The assessment of masturbatory practices and their use in support of the co-design of adapted sex toys

The Centre interdisciplinaire de recherche en réadaptation et integration sociale (CIRRIS; Interdisciplinary Centre for Research on Rehabilitation and Social Integration) in Quebec City, Canada, contributes to the development and knowledge transfer in the field of rehabilitation and social integration.This mission is made possible via research activities studying both personal (impairments and disabilities) and environmental factors (barriers and facilitators) that influence the social participation of persons with disabilities. This research is focused on interdisciplinary and intersectoral approaches that allow the study of complex issues with an integration of biomedical and social research. With the exception of Dr Courtois, all the authors of this chapter are researchers or research professionals at the CIRRIS. The present chapter results from funding by the Fonds de recherche du Quebec—Société et Culture granting programme for “innovative projects,” where the main objectives were to explore the experiences of men and women with upper limb disabilities in relation to masturbation and present a design process for sex toys that would meet their needs.

In order to develop this particular issue, a qualitative methodology' was developed that included meetings involving participants with motor disabilities and a co-design focus group with professionals. The sample included 17 participants aged 18 years and over with motor disabilities of the upper limbs, able to take part in verbal exchanges (expression and comprehension) and with no cognitive impairments, and eight professionals (one caregiver, four occupational therapists, and three sexologists).

Session 1: Individual semi-structured interviews with participants with motor disabilities

The first meeting with each participant was a two-hour, semi-structured interview to identify their individual experiences and the problems they had experienced in their sex lives.The interviews took place at either the participants home or at CIRRIS and were recorded. At the first interview, the project was explained to the participants. The principal researcher or a research professional conducted the interview, sometimes together or with a graduate student, depending on the participants preference as to the sex of the interviewer. The interview included open-ended questions focusing on participants’ experiences, challenges, barriers, opportunities and facilitators during masturbation.The interview guide also included general inquiries about date of birth, gender, sexual orientation, education level, annual income, pathology' and type and model of technical aid used. At the end of the first session, participants were asked to think about possible design solutions for one or more sex aids that would help them to engage in sexual selfstimulation. They were provided with a notebook, pencil and eraser and encouraged to write down and/or draw their projected solutions in the notebook in preparation for the next session. None of these individuals needed alternative methods of writing or sketching.

Session 2: Individual co-design interviews with participants with motor disabilities

One week after the first interview, the principal researcher or a student, sometimes accompanied by a research professional (depending on the participant’s preference) conducted the second codesign interview, which lasted two hours and was also recorded.The co-design sessions drew on participants’ experiences to explore possible design solutions aimed at improving accessibility and inclusion (Sanders and Stappers 2008). This research was based on a user-centred design approach (Sanders and William, 2001), which incorporates participants’ views and sees them as “partners,” who contribute their expertise in the early phases of the design process (Sanofi 2007). Co-design methodologies have been successfully used in many different domains and with diverse populations (Francis et al. 2009; Frauenberger et al. 2011; Morales et al. 2012). For our study, during the co-design sessions, the participants were asked to describe suggestions for the design of alternative solutions for sex aids. The participants described their own ideas to the principal researcher, who simultaneously drew the idea on a large piece of paper. Input was provided by the researchers in order to give concrete form to the ideas and translate them into design proposals. This process generated new ideas and a graphic record (Morales et al. 2012), which were collected by the researcher.

Session 3: Focus group with professionals

An expert focus group, involving caregivers, occupational therapists and sexologists, was conducted by the first author (an architect able to create drawings for validation). In assembling the members of the focus group, a special effort was made to find persons with different professions related to disability, sexuality and problems experienced by people with motor disabilities. We presented the ideas generated earlier by the participants (i.e., both their experiences and the graphic data). This allowed the stakeholders to critique, enrich and validate the design solutions proposed by the participants. Questions were asked about the feasibility and safety of each design and other possible modifications. New design solutions were generated based on these discussions. The main objective of this session was to assess and improve the design proposals from a practical, adaptive and clinical point of view.

 
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