Abstract
Recent epidemiological statistics suggest approximately 250,000 people in the United States live with a spinal cord injury. Men constitute roughly 82% of these individuals. Following spinal cord injury, men frequently experience significant changes in their sexual functioning. As a result, men with spinal cord injuries are at an increased risk for experiencing adjustment difficulties. Unfortunately, relatively little is known about factors that promote or impede men’s adjustment to these changes. In the present article, the authors highlight how men’s adherence to gender scripts for sexual potency may contribute to their adjustment following a spinal cord injury. To organize the discussion, the authors review related literature and, through case examples, illustrate how men’s adherence to this gender norm may influence their post-injury mental health. Directions for gender-sensitive interventions and future clinical research are provided.
Similar content being viewed by others
References
National Spinal Cord Injury Association: More About Spinal Cord Injury. http://spinalcord.org/news.php?dep=17&page=94&list=1191 (2007). Retrieved 8 November 2007
Christopher and Dana Reeve Paralysis Resource Center: Spinal Cord Injury. http://www.paralysis.org/site/c.erJMJUOxFmH/b.1293655/k.CF13/Spinal_Cord_Injury.htm (2007). Retrieved 8 November 2007
Centers for Disease Control and Prevention: Injury Fact Book 2001–2003: Spinal Cord Injury. http://www.cdc.gov/ncipc/fact_book/25_Spinal-Cord_Injury.htm (2005). Retrieved 2 January 2008
Dahlberg, A., Alaranta, H.T., Kautiainen, H., Kotila, M.: Sexual activity and satisfaction in men with traumatic spinal cord lesion. J. Rehabil. Med. 39, 152–155 (2007)
Phelps, J., Albo, M., Dunn, K., Joseph, A.: Spinal cord injury and sexuality in married or partnered men: activities, function, needs, and predictors of sexual adjustment. Arch. Sex. Behav. 30, 591–602 (2001)
Sipski, M.L.: Sexuality and spinal cord injury: where we are and where we are going. Am. Rehabil. 23, 26 (1997)
Alexander, C., Sipski, M.L., Findley, T.W.: Sexual activities, desire, and satisfaction in males pre- and post-spinal cord injury. Arch. Sex. Behav. 22, 217–228 (1993)
Schopp, L.H., Good, G.E., Mazurek, M.O., Barker, K.B., Stucky, R.C.: Masculine role adherence and outcomes among men with spinal cord injuries. Disabil. Rehabil. 29, 625–633 (2007)
White, M.J., Rintala, D., Hart, K., Young, M.E., Fuhrer, H.J.: Sexual activities, concerns and interests of men with spinal cord injury. Am. J. Phys. Med. Rehabil. 71, 225–231 (1992)
Kreuter, M., Sullivan, M., Siosteen, A.: Sexual adjustment after spinal cord injury-comparison of partner experiences in pre- and post-injury relationships. Paraplegia 32, 759–770 (1994)
Fisher, T.L., Byfield, M.G., Tymus, T., Laud, P.: The profile of sexual health needs of individuals 12 months after spinal cord injury. SCI Psychosoc. Process. 14, 5–11 (2001)
Fisher, T.L., Laud, P.W., Byfield, M.G., Brown, T.T., Hayat, M.J., Fiedler, I.J.: Sexual health after spinal cord injury: a longitudinal study. Arch. Phys. Med. Rehabil. 83, 1043–1051 (2002)
Anderson, K.D., Borisoff, J.F., Johnson, R.D., Stiens, S.A., Elliott, S.L.: Long-term effects of spinal cord injury on sexual function in men: implications for neuroplasticity. Spinal Cord 45, 338–348 (2007)
Fugl-Meyer, A.R., Lodnert, G., Branholm, I.B., Fugl-Meyer, K.S.: On life satisfaction in erectile dysfunction. Int. J. Impot. Res. 9, 141–148 (1997)
Krause, J., Kemp, B.J., Coker, J.: Depression after spinal cord injury: relation to gender, ethnicity, aging, and socioeconomic indicators. Arch. Phys. Med. Rehabil. 81, 1099–1109 (2000)
Boekamp, J., Overholser, J., Schubert, D.: Depression following a spinal cord injury. Int. J. Psychiatry Med. 26, 329–349 (1996)
Hartkopp, A., Bronnum-Hansen, H., Seidenschnur, A.M., Biering-Sorensen, F.: Suicide in a spinal cord injured population: its relation to functional status. Arch. Phys. Med. Rehabil. 79, 1356–1361 (1998)
