SexLab Research Update!

Tweet SexLab has been conducting research for over a decade and our blog is coming up to a 2-year anniversary! Over the last two years, we have blogged about many different sexuality topics and discussed some of the awesome research we have conducted.

In this blog, we present you with lab highlights from 2016-17 to celebrate the many amazing accomplishments of our lab members. As well, we want to showcase what to expect from SexLab in the coming years!

First up, our extraordinary Lab Director, Dr. Caroline Pukall, has been incredibly productive with writing 18 new publications, 4 book chapters, and numerous presentations since 2016. On top of that impressive list, she has also published the 2nd edition of her Human Sexuality: A Contemporary Introduction (Oxford University Press, 2017) textbook. The first edition of this Canadian textbook was so well received upon its release in 2014, Caroline was awarded the Professional Book Award from the Society for Sex Therapy & Research (SSTAR) in 2016.

Caroline has also received funding from CIHR, the National Vulvodynia Association, and the American Institute of Bisexuality. Currently, she is working on numerous projects with students and collaborators on different topics, including the following: persistent genital arousal disorder, sexual arousal, vulvodynia, relationships, prostate cancer, postpartum sexuality, and questionnaire development. At the heart of her work is the research she is involved in with her stellar and enthusiastic students.

Next up, our senior PhD students, Jackie Cappell and Katrina Bouchard.

Jackie has completed data collection and analysis for the first study of her dissertation investigating nulliparous women's perceptions of and preferences for childbirth, especially as they relate to mode of delivery. Data collection is ongoing for Jackie's in-lab study investigating the role of mode of delivery on postpartum sexual function. She plans to complete data collection by the Fall 2017, just in time to start applying for Clinical Psychology Residency programs. In the past year, Jackie has published 3 papers (Journal of Sex Research, Midwifery, Canadian Journal of Human Sexuality), and more are coming your way!

Katrina completed data collection for her dissertation in May 2017. The first session of the two-part study was conducted to validate a new way of assessing genital blood flow continuously in women. The second session focused on investigating individual differences in women’s mind-body connection during sexual arousal (i.e., sexual concordance) and how porn preferences might play a role in this relationship. In the past year, Katrina published a paper in the Journal of Sex Research showing that women’s sexual concordance varies depending on how genital response is measured, and the results were covered by Playboy’s Debra Soh. Katrina has also collaborated with Dr. Martin Lalumière at the University of Ottawa on a paper investigating the effect of sex drive on paraphilic behaviours in men and women, which has been accepted for publication in a special issue of the Canadian Journal of Human Sexuality.

After both successfully defending their Master’s in the summer of 2016, our first-year PhD students, Robyn Jackowich and Stéphanie Gauvin have had a very busy year with volunteering, media outreach, and conference travels!

Robyn is in the process of preparing her Master’s research for publication, which focused on: 1) symptom characteristics of persistent genital arousal in women (Journal of Sex and Marital Therapy); 2) the impact of persistent genital arousal symptoms on women’s psychological, sexual, relationship, and daily functioning; and 3) the similarities between persistent genital arousal and vulvodynia (e.g., unexplained, chronic vulvar pain).

Robyn is the well-deserved recipient of the Canadian Institutes of Health Research, Vanier Canada Graduate Scholarship for 2017-2020. As she moves into her doctoral research, she will continue to focus on persistent genital arousal disorder (PGAD). The results of her Master’s thesis highlighted the distressing nature of this condition, as well as the need for greater understanding of PGAD’s complex and unknown etiology so that more effective treatments can be provided. Her doctoral research will include an investigation of psychosocial, sensory, and vascular factors involved in PGAD as well as the interrelationships among these factors (funded by the Canadian Institutes of Health Research).

Stéphanie is currently running a longitudinal continuation of her Master’s Thesis examining how same-gender and mixed-gender couples navigate sexual issues in their relationships. This past year, she co-supervised undergraduate Honours thesis student Jillian Steele’s project examining healthcare students’ attitudes and competency in working with sexual and gender diverse clients. Stay tuned for the results!

