Sexual Issues and Concerns: Tales of Chinese Women with Spinal Cord Impairments

Abstract

Background: Much has been written about the pathophysiological impact of spinal cord impairment (SCI) on sexual function in women, yet the literature offers only sparse coverage of its psychological and emotional impacts on female sexuality, and the factors which may influence the maintenance of sexual identity as a woman with physical disability. Methodology: To gain insights into sexual experiences and concerns, in-depth interviews were conducted with 10 Chinese women with SCI. Narrative data on marital relationships, sexual identity, sexual knowledge, and sexual satisfaction was transcribed and the content analyzed. Results: When disability intrudes in a woman's life, sexuality is reshaped against the foundation of previous sexual experiences and expectations, especially for women who acquired disabilities in adulthood. Constructions of sexuality among these women encompassed broader areas than the sexual act alone. These included the couple's adjustment to her disabilities, society's perception of a woman's image, internalization of messages about women's roles within the family, the attitude of health professionals towards sexuality, and the onset of disability. Conclusion: Sexuality is an important health concern for women who live with long-term physical disabilities and should be acknowledged by sensitive and responsive health practices. Health care professionals need to renounce the sexual myths and stereotypes and genuinely attempt to understand the possible impact of SCI on women's sexuality.

Barriers to sexual activity: counselling spinal cord injured women in Malaysia

“…Difficulties in achieving or maintaining the desired position, both during foreplay and sexual intercourse, can be attributed to muscle weakness and spasticity. 1,[7][8]10 Apart from these barriers, inadequate vaginal lubrication also interfered with sexual activity in one-third of our sample, compared with 65.5% in a study by Anderson et al 11 Our results might fail to reflect the true extent of this problem, because it is based on patient recall and, further, most of our participants had reduced genital sensation, which is important for one's awareness of vaginal lubrication. It is notable that few subjects reported urinary and bowel incontinence as barriers to sexual activity, as both dysfunctions are significant physical problems and have negative impact on self-image and sexual adjustment.…”

“…Indeed, decreased or lack of genital sensitivity is associated with reduced sexual desire and activity. 1,[7][8]10 Sexual positioning was also noted as a barrier to sexual activity. Difficulties in achieving or maintaining the desired position, both during foreplay and sexual intercourse, can be attributed to muscle weakness and spasticity.…”

“…The women in our study perceived themselves to be less attractive, less confident of themselves, feeling dependant and have a concern over satisfying their partners, and these are consistent with earlier studies. 1,[9][10]13 At the same time, however, it should be noted that satisfying one's sexual partner can have slightly different meanings among Asians. The Malaysian population comprises of multiethnic groups and there is tremendous heterogeneity in social and cultural norms.…”

“…[7][8][9][10][11] Women with SCI consistently express their dissatisfaction with the quality of sexual rehabilitation services during their therapy, 5,[8][9][10] which is poor, fragmented and male oriented. [9][10] There is sparse literature on sexuality and disabilities involving Asian women; in fact, no such reports exist in Malaysia. A qualitative study of Chinese women with spinal cord impairments in Hong Kong 10 concluded that they were inclined to have negative attitudes toward their sexuality.…”

Correction to: Sexuality and Reproductive Health in Young People with Disability: A Systematic Review of Issues and Challenges

“…Parents play a critical role in molding the behavior and attitude of youth and developing in them a feeling of reassurance. To ensure a lasting marital and sexual relationship, a supportive partner on equal footing is needed to avoid a feeling of inferiority [30], leading to more complete psychological development. In fact, the maximum development of one's talents activates one's creativity, generating a feeling of esteem and pride.…”