Tepper, M.S.: Letting go of restrictive notions of manhood: male sexuality, disability and chronic illness. Sex. Disabil. 17, 37–52 (1999)
Burns, S.M., Mahalik, J.R.: Understanding how masculine gender scripts may contribute to men’s adjustment following treatment for prostate cancer. Am. J. Men’s Health 1, 250–261 (2007)
Kiesler, D.J.: The 1982 interpersonal circle: a taxonomy for complementarity in human transactions. Psychol. Rev. 90, 185–214 (1983)
Gilbert, L., Scher, M.: Gender and sex in counseling and psychotherapy. Allyn & Bacon, Boston (1999)
Mintz, L., O’Neil, J.M.: Gender roles, sex, and the process of psychotherapy: many questions and few answers. J. Counsel. Dev. 68, 381–391 (1990)
Best, D.L., Williams, J.E.: Gender, culture. In: Matsumoto, D. (ed.) The handbook of culture and psychology, pp. 195–222. Oxford University Press, New York (2001)
Courtenay, W.H.: Engendering health: a social constructionist examination of men’s health beliefs and behaviors. Psychol. Men Masculinity 1, 4–15 (2000)
Lytton, H., Romney, D.M.: Parents’ differential socialization of boys and girls: a meta-analysis. Psychol. Bull. 109, 267–296 (1991)
Golombok, S., Fivush, R.: Gender development. Cambridge University Press, Cambridge, UK (1994)
Mahalik, J.M., Good, G.E., Englar-Carlson, M.: Masculinity scripts, presenting concerns, and help-seeking: implications for practice and training. Prof. Psychol. 34, 123–131 (2003)
Sher, L.: Type D personality, cortisol and cardiac disease. Aust. N Z J. Psychiatry 38, 652–653 (2004)
Helgeson, V.S.: The role of masculinity in a prognostic predictor of heart attack severity. Sex. Roles 22, 755–774 (1990)
Blazina, C., Watkins, C.E., Jr.: Masculine gender role conflict: effects on college men’s psychological wellbeing, chemical substance usage, and attitudes toward help-seeking. J. Counsel. Psychol. 43, 461–465 (1996)
Mahalik, J.R., Lagan, H.D., Morrison, J.A.: Health behaviors and masculinity in Kenyan and U.S. college students. Psychol. Men Masculinity 7, 191–202 (2006)
Locke, B.D., Mahalik, J.R.: Examining masculinity norms, problem drinking, and athletic involvement as predictors of sexual aggression in college men. J. Counsel. Psychol. 52, 279–283 (2005)
Mahalik, J.R., Locke, B., Ludlow, L., Diemer, M., Scott, R.P.J., Gottfried, M., Freitas, G.: Development of the conformity to masculine norms inventory. Psychol. Men Masculinity 4, 3–25 (2003)
Pleck, J.H., Sonenstein, F.L., Ku, L.C.: Attitudes toward male roles among adolescent males: a discriminant validity analysis. Sex. Roles 30, 481–501 (1994)
Addis, M.E., Mahalik, J.R.: Men, masculinity, and the contexts of help seeking. Am. Psychol. 58, 5–14 (2003)
Helgeson, V.S., Lepore, S.J.: Men’s adjustment to prostate cancer: the role of agency and unmitigated agency. Sex. Roles 37, 251–266 (1997)
Martino, W., Pallotta-Chiarolli, M.: “So what’s a boy?” Addressing issues of masculinity in schooling. Open University Press, London (2003)
Lee, C., Owens, R.: The psychology of men’s health series. Open University Press, Philadelphia (2002)
Edgar, D.: Men, mateship, and marriage. HarperCollins, Pymble, New South Wales, Australia (1997)
Kimmel, M.: Manhood in America: a cultural history. Free Press, New York (1996)
Hatzichristou, D., Cuzin, B., Martin-Morales, A., Buvat, J., Porst, H., Laferriere, N., et al.: Vardenafil improves satisfaction rates, depressive symptomatology, and self confidence in a broad population of men with erectile dysfunction. J. Sex. Med. 2, 109–116 (2005)
Schuetz-Mueller, D., Tiefer, L., Melman, A.: Follow-up of vacuum and nonvacuum constriction devices as treatments for erectile dysfunction. J. Sex. Marital Ther. 21, 229–238 (1995)
Korenman, S.G.: New insights into erectile dysfunction: a practical approach. Am. J. Med. 105, 135–144 (1998)
