Last post Sat, May 24 2008 9:22 PM by scrappywheels. 3 replies.
Is Sex Over? Badly Injured Vets Cope With Intimacy Issues
(Click to view original article on TBO.com)
The Associated Press
Published: May 24, 2008
WASHINGTON - When B.J. Jackson lost both his legs to an Iraq war injury, his doctors talked about a lot of things, but they didn't mention how it might affect his sex life.
Jackson's less-bashful wife brought it up. But even then the couple didn't get the answers they sought.
Jackson and his wife, Abby, say it's time to get the issue out in the open in both military medical settings and at home. They got a lot of agreement at a conference Wednesday, billed as the first of its kind, that focused on wounded troops and intimacy with their partners - in the bedroom and outside it.
It Is No Minor Matter
About 3,000 of the 30,000 troops wounded in Iraq and Afghanistan have suffered major physical impairment, said former Sen. Bob Dole, who served last year on a presidential commission that examined the treatment of wounded war veterans. Dole, who lost full use of his right arm to a combat injury during World War II, was among the speakers at the conference.
Vets who have lost a quality-of-life function, such as sexual ability, should be given quality-of-life compensation in addition to other payment, he said.
It's plenty serious at any age, suggested Mitchell S. Tepper, assistant project director at the Center of Excellence for Sexual Health at Morehouse School of Medicine in Atlanta, which organized the conference.
Tepper said badly injured patients are interested in the subject, even if they are shy about asking. He said studies of the general population of people with spinal cord injuries find that some rank the desire to have sex above the ability to walk again.
Healthy intimate relationships add meaning to life and can aid in recovery from other injuries, he said. The loss of a relationship can be detrimental, and a factor in suicide.
As for injured troops, keeping feelings bottled up can be a problem for any couple, said Jackson, who is 26.
"My feeling is the sooner it's discussed and the more it's discussed, the more chance of having less arguments, less confusion, less frustration," he said in an interview. "The more you communicate among yourselves the better off you'll be, instead of well, 'I'm mad, so I'm just going to roll over.'"
The Jacksons' appearance Wednesday underscored the painful aftermath of war and stood as a stark reminder this Memorial Day of the sacrifices borne by many soldiers, veterans and their families. More than 30,000 troops have been wounded in Iraq and Afghanistan, more than half of them were 24 and younger.
Said Dole: "Most of us go through this transition from able-bodied to disabled, and it's tough. And I worry about these young men and women ... who are 17, 18, 19, because I don't think it's really going to hit them until they're 20, 25, 30 years of age."
The Issue Is Often Ignored
For the injured, questions of self-worth and a fear of rejection because of physical or other changes they have undergone can form barriers in their relationships.
Tepper said doctors often aren't bringing up sex, but patients aren't always asking about it either.
"There's this gap where the doctors know that it's an issue, but don't feel they're prepared or if it's appropriate to ask about it," Tepper said. "Patients, it's on their mind but they're not talking about it. They're afraid."
Experts say issues of sexual intimacy don't affect just the relationships of Iraq and Afghanistan veterans with physical wounds, but also those who come home with mental health problems.
A recent Rand Corp. study estimated that about 300,000 of the 1.6 million troops who have served in the recent wars have symptoms of major depression or post-traumatic stress disorder. About one in five said they might have experienced a possible traumatic brain injury while deployed.
Psychological and neurological disorders can interfere with behaviors necessary for successful intimacy, such as experiencing and expressing emotion and understanding someone else's needs, the study noted. Anger and aggression, including domestic violence, have been associated with mental disorders.
According to the Veterans Affairs Department's National Center for Post Traumatic Stress Disorder, sexual dysfunction tends to be higher in combat veterans with post-traumatic stress disorder.
Jackson, of Des Moines, Iowa, was injured in Iraq in 2003 while serving in the Iowa Army National Guard. In addition to losing his legs, he had burns, post-traumatic stress disorder, and he was heavily medicated. When his wife initially wanted to be intimate, he refused.
His wife said she felt rejected, and went to talk to his doctor with specific questions. She said the doctor told her things would get better with time, and she wasn't sure what that meant. She said she and her husband kept talking and were able to work things out.
