sexual device manual for persons with disabilities
Contents
1. Clean attachments with soap and water but do not submerge the handle SPECIAL CONSIDERATIONS Need active grasp need to be able to manipulate 5 Ib weight big switches allow for easy on off need reach to access genitals 20 Universal Cuff Description Leather cuff with elastic strap can hold a variety of objects including sexual devices such as dildos and vibrators e Adjustable for hand size e Plastic extender available for self partner penetration PRICE RANGE SAFETY 15 00 Ensure cuff is not too tight and does not interfere with hand circulation This product contains CLEANING rubber latex Hand wash cuff with mild soap and water Sammons Preston Canada SPECIAL CONSIDERATIONS No active grasp needed need ability to manipulate the device being used i e extension and flexion of arms Note vibrator shown is a Natural Contour 21 Hitachi Magic Wand Description e High intensity 2 speed vibrator that plugs into wall e Large tennis ball size head e G spot attachment Gee Whiz available PRICE RANGE SAFETY 70 00 Come As You Are or Not waterproof Womyn s Ware SPECIAL CONSIDERATIONS CLEANING Device weighs 1 28 Ibs need active Hand wash with mild soap and wide grasp vibrator controlled by damp cloth a dial switch assistance may be required to plug in Device is approximately 1 foot long ideal for people with limited extension in their arms 22 sees toe2. Do not soak use mild soap and water and hang to dry ae SAFETY Ensure straps are snug but do not cut off circulation in thigh SPECIAL CONSIDERATIONS Requires mobility and or set up to put on and take off thigh Ensure skin integrity by checking for any change in skin color i e redness or irritation Loosen or take off harness if this occurs Rider and Rider Deluxe for furniture PHOTO OWOMYNSWARE COM PRICE SPECIAL CONSIDERATIONS 30 Rider 60 Rider Deluxe Reguires mobility to set up Womyn s Ware harness and dildo on furniture and to maneuver for penetration SAFETY Ensure set up is in a location that has lots of room for maneuvering and includes accessible supports such as grab bars or counter tops 33 Positionin Tt s just human Wea a ll have Py jun le sinsideof US all have wants no dneeds and esil strange as hey may seem Tf you stop to think about it we re all pretty creative cooking up all these fantasies It s like a kind of poetry Diane Frolov and Andrew Schneider ve LH 3 34 PRICE Intimate Rider Description e IntimateRider was designed by a person with C6 7 quadriplegia to facilitate positions for sexual activities and to aid with thrusting and sexual movement eA small seat glides on precision bearings to produce a natural fluid motion e Movement occurs with minimal upper body motion elt can
3. e Butt Seriously p 26 e MHP Tongue Vibrator p 27 LIMITED FLEXIBILITY FOR POSITIONING e Intimate Rider p 35 e Body Bouncer p 36 Liberator Shapes p 37 e Thigh rider harness dildo p 32 e Furniture harness p 33 e Hands Free kit p 41 e Thigh rider harness dildo p 32 e Furniture harness p 33 e Positioning products p 34 39 e Hands Free kit p 41 e 5 speed Finger Vibrator p 28 The Strapper or Aslan Men s harness dildo p 30 31 e Thigh rider harness dildo p 32 e Furniture harness p 33 e Positioning products p 34 39 e Love Bumpers p 38 e Thigh Sling p 39 e Hands Free kit p 41 Myth Men and women with spinal cord injuries can t orgasm Reality There is published research to support that about half of women and men with SCI can experience orgasm Further Adaptations of Devices OTs can be very helpful in adapting and modifying equipment to best Suit their client s individual needs For example a hands free flexible stand can be created to hold a vibrator See drawing below or a particular cushion can be adapted to assist with sexual positioning Caregivers can also assist with set up and clean up of devices For example caregivers can set up the thigh rider See p 32 or position the client before they leave them in privacy for the sexual activity Clients are encouraged to ask for assistance in set up and clean up as with any other activity of daily living Example of hands free adaptat