Stéphanie is also getting ready to launch a study examining the sexual and relational experiences of self-identified bisexual individuals (funded by the American Institute of Bisexuality). Her doctoral research (funded by the International Society for the Study of Women’s Sexual Health) will examine the experiences of chemically-induced menopause in survivors of breast cancer.

On top of conducting multiple studies, Stéphanie has found time to attend and present at several conferences and volunteer her time for outreach programs such as Let’s Talk About Sex: Common Sexual Problems and How to Talk About Them. Workshop presented at the Clinical Psychology Outreach Program, Queen’s University, Kingston, ON (Nov. 2016).

The newest additions to the SexLab in September 2016, Meghan McInnis and Lindsey Yessick, have smoothly started their Master’s thesis career.

Meghan has successfully defended her thesis proposal, and is getting ready to launch her study in the next few months--an online survey to learn more about the experiences of prostate cancer patients across various domains (mental health, quality of life, sexual functioning, sexual and relationship satisfaction, and experiences with the healthcare system). For this study, participants of all sexual orientations and gender identities will be recruited in order to explore variation in the experiences of prostate cancer patients. Our plan is to follow up the results of this study with an additional online survey, as well as detailed interviews.

Lindsey has already launched an fMRI study (funded by the National Vulvodynia Association) examining how women who experience genital pain process pain in the brain and spinal cord (with the Stroman lab). She is also working on the details of another exciting imaging study on clitoral structure and changes during varying states of arousal (with the Stroman lab and SageLab supervisor, Dr. Chivers). And if this suite of studies wasn't enough, Lindsey is also partnering with the Attention Lab at Queen’s to examining attentional differences in response to erotic stimuli in women with and without genital pain.

We also have a new student, Kayla Mooney, who will be joining us in the Fall! We cannot wait to provide you with updates about Kayla’s work!

Phew! That is a lot to celebrate. Sexual health is such an essential field of study and here at SexLab we are all equally proud and grateful to be conducting important, progressive research. We are thankful to all the funders, participants, volunteers, collaborators, and blog readers for supporting us! We look forward to decades more sexual health research!

Shannon Coyle, BSc., BAH., MA. Research Associate Sexual Health Research Lab

(Sex)ability Goes All The Way

Tweet Sexual health must be understood holistically including both physiological and subjective sexual functioning. Physiological sexual functioning refers to physical aspects such as the sexual response cycle, frequency, and quality of sexual behaviour, whereas subjective sexual functioning reflects an individual’s appraisal of their sexuality, such as satisfaction with sexual function, or quality of current intimate relationships (Eisenberg et al., 2015). Both psychological and subjective sexual functioning can be negatively impacted by injury and/or disability. Unless you have been personally affected, or are connected to someone who has been affected by disability, you may have never had to imagine what it would be like to have sex under these limitations. Disability can be understood as a result of the interaction between characteristics of the individual and those of their environment (Eisenberg et al., 2015). Using this definition, the importance of adaptation in efforts to diminish disability is realized. It highlights that the interaction between the individual and their environment is the causal factor for disability and not the person’s impairment itself. Some may believe that those who rely on a wheelchair for mobility as a result of paralysis, stroke, cerebral palsy, etc., do not engage in the act of sexual intercourse at all. However, this is not true! The sex lives of those in wheelchairs are often quite active. As described by Eisenberg et al. (2015) disability shapes a person’s physical, emotional, mental, and social experience and expression of their own sexual nature. I hope to address a need to spark discussion about disability-relevant variations of intimate relationships and sexual activity.

Factors affecting sexual health in those with disability can stem from direct consequences of the injury or disease, and also from indirect consequences associated with the condition that interfere with sexual experience. According to Eisenberg et al. (2015), direct factors include any disruptions to the physiological sexual response cycle that are a direct consequence of the injury or disease (i.e. erectile dysfunction after spinal cord injury). Conversely, indirect factors refer to issues associated with the condition (i.e. mobility, bowel and bladder function, cognitive functioning, etc.), as well as psychosocial elements associated with living with a disability (i.e. negative body image) that interfere with the overall sexual experience. Too often the development of sexual rehabilitation plans seeks to restore what would be considered “normal” sexual functioning by focusing on only the direct factors impeding on one’s sexual health. Unfortunately, such a narrow focus discriminates in favour of able-bodied individuals, neglects the psychosocial factors such as body image, sexual self-esteem, internalized negative stereotypes about disability, and cognitive issues that are just as important to address during therapy. These indirect consequences appear to be particularly important predictors of the quality of one’s subjective sexual functioning. Eisenberg et al. (2015) describes a sex-positive, adaptation-focused approach to assessment and treatment that draws on strengths as opposed to focusing on the limitations of people with disability. Sexual assessment is the first step in communicating to a person with disability that the health care provider understands the value of sexual health as part of whole health and is open to discussing sexual issues according to Eisenberg et al. (2015). Assessing the needs of persons with disability seeking medical, and/or mental health care for issues related to sexuality requires an integrated biopsychosocial approach.

How do people in wheelchairs even have sex, you may ask? Well, just like any other person, usually in bed! However, many of the direct consequences of disability can be addressed using aids to help adapt sexual activity. Current aids available on the market include equipment such as vibrators, sex swings, sex wedges, sex chairs (i.e. IntimateRider), and restraints. The partners of wheelchair users have admitted that the wheelchair itself becomes a sexual aid at times. Most modern wheelchairs have removable armrests, swing away footplates, folding backrests, locking brakes, and power tilt, all of which can be used easily to accommodate wheelchair sex and greater sexual freedom. Just as you would for sex in any chair, sliding the male or female’s bottom to the front edge of the wheelchair seat gives greater access for sex. It is important to experiment with your partner, and encourage open dialogue with them. The process of re-learning about your body, or your partner’s body, new likes, and dislikes, can be a pleasurable one. There are many blogs and online forums that allow people with disabilities to ask questions, share their experiences, and provide great suggestions to others. For example, Graham Streets, founder of the Mad Spaz Club Blog, shares a few tips on how to better enjoy sex as a person with disability. He advises that some sex positions are easier to do than others in bed. With that, he cautions when limited sensation below the level of spinal cord injury exists, sensitivity above the level of injury often increases and can become hypersensitive and encourages partners to explore and pleasure these new sensitive spots. He also highlights a new appreciation for scented candles, rose petals, lingerie, nudity, enticement, and foreplay for all sexes as a reminder that sexual intimacy is more than just penetrative intercourse.

Those who were born with, or have acquired a disability of some sort are not damaged goods unable to participate in sexual intimacy, sex is an activity for everyone. Prioritizing the sexual rights of people with disabilities, as well as abolishing stereotypes, and taboos will ensure that people with disabilities, have greater education and access to positive subjective and physiological sexual functioning. Adjustment to disability is an active, ongoing process. Whether it be a medical or a psychological intervention, effective treatment requires a sex-positive, biopsychosocial approach. We must adapt the sexual script to emphasize the strengths of persons with disability putting the patient first, and not the desire to restore normalcy.

Brittany McBeath, BAH, Psychology.

References

Eisenberg, N. W., Andreski, S-R., & Mona, L. R. (2015). Sexuality and physical disability: A disability affirmative approach to assessment and intervention within health care. Current Sexual Health Reports, 7(1): 19-29.

Streets, G. (2011, October 15). Wheelchair sex after spinal cord injury. [Mad Spaz Club Web Blog]. Retrieved from http://www.streetsie.com/spinal-injury-wheelchair-sex/comment-page-1/#comments