Debunking Reasons We Avoid Talking Sex After Spinal Cord Injury: Wrapping Up Our SCI Series

When it comes to discussing sexuality with our clients, occupational therapy practitioners (OTPs) and other healthcare providers can come up with all sorts of justifications not to. But here's the thing: most of these justifications have more to do with our own biases than with the clients themselves. It's time to challenge those biases and ask ourselves, "Why am I avoiding this conversation?"

Here are some common biases that hold us back from addressing sex:

"They have so many other things to worry about right now. Sex is probably the last thing on their mind." 

Look, we can't read minds. We have no idea what our clients are thinking unless we ask them. Just because they don't bring it up doesn't mean they don't have concerns. By initiating the conversation early on, we create a safe space for them to discuss their sexual well-being whenever they're ready.

"I don't want to offend them based on their background or beliefs." 

I've heard it all: "They're conservative," "They're from a rural area," "They're Christian or Muslim," "They're older," "They're gay," and the list goes on. But guess what? People from all walks of life have sex! As OTPs, it's important to recognize and reflect on the assumptions we make about our clients and how other people view sex. Let's not let our biases prevent us from addressing this crucial topic.

"I'll wait for the client to bring it up. I don't want to offend them." 

Waiting for clients to initiate the conversation about sex is a common practice. We fear offending them, but here's the irony: many patients are actually offended by the fact that healthcare providers don't talk about sex. We need to take the lead and create an open dialogue, showing our clients that we care about their overall well-being.

"They can't have sex because of their level of injury."

 Let's get creative here! There are so many technological advancements and adaptive devices available to assist individuals with spinal cord injuries. From mouth sticks to vibrators with Bluetooth control, there are options to explore. And hey, let's expand our definition of sex. It's not just about physical movement. Role playing, power play, and erotic writing can all contribute to fulfilling sexual experiences without a lot of physical activity.

By addressing these biases and actively discussing sexuality after spinal cord injury, we, as OTPs, can make a real difference in our clients' lives. Opening up about sexual concerns, exploring adaptive solutions, and connecting them with appropriate resources are all part of comprehensive care. Let's create an inclusive and supportive environment for individuals with spinal cord injuries to embrace fulfilling and satisfying sexual lives.

And that wraps up our three-part series on addressing sexuality and intimacy after spinal cord injury. We hope these articles have shed some light on the importance of this topic and the role OTs play in supporting individuals with SCI. Remember, by prioritizing conversations about sex, we empower our clients to navigate this aspect of their lives with confidence and well-being.

If you’re interested in identifying and challenging some of your perceptions and biases, as well as building an all around enhanced competency for addressing sexuality with your clients, check out The Certified Sexuality OT.

Looking to explore this topic further? Take advantage of these additional resources:

• [documentary] Take a Look at This Heart by Ben Duffy and Dan Garcia
  • https://www.abilities.com/community/this-heart.html
•  Sexuality and Reproductive Health in Adults with Spinal Cord Injury: What you should know A guide for People with Spinal Cord Injury (Paralyzed Veterans of America)
  • https://pva.org/research-resources/publications/clinical-practice-guidelines/ 
• Living Your Life: Sexuality Following Spinal Cord Injury: Mitchell S. Tepper (United Spinal Association) 
  • https://www.unitedspinal.org/pdf/SexualityFollowingSCIBooklet.pdf 
• Revamp Your Voice:
  • https://www.vilissathompson.com/ 
• Sexual Health Section of Christopher & Dana Reeve’s Foundation
  • https://www.christopherreeve.org/living-with-paralysis/health/sexual-health 
• Sexuality after SCI:
  • https://www.sexualitysci.org/ 
• SCI Sexual Health: Spinal Cord Injury BC
  • https://scisexualhealth.ca/

_{Blog written in collaboration with Brittany Gosserand, MOT OTR}

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