules in the website were determined as sexual health and rights and human body and development. Web-based sexual health education for health professionals may be used as an education method for the individuals with visual impairments.
  PubDate: 2021-05-06
Changes in Sexual Functions and Alexithymia Levels of Patients with Type 2
Diabetes During the COVID-19 Pandemic
- Abstract: This study was conducted to determine the changes in sexual functioning and alexithymia levels in patients with type 2 diabetes during the COVID-19 pandemic. This descriptive, cross-sectional study was conducted with 162 patients with type 2 diabetes. Data were collected using the Information Form, Toronto Alexithymia Scale, Hospital Anxiety and Depression Scale. For 83.3% of the participants, there was a decrease in sexual functioning after diabetes, 69.8% after the COVID-19 pandemic, and 67.2% due to both conditions. The majority of the patients stated the reasons for experiencing sexual problems related to not seeing sexuality as a priority (77.1%), and stress/anxiety experienced during the COVID-19 pandemic (67.9%). Moreover, patients' alexithymia, anxiety, and depression levels were found to be high during the pandemic, when the study was conducted. A positive correlation was identified between alexithymia and anxiety and depression. Further, multiple regression results indicated that about 50% of alexithymia levels could be explained by anxiety and depression levels. The anxiety, depression, and alexithymia scores of those who had decreased sexual functioning before and during the pandemic period were statistically significantly higher than those who did not have any change (p < 0.01). During the COVID-19 pandemic when the study was conducted, high levels of alexithymia, anxiety, and depression were observed in participants, and it was found that their sexual functioning was negatively affected. Healthcare professionals should evaluate their patients in extraordinary situations such as epidemics and pandemics in terms of sexual functioning as well as other vital functions.
  PubDate: 2021-05-04
The Effectiveness of ‘Good-Enough Sex Model’ on Sexual Satisfaction
and Sexual Intimacy in Women with Multiple Sclerosis: A Randomized Trail
- Abstract: Most women with Multiple Sclerosis (MS) suffer from disrupted sexual satisfaction and sexual intimacy. The objective of the current study was to evaluate the effectiveness of a tailored education using the Good-Enough Sex Model (GESM) to enhance the sexual satisfaction and intimacy of women with MS. A parallel randomized trial conducted on a sample of 80 women with a confirmed MS diagnosis in Tehran, Iran. Samples equally were assigned to the intervention and control groups. Accordingly, the intervention group received the educational program in three 90-min sessions. The control group did not receive any education. We used the Index of Sexual Satisfaction and the Sexual Intimacy Scale for collecting data before and one month after the intervention. To analyze the data, independent and paired t-test, Mann–Whitney and Fisher’s exact test were applied. The intervention and control groups were similar in demographic and clinical characteristics. The mean age of women in the intervention and control group was 38.35 ± 5.57 and 36.15 ± 6.79 years, respectively (p = 0.12). Before the intervention, there was no significant difference in sexual satisfaction and sexual intimacy between the two groups. After the implementation of the GESM education, there was a significant difference between the two groups in sexual satisfaction and sexual intimacy (p = 0.001). The findings showed that the Good-Enough Sex Model is an appropriate educational program for improved sexual satisfaction and sexual intimacy in women who suffer from Multiple Sclerosis. Trial registration: IRCT20150128020854N6. Registered 12 August 2019, https://en.irct.ir/user/trial/38583/view.
  PubDate: 2021-04-26
Reproductive Health, Sexual Function and Satisfaction Levels in Women with
Physical, Hearing, and Visual Disabilities
- Abstract: This study was carried out to determine the reproductive health, sexual function and sexual satisfaction levels of women with disabilities. The sample of the study was selected in cooperation with associations and foundations, whose members were individuals with disabilities. The study had a cross-sectional, descriptive and correlational design and was performed between September 2017 and September 2019. Data were collected by using an introduction form, the Female Sexual Function Index and the Sexual Satisfaction Scale. Analysis was performed on the data collected from 67 women with disabilities, who met the inclusion criteria and agreed to participate in the study. Of 67 women, 32.6% did not use any family planning methods. In addition, 83.7% reported that they were satisfied with their sexual life, but 25.6% reported that having disabilities had a negative impact on their sexual life. The percentage of sexual dysfunction was 73% among the women. Sexual dysfunction was below the expected value in women with vision disability. However, it was above the expected value in women with hearing disability. In conclusion, reproductive health and sexual dysfunction are challenges that are frequently experienced by women with disabilities.