Feldman, H.A., Goldstein, I., Hatzichristou, D.G., Krane, R.J., McKinlay, J.B.: Impotence and its medical and psychosocial correlates: results of the Massachusetts male aging study. J. Urol. 151, 54–61 (1994)
Swindle, R., Cameron, A., Rosen, R.A.: 15-Item short form of the psychological and interpersonal relationship scales. Int. J. Impot. Res. 18, 82–88 (2006)
Cappelleri, J.C., Althof, S.E., Siegel, R.L., Stecher, V.J., Tseng, L.J., Duttagupta, S.: Association between the Erectile Dysfunction Inventory of Treatment Satisfaction and the Self-Esteem and Relationship Questionnaire following treatment with sildenafil citrate for men with erectile dysfunction. Value Health 8, S54–S60 (2005)
Anderson, K.D., Borisoff, J.F., Johnson, R.D., Stiens, S.A., Elliott, S.L.: The impact of spinal cord injury on sexual function: concerns of the general population. Spinal Cord 45, 328–337 (2007)
Reitz, A., Tobe, V., Knapp, P.A., Schurch, B.: Impact of spinal cord injury on sexual health and quality of life. Int. J. Impot. Res. 16, 167–174 (2004)
Romeo, A.J., Wanlass, R., Arenas, S.: A profile of psychosexual functioning in males following spinal cord injury. Sex. Disabil. 11, 269–276 (1993)
Sakellariou, D.: If not the disability, then what? Barriers to reclaiming sexuality following spinal cord injury. Sex. Disabil. 24, 100–111 (2006)
Taleporos, G., McCabe, M.P.: The impact of sexual esteem, body esteem, and sexual satisfaction on psychological well-being in people with physical disability. Sex. Disabil. 20, 177–183 (2002)
Janoff-Bulman, R.: Shattered assumptions: toward a new psychology of trauma. Free Press, New York (1992)
Good, G.E., Schopp, L.H., Thomson, D., Hathaway, S., Mazurek, M.O., Sanford Martens, T.: Men with serious injuries: relations among masculinity, age, and alcohol use. Rehabil. Psychol. 53, 39–45, (2008)
Sparkes, A.C.: Sport, spinal cord injury, embodied masculinities, and the dilemmas of narrative identity. Men Masculinities 4, 258–285 (2002)
Courtenay, W.H.: Counseling men in medical settings: the six-point HEALTH plan. In: Brooks, G.R., Good, G.E. (eds.) The new handbook of psychotherapy and counseling with men, pp. 59–91. Jossey-Bass, San Francisco (2001)
Grüninger, U.J.: Patient education: an example of one-to-one communication. J. Hum. Hypertens. 9, 15–25 (1995)
Rappaport, B.M.: Family planning: helping men ask for help. In: Swanson, J.M., Forrest, K.A. (eds.) Men’s reproductive health, pp. 245–259. Springer, New York (1984)
Charmaz, K.: Identity dilemmas of chronically ill men. In: Sabo, D., Gordon, D.F. (eds.) Men’s health and illness: gender, power, and the body, pp. 266–291. Sage, Thousand Oaks, CA (1995)
Bergman, S.J., Surrey, J.L.: Couples therapy: a relational approach. J. Fem. Fam. Ther. 11, 21–48 (2001)
Francher, J., Kimmel, M.S.: Hard issues and soft spots: counseling men about sexuality. In: Kimmel, M.S., Messner, M.A. (eds.) Men’s lives, 2nd edn, pp. 428–450. Macmillan, New York (1992)
Gray, R.E., Fitch, M.I., Fergus, K.D., Mykhalovskiy, E., Church, K.: Hegemonic masculinity and the experience of prostate cancer: a narrative approach. J. Aging Identity 7, 43–62 (2002)
Oliffe, J.L.: Constructions of masculinity following prostatectomy-induced impotence. Soc. Sci. Med. 60, 2249–2259 (2004)
Middleton, J., Tran, Y., Craig, A.: Relationship between quality of life and self-efficacy in persons with spinal cord injuries. Arch. Phys. Med. Rehabil. 88, 1643–1648 (2007)
Fisher, C.G., Noonan, V.K., Smith, D.E., Wing, P.C., Dvorak, M.F., Kwon, B.: Motor recovery, functional status, and health-related quality of life in patients with complete spinal cord injuries. Spine 30, 2200–2207 (2005)
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Burns, S.M., Mahalik, J.R., Hough, S. et al. Adjustment to Changes in Sexual Functioning Following Spinal Cord Injury: The Contribution of Men’s Adherence to Scripts for Sexual Potency. Sex Disabil 26, 197–205 (2008). https://doi.org/10.1007/s11195-008-9091-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11195-008-9091-y