Sex-Positive Sexuality Post-Spinal Cord Injury: A Systematic Review and Qualitative Metasynthesis

Abstract

Purpose/Objective: Many qualitative studies have focused on sex and spinal cord injury (SCI), often taking a deficit lens to interpretation and reporting. However, it is important to understand what can facilitate positive sexuality for people with SCI; therefore this study examines facilitators of sexuality for people with SCI. Research Method/Design: A systematic review and metasynthesis of 38 qualitative papers (published before February 2024) on sexuality for people with SCI was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Thematic synthesis was conducted in three stages: line-by-line coding; the identification of common descriptive themes across papers; and the generation of novel analytical themes. Results: Thirty-eight eligible papers were analyzed. Thematic synthesis resulted in four common descriptive themes that were linked to positive sexuality: (a) being sexually active; (b) trying new and other ways of sexual expression; (c) having a positive relationship with a partner; and (d) peer support. These descriptive themeswere interrelated and incorporated in two in-depth analytical themes: (a) redefining sexuality and (b) establishing a sexual identity. Conclusions/Implications: This study highlights facilitators to sexuality post-SCI. In order to maintain a sex-positive approach to sexuality rehabilitation for people with SCI, sexuality facilitators should remain at the forefront of sexual rehabilitation.