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!

Before you read on, here's a self-assessment to stoke self reflection.

Take a look at Victoria's Secret's website and Rihanna’s SavagexFenty website. Ask yourself: “if my sex and intimacy occupational therapy practice was either Victoria’s Secret or SavagexFenty, which one would it be?”

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!?

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.

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:

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!

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.

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.

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.

Trigger warning: discussion of traumatic experiences.

Trauma-informed care (TIC) practices are becoming more well-known and more widely-implemented in clinical practice. But what does this look like? And how can we as OTs provide TIC while addressing sexuality? In collaboration with OTD Student Hannah Zaininger, I recently did a deep dive into Trauma Informed Care approaches when addressing sexuality and intimacy.

This blog is guest co-written with Kala Plasterer. Kala will share a bit about herself below, but I’m delighted to bring in a mother, OT, and someone passionate about sex after baby to write about this topic. Kala and I have been working together for a while as she is a virtual assistant to The Institute. It was a no brainer to have her write about sex after baby!

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…

If you have a brain, you have a bias. Confronting our own biases is uncomfortable, but it is our ethical responsibility as occupational therapy professionals. Considering how paramount reconciling our biases are to enhancing the therapeutic relationship and treatment efficacy, and reducing patient harm and health disparities…

It's no surprise that as sexual beings we all have our own sexual preferences. Our likes, wants, and needs are unique to each of us and shape our sexual and intimate experiences. But what about our dislikes? Or aversions to certain stimuli? What if the enjoyment and pleasure of sex can quickly turn to pain and kill the mood. For some of us, this might be when our partner lightly touches our skin or grasps too firmly. What is this experience like and how can OT play a role in this??? Many of the clients I have work have sensory preferences and high/low thresholds, and this can be even more so for people with autism or sensory regulation difficulties.

If you've been following along then you know this is the last post of my three part series: The Selfies, Sexplay and Sexual Communication. This post we're talking about Sexual Communication. Whether it's with a casual partner, one with relationship potential, or long time partner helping our clients learn how to establish sexual communication in their relationship is an important part of addressing sexuality and intimacy.

As promised, I'm continuing my three part series of important topics to cover when addressing sexuality and intimacy, which brings us to Sexplay. As a part of Sexplay, I'm going to talk about dirty talk, pleasure, and sensate focus. All of these can be helpful for our clients (and let's be real - US!) to understand as potential activity demands. Below are some strategies and exercises you can share with your clients!

When it comes to helping clients with sexuality and intimacy there are several topics I find important and helpful to address: the selfies, sexplay and sexual communication. Being able to acknowledge and validate their wants and needs to their partner can be uncomfortable for our clients, especially if it's a foreign practice.

Cue, The Selfies.