SEX-INTERRUPTED

By Jenny Palter, Iris Zink and Kirsten Schultz

By the year 2030, as many as 171 million people in the U.S.- more than half of all Americans-will be living with at least one chronic medical condition (data from The Robert Wood Johnson Foundation). Illness or disability can easily derail a person's sex life-but it doesn't have to be that way. Using kindness, honesty, and humor, Iris Zink, BSN,

• Language: English
• Publisher: Atmosphere Press
• Release date: Dec 15, 2020
• ISBN: 9781636495903

Book preview

SEX—INTERRUPTED

Igniting Intimacy

While Living With Illness

or Disability

By Iris Zink, BSN, MSN, ANP, RN-BC

with Jenny Thorn Palter, BS

and Kirsten Schultz, MS

atmosphere press

Copyright © 2020 Jenny Thorn Palter,

Kirsten Schultz, Iris Zink

Published by Atmosphere Press

No part of this book may be reproduced

except in brief quotations and in reviews

without permission from the publisher.

Sex—Interrupted

2020, Jenny Thorn Palter,

Kirsten Schultz, Iris Zink

atmospherepress.com

TABLE OF CONTENTS

Foreword      3

Introduction      5

What Is Sex—and Why Does It Matter?      8

Iris’s Ideas for Maintaining Good Sex and True Intimacy     20

10 Myths Surrounding Sex and Intimacy

Sex=Intercourse32

Sex=Orgasm38

General Health Does Not Affect Sexual Health      45

Good Sex Just Happens54

Disabled People Are Not Sexual62

There Comes A Time When Sex Is Not Important69

My Health and Physical Changes Have Made Me Unattractive 76

I Am Who I Am Sexually Because Of My Parts (Shape, Size, Etc.)84

The Use of Sexual Aids Is Not Sexy90

There Is Nothing More I Can Learn About Sex 104

What Does Honor Your Partner Mean?      111

Conclusion      115

The Last Word(s)      117

Appendix A: Personal Lubricants      118

Appendix B: Sexual Orientation      122

Appendix C: Gender Identity      128

Appendix D: Gender and Culture      135

References       137

Recommended Reading      149

Resources      151

Foreword

By Mimi Secor, DNP, FNP-BC, FAANP, FAAN

Individuals with chronic illness or changes to their body are especially vulnerable to loss of sexual expression. Yet the standard educational curricula used to train healthcare providers often neglects the topics of sex and intimacy. Neither is the subject of sexual health regularly addressed in healthcare settings. Understandably, patients may feel uncertain or shy about bringing up the subject of their sexual problems and concerns—especially when chronic health issues give so much else to worry about. All of these factors explain why being able to talk about sexual health with providers, and provider competency in this area, are critical to overall health.

Sex—Interrupted: Igniting Intimacy While Living With Illness or Disability illuminates the importance of addressing patients’ sexual health concerns in the safety and privacy of the healthcare provider’s office. Written in the direct yet lighthearted manner that reflects how Ms. Zink interacts with her patients and lecture audiences, the book addresses the most common myths about illness and sex. At the same time, it guides and facilitates conversations between providers and patients with a long-term disability or chronic illness. There are also explanations of how providers can give nonjudgmental help to patients, including how to speak in an open, accepting manner while using appropriate terms and easy-to-understand language. Appropriate use of lubricants, sex toys, and physical touch alternatives to intercourse are just a few examples of the topics included.

Yet this book is more than a resource for regaining and maintaining a healthy sex life. By helping us to more confidently discuss the topic of sexual health, the book also enables providers to help patients strengthen, and in many cases heal, intimate relationships that can be so negatively affected by illness or disability. Ultimately, Sex—Interrupted: Igniting Intimacy While Living With Illness or Disability encourages providers and patients alike to be more open and confident discussing sex and intimacy, and will help immeasurably to improve the patient-provider relationship.

Introduction

Not all doctors and nurses are comfortable discussing sexual issues and practices. Most doctors don't routinely ask about your sex life. And patients don't usually begin to discuss their love life with a doctor who hasn't mentioned it. Nobody's talking! (breastcancer.org, 2019)

In the circle of the holistic self, sexual health has the same importance as the other four components—psychological health, social health, physical health, and spiritual health. Yet sexual health is the least likely component to be discussed in a healthcare setting.