4. of Ai Valieve i inthe freedomof a Devices for Penetration desires and have the determination to pursue what s in your heart anything 1S s possible Wendy O Matik Fleshlight Description Realistic penetration device Made with Real Feel Superskin also known as cyberskin non allergenic no latex no silicone Easy to grip with one or two hands Discreet option that comes with a screw on lid No batteries or plug in required PRICE SAFETY 75 00 Come As You Are Use with adequate lubrication and clean after each use CLEANING The insert is removable for clean SPECIAL CONSIDERATIONS ing Use a soft cloth sponge to Need active wide grasp lightweight clean inside Can be challenging 24 Tim s Bit a ET pF a we k i ie i wh 4 re TL ri 4 ob Description The sleeve is lined with dozens of little nubs and a well placed vibrator e Elastic enough to fit most men tight enough to stay on without holding it e Requires 2 x AA batteries for the vibrator control e Vibrator is not very powerful PRICE SAFETY 40 00 Come As You Are Not waterproof CLEANING SPECIAL CONSIDERATIONS Sleeve is open ended for easy Need active grasp to put on and cleaning with soap and water off vibrator controlled by dial switch assistance may be required to change batteries 25 Rectal Vibrator Butt Seriously Description PH
5. as self esteem assertiveness and positive self talk as well as collaborate with partners and family around sexual and fertility issues Psychologists can also address trauma around sexuality 5 RECREATION THERAPISTS Work with clients to explore meaningful recreation and leisure choices Using client interests ranging from creative arts and drama through to physical recreation and sport recreation therapists connect people with community based resources that help build confidence and increase opportunities for social interaction Friendship development through involvement in recreation activities of mutual interest is often key to meeting potential partners PEER COUNSELORS Persons with disabilities themselves are critical sources of information and support They are the experts on what their bodies experience They also have experience accessing different resources in the community and can share suggestions on what has or hasn t worked for themselves or other clients Anatomy These diagrams are for general information Please do not hesitate to speak to your doctor or nurse about any anatomy related questions Further information can be found in the references Elliott 2009 FEMALE REPRODUCTIVE SYSTEM OVARY RECTUM UTERUS CERVIX URINARY BLADDER VAGINA URETHRA ANUS LABIUM MINORA CLITORIS URETHRAL OPENING LABIUM MAJORA VAGINA LABIUM MINORA ANUS MALE REPRODUCTIVE SYSTEM URETER URINARY BLADDER P
6. out what works to help increase sexual arousal or trigger orgasmic release OTHER SAFETY CONSIDERATIONS Device specific safety considerations are provided in the manual It is important to check the materials used in the devices to be sure they do not contain latex silicone or other allergic properties if allergies exist Always clean the devices after use with non abrasive cleaners i e warm damp cloth and soap It is important to follow the specific instructions on cleaning for each device provided by the manufacturer Devices for Different Physical Abilities Below is a list of different types of different sexual devices categorized into specific physical functional categories LIMITED HAND FUNCTION Wahl Massager p 20 Butt Seriously rectal vibrator p 26 e MHP Tongue Vibrator p 27 e 5 speed Finger Vibrator p 28 Universal cuff dildo p 21 e Hitachi Magic Wand p 22 e Fleshlight p 24 e Tim s Bit p 25 e Thigh rider harness dildo p 32 e Furniture harness p 33 NO HAND FUNCTION e Universal cuff vibrator p 21 e MHP Tongue Vibrator p 27 The Strapper or Aslan Men s harness dildo p 30 31 SET UP BY CAREGIVER IF NO HAND FUNCTION e Universal cuff vibrator p 21 e MHP Tongue Vibrator p 27 The Strapper or Aslan Men s harness dildo p 30 31 LIMITED STRENGTH IN THE UPPER EXTREMITY e Universal cuff vibrator p 21 e Hitachi Magic Wand p 22 e Fleshlight p 24 e Tim s Bit p 25
7. ELCHAIR Removable armrests and removable lateral supports can increase the options for sex in a wheelchair The top partner can sit on the bottom partner s lap face to face facing away or facing to the side for penetration or other play The person in the wheelchair can also be penetrated or receive oral sex by moving their buttocks to the edge of their chair and having their partner kneel or sit in front of them In wheelchairs without removable arms try having the top partner sit on the bottom partner s lap facing away using the armrests for support Couples can also choose to transfer into a chair with no armrests to increase ease of positioning Myth People in wheelchairs don t have sex Reality Wrong They remain sexual beings SUPPORTIVE REAR POSITIONS In these positions have the bottom partner lie on his her stomach with option of having a pillow under their hips or belly The top partner can try standing with their partner lying at the edge of a bed table couch if straddling on their knees is uncomfortable This positioning provides optimal balance for the bottom person and allows them to help more with thrusting Making Parts Fit Proper lubrication and firm and reliable erections are helpful when challenged with positioning or balance A physician can suggest or prescribe assistance with these functions if required Personal Lubricants A selection of lu
