Human Sexuality and Disability - Case Study Example

Human sexuality is formed in social interaction in appliance with inter ive denotations, set down by the culture and inner ive perception of individuals. The rationalization of culture brings community to a possibility to have social control over individuals through the sphere of sexual, private, and intimate. In this case sexual sphere often becomes a polygon of fighting for the norm. Social usefulness becomes a kind of a primary criterion, rather than a virtue of a person. Different social practices of modern sexuality time and again bear the marks of normative discursive notions that exist on the wide continuum from family and relatives relationship till popular culture, letter of the law, and specialized expert knowledge. Social control over sexuality, bound up with control over birthrate and morality, becomes a fundamental class and race marker, or just a kind of measure of normality. It should be mentioned that sexuality of individuals with disabilities is mostly taken as taboo and avoided giving publicity, as well as gender identity is often represented as disabled, e. d. problematic. The most ordinary example of the fact that society rejects sexual identity of people with disabilities is symbols on the rest-room doors. ''' '''''' ''''' ' In 1970'es the eugenics, was widely discussed. Eugenics is a movement during the early twentieth century aimed at maintaining genetically pure races; advocated the prohibition of interracial marriages as well as the sterilization of the mentally handicapped (Glossary, website at ). In works related to sexual education written that time, retardate people have been taken as deficient of gender identity and sexuality. As gar as gender difference appears in discursive notions, women with mental disabilities have been arrogated not only with promiscuity in sex, amorality and vulnerability, but also exceeding fertility that brings to begetting of mentally deficient seed. According to Williams and Nind (1999), which have researched problems of women with learning difficulties, sexuality in discursive notion is originated in connection with control over the fertility emphasizing on sexual health, rather than on sexual satisfaction. In the 1980'es the new ideology of 'normalization' came into existence, though eugenics continued to exist showing itself in fear and enmity. People having difficulties in learning have been usually treated as unable to play 'usual' (including sexual) roles. As a matter of fact gender identity makes different possibilities for a man and for a woman. In spite of the fact the demographical data is characterized by predominance of aged disabled women, most of them even of young age are treated like useless from the point of view of fertility, that is to say for performance of traditionally women's roles (Fine and Asch, 1988). Nevertheless on dealing with pure sexuality one may notice that disability in the first instance threatens to masculine. The reason is that female gender identity is not contradictory to disabled people passivity. As for the disabled man it is clear that on drawing an analogy between himself and a popular culture 'hero' character, an active, successful, and well-knit men, he realizes a dissonance. In this case we get conflicting identities. This conflict gets to the center of attention of popular culture, appealing to disabled image. Tom Cruise's character in the movie 'The Men, Born on the Fourth of July' is a classical example of an individual with disability living in US. The white war-horse is heavily trying to get used to own disability, which is presented in the context of emasculation or sexual disability (Shakespeare 1996: 194). All attempts to have some sexual life just face women's jeers. But this disable man gets over the 'lack of masculine', and attains high social status and general acceptance. He returns his own activity, initiative, and control by participation in pacifist movement. However the reality of disabled men too much differs from stereotypical representations. Shakespeare (1996) gives us an example of one respondent, whose disability in childhood didn't keep him away from behaving like 'normal' teenager. When he has come black and blue to the school, most of people have thought that his father had beaten him, as nobody could believe that handicapped person could fight. The other respondent felt that reasoning from his being disabled his masculine identity differs from identity of stereotypical man, because he felt social oppression, a feeling not agreeable with masculinity standard. This man felt solidarity not with white heterosexual men, but with women, gays, and black people, as he shared these groups' experience of marginality and oppression. (Shakespeare 1996: 194-195). The point is not only in difference of mental and physical characteristics, but also in some additional needs closely connected with these characteristics, in particular with some resources essential for self-supporting life. Oliver states that individuals with disabilities in society perceive own 'otherness' as marginalization and social elimination. (Oliver 1989). Sexual identity of individuals with disabilities often becomes an additional means for gender identity formation, and that is why is surrounded by even more intent control of society. It finds its expression in medicalisation of sexual experience of disabled people (mostly men), whose sexuality is treated as problematic, and representations of their extra-masculine