Parent's Guide: emerging sexuality
Surging hormones and the wish for a
successful social life fuel a teenager's interest in sex.
For parents, adolescence can be challenging. For young
people, it is exciting and potentially risky, and a brain injury
can increase these risks.
For example, where judgement, planning skills, social skills and
self-esteem are all affected, a young person is at higher risk of
unplanned pregnancy, sexually transmitted disease and sexual
assault. These young people may be vulnerable to being exploited
and manipulated, and sexual activity may be a response to feeling
isolated. Impulsiveness can further increase the risk.
Reduced self-esteem and self-confidence, and decreased social
skills, can affect a young person's ability to develop
relationships and be accepted by others. In addition, some people
with a brain injury lose the normal inhibitions we
place on our behaviour. They may do and say inappropriate things -
for example, use sexually explicit language or masturbate in public
- and this inevitably affects the way others relate to them.
Physical disability following a traumatic brain injury can
affect a young person's ability to engage in sexual or
self-pleasuring activity, and an injury during adolescence-a time
when acceptance by peers is so important-can have a devastating
effect on self-image and self-esteem.
Sex education & guidance
To negotiate these years safely and successfully, all young
people need to learn about their sexuality. They need to know how
to avoid risks to their health and their social and emotional
development, and find positive and healthy ways to express their
The risks involved in sexual behaviour have changed over time.
Unplanned pregnancies have decreased-but the risks of sexually
transmitted disease, including HIV/AIDS, are real. Attitudes
towards homosexuality are more positive-but young people can still
feel shame, guilt and regret about their sexuality.
Having information is a good first step. It doesn't prevent all
problems-adolescents aren't always able to put theory into
practice. However, research shows that teenagers who receive
appropriate sex education tend to delay first intercourse, use
contraception and avoid pregnancy. Of course, family input is
Like their peers, young people with a brain injury
- Informal education, at all ages, on sex and self care such as
having their questions answered by trusted adults
- Formal sex education, such as that provided by schools.
Young people often need extra time to absorb information and
learn self-care - for example, managing monthly periods for a young
woman. And a young person with a brain injury who
thinks concretely may need to practice skills in a variety of
specific situations - it may be very difficult for them to
generalize from one situation to others.
Young people with a brain injury are also more
likely to need very firm, clear guidelines about what's
appropriate. A degree of tolerance is needed - if they do or say
inappropriate things, shaming or punishment doesn't help. The issue
needs to be dealt with quietly and firmly, without condemning the
Sometimes a trusted adult or young person outside the immediate
family is in a better position to provide information, support and
Good relationships and social skills, and good self-esteem,
provide a strong foundation for a safe passage through the turmoil
of adolescence, and this needs to be the central focus in assisting
and supporting young people with a brain injury. It
also helps to address the biggest concern of many parents: that
their child may not have satisfying social relationships or be able
to find a partner.
For an extensive catalogue of information and services relating
to relationships, sex, sexuality and sexual health when someone has
a disability, contact your local Family Planning Association.
When young people are sexually active
Young people with a brain injury who are
sexually active may be at risk because of poor judgement, planning
and follow-through, and/or of social awareness and skills. For
- They may be less likely to use 'safe sex' methods to prevent
infection or unwanted pregnancy
- They may be more likely to deny symptoms of infection.
- If they have an infection, they may delay seeking treatment or
not complete a course of treatment, especially if symptoms
- They may not inform their sexual partners about any diagnosed
infection they have.
Even when they see a health professional, diagnosis may not be
correct, and relevant health and education issues may not be
discussed. This may be because the young person has difficulty
communicating or because the health professional is unfamiliar with
the effects of a traumatic brain injury.
These are difficult issues for parents to address at the same
time as respecting their young person's privacy. You may be able to
go with your young person to the doctor, or get a friend to go, or
rehearse with the young person what they will say to the
References and further information
Many thanks to Brain Foundation Victoria for permission to adapt
their material for this fact sheet.