Academy of Neurologic Physical Therapy Podcast · Academy of Neurologic Physical Therapy

Spinal Cord Injury SIG: DiSCIS Interview with Nicole Sharf on Sexuality and SCI – Episode 20

May 5, 2025·33 min·2 clips

Kristen Cizat welcomes Nicole Scharf to discuss a 2024 Rehabilitation Psychology article on psychosexual well-being after spinal cord injury. The paper centers perspectives from adults with SCI and rehabilitation clinicians, connecting lived experience to the realities of care. Sexual health matters here. The discussion follows how spinal cord injury can change appearance, bodily function, body image, and the way people understand attractiveness and desire. It also names the social pressure that can land more heavily on women, especially when disability changes appearance or function. That pressure shows up alongside shame, stigma, and a sense of being silenced when people try to ask for help. Family planning comes up too. Women with SCI described misconceptions, negative attitudes, and moments when clinicians seemed to doubt their ability to parent or make informed choices. One account included a nurse questioning child care and threatening to call social services. Those experiences point to a care environment where autonomy can feel fragile and mental health support may be missing during pregnancy and reproductive health care visits. The episode also stays close to clinic logistics. Participants and clinicians both described the difficulty of finding an OB-GYN who is equipped to meet the needs of people with SCI. Inaccessible examination tables become a barrier. When routine screening cannot happen safely or comfortably, preventive care slips further out of reach. Nicole Scharf and the host also revisit the rehabilitation profession's own limits. Clinicians in the study acknowledged gaps in their knowledge and called for more training, research, support, and practical resources around sexual health after SCI. That need is especially clear in day-to-day rehab settings. Clinically useful support has to account for referrals, equipment, access barriers, and the awkward reality that many systems are not built for these visits. The episode keeps its footing by moving from theory to lived care without losing clarity. It is a careful discussion about what people with spinal cord injury face, what clinicians are seeing, and where the field still needs to improve.

As heard by us

A practical look at sexuality, access, and rehab care after spinal cord injury.

Sexuality after spinal cord injury is framed as body function, shame, access, and clinical competence, and the discussion stays focused on what that means in practice.

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Why you'd press play

If you want a clinician-and-researcher conversation on psychosexual well-being after spinal cord injury, start here.

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