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Sexual Identity, Body Image and Life Satisfaction Among Women With and Without Physical Disability
Abstract
The current study examined the association between sexual identity, body image and life satisfaction among women with and
without physical disability. Seventy women with physical disability (spinal cord injuries and injuries resulting from polio)
and 64 women without disability completed the following questionnaires: Sexuality Scale, Body Image Scale and Quality of Life
Questionnaire. The results demonstrated that women with physical disability had the same sexual needs and desires as women
without disability, but their body image, sexual self-esteem, sexual satisfaction and life satisfaction were significantly
lower. These differences were stronger among young adult women than among more mature women. It was also found that sexual
satisfaction was a major factor in explaining the variance in life satisfaction in both groups, and the relationships between
sexual satisfaction and life satisfaction were bidirectional. At the same time, different patterns of congruency and inconsistency
between sexual satisfaction and life satisfaction were exposed in both groups. In addition, the research demonstrated a moderating
effect of family status on links between sexual and life satisfaction.
... This study describes the sexual experiences of women with disabilities in Lagos, Nigeria. Findings from the current study affirm previous findings in Nigeria [35,46] and elsewhere [47][48][49], which suggested that most women with disabilities are sexually active and have similar sexual needs and desires as those without disabilities. However, the sexuality and sexual experiences of women with disabilities in Nigeria, like in many countries in SSA, are often neglected or ignored due to the long-held perception that women with disabilities are asexual or sexually inactive [17,18]. ...
... For instance, Okotie and Jolly [46] reported that women with disabilities in Nigeria continue to be discouraged from getting intimate or expressing their sexual desires. Such suppression of sexual feelings could have a negative impact on the well-being and quality of life of women with disabilities [48]. ...
As of 2021, 1.3 billion people globally live with disabilities, with 80% in low-and-middle-income countries and 12.8% in Africa. Women with disabilities often face gender-based discrimination and limited sexual autonomy, impacting their sexual health. Despite global progress, there is limited research on the sexuality of women with disabilities in sub-Saharan Africa, particularly Nigeria. This study explores the sexual experiences of women with disabilities in Lagos, Nigeria. Using a qualitative approach, 24 women with disabilities, including blindness and mobility impairments, were interviewed to understand their experiences with sexual activity, autonomy, contraceptive use, risky behaviors, and sexual violence. The participants demographic shows that 67% of participants had physical disabilities, while 33% had visual impairments, with ages ranging from 20 to 45 and varying education and employment levels. Themes were generated around the experience of women with disabilities in sexual activities, modern contraceptive use, sexual autonomy, risky sexual behavior and sexual violence. Many participants did not see their disabilities as hindering sexual activity but faced challenges in relationships due to physical limitations and societal stigma. The study found mixed experiences with modern contraceptives, hindered by misconceptions and accessibility issues, and some women reported experiencing sexual violence and inadequate access to reproductive health resources and support. The findings underscore the need for targeted interventions, including improved access to contraceptives, public education to reduce stigma, and enhanced legal protections to support the sexual and reproductive health of women with disabilities in Lagos.
... Societal expectations for men's bodies, which emphasize muscularity, fitness, and leanness, have created a demanding cultural archetype. This "ideal" male physique, constantly reinforced by media and advertising, sets a standard that many find daunting and unattainable, leading to a growing prevalence of body dissatisfaction among men and challenging the stereotype that body image concerns are predominantly a female issue [140,141]. ...
... This shift reflects broader societal expectations and contributes to the internalization of these ideals among men. Constant exposure to images of sculpted, lean physiques across various media platforms sets unrealistic standards, causing many men to perceive their bodies as inadequate or inferior [141]. For some, achieving the idealized body becomes an all-consuming goal that dictates their lifestyle choices and behaviors. ...
