Differences in Sexual Behavior of Teenagers and Young Adults with Cerebral Palsy: The Role of Sexual Needs and Sexual Esteem

Exploring the sexual experiences and challenges of individuals with cerebral palsy

PURPOSE

Cerebral palsy (CP) is a prevalent motor disorder affecting children, with evolving demographics indicating an increasing survival into adulthood. This shift necessitates a broader perspective on CP care, particularly in addressing the often overlooked aspect of sexuality. The purpose of this study was to investigate experiences of, challenges with, and related factors of sexuality and intimacy that people with CP are facing.

METHODS

This was a descriptive and cross-sectional single institution survey among individuals with CP, ages 18 to 65, who had the ability to independently complete an online survey.

RESULTS

A total of 40 respondents participated in the survey (Gross Motor Function Classification System [GMFCS] level I/II, 32.5%; III, 35%; IV, 32.5%). Of those, 45% were partnered, 60% had past sexual experience, 47.5% were currently sexually active at the time of submitting the survey, 80% had masturbation experience, and 45.8% believed it had positive effect on their self-esteem. Only 10% received sex education tailored for people with disability, whereas school (72.5%) and internet (35%) were the most common sources of sex education. Muscle spasms, positioning difficulty, and pain/discomfort were the most common physical challenges experienced during intimate activity amongst all function stratifications. Stratification analysis showed that, compared to higher functioning respondents, a smaller proportion of lower functioning respondents were partnered (GMFCS IV, 23.1%; quadriplegic, 31.6%), had past or current sexual experience (GMFCS IV, 44.4%, 36.4%; quadriplegic, 42.1%, 26.3%, respectively), and had masturbation experience (GMFCS IV, 61.5%); Also, they had worse Quality of Life Scale scores on average (GMFCS IV, 88.4; quadriplegic, 88.3) and a higher rate of reported positive effects of sexual experiences on self-esteem than negative (GMFCS IV, 38.5%; quadriplegic, 35%).

Sexual needs of people with schizophrenia: a descriptive phenomenological study

BACKGROUND

Sexual health is one of the main areas of health and basic human rights which has been paid less attention in schizophrenia. Most studies have focused on sexual dysfunction rather than the sexual needs of people with schizophrenia. This study explores the sexual needs of people with schizophrenia and identify factors hindering sexual activities.

METHODS

We carried out a qualitative study using a descriptive phenomenological approach. Data were collected at a psychiatric hospital in China. In total, 20 patients with schizophrenia were recruited through purposive sampling. Face to face semi-structured in-depth interviews were conducted with them. Interview recordings were transcribed by the research team, and transcripts were analyzed by two independent coders with Colaizzi's descriptive analysis framework by using NVivo 11 software. The consolidated criteria for reporting qualitative research checklist was used for reporting.

RESULTS

The data analysis revealed 10 subthemes categorized into 3 macro themes: (1) multiple barriers hinder sexual activity; (2) significance of sex; and (3) conditions for fulfilling sexual needs.

CONCLUSION

A poor sexual quality of life may be found in patients with schizophrenia. Furthermore, people with schizophrenia did not lose interest in maintaining an active sex life. Mental health services should address this issue in three areas: sexual knowledge, sexual space, and sexual objects.

Determination of sexual developmental characteristics of adolescents with intellectual disabilities

This cross-sectional study was carried out in order to determine the opinions of mothers on sexual development in children with intellectual disabilities. The sampling of this study included mothers of children aged 10-19 years with moderate and severe intellectual disabilities. Of the mothers, 45.7% stated that they felt incapable of providing sexual education to their adolescent children with disabilities and 97.6% stated that they had received no information on this subject themselves. Based on the mothers' opinions, the mean score for the sexual development of adolescent children was 11.33 ± 16.18. In the sub-dimensions of sexual arousal (20.97 ± 5.71), sexual harassment (12.22 ± 3.13), sexual satisfaction (15.79 ± 3.85) and sharing sexual issues (12.74 ± 2.67) the mean score of the scale was found to be high. The knowledge levels of the mothers concerning the sexual development of their children with intellectual disabilities were found to be low, and they required education on this issue.

Facilitators and barriers to developing romantic and sexual relationships: lived experiences of people with complex communication needs

The aims of this study were to investigate the lived experiences of people with complex communication needs in developing romantic and sexual relationships, and identify and explore barriers and facilitators they encountered in pursuing these relationships. For the study, nine participants were interviewed. All were at least 21-years-old, used augmentative and alternative communication, and had physical and communication disabilities since childhood. A methodology employing critical hermeneutics, a form of interpretive phenomenology, and Feminist Standpoint Theory was utilized. The World Health Organization (WHO) International Classification of Functioning, Disability and Health (ICF) model (2013) was used to develop questions for the semi-structured interviews. Interview data were analyzed using reflexive thematic analysis, with the ICF model and the concept of ableism used to identify four main themes: (a) Attitudes of others (ableism), (b) Communication Within Intimate Moments, (c) Assistance of Support Workers, and (d) Additional Education Related to Sexuality and Disability. Most of the barriers participants encountered related to ableist attitudes they experienced from others. Facilitators included creative communication strategies for intimate moments and using dating websites. The participants' experiences bring attention to the need for changes in policies, practice, and research to further support people with complex communication needs in their quest to develop intimate relationships.

Healthcare providers' perspectives with addressing sex-related issues and sexual identity within pediatric rehabilitation: A qualitative study

BACKGROUND

Although having a sexual and reproductive life is a fundamental human right, people with disabilities, especially youth, often have many unaddressed needs. Healthcare providers commonly report lacking knowledge and training in how to address sexual-related topics with youth.

PURPOSE

The purpose of this study was to explore the perspectives of pediatric rehabilitation care providers in addressing sex and sexuality among youth with disabilities.

METHOD

This qualitative study involved a secondary analysis of interviews with 21 participants (18 women, 2 men, 1 trans man) from a range of pediatric rehabilitation disciplines. An open-coding thematic analysis of the transcripts was performed.

FINDINGS

The results highlighted the following themes regarding healthcare providers' perspective of addressing sex-related issues within pediatric rehabilitation: (1) lack of attention to sex-related issues (i.e., taboo topic); (2) coping with clients disclosing sexual identity (i.e., unpreparedness, addressing discrimination and mental health issues, creating a safe space); and (3) navigating parental concerns (i.e., resistance to sex-related issues, privacy and confidentiality, youth's reliance on parents for managing menstruation).

CONCLUSIONS

Pediatric rehabilitation healthcare providers encounter challenges in providing health services and advice to youth with disabilities regarding sex-related issues and may need further training.

Optimal Management of Undescended Testis in Boys with Cerebral Palsy. A Debate

Cerebral palsy is a rare condition following injury of the developing brain and including nonprogressive neurological disorders, spasticity, intellectual impairment and others. Boys with cerebral palsy have a high incidence of undescended testis. Although the motives for treatment (infertility, cancer prevention, psychological aspects, testicular torsion) are not different in boys without neurological impairment, the decision-making process in boys with cerebral palsy is very difficult. Besides medical and surgical arguments the discussion involves challenging ethical issues.