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Previous research has indicated that healthcare support for sexuality after spinal cord injury appears to be neglected or inadequately provided. The perspectives of people living with spinal cord injuries regarding what is lacking and what support they would like to be provided, and why, has yet to be explored. This paper uses critical theory to explore how societal constructs of sexuality and disability shape how sexuality is supported after a spinal cord injury. To do this, we conducted in-depth semi-structured interviews with 11 people with a spinal cord injury from Australia, the United Kingdom, and the United States. We drew from the works of various critical disability theorists to analyze what discourses underpinned the experiences people with spinal cord injuries had when receiving sexuality support. Analysis suggested that the following discourses were apparent: (1) broken bodies require repair, (2) sex is penetration, ejaculation then reproduction, and (3) sexual autonomy is required. Findings indicated healthcare professionals need to recognize people with spinal cord injuries as sexual beings with a diverse range of desires, lives, relations, and bodies. Provision of individualized comprehensive high-quality sexuality support is therefore warranted. To achieve this, healthcare professionals should aim to be aware of, and mitigate, ableist and normative assumptions. [ABSTRACT FROM AUTHOR]

A person's sexuality exerts a powerful influence on their needs, desires, roles, social relationships and personal identity. This study, explored occupational therapists' reasoning and practice in relation to the work they do (or do not do) with clients for whom sexual expression has become problematic. The lens used to explore reasoning and practice was a key conceptual framework adopted by occupational therapists, the occupational perspective of health, which considers humans need to do, be, become and belong. Using a qualitative, phenomenographic approach, 16 occupational therapists from across Australia were interviewed to understand the qualitatively variable ways in which they reasoned about practice in relation to the sexual needs of their clients. Four related, layers of 'conception' are presented. At a foundational level, we describe how participants conceived of their practice role in relation to assisting people in the doing aspect of sex(uality). At the next, more complex level, participants appeared to conceive of practice in relation to their clients' being as a sexual person. The next conception related to how therapists think about their clients in their becoming as a sexual being and finally, in their belonging as a sexual being. These conceptual categories, derived both theoretically and empirically are presented as a hierarchically aligned framework, the occupational perspective of sexuality (OPS). While generated from a study of occupational therapists' reasoning, the OPS has potential to enable a broader, more holistic consideration of sexuality, assisting health care professionals and educators to better understand the ways in which they may address their clients' needs to do, be, become and belong to their sexuality. [ABSTRACT FROM AUTHOR]

Current literature reports women with spinal injury feel concerned about body image, self-esteem, social perceptions of people in wheelchairs, practical issues in expressing sexuality, and the inadequacy of sexual rehabilitation. Through the first author’s personal experience and reflection, a need was identified to share their experiences in the journey of sexual recovery. The study aims to build on the current literature from an Australian and peer’s perspective. The objectives were to document the experiences of women with spinal injury reconstructing their sexual identity and identify the barriers and information they received on sexual rehabilitation. A descriptive study involving seven semi-structured interviews were employed and narrative analysis was conducted along with the authors’ critical reflections. The participants had acquired spinal injuries of various levels ranging from 4 to 39 years ago. Four themes were identified: (1) loss; (2) sexual rehabilitation and information gathering; (3) external factors; and (4) sexual recovery/discovery. The narratives of the participants demonstrated the barriers faced and the process of developing a sexual identity post-injury. Positive and negative factors were identified in each theme, which have the potential to be addressed and molded into a positive sexual identity. Women with spinal injury want access to more information on sexuality as it is experienced post-injury. Future research is required to look at developing resources and the strategies in which they can be delivered to facilitate a timely positive adjustment. [ABSTRACT FROM AUTHOR]