sexuality. Attempts to ruin the myth of disabled people asexuality often leads to a creation of an opposite one - a myth of their oversexed power. Herewith the real-life heterosexuality of disabled men is represented as some experience of 'other sexual culture', and by that to some extent is treated as 'exotic'. Homosexual identity of individual with disability is practically not discussed. Now let us consider human sexuality concentrating on disability ranging from spinal cord injuries, cancer to neurological injuries. It should be noticed that most of the recent studies in this sphere have pored masculine and erective function. Though in these latter day there is a positive tendency of studying the impact of spinal cord injury on female sexuality. Without reference to gender the sexual health of an individual with disability depends on the completeness or incompleteness of the particular injury. It means that first of all it is important to discover whether the neurological damage affecting the individual's sacral spinal segments is an upper or lower motor neuron injury. Spinal cord injury has a grate impact on a man both physiologically and psychologically. The measure of this impact depends on the kind and level of the injury. Men having such disabilities face a lot of difficulties in their sexual life, such as problematic relationships or absence of any sexual relations, fall of sexual activity, or even infertility. Considering man with spinal chord injuries the question of vital importance is to qualify the impact on erections and ejaculations, with respect to a kind of injury. There are actually two types of erection. The first one is psychogenic erection, which is originated due to sexual thoughts, exciting visual and aural stimulus. Human brain sends these signals through pathway of spinal cord to the T10-L2 level, and from there they get to penis originating erection. When we deal with men's spinal cord injury the possibility to have psychgenic erection depends on extent and measure of injury. The second type of erection is reflex one. It is originated due to direct physical contact of penis or other erogenous areas, such as ears, nipples, neck, etc. Reflex erection is unconscious and may be originated without any sexual thoughts. Nerve-centers, which control the ability to have reflex erection, are situated in sacral segments S2-S4 of spinal chord. The majority of men having spinal chord injuries are able to have reflex erection by physical stimulation in case S2-S4 or nerves standing aside of them are not injured. In males with complete spinal cord injuries and upper motor neuron injuries affecting their sacral segments, there is a loss of psychogenic erectile function in conjunction with maintenance of reflex erectile functions (Bors & Comarr, 1960). According to Sipski (1997) man having incomplete upper motor neuron injuries, there is still maintenance of reflex function; however, some of these males may be able to have psychogenic erectile function. Approximately 25 percent of males with lower motor neuron injuries affecting their sacral spinal segments are able to have psychogenic erectile function, whereas none of these males will have reflex erectile function. It is notable that having incomplete lower motor neuron injuries affecting the sacral spinal segments, over 90 percent of the population will be able to have some type of erectile function. The main factor that influence on the ability of a man with spinal chord injury to be a biological father is ejaculation dysfunction. In fact 90% of men suffering from spinal chord injury do not have ejaculation on having sex. Many of them have the so-called retrograde ejaculation, an ejaculation that goes back into the bladder instead of coming out of the penis. There is a myth that the quantity of sperm after spinal chord injury goes down in the course of time. According to the researches that fact is not answerable to real situation and must not make men who wish to become a biological father worry. Notwithstanding the percent of active spermatozoon in sperm of disabled men is much more lower than healthy men have. There are some methods in the direction of men's with spinal chord injuries infertility treatment: Penile vibratory stimulation - PVS, which is used for erection originating, though the main aim is to reach ejaculation. Rectal Probe Electroejaculation - RPE is used in case an inefficiency of above mentioned method. A peculiar electrode is put in rectum, and ejaculation is originated due to electro stimulation. In case all attempts to get sperm using PVS and RPE are failed, a patient may be proposed to have an operation. Now let us appeal to women with spinal chord injuries. Nancy Mairs (1996), who has become handicapped in her middle years, in her book 'Waist-High in the World. A Life Among the Non-disabled' has told about the most common myths related to disabled women: 1. She has a lack of health or competency to have a job. 2. Never a one man will take an interest in such a women and have a desire to take care of her. 3. Disability is just capable to injure, it is not able to strengthen family and friendly relationship. 