"You feel a bit unsexy sometimes": The psychosocial impact of a spinal cord injury on sexual function and sexual satisfaction

STUDY DESIGN: A qualitative, semi-structured interview design. OBJECTIVES: This study aimed to identify, from the perspective of people living with a Spinal Cord Injury (SCI), the primary psychosocial barriers and facilitators that impact on their sexual function and sexual satisfaction post-injury. SETTING: Community-dwelling sample of people with SCI in England, United Kingdom. METHODS: Semi-structured interviews with twenty people with SCI (15 males; 5 females) were conducted using an 8-item interview schedule. Inductive thematic analysis was undertaken of verbatim transcripts coded using Braun and Clarke's (2021) six phases of thematic analysis. RESULTS: Six inductive themes were generated, collectively describing the psychosocial barriers and facilitators impacting on sexual function and satisfaction post-SCI: (1) Internalising societal views and stigmatisation; (2) Diminished sexual confidence; (3) Navigating communication; (4) Managing relationship dynamics; (5) Lack of sexual support provision; and (6) Intervention development recommendations. CONCLUSION: Sexual function and satisfaction are highly challenging areas of rehabilitation for males and females living with SCI. Increased efforts are needed to educate others in society to overcome the negative stereotypical attitudes obstructing acceptance of sex despite disability. Countering sexual stigmatisation for people with SCI would facilitate growth in sexual confidence. Techniques to enhance interpersonal sexual communication and involve the partner/spouse in regaining mutual sexual satisfaction are foundational. The current study highlighted key outpatient-based recommendations for intervention development, clarifying primary targets for future SCI-focused sexual therapeutic work.