Sex in the Brain: Asexuality

Sometimes, when you’re without a partner, it may seem that it would be easier if you had no sex drive at all.  For those with brain injuries, who, for example, are in the hospital or have an inability to safely leave their homes, a lack of sexual urges may seem even more desirable.  However, for those who suffer from asexuality, a.k.a. a loss of sexual urges, this reality is anything but desirable.

In a 1995 report, it was “understood” that, “asexuality typically results from extreme fear of bonding with others, extreme narcissism which results in an inability to genuinely care for or empathize with others and/or severe repudiation of one’s genitals, sexual arousal or gender.”  This millennium, more research and some understanding into post-traumatic asexuality has occurred.  “Individuals post-TBI report frequent physiological, physical and body image difficulties which negatively impact sexual activity and interest,” a 2000 NIH study reports.  This statement, however, is very broad and suggests that post-TBI asexuality was not then fully understood.

Since then, few studies have followed on the topic and those that have been done have contradictory results.  In 2014, though, the NIH reported that “nervous system damage… impairs physiological aspects of sexual response.”  Physical limitations, such as fatigue, resulting muscle weakness, and having different physical abilities than one had prior to their brain injury can also have an effect.  Certain medications may also limit sexuality.  Oft-prescribed antidepressants, for example, can block certain brain chemicals, resulting in ejaculation failure, impotence and decreased libido.  Lastly, stereotypical sexual assumptions towards those with disabilities can have a negative effect.  The public perception that all those with physical and/or neurological disorders must be asexual can lead to psychosocial and emotional issues that inadvertently may cause someone to be asexual, due to lack of opportunity or lack of satisfaction.

Though research into asexuality has broadened, “the particular needs of LGBTQIA+ individuals living with a neurological disorder are neglected in clinical practice and research. The invisibility of LGBTQIA+ individuals with neurological disorders reflects the historical exclusion of marginalized identities and creates disparities of access to healthcare.”  Lack of medical understanding of neurosexuality and a botched medical treatment that left a man with a brain injury and without sexual urges resulted in a hospital being sued for $1.2 million by a now widowed Australian woman this month.  Maybe, if nothing else, it will be a fear of being sued that increases acceptance.

(For those who became asexual following a brain injury or who just want to know more about the topic, visit the Asexual Visibility and Education Network or read The Invisible Orientation: An Introduction to Asexuality.)

A Noble Treatment for TBI on the Table

Following a physical trauma, a person may become comatose or ostensibly inert.  It is through the use of an inert gas, though, that the effects of this trauma may be lessened in the brain.

The inert noble gas xenon (Xe) has been found to be a possible first treatment for brain injury, lessening the progression of the injury.  (Traumatic physical trauma causes both primary and secondary injuries.)  The study in which this discovery was made, published by the NIH in 2018, found that, “Xenon applied 1h after blast exposure reduced injury 24h, 48h, and 72h later, compared with untreated control injury.”  Of course, this study was focused on brain injuries obtained in combat and was tested only in mice, but it seems probable that the effects of xenon would apply to humans who suffer physical traumas, as well.

Beyond being a possible first treatment, xenon has been found to have other benefits related to brain injury.  For example, last year it was reported that when xenon is used in the treatment of cardiac arrest, brain damage is lessened or even prevented.  Xenon provides analgesia, a pain killer, to the body.  Also, Xenon activates TREK-1 channels.  TREK-1 channels have an “important role in neuroprotection against epilepsy,” a common negative side effect of brain injury.  Additionally, inhalation of Xe has been used effectively to eliminate the fear-inducing memories that result from PTSD.

However, Xenon is not a miracle drug.  The World Anti-Doping Agency (WADA), which creates the list of prohibited drugs for the Olympic and Paralympic leagues, has xenon on its Prohibited List.  Xenon can enhance athletics performance likely because it, “stimulates the synthesis of erythropoietin (EPO) by increase of hypoxia inducible factor.”  (EPO is a hormone needed to form red blood cells.  Hypoxia-Inducible factor regulates oxygen consumption.)  Xe, though, is not prohibited by the NCAA or any professional sports league in the United States.

Sex in the Brain: Homo/Heterosexuality

As has been discussed in my previous blog posts, head trauma can affect someone’s sexual preferences in a number of ways.  While uncommon, such things like hypersexuality, an infatuation with pornography and public sexual innuendo can have extremely negative effects.  Another possible effect may not be negative, but rather confusing to the person it happens to is a change from heterosexuality to homosexuality, or vice versa.

The concept of changed sexual orientation post-brain injury was first examined by UCLA and reported to the NIH in 1986.  The study evaluated the medical cases of four people with various types of altered sexual behavior following a brain injury.  Altered sexual behavior is a broad term and implies everything from hypersexuality to pedophilia.  Specific to this article, though, one of these cases followed a married, previously heterosexual woman who, following a brain injury, “made both oral and manual sexual advances to female attendants in the hospital.”

Recently, new evidence was found to promote the idea of the possibility of a change in sexual orientation due to a brain injury when former NFL star and convicted murderer Aaron Hernandez committed suicide.  After his death, letters were found in which he expressed his homosexual urges, which he says followed the head trauma he was subjected to as a player in the NFL.  A post-humorous examination of Hernandez’s body discovered that he did suffer from CTE.  (Hernandez’s wife says that she saw no signs of his new urges and that she and her husband had a healthy sexual life.  Others state that they knew of his sexual orientation and that his urges greatly preceded his head trauma.)

Investigating the medically-defined reason for changes in gender-related sexual orientation has found a number of answers.  Predominantly, injury to the basal frontal area and the temporal lobes of the brain are defined as the reason for changes in sexual orientation.  A condition known as the Kluver-Bucy Syndrome is also identified as a reason.  Also a rare behavior impairment that can be caused either by a head trauma and by herpes, this syndrome involves the sex hormones produced in the brain.  Studies have also found that homosexual men and heterosexual women have a similar smaller volume of hypothalamic nucleuses, among other things.  The size and/or location of amygdia connections and the location of the cerebral hemispheres may also have an effect.

Above I have noted four brain cell alterations that can occur following a brain injury and may affect sexual orientation as it relates to preference.  The fact that the subject of gender sexual orientation after brain injury has been studied by the government for over 30 years, in both animals and humans, is evidence that no definitive reason for the change has been found.  Additionally, while studies seem to all focus on brain injuries changing someone’s orientation from hetero to homosexuality, the opposite must also be true.  Also, others do not believe it is possible for a brain injury to alter one’s sexuality at all.  As homosexuality has gained and will continue to gain more cultural acceptance, perhaps more research and, therefore, more scientific understanding of the topic will be found.