Impotence
Ministerial Meandering
Impotence
This is robbery, in whatever form it takes, and a violation of what it means to be human. Although rarely applied to women, and almost always assumed to be referring to male sexual performance, it can be present in many other forms and guises. Embedded prejudice that excludes any part of society with no recourse to justice or fairness is to render that group impotent. The workforce glass ceiling and emancipation for women are obvious examples.
Bullies work on this principle. By physical, psychological, financial, or emotional dominance, they crush their victims into a state of impotence. Of late - and with many examples worldwide over the centuries - political bullying has been the sport of dictators and despots. Let them only drive other potential powers or countries into submission, and they salivate with delight.
Of course, some such scenarios may reverse upon the perpetrators, but where such impotence has a physical expression on a personal level, then such an about-turn is likely impossible. And here I am referring to mutilating or botched surgery. Or even intentional surgery, such as that which renders the patient permanently disfigured, transfigured, or impotent in some other way. As examples of each I would cite mastectomy, sexual reassignment surgery, and/or castration.
Quite reasonably, one might argue that mastectomy does not leave a person impotent in terms of possible sexual performance, but there is no doubt that some women have felt that such surgery disables them from intimacy with their partners. Indeed, an invisible hysterectomy may make some women feel ‘less than a whole woman’, even when they clearly have no intention of having further children. Such feelings can make that person feel sexually undesirable, and so unable to respond to a partner’s advances. Impotence comes in many forms.
I would not wish to enter into the ethics of transgender reassignment surgery, other than to say that it should not be even entertained without significant and prolonged psychological counselling by someone who does not have a vested interest in anything other than the patient’s well-being in the long term. Already too much has been done to too many by - and to - the ignorant and uninformed, often by those whose main interest is pecuniary.
As for the planned or unplanned side-effects of surgery, it is both shameful and instructive to note that impotence is barely mentioned in the pre-operative work-up of men undergoing radical surgery for prostate or bladder cancers. I speak not only from personal experience, but also for those of my peer group that I know to have undergone the same or similar procedures here in Canada.
Whilst this short (and personal) article in no way resembles any form of statistical significance, more than one of my friends similarly treated have expressed their profound sense of loss at the sudden and permanent loss of their sex lives. Though the frequency of their need for sexual intercourse may not be paramount, the knowledge of the complete inability to perform comes as a crushing blow to their manhood. Although many have told me that their partners have attempted to reassure them that there ‘are plenty of other ways to make love to a woman,’ the failure to produce an erection or be able in any way to penetrate their partner is felt deeply at the core of what a man conceives himself to be.
Some may regard this comment as absurd and even pathetic, but I would urge you to believe me, because it is true.
I have seen this play out in other parts of the world, where euphemism and metaphor are used to express the same sense of loss. In rural Zululand it was not uncommon for older men to come to clinic complaining of a ‘weak back’. This was especially so in the vascular clinic, where advanced atheromatous disease of the internal iliac arteries could produce impotence from lack of blood supply to the penile artery.
It required a little sensitivity to ask a proud old man if he was no longer performing as he had in his younger days. If he complained of a ‘weak back’, I would ask if it affected his legs, or - with a mild hand gesture towards his genitalia - I would ask if ‘this man is still strong’?
One might ask whether it was even a topic worth discussing once past a certain age, but such people might be surprised to learn that some folk are still interested in having a sex life in their nineties. What I believe is necessary is that those who are in a position to affect others by rendering them impotent - whether by accident or design - should spend some time discussing the issue with their patients. If they are not capable or qualified to do so, then they should refer those individuals to an appropriate counsellor. Such action may well change the mind of the patient towards opting for a different form of surgery - or possibly, none at all. As far as prostate cancer is concerned, this is a very definite option.
If people do opt for radical surgery because, like me, they ‘want it all removed,’ then they should ask the surgeon what his complication and impotence rate is before they bare their arm for the anaesthetic. Better still, talk to someone who has had the same procedure by the same surgeon, and ask about the result. Had I done so, I would not be in the pickle I am today. Impotence can be only half the problem.
Philip+