Where does our sexuality come from in our Brains?

It is clear that frontal especially prefrontal lobe plays a role in sexual functioning as the cognitive functions are controlled by these areas and are significantly correlated with sexual functioning 性生活唔協調.  The frontal lobe plays a valuable role in a person’s ability to plan, organize, emotional and behavioural control, personality, problem-solving, attention, social skills, flexible thinking and conscious movement.  Injury to this area can cause problems such as inappropriate sexual behaviour, difficulties with initiating sexual activity or difficulties with motivating oneself to engage in sexual activity.  It can can also cause difficulties with experiencing pleasurable and sexual sensations, spontaneity, and the build-up of arousal.

The temporal lobe plays a role in a person’s memory, recognizing faces, generating emotions, and language. Injury to this area has been linked to an increase in sexual interest and emotions (hyperactive sexuality), although it can also result in a reduced sex drive (hypoactive sexuality) 性生活唔協調. Some people who have had temporal lobe injury have also been found to develop paraphilias (abnormal sexual interests that can sometimes be
dangerous or illegal). Damage to pathways in the frontal and temporal lobes has been linked to difficulties in understanding whether someone else is interested in sexual contact, for example through body language and ‘reading’ emotions.

The parietal lobe plays a role in a person’s perception, spatial awareness, manipulating objects, and spelling; Wernicke’s area – understanding language; Broca’s area – expressing language 性生活唔協調.  Seizures in this part of the brain can cause some brain injury
survivors to experience sensations in their genitals, including heightened sexual arousal or sensations that are not pleasurable. For some survivors these sensations can even be irritating or painful.

The hypothalamus and pituitary gland parts of the brain are responsible for producing hormones in the body that regulate sex drive. Damage to these parts can therefore result in hormonal problems.

Brain injury is known to cause changes in thinking, behavior and body function which alters the way a person experiences and expresses their sexuality.

Changes to sexual behavior after brain injury could include erectile problems, reduced libido, the inability to orgasm, and the reduction in frequency of sex….or the increase and uncontrolled acting out of sexual behaviors/acts.

Brain Injury and Consent – Respecting Boundaries
Uncoordinated sex, both cognitive and sexual functioning were found effected post Brain Injury. However less emphasis is given to sexual functioning by the professionals.

It is important for sexual partners, carers and professionals to recognise that brain injury survivors have the same rights as non-disabled people of having their sexual needs met and making their own decisions about their sexuality.

Brain injury is not to blame for a systemic, patriarchal culture of violence against women—one in which more than 30 percent of women murdered every year are killed by their intimate partners (regardless of same sex or opposite sex). But brain injury cannot be removed from that world either, and we should be considering it as an additional risk factor.

That being said, it is important not to engage in sexual activities with someone without their consent, regardless of gender, sexual identity, or disability.  Keep in mind though, they must also be able to legally consent.

If a brain injury survivor lacks capacity and therefore cannot make a safe, informed decision about sex, a best-interests decision should be made with the support of appropriate professionals to ensure that the survivor’s sexual needs are being met in their best interests.

Persons with disabilities are twice more likely to be sexually assaulted than people without a disability according to the 2017 Bureau of Justice’s.
So what does legal consent mean?
Basically, sexual consent is actively agreeing to participate in a sexual activity before being sexual with someone.  Affirmative consent is when someone agrees, gives permission, or says “yes” to sexual activity with other persons. Consent is always freely given and all people in a sexual situation must feel that they are able to say “yes” or “no” or stop the sexual activity at any point.

Consent can be withdrawn by either party at any point uncoordinated sex. No means no…. every time. Consent must be voluntarily given and may not be valid if a person is being subjected to actions or behaviors that elicit emotional, psychological, physical, reputational, financial pressure, threat, intimidation, or fear (coercion or force). Consent to engage in one sexual activity, or past agreement to engage in a particular sexual activity, cannot be presumed to constitute consent to engage in a different sexual activity or to engage again in a sexual activity. Consent cannot be validly given by a person who is incapacitated (intoxicated, unconscious or asleep).
A person with a mental disorder, a low mental age, or under the legal age of sexual consent, may willingly engage in a sexual act that still fails to meet the legal threshold for consent as defined by applicable laws.

There are different types of consent to consider and each of them are important to understand and some will overlap with each other during a sexual encounter:

Ongoing – anyone can change their mind about what they are interested in doing at any time
Informed/Freely/Expressly given – saying “yes” without pressure or manipulation; who has a clear appreciation and understanding of the facts, implications, and future consequences of their action; clearly and unmistakably stated, rather than implied (may be done orally or in writing, or nonverbally)
Specific – saying “yes” to one act (such as kissing) doesn’t mean you have said “yes” to others (like oral sex); just because you have participated in an act previously does not grant consent for future acts
Informed – not deceiving or lying.  For example, if someone says they will use a condom and they don’t, that is not full consent to do something, not feeling like you have to or should do something;  inferred from a person’s actions and the facts and circumstances of a particular situation (or in some cases, by a person’s silence or inaction)
Unanimous Consent –  general consent, by a group of several parties where everyone in the party consents to a specific act