  PubDate: 2021-04-26
Prevalence of Sexual Dysfunction in Women with Obesity and Associated
Factors
- Abstract: This study aims to examine the prevalence of sexual dysfunction in women with obesity and factors associated with sexual dysfunction. The study was conducted with the participation of 99 women who had body-mass index (BMI) equaling 30 kg/m2 and above and attended the Diet Polyclinic of Kocaeli Reproductive Health and Family Planning Center, Turkey, from July to September of 2017. The control group consisted of 92 women who had BMI below 30 kg/m2 and socio-demographic characteristics akin to those of the case group and applied to the reproductive health and family planning center at above dates. Data were collected through the personal information form and the index of female sexual function (IFSF). For the analysis of data, descriptive statistics, Chi squared test, Fisher’s exact test and t test were used. In the study, 68.7% of the women with obesity had sexual dysfunction. Means of scores obtained by women with obesity from the overall IFSF and its sub-scales, namely, sexual intercourse quality, lubrication, sexual desire, sexual satisfaction, orgasmic function, clitoral sensitivity, were significantly lower than those of the control group (p < 0.05). Additionally, sexual dysfunction was more prevalent in women who were aged 50 years and above, were primary school graduates, perceived their income levels as medium and whose age of marriage was 19 and below, duration of marriage was 11 years and above, number of pregnancies was 2 and above and number of births was 2 and above (p < 0.05). The study recommends that sexual assessments on women with obesity should be carried out by all healthcare professionals. For the best outcome, the study show that a holistic approach is important in the evaluation of sexual life and healthcare services.
  PubDate: 2021-04-15
Sexuality and Intimacy Rehabilitation for the Military Population: Case
Series
- Abstract: Sexuality and intimacy are important aspects of life that are frequently compromised after severe injury or illness, yet these aspects are often overlooked by medical and rehabilitation professionals. This case series describes the Occupational Therapy Sexuality and Intimacy program at a Military Treatment Facility (MTF). Three diverse clients with a range of physical, cognitive and emotional impairments were chosen to illustrate complexities of the Occupational Therapy Sexuality and Intimacy Program at this MTF, and unique skills employed by Occupational Therapists. Consistent themes discovered include: perceived value of the program; appreciation of safe spaces to discuss personal topics; and enhanced awareness of role identity, body image, and emotional regulation. These cases illustrate that sexuality and intimacy interventions may have profound effects on injured service members, improving social reintegration, and quality of life.
  PubDate: 2021-02-19
  DOI: 10.1007/s11195-021-09680-5
Quality of Sexual Life in Iranian Women with Diabetes: Psychosocial and
Cultural Aspects
- Abstract: Diabetes mellitus is a prevalent chronic worldwide disease, and sexual dysfunction is a common complication of this disease. Diabetes and its disabling complications often threaten sexual life. Despite the critical role of the psychosocial and cultural issues in the quality of sexual life in women with diabetes, these aspects have not yet been adequately addressed. This study aimed to explore the psychosocial and cultural aspects of the sexual life quality of women with diabetes in reproductive ages. Purposeful sampling was performed in two diabetes clinics and three physicians' offices in Tehran. After 29 In-depth interviews (25 women with diabetes and four key informants), data saturation was achieved. The qualitative content analysis method by Granheim and Lundman was used for data analysis, and consequently, two themes emerged. The first theme, "The dominant role of sociocultural context," consisted of two categories: "The influence of diabetes stigma on sexual identity" and "preferred silence." The second theme was "The burden of psychological distress on sexual life," which included three categories: "diabetes distress," "distress regarding social and health services unmet needs," and "stress management ability." Preferred silence to sexual problems was identified as the dominant sexual coping strategy of Iranian women with diabetes. This identification is an achievement of this study regarding the first theme. Thus, screening the quality of sexual life in women with diabetes is suggested. According to the second theme, psychological, sexual, and family planning health care integrated with medical diabetes care in diabetes clinics is recommended.
  PubDate: 2021-02-15
  DOI: 10.1007/s11195-021-09683-2
The Sexuality of Disabled Bodies and Individuals with Disability in South
Africa's Comprehensive Sexuality Education Scripted Lesson Plans
- Abstract: Local research has utilized both practical (youth with disabilities accessing sexual and reproductive health services) and theoretical knowledge (decoloniality, disability and sexuality) to understand the sexuality of persons living with disabilities. However, this knowledge has not been utilized to examine the visibility of disability and sexuality in South Africa's comprehensive sexuality education (CSE) scripted lesson plans (SLPs). A content analysis was conducted of all the Department of Basic Education's CSE SLPs (Grades 4–12). The study indicated that only in Grade 10 is disability and sexuality discussed in 3 activities. Within these activities, some attempt has been made to demystify certain misconceptions about the sexuality of disabled bodies (i.e. as celibate, asexual beings, with no romantic or sexual interests). The activities further debunk how various types of disabled bodies are sexual beings (i.e. not just those in wheelchairs). However, the fact that these discourses only emerge and left in Grade 10, raises concerns about the inclusivity of the CSE curriculum for disabled youth (e.g. CSE not acknowledging issues of power and consent amongst youth living with disabilities). A critical discussion is provided of the gaps identified and recommendations provided by existing practical and theoretical knowledge to inform the current CSE SLPs.
  PubDate: 2021-02-09
  DOI: 10.1007/s11195-021-09676-1