Sexual health is always affected by illness or disability. That is why it’s so important for issues of sexual health to be included in any text that offers to help healthcare providers treat and care for people with chronic diseases and disabilities. Yet sexuality, intimacy, and sexual health remain the least likely subjects to be discussed in a healthcare setting, either by the provider or by the patient.

I’ve had all sorts of people—nuns, nurses, physicians, patients, researchers, and many more—come up to me after one of my lectures and thank me for sharing so much information that was new to them. No, I am not an expert on these topics. And it is not necessary for you to be an expert on sexual matters to have a conversation about sex and intimacy issues, whether with a partner or a healthcare provider. Still, someone must start the conversation!

That someone can be you, your healthcare provider, or your partner. But, once the subject is brought up, no matter who is having the discussion, each person needs to know how to listen, and, ideally, the healthcare provider will be able to help with resources and information.

It makes sense to consider this topic from the point of view of those who are affected by some kind of change in their own health or abilities, or by a change that has happened to their partner. To start with, it’s natural to feel that your body has truly let you down when you’ve been diagnosed with a chronic illness or long-term disability. How can you even think about being a sexual person when you’re dealing with pain, fatigue, side effects of medications, and the idea of having a disease or an unexpected and unwelcome change to your body for the rest of your life?

Along with learning to cope with the loss of a former healthy life, you may feel anxiety and guilt because you’re no longer the same person your partner fell in love with and expects you to be. Changes in each person’s role within the relationship, and changes in each partner’s perceptions of the other person, cause stress. At the same time, partners face the challenges of what to say, when to touch, and how to help—and they have desires and needs of their own. All of these factors can affect even the most devoted couples.

Gender identity and cultural upbringing are always relevant in any discussion of intimacy and sexuality. We have included a glossary of currently used and no-longer acceptable gender and sexual identity terms and definitions in the Appendices section. Resources concerning cultural mores and beliefs are more difficult to find; we urge anyone interested in learning more to seek out the most recent published research and studies in the journals cited in our reference list, through the American Association of Sexuality Educators, Counselors, and Therapists, and in the other resources listed at the end of the book.

Whether you are a trained healthcare provider, a person living with a chronic illness, or the partner of someone with a disability, our message is simple: Sexual health matters, and help is available. Don’t let uncertainty, fear of the unknown, or your current beliefs about the role of intimacy stop you from learning more. What you learn may surprise and delight you!

What is Sex and

Why Does It Matter?

On one level, sex is just a hormone-driven bodily function designed to perpetuate the species, write the editors in the introduction to the 2015 Harvard Medical School Special Health Report, Sexuality in Midlife and Beyond. But on a higher level, it is an act that embodies the complexity of human physical and emotional responses.

But even among non-humans, sex appears to be regularly practiced—and for a whole range of non-reproductive benefits. Same-sex behavior, including courtship, sexual pair-bonding, and parental activities, has been seen in more than 450 species of animals, notes zoological researcher Bruce Bagemihl in his 2000 book, Biological Exuberance. Male Bonobos kiss … female Bottlenose Dolphins clasp each other … male Giraffes engage in ‘necking.’ … Sometimes animals gently bite, nibble, or chew on each other's ears (female Hoary Marmots), or wings and chests (Gray-headed Flying Foxes), or rumps (male Dwarf Cavies), or necks (male Savanna Baboons). Even birds get in the act: Hammerheads, Acorn Woodpeckers, and Blue-bellied Rollers have ritualized bouts of courtship and mounting activity that may involve groups of individuals and both same-sex and opposite-sex partners.

But it’s humans that we want to talk about in this text.

What sets human sexuality apart from animal and plant sexuality is our capacity—or even drive—to discover how to give and receive pleasure through sexual activity.—ASHA’s Sexual Health Coloring Book

What actually happens during sex?

From the late 1950s to the mid-1990s, scientists William Masters and Virginia Johnson conducted groundbreaking research that directly observed the physical and physiologic sexual responses of volunteer participants. In doing so, they transformed society's understanding of sexual response and sex therapy. In their invaluable work, they presented the idea of four distinct stages of sexual response, each of which includes anatomic and physiologic changes. The stages are desire, arousal, orgasm, and resolution. (Kinsey Institute, 2018)

According to experts at Harvard Medical School, desire, also known as libido or lust, has three main elements:

Sexual drive—a hormone-dependent impulse for sexual release (examples: a longing to reproduce, a longing to have sex, erotic thoughts or dreams, an urge to masturbate)

Sexual wish—the willingness to have sex (to feel more connected to another person, to feel more feminine or masculine, to feel more