Nurses perceive sexual assistants as unregulated care providers working in anonymity who support people with physical and/or intellectual disabilities across the whole spectrum of their sexuality, and nurses are committed to normalising and regulating their role within a sound legal framework.
Key Findings
Results
The sexuality of people with physical and/or intellectual disabilities remains insufficiently visible in healthcare settings, according to nurses.
This emerged as one of three main themes from qualitative data analysis: 'the need to increase the visibility of people with physical and/or intellectual disabilities sexuality'
22 nurses aged 23–41 years who had provided care to people with physical and/or intellectual disabilities participated in the study
The study was conducted via semi-structured interviews in a region of southern Spain between November 2022 and May 2023
Convenience sampling was used to recruit participants
Results
Sexual assistance for people with physical and/or intellectual disabilities operates under a 'conspiracy of silence' in nursing and healthcare contexts.
This was identified as the second of three main themes: 'sexual assistance: a conspiracy of silence'
Sexual assistants are described as 'invisible, unregulated care providers' whose work is carried out in anonymity
The qualitative descriptive study used semi-structured interviews to explore participants' experiences
Data analysis across 22 nurse participants consistently identified this theme
Results
Sexual assistants support people with physical and/or intellectual disabilities across the whole spectrum of their sexuality, not only sexual pleasure.
In addition to sexual pleasure, sexual assistants provide 'opportunities for bonding, affection, physical contact, stimulation or caressing'
This breadth of role was identified under the third theme: 'defining the role of sexual assistants'
Nurses described sexual assistants as addressing a wide range of intimate and emotional needs
Sexual assistants were described as potentially improving quality of life by providing care across different healthcare settings
Results
Nurses expressed commitment to normalising the role of sexual assistants and advocated for regulation within a legal framework.
Nurses are described as 'committed to normalising the role of sexual assistants and regulating their services within a sound legal framework'
Sexual assistants are currently unregulated, with no formal legal status described in the study context
The study identified that health professionals need 'specific training on sexual assistance in their training programmes'
The study was conducted in southern Spain, where sexual assistance remains an unregulated practice
Background
Nurses acknowledged that the sexual needs of people with physical and/or intellectual disabilities represent 'silent needs and hidden desires' that are not adequately addressed in healthcare.
The study title reflects nurses' framing of these needs as unspoken and unmet
Nurses were identified as 'responsible for meeting the fundamental needs of people with physical and/or intellectual disabilities, yet there are still issues when it comes to their sexuality'
A qualitative descriptive design with semi-structured interviews was used to capture nuanced nursing perceptions
The study notes that 'little is known about these invisible, unregulated care providers,' indicating a gap in healthcare knowledge and policy
What This Means
This research explores how nurses in southern Spain perceive the sexual healthcare needs of people with physical and/or intellectual disabilities, and what they think about the role of 'sexual assistants' — people who help individuals with disabilities experience their sexuality. Through in-depth interviews with 22 nurses, researchers identified three key themes: that the sexuality of people with disabilities is largely invisible in healthcare, that sexual assistance is surrounded by silence and secrecy, and that nurses struggle to define what sexual assistants actually do and should do.
The study found that sexual assistants go far beyond facilitating sexual pleasure — they also help people with disabilities experience physical closeness, affection, bonding, and stimulation. Despite this, sexual assistants currently operate without regulation, legal recognition, or professional oversight. Nurses expressed a desire to change this, advocating for clear legal frameworks and better professional training so that sexual health can be addressed more openly as part of disability care.
This research suggests that sexual health is a fundamental but frequently neglected aspect of care for people with physical and/or intellectual disabilities. The findings highlight a need for healthcare systems to openly acknowledge and address the sexual needs of this population, provide nurses and other health professionals with appropriate training, and consider developing regulatory frameworks for sexual assistance services to ensure safe and dignified care.
Granero-Molina J, Rodríguez Sastre L, Jiménez-Lasserrotte M, Correa-Casado M, Fernández-Férez A, Fernández-Medina I. (2025). 'Silent Needs and Hidden Desires': Nurses' Perceptions of Sexual Healthcare for People With Physical and/or Intellectual Disabilities.. Journal of clinical nursing. https://doi.org/10.1111/jocn.17635