This narrative review examines the interplay among body image perceptions, social media influence, physical measurements, and their impact on psychological well-being, focusing on the roles of cultural and gender differences and the need to understand the research methodologies employed in this field. In the age of digital proliferation, platforms like Instagram and Facebook have reshaped body image concerns, often leading to increased dissatisfaction and psychological distress due to constant exposure to idealized images and a culture of social comparison. Physical attributes such as weight, height, and BMI are scrutinized under societal standards of health and attractiveness, contributing to a spectrum of mental health issues including low self-esteem, depression, and eating disorders. This examination reveals how cultural norms and gender expectations further complicate body image perceptions, affecting individuals differently based on societal and personal ideals. It synthesizes current research and types of methods to illuminate how these factors together influence mental health and self-esteem, advocating for comprehensive interventions and policy measures aimed at mitigating body dissatisfaction and promoting a healthier, more inclusive understanding of body image. By delving into the complexities of body image satisfaction and its psychological implications, this review highlights the necessity of addressing these concerns within public health and social policy frameworks, underscoring the importance of a multifaceted approach to enhance individual and societal well-being.
... Sexual health, is expressed through an individual's rights to freely express their sexuality within consensual relationships, safe sexual experiences, sexual consent, sexual autonomy, contraceptive use, marry, start a family, access comprehensive sexual information, and receive quality sexual healthcare [5]. As a fundamental human right, sexual health should be attainable and accessible to all including PwDs [5,12], as it influences their overall quality of life and life satisfaction [13]. However, society often ignores or stigmatises the sexuality and sexual health of PwDs [14][15][16], assuming they are asexual or that their sexual well-being is less important [14][15][16]. ...
... However, society often ignores or stigmatises the sexuality and sexual health of PwDs [14][15][16], assuming they are asexual or that their sexual well-being is less important [14][15][16]. Nevertheless, research shows that PwDs have similar sexual needs and desires as non-disabled people [13], and that they face higher risks of adverse SRH outcomes, such as sexual violence, unintended pregnancies, and sexually transmitted infections (STIs), including HIV and AIDS [17][18][19][20][21][22]. For instance, Parekh et al. [23] found that women with disabilities are more susceptible to STIs than those without disabilities. ...
Introduction
People with disabilities (PwDs) constitute a large and diverse group within the global population, however, their sexual and reproductive health (SRH) needs are often neglected, particularly in low-and middle-income countries. This may result in adverse outcomes, such as sexually transmitted infections (STIs), unintended pregnancies, and experience of interpersonal violence (IV). This study aimed to assess the factors that influence the sexual lives of PwDs in two districts of Ghana.
Methods
A sequential explanatory mixed-methods study design was used to collect data from PwDs. Quantitative data were obtained from 402 respondents using a pretested questionnaire, and qualitative data gathered from 37 participants using in-depth interviews. The quantitative data were analysed using descriptive and inferential statistics, while the qualitative data were analysed using inductive thematic analysis.
Results
Most PwDs (91%) reported that they have ever had sex, which was associated with age, disability severity, and household size. The prevalence of poor SRH status, STIs, unintended pregnancy, pregnancy termination, and unsafe abortion were 10.5%, 5.7%, 6.4%, 21.6%, and 36.9% respectively. These outcomes were influenced by education, income, health insurance subscription, and proximity to a health facility. The prevalence of IV was 65%, which was related to disability type and severity. The qualitative data revealed five main themes: curiosity to engage in sexual activities, feelings of despair and insecurity with abled partners, preference for sexual relationships with other PwDs, IV and its perpetrators, and adverse SRH outcomes.
Conclusion
The study findings indicate that most adult PwDs have ever had sex and they face various challenges in their sexual lives. They experience multiple forms of abuse and neglect from different perpetrators at different levels of society, which have negative impacts on their well-being. There is a need for comprehensive and inclusive interventions that address the SRH needs of PwDs, as well as the underlying social and structural factors that contribute to their vulnerability. Further research is recommended to explore the perspectives of stakeholders on how to improve the SRH outcomes of PwDs.
... However, studies among older adults [7], older men [6], and aging women [46] have consistently reported that improvement of sexual activity increases the level of life satisfaction. It also appears that there is a bidirectional relationship between women's sexual-related determinants and life satisfaction [47]. ...
... They also stated that individuals with disabilities face many problems in their sexual lives. Moin et al. (2009) determined that women with physical disabilities had similar sexual demands and desires as women without disabilities, but had lower levels of body image, sexual satisfaction, and sexual self-esteem. In a study by Karamidehkordi and Roudsari (2014), it was stated that the sexual functions and marital adjustment of women with high body image were more positive. ...
