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As human beings, individuals with Down syndrome have the right to emotionally satisfying and culturally appropriate sexual expression. As patients, they have the right to routine Down syndrome woman naked health care provided to the general population.

Cognitive and language disabilities may predispose this population to unwanted pregnancy, sexually transmitted disease, and sexual Maria eugenia rito nude. Sex education tailored to cognitive level, learning style, and living arrangements is essential to the education of children and young Down syndrome woman naked with Down syndrome.

Down Syndrome Research and Practice3 2 Issues of sexuality accompany each stage of human development. Sexual Down syndrome woman naked for infants and pre-school aged children include the development of physical and emotional attachment to parents and other family members; issues for school aged children are the emergence of modesty and privacy as well as the beginning of masturbation [ Table 1 ] Haka- Ikse and Mian, ; Grant, Personal safety and self-esteem become important issues for adolescents and young adults [see Table 1] Haka-Ikse and Mian, Little has been written about psychosexual development in Down syndrome.

There have been major advances in interdisciplinary and preventive medical management of individuals with Down syndrome.

Improved medical care, laws ensuring appropriate education and related services for the disabled, Down syndrome woman naked slow changes in societal attitudes have brightened the outlook for individuals with Down syndrome Van Dyke et al, An active life, including participation in work, social, Down syndrome woman naked worship environments, is now possible. As individuals with Down syndrome take their place in these areas, we can expect some of them to assume the sexual roles that the general population takes for granted: lover, spouse, parent Van Dyke et al.

Review of developmentally appropriate sexual issues should be part of the medical and psychological evaluation of all individuals with Down syndrome. All individuals, regardless of disability, are sexual beings. Individuals with Down syndrome and other mental disabilities who engage in sexual behaviors, however, may encounter societal prejudice as well as significant parental anxiety Van Dyke et al.

Historically common sex-segregated living arrangements in now-defunct institutions and the absence of available social outlets point to a societal denial of sexuality in people with disabilities Edwards, The development of a secure sexual identity is a difficult task even in the absence of a physical or mental disability Grant, The emergence of sexual behavior in the individual with Down syndrome alarms some parents and Down syndrome woman naked who may rightly fear that their child's cognitive deficit makes him or her especially vulnerable: to unwanted pregnancy, sexual exploitation and Down syndrome woman naked, and to sexually transmitted disease.

Masturbation, a rhythmic self-stimulation of the genital area, is a healthy and normal part of self-discovery Haka-Ikse and Mian, It may also provide self-gratification; it may or may not prelude sexual intercourse Monat-Haller, In some severely mentally disabled individuals, it may also appear as a form of self-injurious behavior Van Dyke et al.

Numerous experts in physical and sexual abuse acknowledge that the mentally disabled individual is particularly vulnerable to sexual exploitation and abuse Schwab In a study by Elvik et al. The mentally disabled individual is vulnerable to sexual maltreatment Down syndrome woman naked several reasons: isolation; communication deficits; small peer group; and limited mutual support services Schor, Loneliness and frustration may drive an individual to accept any form of individual attention whether it be negative or positive Schor, Other contributing factors include multiple living situations and transient caregivers, some of whom may be paedophiles.

Schor, Personal safety education should begin early in childhood Haka-Ikse and Mian, Older children and individuals with mild language and cognitive deficits may be able to learn the "Circles Down syndrome woman naked, a paradigm of physical and emotional distance Walker-Hirsch and Champagne, In this paradigm, colored circles represent levels of personal relationship Down syndrome woman naked physical intimacy.

Individuals learn appropriate touching behaviors for each circle of intimacy, and are cautioned that "sometimes a friend may want to be closer to you than you want. Like typical young people, then, students with Down syndrome need early sex education accompanied by open discussion Because of significant variations within this population in cognitive levels, learning styles, living arrangements, and health problems, they require an individualized approach to sex education Van Dyke et al, There are no studies of dating patterns or related social behaviors in Down syndrome.

Dating is a normal part of adolescent social development Fegan et al, l The social skills needed for dating can be taught as part of a life-skills based curriculum Fegan et al, l Such preparation is best provided before the actual dating experience. Written by two young men with Down syndrome, Count Us In provides eloquent proof that adolescents with Down syndrome have typical teenage concerns:.

Getting together with boys is okay as friends. But girls, getting to know them, I'd be happy to do it. But, I would like to keep my experience up by dating again and now I'm making decisions of what my values are and what kind of things and responsibilities for me to do in the future of Down syndrome woman naked Tami. It's premature but it's okay Few papers have described marriage in Down syndrome woman naked Down syndrome population.

Studies of marriage in the mentally disabled population by Edgerton ; and by Koller et al have shown that individuals with cognitive deficits who married had only mild mental disabilities. The most troubled marriages were those in which both partners were mentally disabled Koller et al, Down syndrome woman naked 38 married individuals with Down syndrome including 35 female subjects, all had spouses without Down syndrome Edwards, In this study, couples lived in an environment that was closely and consistently supported and in some cases supervised by other family members or advocates Edwards, In general, adults with Down syndrome woman naked syndrome under-use the health care system Elkins et al, l Women with Down syndrome demonstrate significantly lower usage of gynecological and reproductive services than women in the general population Elkins et al, While it is recommended that all females with Down syndrome have a baseline pelvic examination and pap smear between 17 and 20 years of age, this recommendation is infrequently followed Rogers and Coleman, To address this problem, some care providers have developed special clinics for adults with Down syndrome Doty, Men with Down syndrome need to learn testicular self-examination as their cognitive level permits; likewise, women need Down syndrome woman naked learn breast self-examination and the necessity for regular gynecological care Elkins et al, ; Doty, Contraception is often a major concern of parents of individuals with Down syndrome Van Dyke et al, Parents may be uncomfortable discussing sexual and reproductive issues with a physician Van Dyke et al, Health care providers and professionals need to initiate structured, nonjudgmental discussion of contraception and to provide clear information tailored to patient developmental levels Grant, Methods of contraception in males and females with Down syndrome are outlined in Table 2.

