Clinicians can, rightfully so, feel cautions to challenge what clients admit as cultural messages. For example, "I grew up in a Catholic home and still view sex as 'dirty' and 'sinful,' and I’m having a hard time enjoying it,” or “My culture values young women, and women over 40 aren’t considered attractive anymore…

The history of how society has molded perceptions of women is a multifaceted narrative that has endured for centuries, influenced by cultural, regional, and media representations. Women have often found themselves defined by preconceived notions imposed upon them by others, commonly men. Within this context, different groups of women have experienced a spectrum of stereotypes, ranging from asexualization to sexualization, hypersexualization, and fetishization.

The 3rd part of our Pelvic Floor Series is highlighting affirmative clinician strategies for working with transgender and gender non conforming (TGNC) folks. This newsletter doesn’t get into the potential pelvic floor goals or sexual goals of TGNC clients, but is a good prerequisite for any OT/OTA clinician - not just pelvic health OTs.

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?”

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.

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.

Occupational therapy professionals will work with clients who may hire sex workers or who would benefit from working with a sex worker.

Here are 5 things OTs need to know to be prepared to address sex work with clients and to advocate for destigmatizing sex work:

The topic of dating and romance can be quite difficult to initiate with parents of adolescent clients, especially those with autism. However, as an occupational therapist (OT), you can help parents create a safe, calm, and judgment-free space for their teens to freely express their desires.

The Bump’n Joystick adapter is the first sex toy designed for and by people within the disabled community. Research shows that impaired hand function is the biggest barrier to using sex toys currently on the market – over 50% of physically disabled people surveyed said they struggle to achieve an orgasm solo. The Bump’n joystick removes this barrier and makes self-love possible regardless of hand function, by utilizing a person’s gross motor movements.

So what is it?

When I first started addressing sexuality with clients and making recommendations for sex toys I went through the steps of printing out a screen shot of a vibrator on a work computer, folding it in half, and slyly giving it to my client in front of their families.

But now, thanks to the folks at Direct-Rec App, OT clinicians can share sexual wellness products directly and privately with their clients. Dang… where was this 10 years ago!?

A study conducted last year by Bolding et al. (2022) examined the knowledge, clinical preparedness, and attitudinal awareness of occupational therapy practitioners, in regards to the LGBTQIA+ folks. This self-report study was broken down by category and found that on a scale of 1-7, respondents scored a mean of 4.7 in their Knowledge about queer populations, 4.4 in Clinical Preparedness, and 5.6 in Attitudinal Awareness.

I speak often about the importance of self-reflection and processing of our sexual values, beliefs, attitudes, and biases to ensure they aren’t influential in our clinical decision making. As painful or uncomfortable as it might be, I encourage all OT professionals, if you haven’t already, to really sit with the personal thoughts and feelings that come up in self-reflection about what this means for you as a sexual person

Something OT practitioners need to keep in mind as we (humbly) approach the topic of sex with clients is how people can have sex in countlessly different ways –many that may be unfamiliar to us, and some of ways that may even be considered…

Many times we have lamented and noted that patient educational handouts rarely show variety in race, gender expression, bodies, and sexual orientation and that they tend to be white, cisgender and heteronormative. This becomes even more problematic for sexuality handouts as these occupations involve our bodies, other bodies, and those we love and care most about, as well as, the need to navigate body image and stigma.

But the trailblazer, Jennifer Hutchinson (they/them), had an answer.