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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,"...

Welcome to the second part of our three-part series on addressing sexuality and intimacy after spinal cord injury (SCI). Today, we’ll delve deeper into the crucial role that Occupational Therapists (OTs) play in supporting individuals with SCI in this aspect of their lives. With their expertise and unique perspective, OTs can provide invaluable guidance and interventions to empower SCI patients and promote a positive and fulfilling sexual experience. The OT can be the shining light of comfort and advocacy! OTs are perfectly situated to lead these efforts in a clinical setting both for their patients and for the interdisciplinary team. Let's continue our exploration of the strategies and approaches that OTs employ in this domain.

Education and Understanding:

One of the primary responsibilities of OTs is to educate SCI patients about the impact of their injury on sexual health. By providing comprehensive education, OTs help individuals understand the changes in their...

As Sexuality and Intimacy Trailblazers, we know that sexuality and intimacy are important parts of our lives, bringing us joy and enhancing our overall well-being. However, when someone experiences a spinal cord injury (SCI), these aspects can be profoundly affected. Today, we'll discuss when to address these topics, the impacts of SCI on sexual health, specific complications that can arise, and the role of occupational therapy in supporting individuals on this journey.

When to Address Sex and Intimacy:

So, the big question is: when should we start talking about sex and intimacy with SCI patients? 

The answer? at every point in their occupational therapy (OT) engagement! 

It's not about when exactly, but more about what to focus on depending on where the individual is in their injury timeline. In the inpatient setting, when people have recently experienced acute trauma, they may benefit from SCI sexuality education. On the other hand, those receiving outpatient care have...

I recently attended a webinar by Dr. Farris on Sexuality and Intimacy After Brain Injury with the Brain Injury Association of America. It was a great presentation that shed light on some important points that we as OTs should be making sure to address and incorporate into our practice.  

Consider the Partner

When it comes to addressing sexuality and intimacy with a client after brain injury it’s important to consider the impact on the partner, too. How has this injury impacted the couple? What is the partner’s comfort level with addressing sex and intimacy?

Studies have shown that, often, the client is typically comfortable with discussing changes in their sexual function with their healthcare providers and many individuals who did not receive sexual counseling within the first year after an injury wish they would have.

The impact of a brain injury doesn’t stop with the person directly affected. It’s not uncommon for the...

What’s an OT to do when Valentine’s Day is approaching, the clinic is covered in hearts and cupids, you're wearing red or pink on every portion of your body, yet your client shows up and says, “I’m dreading Valentine’s Day.”

You dig a little deeper.  

They say, “I’m dreading Valentine’s Day, because I know my partner will want to have sex with me and I have no desire for it.”

Ok, ok, ok, before you freeze up eyes wide open, here’s what you talk about:

Validate them: The hardest part about low desire when “sex is the last thing on your mind” is when it’s met with your partner’s higher desire – among all the things you’re juggling this can feel like a recipe for inadequacy, insecurity, resentment, guilt.

Knowledge is pleasure!  When your clients can understand the changes that happen in their body and how this impacts sexual health, they can also enlighten your partner...

I had the pleasure of speaking with Dr. Sam for my latest Teach Me Sex episode and it was a great one! Dr. Sam DuFlo PT, DPT, PRPC is a physical therapist as well as the owner and founder of Indigo Physiotherapy, based in Maryland.  She and her team of fellow healthcare workers including PTs, lactation consultants, Craniosacral therapists and bodywork therapists focus on pelvic health, pelvic physical therapy, prenatal and postpartum training, oncology and women’s/men’s/pediatric/transgender health concerns. You can learn more about Dr. Sam and Indigo Physiotherapy here!

Dr. Sam is passionate about the care she and her team provide. It was when she realized that she wanted a space where she can provide treatments that are more trauma aware, pleasing to the senses and not so much like the traditional healthcare settings (fluorescent lighting, sterile environment, etc.) that she set out to start Indigo...

I’m SO excited to share my latest “Teach Me Sex” interview with you. It was juicyyy!

I had the pleasure of speaking with Sormeh, a fellow OT and recent OTD graduate. Sormeh's identities include queer, first generational woman of color, and hard fem. She has been active in the queer community for just over a decade and was previously active in the polyamory community.

To Sormeh, queerness falls on a spectrum. It involves all sorts of people, bodies, and includes whatever body parts those individuals do or don’t have. It also shouldn’t be dependent upon how others view you. I think this explanation is a great reminder that sexual identities aren't simply one size fits all terms. - they are identities NOT terms or categories. There are many qualities and traits that fall within an individual’s sexual identity that are unique to them. And sexual identity isn’t defined by how someone looks or how they are viewed by others....

One question I often get asked is, how should I address sexuality and intimacy with teens and young adults? And I get it... it sounds like it can be an uncomfortable conversation to have! But, I'm here to tell you it doesn't need to feel that scary. There are a handful of topics that fall within our scope of practice and relate to sexuality and intimacy.  

If you haven't already heard of the podcast OT After Dark, it's another great resource for learning more about this niche world of sex, intimacy and OT. Episode 19, Accessible Sex Education: Addressing the Sexual Needs of Individuals with IDD (Intellectual and Developmental Disability) is a great listen and is available on Spotify and apple podcast!

In this episode Dr. Elizabeth Schmidt, PhD, shares her dissertation research and current recommendations on how to address sexuality and intimacy with teens, young adults and more specifically individuals with IDD. 

Individuals with IDD...