Sexual Functioning in Men With and Without Disabilities: Findings From a Representative Sample of Australian Men

Abstract

Introduction. Studies on sexual function in men with disabilities have mainly relied on clinical samples; population-based evidence on this topic is limited. Aim. We aimed to compare aspects of sexual function between disabled and non-disabled men using a representative sample. Methods. We used data from Ten to Men, a national cohort study of Australian men aged 18 to 55 years. We first compared the prevalence of 15 sexual function-related difficulties in disabled versus non-disabled men. Next, we used Poisson regression to examine associations between disability and sexual function. The main analytic sample had 8,496 men. Weights and adjustments appropriate to the sampling methodology were applied. Models adjusted for potential confounders. Results were reported as prevalence ratios (PRs). P-values of <0.05 were considered statistically significant. Outcomes. Outcomes were 15 individual items from the Natsal-SF, a validated measure of sexual function with items in 3 domains: physio-psychological aspect; relational aspect; and global selfrating (the 16 th item on help-seeking was excluded). These were coded as binary variables denoting past-year sexual problems. Results. Disabled men had higher prevalence of all outcomes than non-disabled men. 25.6% of men with disabilities and 15.1% of non-disabled men experienced at least 2 out of 15 difficulties. The most prevalent problems were 'orgasmed too early' (43.8% of disabled men, 37.1% of non-disabled men), imbalance of sexual desire between partners (47.6% of disabled men, 39.2% of non-disabled men), and overall sexual dissatisfaction (39.4% of disabled men, 26.7% of non-disabled men). All adjusted PRs were greater than 1.00 for disability; associations were statistically significant except 'partner experienced sexual difficulties' (PR 1.23; 95% CI 0.99, 1.53; p=0.058) and 'orgasmed too early' (PR 1.16; 95% CI 1.00, 1.35; p=0.050). 'Presence of discomfort/pain' had the largest adjusted PR for disability (PR 2.77, 95% CI 1.89, 4.06; p<0.001). Clinical Translation. This population-based comparative analysis helps contextualize evidence from clinical studies on the relationship between disability and sexual function, and may lead clinicians to new insights about sexual function in male patients with disabilities. Strengths & Limitations. Two major strengths of this study are that the sample included a nondisabled reference group and results are generalizable to Australian men. A key limitation is that disability and sexual function measures are self-reported. Conclusion. This study provides a broad foundation of population-based evidence about sexual function in men with disabilities, relative to men without, showing positive associations between disability and 13 of 15 sexual difficulties.

Socioeconomic Characteristics, Lifestyle Behaviors, and Health Conditions Among Males of Reproductive Age With and Without Disabilities, NHANES 2013–2018

“…Less information is available for males of reproductive age with disabilities. Greater likelihood of sexual dissatisfaction, sexual anxiety, sexual dysfunction, and sexually transmitted infections have been reported among males with disabilities compared to those without disabilities ( Bollier et al, 2019 ; McCabe & Taleporos, 2003 ). Among fathers participating in the 2016 Behavioral Risk Factor Surveillance System, those with disabilities were approximately 1.5 to 5.5 times more likely than their nondisabled counterparts to report insufficient sleep, current smoking, poor or fair health, frequent physical distress, or frequent mental distress ( Namkung et al, 2019 ).…”

Ten to Men: The Australian Longitudinal Study on Male Health: Waves 1–3

“…The breadth of data collected across multiple domains has facilitated explorations of complex topics including: sexual functioning in men with and without disability (Bollier et al 2019), psychosocial job stressors and suicidal thinking (Milner et al 2017), comorbid depression and obesity (Haregu et al 2020), and the influence of masculine norms and mental health on health literacy (Milner, Shields and King 2019). The broad range of information collected in TTM means the study is of particular interest to researchers across diverse disciplines, policymakers and health practitioners who work with males.…”