8. OTO O OWOMYNSWARE COM e This silicone anal dildo vibrator can be used by men or women Textured shaft provide some resistance e Variable speeds available e Requires 2 x AA batteries e Can be used with a harness PRICE RANGE 50 00 without vibrator S60 00 with Mini Pearl vibe Womyn s Ware CLEANING Vibrator is easily removable for easy Sterilizing Always clean and Sterilize the silicone shaft between each user and or put a condom over it SPECIAL CONSIDERATIONS Need active grasp lightweight need reach for positioning switch is large and can be turned on with palm 26 SAFETY Tips to keep in mind when purchasing an anal vibrator Have a wide flared base or ring or something significantly big enough to prevent it from being drawn up into the rectum Be seamless with no sharp edges or rough pointy parts Be sure that there are no parts that can come off Short length only Use lots of lubrication thick lube is recommended Vibrators to wear MHP Tongue Joy Description e An excellent little massager that attaches to your tongue or any other body part with one of the elastic silicone bands provided in the kit e Wired hand held Turbo pack increases the intensity of vibration variable speed control and long lasting power Comes with pair of miniature batteries for self contained use but the Turbo pack requires 2 x AA batteries e Attachment Added ear extensions made out o
9. ROSTATE GLAND VAS DEFERENS FORESKIN Sie EEC EPIDIDYMIS PUBIC BONE TESTES SCROTUM URETHRA GLANS PENIS Routines Sometimes the time of day and other activities planned can facilitate or hinder sexual expression Below are a few suggestions for clients e Plan to be sexual when medications for symptoms that interfere with sexual activity Such as pain or spasm are most effective Complete bladder and or bowel routines before starting sexual activity e Try being sexual during times of the day or night when feeling well rested e Allow enough time e Although it may be difficult try to let go of the expectation of spontaneity and savor the planning of sexual activity a AT j i a ink i times E othersi conne Fring reflects i our Cnet Af as almost nothing else does j the nside it begins with your own self Ind intimacy eine Stephanie Dowrick W Safety 1 SKIN INTEGRITY be aware of activities that cause skin friction or prolonged positions and of current skin irritation breakdown and pressure sores in order to prevent further damage 2 ALTERED SENSATION caution is recommended with the insertion of sexual aids into a body orifice that has diminished feeling Mechanical sexual aids that increase in temperature with use or devices that constrict the genitalia should also be used with caution 3 AUTONOMIC DYSREFLEXIA AD This condition also known as hyperreflexia is a state th
10. at is unique to patients after SCI most often at a T 6 level and above and can be seen in other conditions such as Multiple Sclero sis AD is an abrupt onset of excessively high blood pressure usually originating from a noxious or non noxious stimulus below the level of injury to the spinal cord AD is commonly caused by an over distention of an organ i e bladder or bowel or a pain stimulus but can also be triggered by sexual arousal orgasm ejaculation or stimuli to the pelvic region that would ordinarily be painful if sensation were present Some key signs and symptoms include e Pounding headaches e Nasal Congestion Blotching of the skin e Nausea e Sweating above the level of injury AD is a medical emergency and if untreated can lead to life threatening seizures or stroke If AD is experi enced while being sexual and the sexual activity is the only triggering cause identified the activity should stop and a sitting position head up feet lowered be attained if at all possible to reduce the symptoms If AD symptoms do not dissipate after 5 minutes the sitting position Should be maintained and emer gency medical personnel contacted Krassioukov et al 2009 e Goose bumps e Slow Pulse Flushed red face e Restlessness Myth Orgasms only come from partners they don t happen alone Reality False Orgasms can hap pen alone or with a partner Practicing alone can help the individual figure