They now have four children and are adopting a fifth. Two of their kids were born after he was injured. He works as director of event management for the nonprofit group Coalition to Salute America's Heroes.
She encouraged her husband to join her in publicly discussing the issue with the hope that it can be talked about more frequently.
"I think it's like the hidden secret that everyone wants to know the answer to, but are very fearful of even mentioning it," Abby Jackson said.
Harold Wain, chief of the psychiatry consultation liaison service at Walter Reed Army Medical Center, said staff at the hospital are encouraged to bring up questions about sex, but hearing speakers at the conference such as the Jacksons convinced him more needs to be done.
He said it's common for patients to question how their appearance is perceived, whether they can perform sexually, and whether they will be loved again.
"What you want to do is give back to the injured person the sense that they are whole and they have appropriate behavior patterns and they can be loved for who they are," Wain said.
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Isn't it interesting that no matter how you get your injury, the theme of sexual attractiveness and sexual proficiency is still the same?
Unfortunately, too often popular culture tends to equate "sexuality" with "normality." Instead of stressing love and intimacy, which naturally can lead to sexuality, people think OMG, that person's not "normal" (or someone who has a disability might think that for whatever reason - NOT saying all PWD think that so don't crucify me) and that it will then eliminate a "normal" sex life. And depending on what experiences someone who's AB has in their life up until they become a PWD, it can effect how they look at themselves later.
The bottom line is, what is "normal" except a setting on a washing machine? *LOL* I think as a culture if the stress is more on love and intimacy instead of "sex" then it would be easier for people as a whole to be more comfortable with their bodies and their abilities, regardless of any "limitations" they might have or think they have.
And the funny thing is, this isn't something limited to PWD. This is something many people struggle with, regardless of their "normality." My dh is 5' 3", I'm 5' 8" and I could care less. I think he's sexy. He's sexy to ME. We just had a conversation a little while ago about this very thing. He still (and we've been married going on 11 years, mind you) doesn't understand WHY I think he's sexy. He's 21 years older than me, and dang it, he's the ONLY person who's ever made me feel the way he makes me feel. To ME, that's sexy. I think he's handsome. I'm about 25 pounds overweight, most of that in the hindquarters because I sit on my butt all day in front of a computer working. I don't think I'm sexy, but he does. So who am I to question that I turn him on? It's all in the eye of the beholder. And sometimes, even when WE don't think we're sexy, our partner, who loves us, does.
There's no easy fix for this, either. I really think rehab programs should do a better job educating not just about the physical aspects of sexuality, but the emotional and mental as well. But it's that "taboo topic" that people have a hard time talking about. I mean, honestly, how many people want to go to a sex therapist in rehab and say, "Okay, talk to me about masturbation and intercourse." Seriously? Yes, they'll want to ask about it, but how many will do it (no pun intended) or feel comfortable doing it? How many people who become a PWD will feel comfortable talking with their partner (if they have one) about their "new" sexual life?
Considering that a lot of people who are AB are uncomfortable telling their kids about the birds and the bees or talking to a partner about sexual preferences/safe sex issues, it's not surprising that such a drastic change in life for a PWD would create a reluctance to discuss this.
There's no easy answer, unfortunately.
Well, you also throw into the mire the whole mess of military spouses being seperate for so long and its a mess. I mean a normal, no-injury marriage is hard enough to keep together when you've been put on 3 hardship tours in a row, I can't imagine the curveball that is an injury. I also think that the VA system fails our vets in so many other ways, I'm not surprised that they receive very little if any help in the sexuality department. My husband's an injured vet of Desert Storm, so we've had first hand experience with the VA system.
Seriously, though, I totally agree with you about attractiveness thought. Being a disabled person and a woman, its been a long road to come to terms with my sexual attractiveness and body issues. I believe love can come to us all but thats not the same as saying all the issues from all the times you been rejected will magically disappear once you find love, and someone who finds you sexually attractive. I also throw in the 60+ pounds of extra baby weight since we were married and well, you can understand. I, fortuntely, have a husband that still finds me sexy - extra weight and atrophied legs and all.
I appreciated the couple in the article who worked through their hardship with their relationship, because I believe society is so concentrated on those that just give up and divorce, they sometimes forget about the ones that put in some majorly hard work to get the relationship going again.