Aim: This study was to evaluating the effect of body image on the sexual quality of life of married women with physical disabilities. Methods: The present study was carried out at the physical therapy and rehabilitation clinics of a hospital in southeast of Turkey between October and December 2022. The sample of the study contains 106 married women with physical disabilities. ‘‘Descriptive Features Form (DFF)’’, ‘‘Body Image Scale (BIS)’’, and ‘‘Sexual Quality of Life Questionnaire-Female (SQLQ-F)’’ were utilized to collect data. Results: There was a positive and moderate correlation between the BIS and the SQLQ-F (r=0.632, p
... Sexuality has been described by the World Health Organization (WHO) as a "central aspect of being human" and includes many aspects such as: intimacy, sexual activity, sexual orientation, gender identity, fantasies, desires, and beliefs [2]. Existing literature has established intimacy and sexual selfesteem are connected to quality of life and life satisfaction for most (but not all) people [3][4][5]. For example, research suggests that when people participate in sexual activity, there are short-and long-term benefits such as decreased pain, improved mood, improved overall-wellbeing, and decreased morbidity [6]. ...
Previous research has indicated that healthcare support for sexuality after spinal cord injury appears to be neglected or inadequately provided. The perspectives of people living with spinal cord injuries regarding what is lacking and what support they would like to be provided, and why, has yet to be explored. This paper uses critical theory to explore how societal constructs of sexuality and disability shape how sexuality is supported after a spinal cord injury. To do this, we conducted in-depth semi-structured interviews with 11 people with a spinal cord injury from Australia, the United Kingdom, and the United States. We drew from the works of various critical disability theorists to analyze what discourses underpinned the experiences people with spinal cord injuries had when receiving sexuality support. Analysis suggested that the following discourses were apparent: (1) broken bodies require repair, (2) sex is penetration, ejaculation then reproduction, and (3) sexual autonomy is required. Findings indicated healthcare professionals need to recognize people with spinal cord injuries as sexual beings with a diverse range of desires, lives, relations, and bodies. Provision of individualized comprehensive high-quality sexuality support is therefore warranted. To achieve this, healthcare professionals should aim to be aware of, and mitigate, ableist and normative assumptions.
... The attainment of mental health has also been linked with diversified factors such as physical health of a person [75], healthy family relations [76,77], extraversion in personality [78], optimism for the future [79], being married [80,81], sexual satisfaction [82], body image [83], financial stability and job satisfaction [84][85][86][87][88][89][90][91]. ...
The assessment of mental health and mental disorders has undergone extensive exploration within the field of psychology, resulting in various models and approaches. In addition to traditional ways like the Diagnostic and Statistical Manual of Mental Disorders, psychologists have proposed alternative perspectives for evaluating mental health. One such innovative approach is the psychosocial health model, which defines mental well-being as sexual, emotional, social, environmental, cognitive, religious, moral, and spiritual satisfaction. This paper presents four consecutive studies aimed at developing and validating a new scale, Sukoon Psychosocial Illness Scale (SPIS), to measure psychosocial illness and its sub-factors based on the model of psychosocial health. SPIS was developed and validated through four sequential studies involving 684 participants. Rigorous exploratory and confirmatory factor analyses were employed to establish content and construct validity. Convergent and discriminant validity were assessed by examining associations with psychological distress and overall psychosocial health. Reliability was evaluated using internal consistency, test-retest reliability, and item-total and item-scale correlations. The results of the study confirm the high reliability and validity of SPIS. This refined instrument consists of 21 items presented in English, employing a 7-point Likert scale for responses. The scale comprises six distinct sub-scales, namely emotional problems, sexual problems, religious and moral problems, social problems, spiritual problems, and professional problems. SPIS emerges as a promising tool for future researchers and clinicians, offering a fresh perspective on mental disorders through the comprehensive lens of psychosocial health. This instrument contributes to the evolving landscape of mental health assessment and underscores the importance of considering diverse dimensions for a holistic understanding of psychosocial well-being.
