The Vital Role of OTs in Addressing Sex & Intimacy after SCI: Part Two of a Three Part Series

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 bodies and navigate the challenges they may encounter. This knowledge forms the basis for addressing sexuality and intimacy effectively and tailoring interventions to meet the specific needs of each individual.

Adaptive Equipment and Techniques:

OTs can play a pivotal role in suggesting adaptive equipment and techniques that enhance the sexual experience for SCI patients. Beyond sex toys, OTs can identify and recommend adaptations for various activities related to intimacy, personal care, and dressing. This may involve addressing condom application techniques or suggesting aids like leg spreaders for individuals with lower extremity spasticity. By considering the unique goals and requirements of each patient, OTs can provide valuable guidance on adaptive equipment and techniques that facilitate comfortable and pleasurable sexual experiences.

Assessing Environment and Positioning:

Creating a supportive and accessible environment is crucial for SCI patients to engage in satisfying sexual activities. SCI patients may have unique positioning needs, and OTs can provide guidance in exploring adaptive positions. For example, the Intimate Rider is a popular product specifically designed for individuals with lower-level paraplegia. By understanding the client's desired sexual activities, OTs can perform activity analysis on the sex the client wants to have, rather than assuming based on preconceived notions.

Taking a Holistic Approach:

SCI brings significant changes to a person's body and can impact mental well-being, self-esteem, and body image. OTs can create a safe space that promotes confidence and supports emotional healing. Mental health tools such as mental imagery, positive self-talk, and motivational interviewing can be employed to facilitate a positive mindset. Encouraging open communication and expression of desires becomes crucial in situations where physical control may be limited. Additionally, OTs can guide clients in selecting clothing that makes them feel sexy and boosts their confidence. Promoting activities like couples going on dates helps break away from caregiver roles, creating space for sexual desire. Exploring how their body was changed through self-exploration before engaging in sexual activities with others can also be encouraged.

Connecting Clients with Community Resources:

While we provide invaluable support as OTs, connecting SCI patients with community resources is equally important. Peer support and engagement with individuals who have shared similar experiences can provide a unique level of understanding and validation. I’ve had clients who wouldn’t talk to me about sex, but opened up immediately upon chatting with a peer volunteer. OTs can facilitate these connections and help patients access relevant community resources, support groups, or the aforementioned peer volunteer programs. By connecting with others who have faced similar challenges, SCI patients can find additional sources of support and gain insights from those who have walked a similar path.

Promoting Interdisciplinary Collaboration:

If you’re in a setting where interdisciplinary teams are already confident and competent in addressing sexuality and intimacy, that's fantastic! If not, a customized interdisciplinary training can help build programming and preparedness to address the topic better. 

 Occupational Therapists play a vital role in supporting individuals with SCI in addressing sexuality and intimacy. Through education, recommendations for adaptive equipment and techniques, assessment of the environment and positioning, a holistic approach, connecting clients with community resources, and promoting interdisciplinary collaboration, OTs empower SCI patients to navigate their sexual health with confidence and embrace a fulfilling sexual life.

Stay tuned for the final part of our series, where we'll explore additional insights into the role of OTs in spinal cord injury rehabilitation. Together, let's foster a more inclusive and supportive environment for individuals with SCI.

This blog was written in collaboration with Brittany Gosserand, MOT OTR | brittany.gosserand@gmail.com