In this section
Sexuality is a healthy and natural part of living. A child's
sexuality reflects their personality and encompasses thoughts,
feelings, values, physical development, actions and drives. It is
more than sexual activity and behaviour. As a child progresses
towards adolescence, their sexual development and growing maturity include the additional issues of physical and hormonal changes,
relationships, body image, sexual characteristics and sexual
While issues of sexuality impact on a child from the time of
birth to adulthood, it is during the transition period of
adolescence that the impact of sexual development and disability
can become a concern for children, families, school and
Parents and teachers may be concerned the child's brain injury
may impact on normal sexual development and behaviour. For some
young people, the brain injury will have no effect or little impact. It will not cause physical changes or interfere with the child's
ability to learn about sexuality, or to make friends and develop
relationships. However, for some children, the physical,
cognitive, psychological, emotional and behavioural changes or
difficulties following brain injury may impact on sexual
development or behaviour.
After a brain injury, some children with moderate to severe
physical disabilities may have specific problems which will impact
on their sexuality and possible sexual activity. Some severe
physical problems could directly affect a young person's ability to
engage in and enjoy normal sexual activities or to manage
menstruation. The social impact of physical impairments can affect a young
person's ability to be accepted by others and develop more socially
mature relationships. For many young people, this can result in reduced or poor self-image.
Occasionally, after severe brain injury, puberty may begin
earlier than would normally be expected (ie. under the age of nine or
10 years). Development of sexual interest and growth spurts are
part of this precocious (early) puberty. Managing these physical
and emotional changes can cause problems for the child, family,
peers and school.
Following a brain injury, some young people may behave in a disinhibited or sexually
inappropriate way. Sexual innuendoes and comments and/or inappropriate touching may lead to peer rejection,
ridicule or punishment at school. Sometimes this disinhibited
behaviour, together with poor awareness and impaired social skills,
may place a child in a vulnerable social situation where they could be the subject of exploitation or sexual abuse.
The ability for young people to develop relationships and learn
appropriate social skills may be affected by physical and
psychological impairments. They may feel less attractive and
socially capable than their peers and these feelings can impact on their ability
to develop and maintain relationships. It could also contribute to
low self-esteem and lowered self-confidence. Together with problems
of impaired memory, planning and organisation, decreased
intellectual skills can also affect a young person's ability to
learn about sexuality and appropriate behaviours.
Developed by The Royal Children's
Hospital Paediatric Rehabilitation Service based on information from the Brain
Injury Service at Westmead Children’s Hospital. We acknowledge the input of RCH
consumers and carers.
Reviewed September 2020.
Kids Health Info is supported by
The Royal Children’s Hospital Foundation. To donate, visit www.rchfoundation.org.au.
This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.