Sexual Self-Image

Overview
This chapter will cover the effect of spinal cord injury on self-confidence and self-esteem. It will
provide you with suggestions on how to begin the process of redefining your sexual self.

What Is It?
What’s Different Now?
What Can I Do About It?
What Do I Need to Know?
My Role
Who Can Help Me?
Conclusion & Resources

MYTH
Now that I have a spinal cord injury, I’ll never feel sexy again.
FACT
It may take some work, but you CAN feel sexy again.
What Is It?
Gila Shipiro (a psychotherapist and certified sex therapist) defines sexual self-esteem as “the
feelings you have about your body and your confidence level in how you relate intimately to
someone else. It’s what you bring of yourself, both emotionally and physically, to sex and
relationships — what you do with that and how you share that with someone else. Sexual self-
esteem affects every sexual choice you make.”
Sexuality can be influenced by many things, as illustrated in the image below.

What’s Different Now?

Typically, people don’t think about how they developed their sense of sexuality, it just happens
through your lived experience. Most people don’t realize the importance of the different
components that shape your own identity until a major life event happens. This event can impact
things such as not being able to go to your favourite restaurant because it is inaccessible, not
being able to hug your kids or your partner because of limited arm function, not being able to go
back to the same job and feeling like you can’t provide for your family, or even just looking in
the mirror and seeing a different body than you are used to seeing.
After a spinal cord injury you may experience some of these changes and ask yourself “who am I
now?”. This is a very common question and can lead to moments of feeling sad, lonely,
depressed, frustrated, and you may worry that your sex life is over. This can have an impact on
your confidence and cause uncertainty in how you feel about yourself in relation to sex.
FUN FACT
“Sex is what we do and sexuality is who we are”
What Can I Do?
Finding things that give you control of your life and give you a sense of accomplishment,
purpose, responsibility, and routine can help boost your confidence and motivation. This means
finding a reason to get up and get out into the world every day. This can include a hobby, a job, a
volunteer role, schooling, an exercise program, social activities, whatever you want!
Once you are a little more confident, you will naturally become more curious about what’s
possible and may become more open to trying different things. Positive experiences can help
build your confidence further. Exploring your sexuality is a step by step process—here are some
What Do
exercises I Need that
and resources TocanKnow?
help you along the way.
The path everyone takes will look different and everyone will build their confidence in their own
way. Finding the resources that are available to you in your area and how to access them is an
important place to begin
My Role
The process of regaining your sexual self-view, self-confidence, and boosting your self-esteem
can seem very overwhelming at the beginning. These feelings are common especially soon after
injury. To gain a better understanding of yourself and get back in touch with yourself takes time,
a sense of openness, and support from peers, family, friends and health care professionals. But
ultimately, no one can do this for you — it’s up to you to start the process.
Who Can Help Me?
Sexual Health Rehabillitation Service, SCI BC, peers, friends, family, counsellors, psychologists,
other health care professionals

A Course on Sexuality and SCI

Conclusion
Redefining you sexual self after spinal cord injury can be a challenge. However, spinal cord
injury does not limit your ability to be a sexual person. Despite your physical changes, it’s
important to remember that sexuality comes from within. This process can often take a long time
and can involve taking some risks and pushing yourself outside your comfort zone. You will
likely experience mishaps, fumbling, setbacks, or disappointments along the way but keep in
mind that risks often come with rewards! This is part of the journey towards growth and
regainingUp until today, with the exception of the Wiederman and Hurst study
in 1998, no research has been done with regard to the relationship between
women's sexual self-esteem, body mass index, physical satisfaction and body
image. Through two studies done on adult women, our objective was to better
understand the impact of physical satisfaction on women's sexual self-esteem
as well as investigate the elements on which the latter is founded. Data from
the first study seem to indicate that BMI would be correlated in a negative and
moderate manner to women's sexual self-esteem. A clearer relationship,
however, is observed between sexual self-esteem and body/physical
satisfaction. Results from the second study indicate no relationship between
BMI and sexual self-esteem but they do, however, indicate a relationship
between sexual self-esteem and body image/esteem. Furthermore, the most
salient traits of attractiveness/seduction were found to be related to the face
(eyes, lips, smile). Altogether, research results seem to suggest that
“relationship to the body” may be central to women's conceptualization of
sexual self-esteem. a better sense of yourself.