Wikipedia:Featured article candidates/Sexuality after spinal cord injury/archive1


 * The following is an archived discussion of a featured article nomination. Please do not modify it. Subsequent comments should be made on the article's talk page or in Wikipedia talk:Featured article candidates. No further edits should be made to this page.

The article was promoted by Ian Rose via FACBot (talk) 14:07, 11 March 2016.

Sexuality after spinal cord injury

 * Nominator(s): delldot   &nabla;.  20:27, 31 December 2015 (UTC)

Spinal cord injury has profound implications for sexual function and for sexuality in its broadest sense, affecting relationships, self-esteem, and quality of life. However the effects are different from what most people expect. This article has had a peer review, and two of the experts cited in the article were kind enough to give it detailed reviews as well. I'm excited to hear your thoughts! delldot  &nabla;.  20:27, 31 December 2015 (UTC)

Comments from
Some immediate impressions Hope this helps. I'll try to read more fully, but these popped out at me. &mdash; soupvector (talk) 00:09, 1 January 2016 (UTC)
 * Images are important, but sparse in this article (not a deal-breaker, I would think, but something to consider).
 * Two of the images may lead some readers to confuse/conflate afferent and efferent pathways (though both are high-quality). The dermatome map is afferent, and the "pathways" figure is efferent. Arrows (pointed from the CNS toward the genitals) might help with the latter. The caption of the former should stipulate prominently that's its a sensory map.
 * Thanks for the comments!
 * Yeah, I've thought hard about what images I can add, but not come up with much that would do more than decorate. There's a photo of different personal lubricants I could add, and I've actually thought of taking photos of someone in a wheelchair holding hands with or kissing someone for the lead.  Not sure if either or both of those would help, what do you think?
 * I added "sensory" to the dermatomes map. The image I based the reflexogenic and psychogenic image on has both afferent and efferent functions. (erm, click on the first link in this search). e.g. "The pudendal nerves from S2–S4 comprise both motor efferent (neuronal cell bodies in Onuf’s nucleus) and sensory afferent fibers" in the caption. Did I oversimplify this so much it lost meaning? Thanks for the help soupvector! delldot   &nabla;.  01:00, 1 January 2016 (UTC)
 * I could add arrows downward from the brain for the thoracic segments and bidirectional arrows for the sacral ones. What do you think, ?  delldot   &nabla;.  01:59, 17 January 2016 (UTC)
 * Yes, I think that would be a big improvement. &mdash; soupvector (talk) 02:27, 17 January 2016 (UTC)
 * What do you think about this, ? Thanks for the input so far, I'm eager to hear any other thoughts you might add. delldot   &nabla;.  02:37, 17 January 2016 (UTC)
 * Better, but aren't the efferent arms opposite in effect (you have them colored the same way)? I recall that the thoracic psychogenic arc is sympathetic and inhibitory, whereas the sacral reflexogenic efferent arc is parasympathetic and stimulatory. If that's the case, maybe it's worth making the efferent arrows differ in some way that could be explained in the caption or text? I am not confident that the text conveys this currently, either. &mdash; soupvector (talk) 02:47, 17 January 2016 (UTC)
 * Ah, good point, I tweaked the image and added wording to the caption and text like so.  delldot   &nabla;.  03:38, 17 January 2016 (UTC)
 * I also added an image to the lead per your first comment. What do you think soupvector?  delldot   &nabla;.  01:17, 18 January 2016 (UTC)
 * I think a powerful image is an asset for the lead. My impression is that the image of the two people holding hands in a park evokes friendship more than sexuality, and conflating the two might not be ideal - but I think it's a net positive and someone might find a better one now that there's something to prompt them. &mdash; soupvector (talk) 06:54, 19 January 2016 (UTC)

what do you think of this? Also there are several other variations on that image with varying degrees of steaminess. delldot  &nabla;.  05:25, 26 January 2016 (UTC)
 * Yes, that's better - less Platonic. &mdash; soupvector (talk) 05:40, 26 January 2016 (UTC)
 * Regarding the pathways image - I've tweaked the caption to be a little clearer (since there's no legend regarding the meaning of the blue/red colors). HTH. &mdash; soupvector (talk) 13:19, 31 January 2016 (UTC)
 * Fantastic, thank you! delldot   &nabla;.  16:15, 31 January 2016 (UTC)

