Saturday, January 12, 2013

TBI, Sexual Dysfunction, Medical and Behind Closed Doors.

http://psychiatryonline.org/book.aspx?bookid=30&goback=%2Egmr_127301%2Egde_127301_member_203702366

TBI, Sexual Dysfunction, Medical and Behind Closed Doors.


In 2009 I happened upon the Textbook of Traumatic Brain Injury editted by Jonathon M. Silver, MD, Thomas W. McAllister, MD, and Stuart C. Yudofsky, MD and Chapter 25 written by Nathan D. Zasler, MD and Michael F. Martelli, PhD on Brain Injury and Sexual Dysfunction after discovering that my brother's roommate had been taken to a strip club at the facility where he currently resides. I was devasted after learning from the case manager who referred us to this facility that some places do indeed hire prostitutes and that it is done discreetly between family members and medical. 

In this chapter it states on page 447 two paragraphs that I wish to open up the doors for discussion with people's thoughts and opinions (I have quite a few questions and concerns): 

"Families and patients should be counseled regarding 
alternatives for sexual release, particularly for patients 
without active sexual partners. Masturbation should be discussed as one potential option as long as it is done in an appropriate social context. For those clients requiring external stimulation to aid in successful masturbation, sexual stimuli (e.g., erotic reading materials, pictures,videotapes, and telephone sex services) can be provided. Obviously, many of the aforementioned suggestions may not be acceptable to certain people because of their moral 
or religious beliefs, or both, but they should be discussed with all patients and families as appropriate." 

"Some health care professionals and family members 
have advocated, as well as condoned, the use of sexual surrogates and prostitutes in addressing the sexual frustrations of people after TBI who might otherwise never find 
sexual partners. Although there are differences between surrogates and prostitutes, many state laws do not make a legal distinction. In an era of high awareness regarding sexually transmitted diseases and legal liability, most professionals seem to be shying away from making use of this 
class of “community resources.”"


 I would first like to say that sex is one of the greatest and most beautiful gifts of the 'human experience', afterall, we would not be here without it. The human touch, whether with self or with another, can be very healing.


This book and chapter is in all our medical universities and is being taught to our younger generation of health care professionals. I am hoping that someone can shed some light on this situation for I would not care to have a member of my family being taught that all of this is "appropriate" given their pursuits in the field.

Who pays for this: medicare, medicaid, workman's comp., etc, or listed under "petty cash"? Do the health care professionals have a local listing for telephone sex companies, hire the prostitutes (and test them out), do they test prostitutes for STD's and HIV? Is pornography/prostitution listed under occupational, recreational or physical therapy?

I was told by a member of the National Brain Injury Association in Washington, DC that at an International Brain Injury Conference in 2010 a medical professional from Australia spoke on this subject given that prostitution is legal in their country but that they did not have enough data conclusive yet for benefits. I am assuming that medical doctors do not write up a script for such to be paid as a "medical necessity" by insurance companies, to this date.

I have talked with people over the past four years, and many health care professionals of my concerns and worries. The health care professionals that I spoke with pointed out to me that the latest research shows pornography (which is widely spread on our internet) actually creates erectile dysfunction in males of our so called "normal sectors of society".

My gravest concerns are that the porn industry is exploitation/trafficking of women and children, with abuse, and that the medical has been bringing this into our universities, families and homes, institutions, facilities, etc. Pornography was discovered on the computer in my brother's apartment and the staff (women) and I were most offended. I have yet to see this being advocated with mental health patients, other forms of disability (although my main focus has been on TBI), and what about "normal people" who are left without partners? And what about the TBI female survivors?

Is it feasible that we as a humanitarians can teach men "what a true intimate relationship is with self and with "others"?