Dr. Andrew Allen

Objectives: Sexuality is a key domain of wellbeing that is significantly compromised by SCI but often left unaddressed during rehabilitation, with a typical focus being genital functioning and fertility. Using a theory-driven qualitative methodology and applying Material, Discursive, Intrapsychic Theory (encompassing multiple dimensions of sexuality), this study explored the support experiences of nine Australian adults with an SCI.

Design: This qualitative methodology took a deductive, critical and constructionist theoretical perspective, which prioritised the collection of information-rich data over acquiring a large sample size, and utilised a contextual approach to understanding the facets of sexual wellbeing.

Setting & Methods: Male (N = 8) and female (N = 1) participants with varying levels of SCI completed an online interview which was primarily participant-led.

Results: Participants’ responses reflected previous research on sexuality in SCI, noting an emphasis on physical aspects (e.g., erection and ejaculation ability) to the neglect of the psychological and interpersonal. The three core components of Material, Discursive, Intrapsychic Theory were mapped onto themes from the data, with multiple sub-themes comprised in each, demonstrating that aspects aside from sensation loss like gender identity, self-confidence, and disability stereotypes all effect sexual wellbeing. An additional fourth theme of relationship dynamics was also identified, including aspects such as connectedness and perceived safety in relationships.

Conclusions: This provides practical implications for support experiences such as the inclusion of partner support in rehabilitation. Further investigation is recommended to provide specific interventions for regaining sexuality in the context of a SCI.

Sexual quality of life (SQoL) challenges are prevalent and persistent for people with a cancer diagnosis. Using a qualitative design, this study investigated the impact of a cancer diagnosis on SQoL. Participants (N = 18) with a current or past cancer diagnosis of various sites and severity. Thematic analysis identied three themes: gender attachment, vulnerability, and growth vs. xed mindset. The theme of gender attachment is related to the impact of understanding SQoL based on heteronormative denitions of masculinity and femininity. The second theme of vulnerability suggested that pre-existing relational or personal challenges can amplify the impact of a cancer diagnosis on SQoL. The third theme of growth vs. xed mindset explored how cognitive exibility and optimism can support SQoL, while a rigid and pessimistic mindset can exacerbate SQoL challenges. The ndings of this study build on the traditional medical understanding of SQoL and can inform SQoL support in cancer care settings.