Lived Experiences of Sexuality and Sexual Functioning in Males with SCI: A Mixed-Methods Study

Rachel Lai; Rory McKerchar; Max J Western; Ryan Flannigan; Andrei V Krassioukov; Stacy Elliott; Tom E Nightingale

doi:10.46292/sci23-00082

Lived Experiences of Sexuality and Sexual Functioning in Males with SCI: A Mixed-Methods Study

Rachel Lai, Rory McKerchar, Max J Western, Ryan Flannigan, Andrei V Krassioukov, Stacy Elliott, Tom E Nightingale

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND: Sexual dysfunction is highly prevalent in males with spinal cord injury (SCI) and has been recognized to be a key recovery priority.

OBJECTIVES: This cross-sectional, mixed-methods study aimed to investigate the major themes linked to sexual functioning in males with chronic (>1 year) SCI.

METHODS: Twenty male participants with SCI, aged 25 to 59 years, completed validated questionnaires exploring sexual function/satisfaction and health-related quality of life and a semi-structured interview with an experienced sexual medicine physician. Sex hormone concentrations and metabolic biomarkers, along with body composition and habitual physical activity levels, were assessed. Interview recordings were transcribed and thematic analysis performed using combined COM-B (Capability, Opportunity, Motivation, and Behavior) and biopsychosocial models to identify and organize major contributors and barriers to sexual functioning.

RESULTS: Metabolic and hormonal biomarkers largely fell within normal physiological ranges despite reduced sexual functioning reported in our cohort (19/20 participants reported some degree of erectile dysfunction). Qualitative analysis of interview transcripts revealed 24 themes. Adaptability was important for improving sexual satisfaction. Attraction and attentiveness to sex and partners remained stable over time, while the desire for intimacy increased post injury. Sexual social norms, and comparisons to the able-bodied population, provided challenges for sexual activity and partnership. Environmental concerns regarding access to sexual health resources and accessible physical spaces during intimacy were relevant. Mood disorders and general life stressors negatively impacted sexual desire, while physical activity encouraged sexual activity.

CONCLUSION: By considering a holistic view of sexuality in males with SCI, we identified key contributors and barriers to sexual functioning for the cohort studied.

Original language	English
Pages (from-to)	37-53
Number of pages	17
Journal	Topics in spinal cord injury rehabilitation
Volume	30
Issue number	2
Early online date	23 May 2024
DOIs	https://doi.org/10.46292/sci23-00082
Publication status	Published - 23 May 2024

Keywords

Humans
Male
Middle Aged
Adult
Cross-Sectional Studies
Spinal Cord Injuries/psychology
Quality of Life
Sexual Dysfunction, Physiological/etiology
Sexual Behavior/physiology
Sexuality/physiology
Surveys and Questionnaires

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10.46292/sci23-00082

Cite this

@article{9ee1855da1ef4d24a998fc083e254648,

title = "Lived Experiences of Sexuality and Sexual Functioning in Males with SCI: A Mixed-Methods Study",

abstract = "BACKGROUND: Sexual dysfunction is highly prevalent in males with spinal cord injury (SCI) and has been recognized to be a key recovery priority.OBJECTIVES: This cross-sectional, mixed-methods study aimed to investigate the major themes linked to sexual functioning in males with chronic (>1 year) SCI.METHODS: Twenty male participants with SCI, aged 25 to 59 years, completed validated questionnaires exploring sexual function/satisfaction and health-related quality of life and a semi-structured interview with an experienced sexual medicine physician. Sex hormone concentrations and metabolic biomarkers, along with body composition and habitual physical activity levels, were assessed. Interview recordings were transcribed and thematic analysis performed using combined COM-B (Capability, Opportunity, Motivation, and Behavior) and biopsychosocial models to identify and organize major contributors and barriers to sexual functioning.RESULTS: Metabolic and hormonal biomarkers largely fell within normal physiological ranges despite reduced sexual functioning reported in our cohort (19/20 participants reported some degree of erectile dysfunction). Qualitative analysis of interview transcripts revealed 24 themes. Adaptability was important for improving sexual satisfaction. Attraction and attentiveness to sex and partners remained stable over time, while the desire for intimacy increased post injury. Sexual social norms, and comparisons to the able-bodied population, provided challenges for sexual activity and partnership. Environmental concerns regarding access to sexual health resources and accessible physical spaces during intimacy were relevant. Mood disorders and general life stressors negatively impacted sexual desire, while physical activity encouraged sexual activity.CONCLUSION: By considering a holistic view of sexuality in males with SCI, we identified key contributors and barriers to sexual functioning for the cohort studied.",

keywords = "Humans, Male, Middle Aged, Adult, Cross-Sectional Studies, Spinal Cord Injuries/psychology, Quality of Life, Sexual Dysfunction, Physiological/etiology, Sexual Behavior/physiology, Sexuality/physiology, Surveys and Questionnaires",

author = "Rachel Lai and Rory McKerchar and Western, {Max J} and Ryan Flannigan and Krassioukov, {Andrei V} and Stacy Elliott and Nightingale, {Tom E}",

year = "2024",

month = may,

day = "23",

doi = "10.46292/sci23-00082",

language = "English",

volume = "30",

pages = "37--53",

journal = "Topics in spinal cord injury rehabilitation",

issn = "1082-0744",

publisher = "Allen Press Inc.",

number = "2",

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T1 - Lived Experiences of Sexuality and Sexual Functioning in Males with SCI