4. Suicide is rather understandable and even rational reaction on physiological deficiency. Glamour magazine has invited Nancy Mairs to write an article according to disabled women letters, who have sent the stories of their lives to editorial office. Despite all of these women have had some disabilities, all of them have been so much differ. So Nancy have had to work hard in order to make at least some generalization. One of these women has written that most of people prefer (consciously or not) to speak about people with disabilities in general, thinking that all of them have the same problems, and what is even worthier, that all problems they have are caused by their disability. Disability is just a one of the elements of their complex and many-sided personality, which does not necessary disagree with all the rest in their lives. Surely there are many factors that influence sexual life of women with spinal chord injuries. Here is a list of common areas of concern for women with spinal cord injury (White, 1993): Urinary Accidents Bowel Accidents Not satisfying a partner Feeling sexually unattractive Others viewing me as sexually unattractive Not getting enough personal satisfaction Preparation too much trouble Hurting self Loss of interest Not liking methods for satisfaction Women who have lost the sensibility of genitalia are not able to get physical orgasm. But women who have partial sensibility are able to get orgasm due to feel of other erogenous areas. It is known that a great number of healthy women do not know what orgasm is. Moreover the frequency and intensity of orgasm is dependant on experience, knowing own body need, psychological freedom, external environment, and partner's skills. Women's erogenous areas are spread over the body, and therefore even in case of complete loss of clitoris sensibility, majority of them are able to feel some sexual excitement. Recent researches has supported the hypothesis that women with complete spinal cord injuries and upper motor neuron injuries affecting the sacral spinal segments will maintain the capacity for reflex lubrication while losing the capacity for psychogenic lubrication (Sipski and Alexander, 1995). Let us consider the fertility. The most of women having spinal cord injuries face temporary loss of menstruation. With a course of time periods become regular again. Menstrual pain is still present after spinal cord injury and there is generally not a decrease in the ability of a woman with a spinal cord injury to conceive (Sipski, 1997). The fertility of women with spinal chord injures may be affected in the first months after injury. Notwithstanding, the majority of women save the ability to become pregnant. Besides a lot of disabled women are able to carry babies to full term. The point is that it is necessary to medicals to explain and to warn women who become pregnant after spinal cord injury off all potential complications, such as anemia, urinary tract infections, pressure sores, problems with transfers due to weight gain, and, most significantly, autonomic dysreflexia. That is why the question of vital importance is to use birth control for such women. Human sexuality is the origin of the deepest bond between human beings and is essential to the well-being of individuals, couples, families and society. Therefore, the respect for sexual rights should be promoted through all means (Valencia Declaration on Sexual Rights, 1997). The right to freedom, which excludes all forms of sexual coercion, exploitation and abuse at any time and in all situations in life, has an every single person in the world. As for the realization of this right disabled people are seen to be the most vulnerable group. The majority of disabled people are not able to negotiate this right not because of physiological, but sociological reasons. All over the world the issue of disabled people life refinement becomes a foreground direction for government social programs. People having spinal chord injuries are often in need for medical care just temporary, in contradiction to process of rehabilitation that may last for all life. That is why society must by all available means assist disabled people in getting chance to feel and get pleasure from own sexuality. References List: 1. Bors, E & Comarr, AE 1960, Neurological disturbances of sexual function with special reference to 529 patients with spinal cord injury, Urology Survey, pp. 110, 191-221. 2. Fine, M & Asch, A (Eds.) 1988, Women with'disabilities:' Essays in psychology, culture, and politics,'Temple University'Press, Philadelphia. 3. Glossary, n.d., viewed 20 January 2007, 4. Mairs N 1996, Waist-High in the World. A Life Among the Nondisabled, Beacon Press, Boston. 5. Oliver M 1989, Disability and Dependency: A Creation of Industrial Societies // Barton L (Ed.) Disability and Dependency, The Falmer Press; London, New York, Philadelphia, pp. 6-22. 6. Shakespeare T 1996, Power and Prejudice: Issues of Gender, Sexuality and Disability // Barton L. (Ed.) Disability and Society: Emerging Issues and Insights, Essex: Longman, pp.191-214. 7. Sipski, ML 1997, Sexuality and spinal cord injury: where we are and where we are going - Spinal Cord Injury, Part 3, viewed 20 January 2007,http://www.findarticles.com/p/articles/mi_m0842/is_n1_v23/ai_19755794/pg_1. 8. Sipski, ML, Alexander, CJ, & Rosen, RC 1995, Physiological parameters associated with psychogenic sexual arousal in women with complete spinal cord injuries, Archives of Physical Medicine and Rehabilitation, 76, pp. 811-818. 9. Williams L & Nind M 1999, 'Insiders and Outsiders: normalisation and women with learning difficulties', Disability and Society, Vol.14, No.5, pp. 659-672.' 10.White, MJ et al. 1993, 'Sexual activities, concerns and interests of women with spinal cord injury living in the community', American Journal of Physical Medicine and Rehabilitation, 71 (4), pp. 225-231. Read More