Comments from
Just a few initial comments:
 * I couldn't find the two expert reviews mentioned above - please provide links, or even transclusions in the article Talk page if they are not too long. Unless of course I'm simply not seeing obvious links.
 * The sourcing and referencing is very good, no concerns there. You've managed to cite a good mix of strictly MEDRS and more general non-medical sources. I come to this FAC review from a disability rights POV so I really appreciate the non-medical content. All too often the medical world treats PWDs as "lab specimens" rather than complete people who do actually have lives outside of hospitals and doctors' surgeries.
 * The prose appears well written, I haven't gone through it wearing my "grammar nazi" hat yet, but will do so soon.
 * As far as images are concerned I think it's sufficient, there's no need to include "crip porn".
 * (Content comment, not really FAC issue) You've cited the Push Girls tv series in the "Society and culture" section for the women's POV, have you ever seen Murderball? It's a documentary about the US national wheelchair rugby team. It contains quite a bit of "locker room banter" from the male "sports jock" POV as well as a very frank "interview" that includes some discussion of sexuality. Roger (Dodger67) (talk) 11:14, 1 January 2016 (UTC)
 * Thanks for the kind words! The two experts gave me the reviews over email, I failed to ask them if I could post their names or words online. I could ask them for permission, if you think it's best, but I do feel kind of awkward bugging them again after they were already so generous with their time.  Would it work for me to forward you their emails? I'm not trying to be sketchy here, I don't know if there's a procedure for this.  Here are some of my edits in response to the reviews:
 * I have seen murderball the sport, but not Murderball the documentary. Let me look for sources and see if there's something that would be good to include.  Thanks for all the input here and beforehand!  delldot   &nabla;.  20:55, 1 January 2016 (UTC)
 * I'm not sure how emailed external reviews should be treated but published reviews are handled according to WP:External peer review. You're welcome to contact me through email - there should be a menu item "Email this user" when you're on my user page. Roger (Dodger67) (talk) 09:25, 2 January 2016 (UTC)
 * Cool, I've emailed them to you. delldot   &nabla;.  21:54, 2 January 2016 (UTC)
 * Roger, are you planning to check grammar soon? I saw a couple of things that probably need to be adjusted, but nothing major.  (It'd probably make more sense just to fix them instead of making a list.)  WhatamIdoing (talk) 19:33, 29 January 2016 (UTC)
 * Sorry WhatamIdoing, I've not done it - too much to do, not enough time! I've had an insanely busy few weeks both on and off-Wiki. Please go ahead with the language check if you want to. Roger (Dodger67) (talk) 19:44, 29 January 2016 (UTC)
 * I've done the first few sections, and need to take a break. If you or anyone else wants to have a go, then feel free.  WhatamIdoing (talk) 21:11, 29 January 2016 (UTC)
 * Hey Roger and WhatamIdoing, thanks for the work you've put in so far! Any further thoughts? I'd be eager to hear them if you have time. Thanks again!  delldot   &nabla;.  07:17, 9 February 2016 (UTC)

