Psychosexual Well-Being Following Spinal Cord Injury: Perspectives of Adults With Spinal Cord Injury and Rehabilitation Clinicians

Abstract

Objectives: This study aimed to identify important mental health topics for people with spinal cord injuries (PwSCI) and garner insights from health care clinicians working with this population. In doing so, we identified psychosocial adaptations in the context of sexuality, intimacy, and reproductive health. Method: A qualitative, phenomenological approach was used, with 60–90-min virtual focus groups involving PwSCI, rehabilitation clinicians, and psychologists. Themes were identified through deductive and inductive transcript analysis. Eligibility for PwSCI included: (a) SCI for ≥1 year, (b) 18+ years, (c) U.S. residency, (d) conversational English skills, and (e) cognitive capacity to provide informed consent. Clinicians required ≥5 years of rehabilitation experience. Results: Sixteen PwSCI, eight rehabilitation clinicians, and four psychologists participated. Three major themes emerged: (1) The effects of SCI on relationships with noninjured significant others with subthemes of (a) internalized and partnered ableism in intimate relationships and (b) navigating care partner dynamics and resource gaps; (2) sexual self-esteem with subthemes of (a) gender role adaptation and (b) body image concerns; and (3) challenges in sexual and reproductive health with subthemes of (a) family planning and self-advocacy in health care settings, (b) access to specialized care, and (c) health care provider competence. Conclusions: This report illuminates the complex effects of SCI on their relationships with noninjured partners, revealing how internalized and partnered ableism can heighten feelings of inadequacy and alter relationship dynamics. These findings underscore the need for more research, support, and services in sexual and reproductive health for all PwSCI.