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Sexuality ‘silenced’ after stroke

[Stroke] doesn’t change the essence of who I am or what I want, before and after. It only changes what I can do. It doesn’t change what I want.

Australian researchers are reminding clinicians to talk with stroke survivors about sexuality.

They argue that sexuality remains important to survivors, but they and their partners don’t have access to adequate support to deal with changes to their relationships, self-identity, gender roles and intimacy following stroke.

Lead author Dr Margaret McGrath from the University of Sydney said their review shows that sexuality is essentially silenced following stroke.

“Issues around post-stroke sexuality and where to seek support are rarely discussed with stroke survivors or their loved ones despite numerous interactions with medical, rehabilitation and counselling staff,” said McGrath, an occupational therapy researcher.

“Sexuality and disability is viewed as a taboo topic so stroke survivors don’t know how to talk about it and health professionals don’t ask the questions.”

The study said this lack of dialogue could lead to an increased incidence of anxiety and depression and poorer quality of life outcomes.

The researchers pooled data from studies involving more than 650 male and female stroke survivors and their partners.

McGrath said men often struggled with an inability to be what they viewed as a “protector” or “provider” for the family, while female stroke survivors lamented a loss of their role as wife, mother or homemaker.

“This also impacts partners’ self-identity, particularly when they moved from being an intimate partner to a primary caregiver,” she added.

Stroke also had an impact on those who were not in a relationship or whose relationship ended, as they felt less confident and willing to seek out new relationships.

One stroke survivor said:

Why should a lady want to go out with me if you can go out with someone who does not have a disability?"

McGrath said: “Stroke also impacted the survivor’s relationship with their own body, with many seeing their body as unpredictable or separate from themselves.

“Being sexually intimate exacerbates these feelings, leading to heightened levels of anxiety.”

She added that many of these fears and misconceptions could be addressed through proper support from health and rehabilitation professionals.

“Health professionals’ reluctance to address sexuality is due to a lack of knowledge and confidence. We need tailored education and training to address this knowledge gap.”

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