Comments from
Compliments on this important article. It is very comprehensive and meticulously sourced. A small number of comments in addition to my previous peer review: JFW &#124; T@lk  12:07, 4 January 2016 (UTC)
 * The choice of section headers and levels is still a little bit unclear. The "Sexuality and identity" starts by summarising normal function, then moves to the situation after SCI. Can the content be integrated into the larger section called "sexual function", with a somewhat clearer distinction between "normal" and "post-SCI"?
 * This resulted from a discussion  about sexuality as a broader topic than sexual function (justifying inclusion of topics like relationships, social stigma, self-esteem, etc.) and a concern that 'sexuality' might be confused with sexual orientation.  So I thought it was important to have a "what do we mean by sexuality and why is it important" section first, defining the term.  If the name of the section is a problem, could rename it to 'Sexuality defined' or 'Definitions' or something. I edited the section to distinguish better between pre- and post-SCI, what do you think?  delldot   &nabla;.  07:43, 5 January 2016 (UTC)
 * The section title is tricky, because IIRC the MOS discourages sections called "introduction" etc. Not a dealbreaker in any form; clearly some definitions are required for the remainder of the article to flow well. JFW &#124; T@lk  09:40, 5 January 2016 (UTC)
 * The opening sentence of the section "sexual function" says "Sexual dysfunction usually results from SCI". Would active an form be better?
 * Good call. Done. delldot   &nabla;.  07:43, 5 January 2016 (UTC)
 * There is a single red link to American Spinal Injury Association - perhaps a stub could be created as this appears to be a notable professional organisation. (Almost synchronicitically I bumped into the ASIA website this morning when looking at a journal article about spinal examination!)
 * Done. delldot   &nabla;.  07:43, 5 January 2016 (UTC)
 * This might be hard, but the images in the subsection "Level of injury" are both colour-coded, but differently. What's the chances of harmonising the colouring?
 * Ooh, I know, this bugged me too. I will work on this but I'm not sure my attempt at images in Inkscape is going to be better than what's there. delldot   &nabla;.  07:43, 5 January 2016 (UTC)
 * Done. What do you think,  JFW ?  delldot   &nabla;.  05:34, 6 January 2016 (UTC)
 * Terrific! A marked improvement & can be used in quite a few other articles. JFW &#124; T@lk  10:31, 6 January 2016 (UTC)
 * I found a fair number of links that go through redirects.
 * Done. delldot   &nabla;.  07:43, 5 January 2016 (UTC)
 * Thank you JFW !  I'll ping you when I've worked on those images.  delldot   &nabla;.  07:43, 5 January 2016 (UTC)


 * Great, thanks! JFW &#124; T@lk  09:40, 5 January 2016 (UTC)
 * the WP:Graphics Lab can help with improving and editing images. Roger (Dodger67) (talk) 09:33, 8 January 2016 (UTC)
 * Ooh, good to know, thanks. I gave the svg image a few more tweaks in inkscape to match the spinal column, so now I'm pretty pleased with it.  I'm satisfied with the images if others are!  delldot   &nabla;.  21:49, 8 January 2016 (UTC)
 * and, I think I've addressed all your comments so far. Have any more thoughts to add? Thanks to both of you!  delldot   &nabla;.  02:40, 17 January 2016 (UTC)


 * Not as such. I haven't done the standard checks for consistency in references and the like, but I would support for FA based on the content. JFW &#124; T@lk  15:29, 17 January 2016 (UTC)
 * Great, thanks so much! delldot   &nabla;.  23:42, 17 January 2016 (UTC)

Comments Support from
This is a fascinating and well-written article. Although my academic and professional life has little to do with the biomedical sciences, I found the prose easy to understand and very interesting. You have done an excellent job covering many complex aspects of a very important subject. Well done! I only have a few brief comments: Let me know if any of my comments don’t make sense. Thanks again for your incredible work with this! Best, -- Notecardforfree (talk) 01:13, 30 January 2016 (UTC)
 * 1) In the section about "sexuality and identity," the article says that SCI "most frequently happens to young people, who are at a peak in their sexual and reproductive lives." Spinal cord injury appears to provide some conflicting information about this. First, it cites a source that says the average age at the time of injury is 41. Later in the same paragraph, it says that "[m]ost of these injuries occur in men under 30 years of age." Can you verify that the statement in the section about "sexuality and identity" is accurate?
 * 2) In the section about "complete and incomplete injury," the final sentence of the section says "In both injured and uninjured people, the brain is responsible for the way sensations of climax are perceived." It isn't really clear to me what the implications of this statement may be. It might be helpful to add a sentence that says something like: "Therefore, for people with and without SCI, the qualitative experiences associated with climax are modulated by the brain, rather than a specific area of the body" (and cite to the Courtois article). Of course, I might be totally misreading the source.
 * 3) At the end of the section titled "Factors in reduced function," the article says, "Feelings of undesirability or worthlessness even lead some to suggest to their partners that they find someone better." Instead of saying "someone better," maybe this should say something like: "someone without SCI"? I wouldn't want the casual reader to think that the article is making a value judgment.
 * 4) In the final sentence of the section about society and culture, that article says, "SCI may necessitate reappraisal and rejection of assumptions about gender norms ..." Is this referring to society's reappraisal or a reappraisal conducted by the individual with an SCI? Or both?
 * 5) This probably isn't worth including in this article, but some scholars believe that there is a distinction between the mind and the brain.
 * Thanks so much for the review! I'm gonna go through and reply to each thing.  I thought I'd note for full disclosure that I've been and am reviewing some articles Notecard has been working on at GAN, not that I think it'll bias either of us.  These are good and thoughtful points, thanks again for them!   delldot   &nabla;.  02:13, 30 January 2016 (UTC)