11. bricants is now available at most larger chain drug Stores and not found only at sex toy stores Lubricants lube come in single use packets or bottles Consider the ease with which packages or bottles are opened and closed Consider using a pump dispenser or an adapted bottle holder The use of long lasting chemically neutral lubricants are important for vaginal and anal penetration to help protect the delicate tissues from irritation and damage Avoid flavored coloured or warming lubricants as they may contain chemicals that provoke allergic reactions WATER BASED LUBRICANT Safe to use with condoms and all sex toys Inexpensive Check the label for glycerin and or preservatives as they may cause a reaction in some people Water based lubricants will dry out during use so add more water or more lubricant as needed SILICONE BASED LUBRICANT Doesn t dry up lasts longer than water based lubes Does not contain glycerin and will not absorb into body It can be more expensive and some brands have a chemical taste Note Silicone lubricants cannot be used with silicone sex toys since the silicone in the lubricant will degrade the silicone toy OIL BASED LUBRICANT Oil deteriorates latex Consider using a water based or silicone lubricant if latex gloves or condoms are being used Information based on material from www comeasyouare com Safe Sex When engaging in sexual activities with others it is important to be aware of sa
12. covers come in a variety of colors and prints SPECIAL NOTE Black Label line is available This line of positioning pillows includes snaps and buckles to attach soft cuffs and tethers PRICE WEDGE SAFETY 85 115 Black Label Ramp 140 Use caution when transferring and 150 Black Label Scoop 235 maneuvering on the pillows S285 Black Label Liberatorshapes com SPECIAL CONSIDERATIONS Need to be able to transfer on off CLEANING may need assistance to position Pillow covers are machine washable pillows 37 Love Bumpers PRICE S 85 00 340 00 www lovebumper com CLEANING Pillow covers are machine washable 38 SAFETY Use caution when transferring and maneuvering on the pillows SPECIAL CONSIDERATIONS Need to be able to transfer on off may need assistance to position pillows Product will provide support in maintaining certain positions Thigh sling PRICE S144 www stockroom com CLEANING Cleaning depends on the type of leather purchased Some leathers need a special leather conditioner Please refer to the cleaning guidelines from the manufacturer for specific order SAFETY Please ensure that the product is positioned in the correct fashion i e legs in loop holes and brace around neck Ensure skin integrity by checking for any change in skin color i e redness or irritation Loosen or take off Sling if this occurs SPECIAL CONSIDERATIONS R
13. design and illustration The Sexual Health Clinicians of the GF Strong Sexual Rehabilitation Service Vancouver BC for the extra time and effort they put in Supporting this project The staff at Womyn s Ware Vancouver BC for their helpful informa tion on sexual devices Occupational and Physical Therapists and clients from GF Strong Vancouver BC for providing their expert knowledge Members of the BC Institute of Technology team Vancouver BC for developing and providing information on the VSD devices 44 Beauty to me means confidence An indisputable confidence that only comes from being comfortable as being yourself Something we should all strive for E Shur Photography aes am There is nothing you can t do if you set your mind to it Anything is possible Rick Hansen
14. e for reduction or loss of typical body functioning in order to sexually satisfy self and or partner and alter or eliminate environmental barriers to improve the quality of sexual activity e g poor lighting inadequate bed system etc OTs can also adapt sexual devices to meet the abilities of clients e g adding switches making hands free options etc PHYSIOTHERAPISTS PT Address clients physical function They can educate and assist clients with skills such as transferring from wheelchair to bed repositioning in bed maintaining balance managing spasm and maximizing comfort in sexual positioning alone or with partners NURSES RN Can assist with the execution of many of the suggestions given by the OT PT or MD and are critical in assisting with the overall medical management of a disability Sexual Health Clinicians SHC are nurses specialized in the area of sexual health They are experts in educating clients and their partners on the complex changes to sexual function as a result of chronic illness or disability and are qualified to make specific suggestions to enhance sexual functioning and or fertility SOCIAL WORKERS SW Can play a large role in educating and counseling partners and families around sexual and fertility issues Social workers can also assist with funding options for the purchase of equipment PSYCHOLOGISTS Explore in depth with clients the many different emotional components of sexuality such
