Sexuality is a fundamental part of a full and healthy life and it is also a basic human right. Sexuality contributes to quality-of-life in everyone but all in persons with chronic conditions including amputation.  Despite this, it is rarely addressed by health professionals, and conversations with persons with chronic disease or with amputations about sexuality rarely occur.

Sexuality can be defined as a combination of “sexual well-being” and “sexual functioning”.  Sexual well-being refers to how someone experiences sexuality in the context of their personal life.  Sexual functioning refers to the performance standards of the sexual response cycle.

Illness, injury, and disability can have a negative impact on sexuality and particularly on sexual functioning.  Sexuality and sexual functioning may be affected after an amputation.  In the 11 or so published research papers on sexuality in persons with lower-limb loss, lack of satisfaction with their sexual life is reported by between 13 and 75% of persons with amputation (Geertzen et al, 2009).  This is a very wide range considering that about 20% of the population without amputation is dissatisfied with their sexual life.

What is your role as a peer visitor?  Prepare, in advance of your meeting, how you would respond if the person you are visiting expresses concerns about sexuality.  During the visit, if you sense that it might be an issue for the person and they have not broached the topic, use a question about relationships to break the ice.

Read the article Sex and Intimacy after Amputation published in the Amplitude magazine in 2019.  After reading the article, complete the questions to check your understanding.

Check your understanding

Skin hunger is the desire for physical touch.
• True
• False
The desire for physical touch is referred to as skin hunger.
Physical touch does not affect our hormones.
• True
• False
It can result in hormones that boost mood.
Intimacy is always physical.
• True
• False
It does not have to be physical. Sharing thoughts and feelings in one on one conversation with another person is intimate.
Open conversation with a peer visitor can remove the fear of returning to physical intimacy.
• True
• False

Scenario:

The amputee you are supporting tells you that they are worried about what others might think of them, especially what their significant other thinks. They are worried that they might not have the same intimacy ever again. What would you say to them in comfort/advice?

Scenario:

The amputee you are supporting confides in you and tells you that they are a lesbian but she pretended to be straight because she feels that her family might not support her through the recovery process if they found out the truth. She doesn’t know what to do and asks you for advice. What would you do/say to help her?

Scenario:

The amputee you are supporting is a transgender woman in her 20s. She tells you that she has lost a lot of friends due to her gender identity and even the ones remaining aren’t very supportive but her family accepts her for who she is. However, becoming an amputee has made her life harder in addition to the on-going discrimination from others and now she feels really self-concious about her body. She also feels that she could lose her only support system, her family, because she feels she might be a burden to them. What would you do/say to help her?

Instructor Notes: