What is known about sexual health after pediatric acquired brain injury: A scoping review

Issue title: Special Section: Neurosexuality: A Transdisciplinary Approach to Sexuality in Neurorehabilitation

Guest editors: Alexander Moreno, Caron Gan and Nathan D. Zasler

Article type: Research Article

Authors: Simpson, Grahame^{a; b; *} | Simons-Coghill, Martine^c | Bates, Annerley^d | Gan, Caron^e

Affiliations: [a] Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Liverpool, Sydney, NSW, Australia | [b] John Walsh Centre for Rehabilitation Research, Kolling Institute, Sydney School of Medicine, University of Sydney, Sydney, NSW, Australia | [c] Brain Injury Service, Kids Rehab, The Children’s Hospital at Westmead, Sydney, NSW, Australia | [d] Princess Alexandra Hospital, Brisbane, QLD, Australia | [e] Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada

Correspondence: [*] Address for correspondence: Grahame Simpson PhD, Brain Injury Rehabilitation Research Group, Ingham Institute of Applied Medical Research, c∖o Liverpool Brain Injury Rehabilitation Unit, Locked Bag 7279, Liverpool BC, NSW 1871, Australia. Tel.: +61 2 8738 5495; Fax: +61 2 8738 5497; E-mail: [email protected].

Abstract: BACKGROUND:Positive sexual development is a core task in the transition from childhood/adolescence to adulthood. Little is known about the extent of research addressing this topic after acquired brain injury (ABI). OBJECTIVE:To identify publications (1980 to 2016) addressing positive sexual health among children/adolescents with ABI. METHODS:A scoping review. RESULTS:A search conducted using OVID and PubMed databases yielded 2021 citations with 28 publications meeting the inclusion criteria (six reviews, one expert account, 19 observational and two intervention studies). Teenagers with ABI reported poorer body image, feeling less sexually or physically attractive than sex and age matched non brain-damaged controls. The one study with findings on sexual orientation, reported 15% of adolescents with ABI identified as lesbian, gay or bisexual. Precocious puberty was a rare outcome from ABI, but the most common focus of the publications (14/28). Finally, two case studies (genital touching and classroom masturbation respectively) found that behavioral interventions were an effective means of extinguishing inappropriate sexual behaviour after childhood ABI. CONCLUSIONS:Sexual health is a neglected area of research in post-ABI care for children/adolescents. A better understanding of the needs and challenges will help rehabilitation professionals and parents provide more informed and effective supports.

Keywords: Neurosexuality, pediatric, adolescence, traumatic brain injury, acquired brain injury, sexual health, sexual orientation, body image, precocious puberty, inappropriate sexual behaviour, scoping review

DOI: 10.3233/NRE-172197

Journal: NeuroRehabilitation, vol. 41, no. 2, pp. 261-280, 2017