Sex guilt refers to a feeling of shame or anxiety induced by sexual behavior due to the inconsistency between a person's value and their sexuality. Sex guilt often stems from traditional, gender stereotypical sexual views and attitudes. In this study, we inquired what factors could be predicting sex guilt. Negative sexual messaging (NSM) refers to the promotion of abstinence and the glorification of virginity, representing a set of sex‐negatives views. We evaluated the relationships between NSM in childhood and sex guilt in adulthood. We include childhood sexual abuse as an alternative predictor of sex guilt to anchor our results with NSM. Participants were recruited through undergraduate groups and online platforms (total N = 1322) and completed an online survey regarding about their sexual experience. We found that NSM was a strong, persistent predictor of sex guilt. Those who experienced more NSM reported higher sex guilt. Our findings could be particularly informative for educators and policy maker who creates sex education curricula. Further study is needed to clarify the mechanisms through which NSM are associated with sex guilt.
Purpose
Mindfulness‐based interventions (MBIs) are well‐validated interventions to enhance the favourable body image of individuals. Despite their wide application, the efficacy of MBIs in reducing body image dissatisfaction (BID) among various clinical populations remains unclear. This study aims to expand the literature on MBIs for BID and identify effective types of MBIs for reducing BID in diverse clinical populations for future research and practice.
Methods
A systematic search for studies published in English on the effectiveness of MBIs for BID among the clinical population was done on APA PsycNet, PubMed, Science Direct, Web of Science and Google Scholar databases in August 2023. Of the 1962 articles initially identified, 17 were found eligible and evaluated based on the JBI checklist.
Results
Random effects meta‐analyses on six MBIs revealed their effectiveness in reducing BID among the clinical population (SMD = −.59 and 95% CI = −1.03 to −.15, p = .009), with Acceptance and Commitment Therapy (ACT) (SMD = −1.29, 95% CI = −2.06 to −.52, p = .001) and My Changed Body (MyCB) (SMD = −.24, 95% CI = −.46 to −.01, p = .04) reporting significant effect sizes. Among the patients with breast cancer, MyCB (SMD = −.24, 95% CI = −.46 to −.01, p = .04) showed a significant effect size.
Conclusions
MBIs appear to be promising interventions in reducing BID among the clinical population. However, findings should be considered cautiously due to the possible publication bias, high heterogeneity and fewer available studies.
This article describes the development of the Sexuality Scale, an instrument designed to measure three aspects of human sexuality: sexual‐esteem, defined as positive regard for and confidence in the capacity to experience one's sexuality in a satisfying and enjoyable way; sexual‐depression, defined as the experience of feelings of depression regarding one's sex life; and sexual‐preoccupation, defined as the tendency to think about sex to an excessive degree. The procedure involved (a) item construction, selection and subsequent validation through item analysis; and (b) a factor analysis of the items on the Sexuality Scale and the establishment of factorial validity. The results indicated that the three subscales were psychometrically sound, that males reported more sexual‐preoccupation than did females, and that the three subscales have unique intercorrelation patterns. The exploratory nature of these findings are discussed.
Several studies have documented disproportionately low sexual and body esteem in women with high degrees of physical impairment.
Moreover, other studies have begun to examine the problem of intimate partner and other forms of abuse in women with physical
disabilities. In this article we examine the link between low sexual and body esteem and intimate partner abuse in women with
physical disabilities based on findings obtained from an in-depth qualitative study. Findings indicate that women with high
degrees of physical impairment are more likely to perceive themselves as sexually inadequate and unattractive than women with
mild impairment. These negative perceptions, when combined with a strong desire to be partnered, increased women’s vulnerability
to getting into and staying in abusive relationships over time. Major themes presented in the article include: societal devaluation,
low sexual and body esteem, preference for non-disabled men, desire to be partnered, and relationship decision-making. We
depict the relationships between each of these themes in a simple model to further aid the reader’s understanding.
Thinkers have discussed the good life and the desirable society for millennia. In the last decades, scientists offered several alternative approaches to defining and measuring quality of life: social indicators such as health and levels of crime, subjective well-being measures (assessing people''s evaluative reactions to their lives and societies), and economic indices. These alternative indicators assess three philosophical approaches to well-being that are based, respectively, on normative ideals, subjective experiences, and the ability to select goods and services that one desires. The strengths and weaknesses of the various approaches are reviewed. It is argued that social indicators and subjective well-being measures are necessary to evaluate a society, and add substantially to the regnant economic indicators that are now favored by policy makers. Each approach to measuring the quality of life contains information that is not contained in the other measures.
