Add An Acquired Disability
What happens if we lose our ability to attain or maintain an erection, or to ejaculate as a result of an acquired disability? What happens if we lose sensation in our genitals, if we use a catheter, or if we have physical limitations? Whether resulting from Crohn's disease, SCI, or any other acquired disability or chronic illness, a medical impairment inevitably impacts male sexuality. Issues such as dependency, diminished body image, impaired sexual function, and loss of earning potential may threaten a man's gender identity or core sense of himself as a man and his ability to carry out established gender roles.
Men arrive at rehabilitation with all the baggage society, culture, the media, parents, friends, and religion packed for us. We were socialized to be strong and self-reliant, successful, manly, and sexual performers. We learned the same myths and fantasy model of sex as our peers. What happens when we are faced with the loss of strength and self-reliance, loss of sexual prowess, and loss of success? What happens when we do not have our penis to fall back on or to stand up and let us be counted as a man?
For some men with an acquired disability loss of strength and self-reliance, loss of sexual prowess, and loss of success can equate to loss of manhood. To men who are faced with sexual problems and physical impairments, the perceived loss of their manhood or sexuality could be devastating. Zilbergeld (1992, p.20) discusses this link between gender roles and gender identity as follows:
"Because we learn from an early age that manhood is conditional rather than absolute, males are in constant danger of losing their manhood and their identities. Not making the team, not being willing to fight, not performing in bed, losing a job - that's all it takes and our man no longer believes that he's a man...[furthermore] their behavior must conform to what is considered manly. Any slight deviation, small sign of weakness, and they might lose their place among other men and be labeled "lady," "woman," or "pussy"-all signifying a non-man or less than a man. But if a man isn't a man, than what is he? The answer most seem to believe is: Nothing at all. For their identities are inextricably linked to their gender-roles. If the results of changing one's behavior can be so dire as a loss of identity, one doesn't take change lightly..." (p. 20)