15. equires little to no hand function assistance may be required to put device on and take off 39 Ep omg a Comma aaa l A atk I eee ee ri an S ree a oat k LEES EE 5 tes abs i ie me E i T 5 os i L yaen Each body has its art aa a k i Lotte ag aise Gwendolyn Brooks ss Masturbation Aids that are Hands Free Devices are available for self pleasuring and penetration that are motorized and non motorized For example there isa rocking seat with a special pivoting thrust arm assembly which holds and thrusts a wide variety of sex toys Monkey Rocker and others that are designed to be hands free see following page However these Should not be used in areas with reduced sensation as damage can occur when penetration is not controlled by one s own hand 40 Hands free kit P i j Description e Designed to enable hands free vibrator stimulation to assist persons with spinal cord injuries e Includes metal grab bar and hardware to attach to wall the Lean On Me link and a two speed Homedics plug in massager e Individual pieces of this kit are available for purchasing PRICE SAFETY 190 00 Come As You Are Not waterproof CLEANING SPECIAL CONSIDERATIONS Hand wash vibrators with mild Switches are small might need soap and damp cloth assistance with set up installation of grab bar choose location with room for maneuvering Position for standin
16. f elastic band to ensure that is does not slip off of your tongue PRICE SAFETY 32 95 US Order online from www nitetimetoys com Try to avoid any contact with your teeth Using it for a long time could be damaging to CLEANING mouth tissues Clean with soap and water between use SPECIAL CONSIDERATIONS Requires little to no hand function assistance may be required to put device on tongue lightweight 27 Five speed Finger Vibe Description e Lightweight fits on any finger e Comes with 4 different textured tips and 5 different kinds of vibrations e Requires 3 watch batteries Powerful vibrator e Not waterproof PRICE SAFETY 25 00 Come As You Are Not waterproof CLEANING SPECIAL CONSIDERATIONS Clean between each use using Does not require active grasp no damp cloth and soap wrist strength needed batteries may be difficult to change 28 inhibition M agi 1 Sa 2 T R J a 1 f a p ia i i lE i AE T rs y ete E i Lyi E E i T f mall pe e i E L Eii a hk se J 4 i ark i 1 et Harnesses Er n sT f a 3 Beauty is honesty openness and awareness The ability to perceive all the invisible energies at work and to share and communicate without ae aR Bai A Aut otguphe i ENA SS i J Fi a ia ci aa i 4 Ea i Foal ni i Fa of F a P had i T an TE MEE m Ay ee i pS Gi ae as F tad af 3 Ter ae k M oe a The
17. fe sex practices For more information contact a doctor nurse or sexual health clinic The following are some general tips Get tested regularly for sexually transmitted infections STIs Before engaging in sexual activities have a conversation with the sexual partner about safe sex practices Use barriers such as condoms latex gloves dental dams to prevent the transmission of STIs and unwanted pregnancy a f ia ke ae ee i F a ia m pp ia oe aS g A n a ple A Ms me pmm Pa Sexual Devices Beauty means someone is exhibiting their natural impulses without fear or being self conscious i E Dorfman Photographer s m or ge A 2a lt a ae al ae P p ba EET ae al Cy j a to i tt oe ne x k o S i The prices stated reflect current dollars and are subject to change 18 Wahl Massager PHOTO OWOMYNSWARE COM Description Powerful massager can be used on whole body e Includes 2 speeds and 7 attachments e Cup attachment good for penile stimulation e Quiet e Plug in no batteries required e Option of having a heat function use with caution and do not use in areas without sensation PRICE RANGE PRECAUTIONS S 20 00 amazon com S 70 00 Womyn s Ware Don t press too hard on sensitive body parts Can use massage oils on most body parts but refrain from putting oils on genital area Clean on regular basis CLEANING
