A new study published in NeuroRehabilitation , the experts discuss how sexuality can affect neurorehabilitation in patients suffering from a range of conditions, from stroke and spinal cord injuries to sexual behavior in patients with dementia.
Research addressing the relationship between sexuality and the brain has a long history in neurological and behavioral sciences. This increased awareness has led to a better understanding within the scientific community regarding the importance of sexuality as a health outcome to promote the quality of life of individuals with neuro-disabilities.
"Neurosexuality care should be driven by a transdisciplinary approach to appraise the evidence base of the potential negative consequences of different neuro-disabilities on sexuality and to build upon sound treatment strategies to address these complexities," explained guest editors Alexander Moreno and Nathan D. Zasler.
An important contribution to this issue advocates for changing the culture of neurodisability through language and sensitivity of providers in order to create a safe place for lesbian, gay, bisexual, transgender, queer, intersex, asexual, and people with other sexual orientations and forms of gender expression ( LGBTQIA + ).
The invisibility of LGBTQIA + individuals with neurological disorders translates into diminished quality of care or inappropriate care, lack of recognition of all family configurations, exclusion of family caregivers, and violations of human rights. Shedding light on the diversity of individuals with neurological disorders has the potential to improve healthcare by helping rehabilitation professionals to be sensitive to the particular needs of LGBTQIA + individuals.
The authors surveyed the literature concerning neurological disorders affecting LGBTQIA + individuals. They found that the relative neglect of LGBTQIA + individuals with neurological disorders in clinical practice and research is striking. The authors provide 20 recommendations to guide clinicians, researchers, and policy professionals about the care of the LGBTQIA + community.
The study emphasized that "being part of a positive change in the rehabilitation of LGBTQIA + people with neuro disabilities is part of our obligation as healthcare providers who are self-reflective, critical, and willing to improve the quality of the services provided in an ethical framework . "
The authors reviewed over 2000 studies and found That literature About sexuality in children and adolescents With acquired brain injury has mainly physical issues addressed, with positive sexual health. Older patients showed sexual problems, lower sexual desire, and suffered more from anxiety and depression than younger patients, suggesting that clinicians should be aware of age differences when treating their patients.
A literature review of post-stroke sexual functioning describes how various dysfunctions are related to stroke location, laterality, and physical and psychological changes. Three programs are presented to address post-stroke rehabilitation.
For Patients With m ultiple sclerosis , assessment, and treatment of sexual dysfunctions, even relationships, fertility, pregnancy, and parenting issues are described. They emphasize that, like other neurological disorders, there is a need for more collaboration among providers in addressing sexual concerns in MS.
Surveys of both patients with amyotrophic lateral sclerosis (ALS) , also known as Lou Gehrig's disease, and ALS care providers revealed uncomfortable feelings when the subject of sexuality was raised. The authors call for more education among ALS specialists in sexuality and a policy change that guarantees the inclusion of sexuality in their guidelines.
Spinal cord injury (SCI) can impact sexual response, male infertility, and its treatments, as well as pregnancy issues. The authors emphasize the importance of providing education and specific sexual recommendations based on the individual's sexual potential. They also present advanced treatments for sexual dysfunctions and discuss other challenges in the management of sexual dysfunction of individuals with SCI.
"We hope that this thematic issue provides an impetus for rehabilitation and other health professionals, students in the health sciences, and researchers to develop their competence and awareness of the importance of sexual neurorehabilitation in persons with neuro disabilities," Alexander Moreno concluded.