sexuality
Meaning of sexuality: Illness, surgery, medication and aging all reach this part of life, which is why care teams raise it alongside other quality of life concerns.
Definition of sexuality
Sexuality covers a person's sexual feelings, attractions, behaviors and attitudes, together with the sense of identity attached to them. It is shaped by biological, psychological and social influences at once, and it can shift across a lifetime. In healthcare it is treated as one dimension of overall wellbeing rather than as a separate specialty topic.
What shapes it?
Three strands run through it, and they rarely act alone. The biological strand covers hormones, nerve supply, blood flow and general physical health. The psychological strand covers mood, self image, past experience and anxiety about performance or appearance. The social strand covers relationships, culture and expectation. A physical change and the worry that follows it usually arrive together, which is why an explanation resting on one strand alone tends to be incomplete.
How do illness and treatment affect it?
| Cause | Common effect |
|---|---|
| Surgery near pelvic nerves or organs | Altered sensation, function or body image |
| Chemotherapy and radiation | Fatigue, hormone changes, changes in tissue |
| Hormone lowering treatments | Reduced desire |
| Some antidepressants and blood pressure drugs | Changed arousal or difficulty reaching orgasm |
| Long term pain, breathlessness or fatigue | Less activity of any kind, including sexual |
| Depression and anxiety | Reduced interest, independent of physical capacity |
Because so many treatments touch it indirectly, sexuality is one of the areas that goes unmentioned unless a clinician opens the subject. Nurses, physicians and a social worker may each raise it from a different angle within the same care plan.
How is it different from gender identity?
Sexuality is the broad term. Sexual orientation, the pattern of who a person is attracted to, sits inside it. Gender identity is something else again: a person's internal sense of their own gender. It is not a subset of sexuality and does not follow from it, and the two are described separately in medical records for that reason. Confusing the two is common, and in a clinical setting it can lead to a question being asked about one when the relevant issue is the other.
Used in a sentence
The consultation included a discussion of how the treatment might affect the patient's sexuality.
Good to know
Sexuality and gender identity are related but separate concepts, and a change in one following illness or treatment does not imply a change in the other.