18. fold up discreetly and has non skid feet ACCESSORIES Slip covers available in many different colors CLEANING Slipcovers are machine washable SAFETY Ridermate is an adjustable cot i Requires trunk stability for partner Transfer legs for the IntimateRider SPECIAL CONSIDERATIONS provide additional stability for Need to be able to transfer on off transferring product set up in a location with room for maneuvering and includes accessible supports IntimateRider 500 00 Rider such as grab bars or counter tops mate 150 00 Transfer legs as needed 90 00 Intimaterider com 35 Body Bouncer Description e Steel frame soft rubber seat e Slight flexing of thighs will cause bouncing movement 8 9 drop e 23 long x 17 high x 20 wide eRecommended weight limit of 225 Ibs e Assembly required PRICE SAFETY 200 US shipping costs www bodybouncer com Use caution when trying new positions and check saddle for wear Be careful of falls risk and CLEANING use in an area with grab bars or Use warm water and mild soap to counter tops to help stabilize wash the saddle SPECIAL CONSIDERATIONS Person on top needs stable trunk control and good sitting balance during movement 36 Liberator Shapes Description e Soft core foam positioning pillows that can be used in a variety of ways during sexual activities e Wedge ramp and rocking pillows are available e Soft micro fibre
19. g sitting or lying depending on mobility needs 41 Vibro stimulation Devices VSD PHASE VSDs NOT YET IN PRODUCTION Contact Information James Wells B Sc Business Development Officer Email JamesWells bcit ca Telephone 604 451 7155 42 References Anderson K 2004 Targeting Recovery Priorities of the Spinal Cord Injured Population Journal of Neurotrauma Vol 21 No 10 1371 1383 Burke N Oatman N Miller W C Elliott S amp Krassioukov A 2007 Sexual health of men with quadriplegia and occupational therapists role APS Annual Meeting Elliott S 2009 Sexuality after Spinal Cord Injury Chapter 21 in Spinal Cord Injury Rehabilitation Edelle C Field Fote editor F A Davis Company Philadelphia pgs 513 529 Kaufman M Silverberg C amp Odette F 2007 The Ultimate Guide to Sex and Disability for all of us who live with disabilities chronic pain and illness Publisher Cleis Press Inc Krassioukov A MacHattie E Naphtali K Miller W C Elliott S Development of sexual device manual for persons with spinal cord injury J Spinal Cord Med 2009 In preparation Krassioukov A Warburton DE Teasell R Eng JJ Spinal Cord Injury Rehabilitation Evidence Research Team 2009 A systematic review of the management of autonomic dysreflexia after spinal cord injury Arch Phys Med Rehabil 90 4 682 95 Kroll K amp Levy Klein E 1992 Enabling Romance A guide to love
20. ic experience ae DISCLAIMER The devices and ideas discussed in this manual are examples and not specific recommendations of products chosen to illustrate potential sexual options for persons with disabilities The authors attempted contact with the relevant manufacturers for permission to illustrate their products and were not solicited by or compensated in any way by the manufacturers This information reflects the opinions of the authors and not necessarily those of other staff management and physicians of Vancouver Coastal Health WARNING The authors do not take responsibility for any harm or injury caused by using the devices included in the manual and persons and clinicians must be aware of the individual s specific body abilities and sensations and weigh the risks and benefits of utilizing any product or suggestion a a i hopr a Introduction This manual was created as a practical resource for persons with disabilities and health care clinicians who work with these clients It includes research clinical expertise and product information to aid with dialogue surrounding sexual and reproductive issues and disabilities The information presented here is not prescriptive and the specific products not recommended per se but are meant to provide examples and illustrations of some of the potential options that can be introduced into the sexual practices of the individual or be used as an adjunct in the discussions of sex
21. ion that OT could build Positioning For Sexual Activity Tf any thing is sacred the human body is sacred Walt Whitman There are no rules to positioning Key concepts are comfort balance and safety Experiment and refer to OT and PT for more suggestions on specific needs Below are some tips modified from The Ultimate Guide to Sex and Disability Kaufman Silverberg amp Odette 2007 ONE PARTNER ON TOP Experiment with both the top partner and the bottom partner assisting in sexual movement thrusting or otherwise For the bottom partner use pillows behind the lower back and or knees for support Using a wedge pillow under the bottom partner s knees can help alleviate Spasm reduce lower back pain and offer easier access to genitals SIDE LYING POSITIONS In a Spoon position one partner lies in front of the other both facing the same direction on their sides This position can be useful for people who wear catheters and have a leg bag A cushion between a person s legs can ease hip discomfort and facilitate penetration or sexual acts from behind Side positions facing each other can allow both partners to be involved in the thrusting of penetration or sexual act Alternatively one person can lie on their side with the other partner penetrating from behind with their body positioned at a 90 degree angle this reduces the need for upward thrusting USING A CHAIR OR WHE
