Sexual health issues should be an integral part of quality rehabilitation care for people with disabling health conditions, requiring a personalized biopsychosocial and integrative approach by the entire multiprofessional team.
Disabling health conditions can impact multiple dimensions of sexual health including function, identity, self-esteem, self-image, fertility, and pregnancy.
People with disabling health conditions can experience both primary and secondary impairments affecting sexual health.
Limitations of activities and participation restrictions resulting from disabling conditions can impact intimacy, sexuality, and reproduction.
Sexual rehabilitation programmes should encompass multiple components addressing biological, psychological, and practical dimensions.
Sexual rehabilitation requires a personalized biopsychosocial and integrative approach delivered by the entire multiprofessional team, including peer counsellors.
This paper examines how disabling health conditions affect sexual health and what rehabilitation programmes should do to address these issues. The authors find that disability can interfere with sexuality in many ways — not just through direct physical effects like loss of sensation or erectile dysfunction, but also through secondary problems such as pain, fatigue, bladder control issues, and spasticity, as well as broader limitations on participation in daily life and relationships. All of these layers can affect a person's intimate life, sense of identity, self-esteem, and ability to have children. The paper outlines what a comprehensive sexual rehabilitation programme should include: education for patients and their partners, practical guidance on adapting sexual activity (such as trying new positions), medications, assistive tools (including lubricants, vibrators, and sex toys), pelvic floor exercises, psychological support for coping and self-image, and encouragement for people to explore and experiment with their changed bodies. Crucially, the authors argue this support should not be left to one specialist but should involve the whole rehabilitation team, including peer counsellors — people with lived experience of disability who can offer relatable guidance. This research suggests that sexual health is a legitimate and important part of rehabilitation medicine that is often overlooked, and that addressing it requires a holistic, personalized approach that considers physical, emotional, mental, and social factors together. The inclusion of peer counsellors alongside medical professionals reflects a recognition that lived experience has a valuable role alongside clinical expertise in supporting people to rebuild fulfilling intimate lives after disability.
Laxe S, Rathore F, Kiekens C. (2025). The rehabilitation management of sexuality and fertility issues in people with disabling health conditions.. JPMA. The Journal of the Pakistan Medical Association. https://doi.org/10.47391/JPMA.25-59