Trauma, Sex and the Wounded Warrior

Human contact and sexuality are natural and essential parts of our overall well-being. All too often combat warriors experience catastrophic injuries and come home to face emotional and physical barriers to intimacy. Sexual dysfunction in wounded veterans is a problem that is not commonly discussed. The reality is that need, and desire does not dissipate when someone has experienced a traumatic injury. While injuries may cause profound changes to one’s life, intimacy and sexual activity are still possible.

Sexual function issues are an often-hidden wound, one that is frequently given inadequate attention and care within the military health care system. The injuries are not always just a matter of mechanics. They may stem from an isolated physical injury or from a complex web of physical and/or psychological injuries. Studies have found that people who have been exposed to traumatic events may be more likely to experience sexual dysfunction.

Examples of physical injury – traumatic brain injury (TBI), spinal cord injury (SCI ), groin, genitalia, bowels, buttocks and urinary tract, orthopedic injuries involving muscles, bones, nerves, and limb amputations. Or injury could be an event that is caused by psychological trauma, like sexual violence – trauma from sexual assault or post-traumatic stress disorder (PTSD).

Regardless of the type of injury, for the injured, the psychological impact of trauma in any form can have a profound impact on a victim’s physical and mental health and can lead to an interference in sexual functioning and fertility.

There are several reasons why PTSD, TBI, a genital-blast injury or a spinal cord injury may increase the risk for sexual dysfunction. In PTSD, psychological reactions like anger, irritability, fear or high levels of anxiety during arousal can interfere with sexual functioning. A man or woman may feel disconnected and detached from loved ones, which can greatly interfere with intimacy. After a TBI for example, sexual pleasure is often affected or hindered because of a disruption in hormonal regulation.

Being carried off the battlefield with a life-altering, devastating genital Injury can leave a person struggling to engage in something resembling the sex they used to have. Having a disability whether from military service or otherwise is bound to complicate one’s sex life and will likely affect the ability to enjoy sexual pleasure and satisfaction. Decreased sexual desire/energy, loss of sensation, memory problems, and poor self-image may contribute to a person feeling anxious rather than relaxed in intimate settings. But if the new changes are embraced, they won’t end it. You can still experience good sexual health and be a capable and loving partner.

For those who have suffered a catastrophic injury, significant changes in self-image often adversely affect relationships. Besides facing the ongoing struggles of recovery, questions of self-worth and a fear of rejection because of physical or other changes the injured person has undergone can form barriers in their relationships.

Often health care facilities are ill-prepared to manage the sexual intimacy issues of patients with sexual dysfunction and or genital injuries. They focus efforts on healing and saving the lives of the injured more so than the aftermath — the sexual health and intimacy for our wounded warriors and their families. That is changing, however. While still not enough, facilities are becoming experts on treatment that encompasses all aspects of trauma-informed care and are developing protocols for the treatment of sexual health issues in severely wounded servicemen and women.

In addition, there are other creative therapies available to teach veterans with physical and emotional issues alternative ways to be intimate — with a focus on improving self-awareness and confidence to promote positive intimate and sexual experiences leading to an overall better quality of life.

Occupational therapy may help wounded warriors address sex and intimacy focusing on the physical, cognitive, and emotional components of activities humans find satisfying including sexual activity and intimate social participation.

Other professionals including physical therapists, urologists, and mental and behavioral health providers may also help wounded warriors face physical and psychological issues that can impact intimacy and sex.

Struggling to regain sexual function or drive and the ability to engage in intercourse may take years to adapt. The daily routine of caring for an injured service member changes the relationship from couple to a caregiver/patient scenario. This thought is echoed in the Huffington Post’s article on Five Ways Wounded Warriors’ Wives Deal with Post-injury Sex & Intimacy. The article mentions a very thought-provoking statement “When someone we love is wounded, we feel hurt, too, and many wives are hit by what I call PTS shrapnel.” Not having an orgasm or being able to provide one to your partner is a major change after all.

You will often have to re-imagine your relationship and relearn how to have sex and what being intimate truly means. Sex can be had without penetration and intimacy without sex. Shift the focus to your partner’s arousal and slowly learn what turns you on in your new body. Include sex toys aimed at stimulating different parts of the body, hormones and oral/injectable treatments for ED (erectile dysfunction) may help facilitate improved levels of self-esteem and can have improved quality and quantity of sexual encounters.

For physically disabled Wounded Warriors, intimate products that support the body and improve sexual mobility can help overcome restrictive issues and improve intimate relations. Enabling disabled individuals to have an active sex life is empowering and leads to better mental health and overall well-being of the individual.

We hope that this information proves useful and provides hope for any of our afflicted Veterans. Thank You for Your Service. Happy Memorial Day.



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