As in the general population, the only nonsurgical method available to males is the condom. Because barrier methods require application at the time of each coitus, they may not be practical for individuals with Down syndrome who may need supervision in Down syndrome woman naked such devices Elkins, There are a number of contraceptive methods for females including condoms, spermicidal foams and gels, diaphragm, sponges, cervical cap, IUD, oral contraceptives, Norplant, and Depo-Provera.

No form of contraception is totally contraindicated for individuals with Down syndrome Schwab, Oral contraceptives are frequently used by females with Down syndrome. Contraindications for this therapy in Down syndrome are the same as in women in the general population; both absolute and relative contraindications are outlined in Table 3 Heaton, ; Laros, Medroxyprogesterone Depo-Provera and Norplant levonorgestrel implant are frequently used depot forms of contraception.

Norplant is a progestin-impregnated silastic implant that is usually inserted into upper arm subcutaneous tissue. It is usually effective for five years but may be removed sooner Laros, Reports of complications requiring removal - including irregular vaginal bleeding - have dampened some of the initial Down syndrome woman naked for Norplant.

Surgical contraceptive procedures include laparoscopic tubal ligation and total abdominal hysterectomy. Both procedures require informed consent and involvement of the patient and Down syndrome woman naked. A helpful reference regarding sterilization issues appears in the publication by the American Academy of Obstetrics and Gynecology on Ethics.

The process of obtaining a sterilization procedure can be emotionally draining and financially burdensome for parents Van Dyke et al, It is important to remember that the condom is the only contraceptive method available which also helps prevent the transmission of disease.

Consistent and correct use of barrier methods such as condoms may be Down syndrome woman naked practical in the Down syndrome population Elkins, l Individuals with Down syndrome may be at increased risk for sexually transmitted disease STD.

Transmission risks for some STDs are outlined in Table 4. While no reports estimate Down syndrome woman naked incidence of HIV infection in Down syndrome, HIV has been reported in the mentally disabled population Kastner et al, Clearly, other sexually transmitted diseases including syphilis, chlamydia, herpes simplex, venereal warts, and hepatitis B are potential concerns in the sexually active individual.

In a national study by Marchetti et ala total of 45 developmentally disabled individuals in 11 states were identified as having HIV infection Marchetti et al, Risk factors associated with HIV infection in Down syndrome are identical to those in the general population and include heterosexual activity, homosexual activity, Down syndrome woman naked drug abuse, and contaminated blood transfusions Simonds and Rogers, Significantly impaired fertility of both sexes is evident in the Down syndrome population Rogers and Coleman, While males Down syndrome woman naked long been assumed to Down syndrome woman naked sterile, Sheridan reports one case of a cytogenetically normal male infant that was fathered by a man with Down syndrome Sheridan et al, Women have impaired but still significant fertility: Korean hot model nude photo number of reviews document women with Down syndrome carrying pregnancy to term and delivering infants with and without Down syndrome Bovicelli et al, ; Rani et al, Infants born to mothers with Down syndrome are at increased risk for premature delivery and low birth weight Bovicelli et al, Pregnancy outcomes obtained from a study of mothers with Down syndrome are displayed in Table 5.

Whether a woman with Down syndrome constitutes a high risk pregnancy depends largely on cognitive level and medical status. Obviously, the presence of maternal cardiac, thyroid, or hepatic disease, as well as seizure disorder, complicates a pregnancy. The high incidence of congenital heart disease in any offspring with Down syndrome contributes to pregnancy risk, including stillbirth and neonatal death Gordon, Offspring without Down syndrome have a greater than average number of congenital anomalies Bovicelli et al see Table 5.

Only scant information is available on the parenting abilities of individuals with Down syndrome Van Dyke et al, The issue of parenting by a mentally disabled individual is a controversial one. Some professionals maintain that children of mildly retarded couples are probably no worse off than children of Down syndrome woman naked who are "classified as culturally deprived" Nigro, Other authors opine that mentally disabled parents may be more likely to neglect their children through acts of omission but that purposeful abuse may be infrequent, especially in the setting of adequate societal and family supports Tymchuk, In summary, sexuality is an intrinsic aspect of human development.

Individuals with Down syndrome need individualized instruction and education to develop appropriate sociosexual behaviors.

While individuals with Down syndrome have unique and sometimes complex medical needs, they still require routine reproductive health services recommended for the general population including urological care for men, gynecological care for women, and preventive medical services. Down syndrome woman naked and counseling to prevent unplanned pregnancy, Down syndrome woman naked, and sexually transmitted disease should be part Down syndrome woman naked the routine medical care and education for individuals with Down syndrome.

All individuals with Down syndrome have the right to develop and express sexuality in an emotionally satisfying and socially appropriate manner.

It is the responsibility of care providers to facilitate communication, research, and support services to accomplish this goal. Cookies on Down syndrome woman naked sites - We use cookies to provide essential functionality and to analyse how our sites are used.

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