In this chapter I review the social psychological underpinnings of identity, emphasizing social cognitive and symbolic interactionist perspectives and research, and I turn then to key themes of current work on identity—social psychological, sociological, and interdisciplinary. I emphasize the social bases of identity, particularly identities based on ethnicity, race, sexuality, gender, class, age, and (dis)ability, both separately and as they intersect. I also take up identities based on space, both geographic and virtual. I discuss struggles over identities, organized by social inequalities, nationalisms, and social movements. I conclude by discussing postmodernist conceptions of identities as fluid, multidimensional, personalized social constructions that reflect sociohistorical contexts, approaches remarkably consistent with recent empirical social psychological research, and I argue explicitly for a politicized social psychology of identities that brings together the structures of everyday lives and the sociocultural realities in which those lives are lived.
“Identity … is a concept that neither imprisons (as does much in sociology) nor detaches (as does much in philosophy and psychology) persons from their social and symbolic universes, [so] it has over the years retained a generic force that few concepts in our field have.” ( Davis 1991 :105)
“[I]dentity is never a priori, nor a finished product; it is only ever the problematic process of access to an image of totality.” ( Bhabha 1994 :51)
The final report of the National Study on Women with Disabilities provides an overview of the research conducted from 1992 to 1996 at the Center for Research on Women with Disabilities. The report addresses the methodologies used in the recruitment of women and reviews the various analyses conducted on the data. In addition, the report provides a discussion of recruitment techniques used for nondisabled women and the analysis used for this population as well. It provides a summary of findings in the areas of sense of self, relationships, information about sexuality, sexual functioning, pregnancy, sexually transmitted diseases, abuse, chronic conditions, health maintenance behaviors, gynecologic health, and health care utilization.
The phenomenological study described in this paper examines the sexuality and relationship lived experiences of 15 adult women who sustained complete spinal cord injury between the levels of T6 and L2 verified by a physiatrist. Audiotaped, semi-structured interviews were conducted by an interdisciplinary team of investigators. A set of themes and sequentially consistent patterns emerged from post-injury data that were labelled: Cognitive-genital dissociation, sexual disenfranchisement, sexual exploration, and sexuality reintegration. Sexuality and relationship issues in women with complete SCI are discussed, and indications for future studies and educational implications are presented.
The study evaluated relationships and sexuality among people with multiple sclerosis (MS) and their partners. The results
were compared to findings among couples in the general population. Participants were 45 heterosexual people with MS and their
partners and 32 heterosexual people from the general population and their partners. There was a high level of concordance
between the views of couples from the general population, but not among couples where one partner had MS. Partners of people
with MS were more likely than people with MS to feel that MS had a negative impact on the physical and emotional support in
their relationship. People with MS also experienced more problems in their relationship and sexual functioning, but not their
sexual satisfaction, than people from the general population. The implications of these results in terms of support programs
for people with MS and their partners are discussed.
The sexual experience of 167 women was compared: 82 women who suffered from a physical disability; 85 women free of physical impairment. Each participant filled out an extensive questionnaire (Frenken & Vennix, 1978). Areas investigated were sexual acceptance, psychosexual stimulation, sexual motivation and general sexual satisfaction. Sexual knowledge and sexual experience were briefly explored. Conclusions, which can be drawn from the study, appear to be that women with a disability have a more rejective attitude towards sexuality, less sexual knowledge and less experience with intercourse. They are less satisfied with their sexual experience. No difference was found with regard to sexual desire and fantasy; likewise both groups share equal sexual motivation when actively living in a sexual relationship.
This study was designed to evaluate the association between the sexuality and quality of life of people with congenital physical disability. Sixty people with congenital physical disability (33 males, 27 females, mean age = 28.64 years) who were living in the community participated in the study. Each respondent completed the Sexual Knowledge, Experience and Needs Scale which assesses levels of knowledge, experience, feelings and needs in 12 different areas of sexuality. Respondents also completed the Comprehensive Quality of Life Scale which assesses both subjective and objective dimensions of quality of life in seven broad domains. Surprisingly, there were few associations between sexuality and the quality of life domains. The strongest associations were between sexual intimacy and importance of quality of life. The implication of these findings for the lives of people with physical disabilities are discussed.