It may seem surprising to you that someone who has just met with a major accident and facing the prospect of a spinal cord injury and loss of limb function, would ever ask you “will this injury also affect my sex life, doctor? Will I be able to have active sex life back? Yes, it is true. People have their own perspective of themselves and their life, they have their own priorities which we simply need to appreciate and respect.
Do you know that the Sex, bladder, and bowel function rank amongst the top 5 most important functions for persons with SCI. It has been well appreciated by now that sexuality has major bearing on the person`s self -confidence, motivation and Quality of life after SCI.
After the spine fixation surgery and early recovery, the focus shifts to rehabilitation for early mobilization. However the issues that are generally ignored are the urinary, bowel and sexuality related concerns. Sexuality remains the hidden agenda that nobody talks about. Patients are ridden with guilt and anger and feel too shy and embarrassed to ask, lest they may be ridiculed. Professionals are generally ignorant or scared to talk lest they may offend the patient`s sensibility. As a result, the care providers adopt a defensive, watchful posture that we may discuss if someone chooses to talk about sexual issues. Thus the sexuality goes behind the visible lines and remains hidden and sulking.
For many years, young SCI persons stay at home fighting their battle with a new life which is already full of challenges and try their best to adapt and manage. The numbers of their immediate concerns vary from basic physical needs to social adaptation, vocational readjustment, and financial survival. Most patients take time to adapt to their new physical form and rarely ever think of themselves as likeable. Their self confidence remains low and their sexual self is buried somewhere deep to survival needs.
All SCI persons have a question about their sexuality and that definitely does need to be addressed. It`s important to appreciate that they are not looking for an immediate solution, they are just looking for a reassurance that they can be helped and when the time is right they may be sexually active once again. We cannot deny them that. We have to break the ice barrier that is chilling the warmth out of their sexual self. We have to extend a helping hand to help them out of their psychological cocoon.
In a study of 350 SCI respondents from 4 European counties, they identified sexual activity as the area of greatest unmet need. You can well imagine what may the status be in Indian subcontinent where talking about sexual matters is a taboo, cultural antagonism and religious blasphemy. Our SCI population is nearly totally deprived of sexuality guidance which is so nearly manageable in nearly every SCI person.
In another study of 681 persons with SCI (25% females, 75% males) who were asked about what functional gain was most important to their QOL (including sexual function, return of sensation, walking, and bladder and bowel function). You won`t believe that majority of SCI persons with paraplegia, regaining sexual function was their highest priority; while among the Quadriplegic SCI persons, it was the second highest priority (preceded only by regaining hand and arm function).
Why do you think SCI persons value their sexuality? As you can appreciate that our sexual self is such an important part of our Whole self. “Sexuality” is what we are. It is there in our genes (X an Y chromosomes), our Brain centres (Amygdala, Hypothalamus, thalamus) and our hormones (testosterone and estrogen), our whole body (as a male and female), our body organs (Genital organs). It is there in our emotions, our social behaviour and our sexual orientation and attraction. In fact today whatever we like, we say how I love it…..Love is the root of sensuality, sexuality and our sexual self. So our sexuality connects to everything we are and everything we do, we love to do.
Sexual emotions are one of the strongest emotions and thus weigh heavily on one`s mind always. It is well recognized that a sexually well-adjusted SCI person stay more committed to his overall physical rehab than those who are denied a chance to rediscover their sexual identity. Most SCI persons feel that their SCI had altered their sexual sense of self and that improving their sexual function would improve their quality of life in more ways than one.