22. l devices to optimize sexual expression once bodily changes have occurred A description of the required motor abilities needed to use the device and other special considerations are added to assist in whether specific devices are appropriate It is critical that clients take responsibility to consider and or discuss with health care professionals the pros and cons and potential risks and benefits of each suggestion Further information on sexuality and disability can be found in the references listed on p 43 Who are the Health Care Clinicians that can address sexual rehabilitation SEXUAL MEDICINE PHYSICIANS OR PHYSIATRISTS MD Are specialized doctors who can assist with maximizing sexual physiology and reducing the medical issues that often interfere with sexual interest and activities e g medications pain bladder and bowel continence autonomic dysreflexia see definition below and spasm Other physicians urologist gynecologist neurologist etc may also have valuable expertise These physicians can refer clients to other health care professionals as needed They can also assist with fertility difficulties Elliott 2009 OCCUPATIONAL THERAPISTS OT Help enable clients to manage and perform their daily activities OTs can address issues around sexuality by teaching skills such as how to organize a daily routine to allow time and energy for sexual activities manage personal hygiene before and during sexual activities compensat
23. re pleas SEXUAL DEVICE MANUAL FOR PERSONS WITH DISABILITIES Kate Naphtali Stacy L Elliott MD Edith MacHattie MOT Director B C Centre for Sexual Medicine University of British Columbia UBC Clinical Professor Depts of Psychiatry and Vancouver BC Canada Urological Sciences UBC GF Strong Rehabilitation Center Under the supervision of ICORD Dr Andrei Krassioukov MD PhD FRCPC Associate Professor Div Phys Med amp Rehab UBC G F Strong Rehabilitation Centre ICORD Contents Letter from authors 2 Introduction 3 What research has shown 3 Who is this Manual for 3 What is in the manual and why 4 Who are the Health Care Clinicians that can address sexual rehabilitation 5 Anatomy 6 Routines f Safety 9 Devices for Different Physical Abilities 10 Further Adaptations of Devices 12 Positioning For Sexual Activity 13 Making Parts Fit 17 Personal Lubricants 17 Safe Sex 17 Products 18 Devices for Penetration 23 Harnesses 29 Positioning Products 34 Hands Free 40 Copyright MacHattie E Naphtali K Disabilities Health Research Network 2009 All rights reserved May be reproduced and distributed for clinical purposes only Direct requests to dhrnmanual gmail com Wincoryver Health Research Institute Ax cs Ave a Health icord esearch Network Making BC Disability Research a Priority Tam convinced that life i in Ae physical body is meant to bean I Te t S Gawain ecstat
24. se EE are made for dildos A ides IS an object usually made OT finm silicone or latex that is used to penetrate bodily orificesina sexual way They are available in a wide assortment of colours textures and sizes People can use them as hand held sexual devices or fit them an harnesses as described on the following pages Both Womyn s Ware and z SGT AS You Are have large selection of dildos and well educated staff who if provide recommendations on making a selection A Af er M 3 29 The Strapper Aslan Men s Harness PHOTO O OWOMYNSWARE COM PRICE SAFETY 80 100 Womyn s Ware Ensure straps are snug but do not cut off circulation around waist or thighs PRICE SAFETY 160 Come As You Are Ensure straps are snug but do not cut off circulation around waist or genitals CLEANING Do not soak use mild soap and water and hang to dry SPECIAL CONSIDERATIONS Requires mobility and or set up to put on and take off Ensure skin integrity by checking for any change in skin color i e redness or irritation Loosen or take off harness if this occurs CLEANING Do not soak use mild soap and water and hang to dry SPECIAL CONSIDERATIONS Reguires mobility and or set up to put on and take off Ensure skin integrity by checking for any change in skin color i e redness or irritation Loosen or take off harness if this occurs 30 31 Thighrider PRICE S70 85 Come As You Are CLEANING
