Sexuality in persons with severe physical disability: a guide to the physician.

Persons with disabilities, as a group, may have distinctly fewer options for functioning sexually according to their own needs and goals than have able persons. Physicians have three special roles in providing sexual health care: identifying problems that are sexual; assessing these problems; and providing in-depth management. Assessment includes a review of the disabled person's sexual response abilities, fertility potential and capability to use birth control, and estimates of musculoskeletal functions for intimate physical contact and bowel and urinary continence. Other areas to assess include partnership capabilities, sexual self-esteem, and sexual interest levels. Management is a team effort. Psychological, medical, and surgical methods developed for sexually dysfunctional persons may be adapted for persons with disabling conditions.