T2 - A Mixed-Methods Study

AU - Lai, Rachel

AU - McKerchar, Rory

AU - Western, Max J

AU - Flannigan, Ryan

AU - Krassioukov, Andrei V

AU - Elliott, Stacy

AU - Nightingale, Tom E

PY - 2024/5/23

Y1 - 2024/5/23

N2 - BACKGROUND: Sexual dysfunction is highly prevalent in males with spinal cord injury (SCI) and has been recognized to be a key recovery priority.OBJECTIVES: This cross-sectional, mixed-methods study aimed to investigate the major themes linked to sexual functioning in males with chronic (>1 year) SCI.METHODS: Twenty male participants with SCI, aged 25 to 59 years, completed validated questionnaires exploring sexual function/satisfaction and health-related quality of life and a semi-structured interview with an experienced sexual medicine physician. Sex hormone concentrations and metabolic biomarkers, along with body composition and habitual physical activity levels, were assessed. Interview recordings were transcribed and thematic analysis performed using combined COM-B (Capability, Opportunity, Motivation, and Behavior) and biopsychosocial models to identify and organize major contributors and barriers to sexual functioning.RESULTS: Metabolic and hormonal biomarkers largely fell within normal physiological ranges despite reduced sexual functioning reported in our cohort (19/20 participants reported some degree of erectile dysfunction). Qualitative analysis of interview transcripts revealed 24 themes. Adaptability was important for improving sexual satisfaction. Attraction and attentiveness to sex and partners remained stable over time, while the desire for intimacy increased post injury. Sexual social norms, and comparisons to the able-bodied population, provided challenges for sexual activity and partnership. Environmental concerns regarding access to sexual health resources and accessible physical spaces during intimacy were relevant. Mood disorders and general life stressors negatively impacted sexual desire, while physical activity encouraged sexual activity.CONCLUSION: By considering a holistic view of sexuality in males with SCI, we identified key contributors and barriers to sexual functioning for the cohort studied.

AB - BACKGROUND: Sexual dysfunction is highly prevalent in males with spinal cord injury (SCI) and has been recognized to be a key recovery priority.OBJECTIVES: This cross-sectional, mixed-methods study aimed to investigate the major themes linked to sexual functioning in males with chronic (>1 year) SCI.METHODS: Twenty male participants with SCI, aged 25 to 59 years, completed validated questionnaires exploring sexual function/satisfaction and health-related quality of life and a semi-structured interview with an experienced sexual medicine physician. Sex hormone concentrations and metabolic biomarkers, along with body composition and habitual physical activity levels, were assessed. Interview recordings were transcribed and thematic analysis performed using combined COM-B (Capability, Opportunity, Motivation, and Behavior) and biopsychosocial models to identify and organize major contributors and barriers to sexual functioning.RESULTS: Metabolic and hormonal biomarkers largely fell within normal physiological ranges despite reduced sexual functioning reported in our cohort (19/20 participants reported some degree of erectile dysfunction). Qualitative analysis of interview transcripts revealed 24 themes. Adaptability was important for improving sexual satisfaction. Attraction and attentiveness to sex and partners remained stable over time, while the desire for intimacy increased post injury. Sexual social norms, and comparisons to the able-bodied population, provided challenges for sexual activity and partnership. Environmental concerns regarding access to sexual health resources and accessible physical spaces during intimacy were relevant. Mood disorders and general life stressors negatively impacted sexual desire, while physical activity encouraged sexual activity.CONCLUSION: By considering a holistic view of sexuality in males with SCI, we identified key contributors and barriers to sexual functioning for the cohort studied.

KW - Humans

KW - Male

KW - Middle Aged

KW - Adult

KW - Cross-Sectional Studies

KW - Spinal Cord Injuries/psychology

KW - Quality of Life

KW - Sexual Dysfunction, Physiological/etiology

KW - Sexual Behavior/physiology

KW - Sexuality/physiology

KW - Surveys and Questionnaires

U2 - 10.46292/sci23-00082

DO - 10.46292/sci23-00082

M3 - Article

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SN - 1082-0744

VL - 30

SP - 37

EP - 53

JO - Topics in spinal cord injury rehabilitation

JF - Topics in spinal cord injury rehabilitation

IS - 2

ER -

Lived Experiences of Sexuality and Sexual Functioning in Males with SCI: A Mixed-Methods Study

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