 * Epidemiology. Sure, I can give more data on that. That SCI happens most in the young is well known. For right now, the Cramp 2015 source says "Traumatic spinal cord injury (SCI) most commonly occurs in young adults at a point in their lives when sexual activity levels and reproductive capacity are at their peak." But this gives me the idea to put a pie chart in the SCI article with a breakdown by age of injury. I just have to find a source with worldwide data.
 * Added some info to the age para in Spinal cord injury. The reason for the higher-than-expected mean is probably the bump in cases in the elderly (but not at rates as high as for people under 30).
 * Thanks for adding the extra info. I wonder if these numbers result from the fact that men under 30 years of age are more likely to engage in risk-taking behaviors that result in spinal cord injuries? Very interesting stuff. -- Notecardforfree (talk) 20:56, 1 February 2016 (UTC)
 * Totally, beyond a doubt. It's 4:1 male to female, too.  delldot   &nabla;.  21:22, 1 February 2016 (UTC)
 * brain and sensations of climax. Yes, you understood the gist right, and your suggestion is good. Let me make sure I can back that up with a source and I will add something like it.
 * I looked back at the source and I think you read it right. So I just combined the last sentence with the one you suggested.
 * Thanks for clarifying this. This looks great! -- Notecardforfree (talk) 20:58, 1 February 2016 (UTC)
 * Someone better. Good point. Changed to 'find someone able bodied'. How is that? Or maybe 'find someone uninjured'?
 * Thanks for clarifying this. -- Notecardforfree (talk) 20:59, 1 February 2016 (UTC)
 * Reappraisal of gender norms. I suppose both would help, but the source was talking about an individual's path toward acceptance of and adjustment to the injury. From that source, I added, "those who are able to change the way they think about gender roles may have better life satisfaction and outcomes with rehabilitation."
 * The text looks great. Thanks for clarifying this. -- Notecardforfree (talk) 20:59, 1 February 2016 (UTC)
 * Mind/brain I can see why you'd include it but I can't think where. Perhaps I should emphasize the mind/body difference more in the Changes in sexual practices section in the first para?  I recall reading somewhere "the most important sexual organ is the brain."
 * Yeah, I think a discussion about the mind/brain distinction would be too far outside the scope of this article. Of course, if you really wanted to get philosophical, you could talk about the spiritual and metaphysical aspects of intimacy and lovemaking, but you have done an excellent job keeping this article focused on its subject. -- Notecardforfree (talk) 21:02, 1 February 2016 (UTC)
 * I'll ping you when I'm done working on the first couple. delldot   &nabla;.  03:07, 30 January 2016 (UTC)
 * I think I've addressed everything you brought up, what do you think? Thank you again for the input!  delldot   &nabla;.  08:08, 30 January 2016 (UTC)
 * Thanks so much for taking the time to address my comments. This article looks great! In all respects, it complies with the Featured Article Criteria. It is well-written, comprehensive, well-reserched, neutral, stable, and it complies with relevant style guidelines. I don't see any issues with the media used in this article, and as I mentioned above, you do a nice job keeping things focused without going too far afield with tangential information. I am pleased to offer my support for this excellent article. Well done! Best, -- Notecardforfree (talk) 21:08, 1 February 2016 (UTC)
 * Thank you so much! I appreciate your time and well considered thoughts.  delldot   &nabla;.  21:22, 1 February 2016 (UTC)

