SEXUALITY AND DISABILITY
DU FRANÇAIS À L’ANGLAIS
professeur d’anglais aux écoles d’ergothérapie de Nancy et Mulhouse
A trainee nurse (TN) and an occupational therapist (OT) are discussing the subject of sexuality in disabled people prior to the former’s internship in a nursing home.
OT: First of all, you need to know that sexuality refers to the natural capacity to experience pleasure from sexual activity. And, for disabled people with physical or cognitive handicap, enjoying sexuality positively contributes to physical and mental health. But then what is sexual dysfunction for you?
TN: Umm. I don’t know. It can be anything.
OT: Well, it’s when you’re facing important challenges related to your ability to experience pleasure even if you’re physically, cognitively or neurologically disabled.
TN: Therefore, we need to consider that people with disabilities are sexual individuals with desires like anybody else.
OT: Exactly, and in that sense we should bear in mind that there is not one and only criterion for sexual pleasure. For example, talking about sex is natural, men do not always initiate sexual activity, and a firm penis is not a requirement for satisfying sex. Also, the sexual activity may not be spontaneous and doesn’t have to be through sexual intercourse and end with an orgasm. Here, concerning our subject, the sexual function is as important as any other aspect in the process of rehabilitation from a disabling disease, symtom or injury. And when impaired, the person may experience depression from altered body image and social distance with the others, but also from fear of rejection, inadequate performance and pain.
TN: From what you’ve just said, I guess that the issue of sexuality must be handled with care and compassion to help avoid reduced self-esteem. But then, what solutions do we have at hand?
OT: First of all, we implement what we call team approach, that is when the diagnosis of sexual dysfunction is determined, many health care providers, among whom are physiatrists, urologists, gynecologists, psychologists, occupatinal therapists and certified sex therapists must participate in the process of treatment before resorting to medical or non-pharmaceurical options.
TN: Does a care professional, like nurses, have any role to play here?
OT: For sure, at least as far as asking for, and giving information about, the sexual function of the patient before and after disability to bring the patient to consider physical and mental changes that have occurred in order to propose tailored solutions and coping strategies so that sex might not be considered only in terms of sexual intercourse and orgasm.
TN: You mean that once the dysfunction is identified, individualized suggestions can be given. But like what?
OT: Exactly. This can address pain and limitation of motion, relaxing massage, strategic positioning, timing, strengthening and endurance training and general rehabilitation programs, and being aware of body areas that can be aroused.
VOCABULARY
Disabled people
Personnes en situation de handicap
Sexual dysfunction
Dysfonctionnement sexuel
Satisfying sex
Relations sexuelles satisfaisantes
Sexual intercourse
Rapports sexuels
Disabling diseases
Maladies invalidantes
Altered body image
Altération de l’image corporelle
Social distance
Distance sociale
Fear of rejection
Peur du rejet
Reduced self-esteem
Diminution de l’estime de soi
Certified sex therapists
Sexothérapeutes certifiés
Relaxing massage
Massage relaxant
Strategic positioning
Positionnement stratégique
COMMON PHRASES
For disabled people with physical or cognitive handicap, enjoying sexuality positively contributes to physical and mental health.
Pour les personnes en situation de handicap souffrant d’un problème physique ou cognitif, le fait de jouir de la sexualité contribue positivement à la santé physique et mentale.
We need to consider that people with disabilities are sexual individuals with desires exactly like anybody else.
Nous devons considérer que les personnes handicapées sont des individus sexuels avec des désirs, exactement comme toute personne.
The sexual function is as important as any other aspect in the process of rehabilitation from a disabling disease, symtom or injury.
La fonction sexuelle est aussi importante que tout autre aspect dans le processus de réadaptation à la suite d’une maladie, d’un symptôme ou d’une lésion invalidante.
When impaired, the person may experience depression from altered body image and social distance with the others, but also from fear of rejection, inadequate performance and pain.
Lorsque la personne est handicapée, elle peut souffrir de dépression suite à une altération de son image corporelle et à une distance sociale avec les autres, mais aussi à la peur du rejet, d’une performance inadéquate et de la douleur.
The issue of sexuality must be handled with sensitivity and compassion to help avoid reduced self-esteem.
La question de la sexualité doit être traitée avec sensibilité et compassion afin d’éviter une baisse de l’estime de soi.
We implement what we call team approach, that is when the disgnosis of sexual dysfunction is determined, many health care providers, among whom are physiatrists, urologists, gynecologists, psychologists, occupatinal therapists and certified sex therapists must participate in the process of treatment before resorting to medical or non-pharmaceurical options.
Nous mettons en œuvre ce que nous appelons une approche d’équipe, c’est-à-dire que lorsque le diagnostic de dysfonctionnement sexuel est établi, de nombreux professionnels de soins et de santé, parmi lesquels des physiatres, des urologues, des gynécologues, des psychologues, des ergothérapeutes et des sexothérapeutes certifiés, doivent participer au processus de traitement avant de recourir à des options médicales ou non pharmacologiques.
As nurses, we can at least ask for, and give information about, the sexual function of the patient before and after disability to bring them to consider physical and mental changes that have occurred in order to propose tailored solutions and coping strategies so that sex might not be considered only in terms of sexual intercourse and orgasm.
En tant qu’infirmières, nous pouvons au moins demander et donner des informations sur la fonction sexuelle du patient avant et après le handicap pour l’amener à considérer les changements physiques et mentaux qui se sont produits afin de proposer des solutions adaptées et des stratégies d’adaptation pour que la sexualité ne soit pas considérée uniquement en termes de rapports sexuels et d’orgasme.
Once the dysfunction is identified, individualized suggestions can be given that may address pain and limitation of motion, relaxing massage, strategic positioning, timing, strengthening and endurance training, and general rehabilitation programs, and being aware of body areas that can be aroused.
Une fois le dysfonctionnement identifié, des suggestions personnalisées peuvent être formulées, qui peuvent porter sur la douleur et la limitation des mouvements, le massage relaxant, le positionnement stratégique, le choix du moment, l’entraînement au renforcement à l’endurance, les programmes de rééducation générale et la prise de conscience des zones du corps qui peuvent être excitées.