ABC of sexual health: Sexual problems of disabled patients

Almost 4% of the UK population have some form of physical, sensory, or intellectual impairment—almost 2.5 million people. Many of these disabling conditions can produce sexual problems of desire, arousal, orgasm, or sexual pain in men and women. Sexual difficulties may arise from direct trauma to the genital area (due to either accident or disease), damage to the nervous system (such as spinal cord injury), or as an indirect consequence of a non-sexual illness (cancer of any organ may not directly affect sexual abilities but can cause fatigue and reduce the desire or ability to engage in sexual activity). The two main points for consideration are how disabling conditions affect sexual function and behaviour and which sexual difficulties most commonly arise. Women who undergo radical mastectomy or a disfiguring trauma often report concerns about their femininity and self image such as feelings of lowered self worth or the fear that men will find them less attractive. Similarly, young men with erectile dysfunction often avoid meeting potential partners because of their embarrassment over their inability to perform. “Sexuality” describes how people express their view of what is sexual. That awareness is the result of all the physical, emotional, intellectual, and social factors that have influenced their development up to that point in their life. Defining sexuality as wider than just physical functionis particularly important for people with disabilities. A person who is not able to use part of his or her body still has an equal right to full sexual expression. ### Key questions in cases of disability Present condition Effect of condition on sexuality