Tony1
I've looked only at the lead. A few points:
 * 1) Lots of subsetting: include and variants occur seven times in two paragraphs, and there's a "such as", too. Any inline lists that you feel could do without explicit subsetting, do it. I see a few that may be possible.
 * Got rid of as many as I thought possible.  delldot   &nabla;.  16:14, 31 January 2016 (UTC)
 * 1) SCI ... we memorise the abbreviation, but then you spell it out again in the second para.
 * Done. delldot   &nabla;.  16:14, 31 January 2016 (UTC)
 * 1) At least two "also"s could be zapped.
 * Went throughout and zapped many. I hope this works. delldot   &nabla;.  16:14, 31 January 2016 (UTC)
 * 1) "Body image issues and other insecurities affect sexual function, and they have profound repercussions on ...". One word could be binned.
 * Done? Body image and other insecurities affect sexual function and have... delldot   &nabla;.  16:14, 31 January 2016 (UTC)
 * 1) not just ... not just.
 * Got rid of one. delldot   &nabla;.  16:14, 31 January 2016 (UTC)

Tony  (talk)  11:30, 31 January 2016 (UTC)
 * Thank you Tony! I'm a fan of your writing tutorials. I have tried to address these throughout the article so you hopefully won't run into them again if you keep going.   delldot   &nabla;.  16:14, 31 January 2016 (UTC)
 * Any more thoughts, Tony? I'd love to hear them if you have time. Thanks!  delldot   &nabla;.  07:24, 9 February 2016 (UTC)
 * Sure. I'd probably be crestfallen to go through those tutorials again, renovating. Maybe some time in the coming months. You may still prefer the comma after "function" (there are two "and"s).  Tony   (talk)  09:24, 9 February 2016 (UTC)
 * Ah, ok, comma added. Thank you! delldot   &nabla;.  17:41, 9 February 2016 (UTC)

Comments from Cas Liber
I passed this for GA and think it is looking better than then. Queries below:


 * People with SCI need to take special measures during sexual activity to deal with SCI effects such as weakness and movement limitations - I wonder if "special" is redundant as we go into specifics afterwards...


 * Sexuality involves not only sexual behaviors... - there are four "sexuality"s in the first four sentences of this section...can we change this one to "It..." maybe?

These are minor - support on comprehensiveness and prose. Cas Liber (talk · contribs) 13:21, 4 March 2016 (UTC)
 * Thanks so much Cas! Got rid of two 'sexualitys' in the para you mentioned. And you're right, 'special' is not the right word here. Got rid of that one and a few other 'specials'. Thank you again!  delldot   &nabla;.  21:12, 4 March 2016 (UTC)

Coord note
Didn't spot image licensing or source reviews above, these can be requested at the top of WT:FAC. Cheers, Ian Rose (talk) 12:12, 11 March 2016 (UTC)


 * I'll take a look..it's medical so up my alley. Cas Liber (talk · contribs) 12:57, 11 March 2016 (UTC)


 * Images appropriately licenced, tagged and sourced.
 * Reference formatting all consistent.

Using this version as stable point:


 * FN 9 used once - material faithful to source
 * FN 44 used fourteen times - material faithful to source
 * FN 56 used once - material faithful to source
 * FN 75 used once - material faithful to source

Ok, I think that does it...off to bed now. All looks in order. Cas Liber (talk · contribs) 13:42, 11 March 2016 (UTC)

Ian Rose (talk) 14:07, 11 March 2016 (UTC)
 * The above discussion is preserved as an archive. Please do not modify it. No further edits should be made to this page.