25. sex and relationships for people with disabilities and the people who care about them Publisher No limits Communication Neistadt M 1986 Sexuality counseling for adults with disabilities A module for an occupational therapy curriculum AJOT 40 542 545 We welcome any questions or feedback to make the next edition even better Please go to www scisexualhealth com for further resources and contacts or you can contact the authors directly via email at dhrnmanual gmail com Funding for this project generously provided by Z N JN NE WAS Disabilities Health Var Research Network Making BC Disability Research a Priority The mission of the DHRN is to increase knowledge about biological psycho social and community related factors in order to minimize further impairment improve levels of ability and enhance community participation of persons with disability www dhrn ca The authors wish to thank Mr Ted Emes and the British Columbia Paraplegic Association for their support in this grant 43 The authors gratefully acknowledge Cory Silverberg Toronto ON AASECT certified sexuality educator author media contributor and researcher for supporting the project with advice information and product photos and for contributing his knowledge from www comeasyouare com and his book The Ultimate Guide to Sex and Disability Mr Winston Elliott West Vancouver BC illustrator Mr Keith Leinweber Vancouver BC for manual
26. sing eating and toileting in terms of activities to focus on during rehabilitation Friedman 1997 There are a number of different appropriate clinicians see p 5 involved with clients during the rehabilitation process who can discuss sexuality with them The occupational therapists who co wrote this manual are an integral part of this team and are particularly suited to address how clients with disabilities manage all their ADLs However occupational therapists have limited resources within their profession for training in this area of sexual rehabilitation Neistadt 1986 While not much has changed in terms of sexual health training for health care professionals recognition that sexuality and disability is an important area to be addressed is now found in recent studies books and articles in the area of sexual rehabilitation However there is still a lack of resources that offer practical suggestions for clients and clinicians This manual was created to help address this gap What is in the manual and why The ability of persons with disabilities to engage in sexual activity can be significantly compromised by motor i e movement of limbs sensory i e touch and temperature sensations and autonomic i e blood pressure regulation dysfunctions This manual was designed to familiarize clients and clinicians about the available devices on the market and to encourage creativity in adapting these or other assistive sexua
27. uality and disability by the health care clinician The devices included are a sampling of what is available in Canada in 2009 What research has shown The sexual health concerns of persons with disabilities need to be taken into account and addressed Compared to other rehabilitative specialties little research on sexual rehabilitation is available Anderson 2004 surveyed hundreds of individuals with spinal cord injury SCI to assess what priorities would most impact their quality of life For persons with quadriplegia she found that regaining arm and hand function was most important and regaining sexual function was their second highest priority Regaining sexual function was the highest priority for people with paraplegia A recent study has also linked hand impairment with reduced sexual satisfaction in persons with SCI Burke et al 2007 Unfortunately since rehabilitation clinicians infrequently address sexual issues with their clients Krassioukov et al in preparation studies such as these underline the urgent need to address sexual issues in clinical settings Who is this Manual for This manual is for clients with various disabilities and health care professionals involved in their care The American Occupational Therapy Association AOTA 1986 has categorized sexual expression defined as engaging in desired sexual and intimate activities as an activity of daily living ADL This places it in the same realm as dres
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