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…

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?”

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.

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.

Despite anecdotal evidence regarding the potential for pleasure from anal play, it remains a taboo subject in the context of female sexuality. This partly stems from the fact that we often associate anal pleasure specifically with anal sex, namely anal penetration of a penis, which can be a daunting proposition for a woman who has never experimented with any sort of anal stimulation.

Working with clients on their sexual routines is one of my top 5 ways I fall in love with OT again and again - every time. It reminds me how perfectly situated Occupational Therapy Professionals are to discuss sexuality in our clinical practice. We understand the impact of routines and specifically how occupations are sequenced together to facilitate participation, satisfaction, quality of life, and in some cases a great roll in the hay!

I have often thought about the lack of discussion around pleasure and conversely the prioritization of discussing sexual risk and pathology in sexual dialogues – to include academic dialogues, professional dialogues, and even familial or personal dialogues.

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.

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…