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Kamali M, Arabkari Z, Esmaeil M J. Navigating Sexual Life After Spinal Cord Injury: A Qualitative Exploration of Challenges, Spousal Dynamics, and Societal Barriers. Iranian Rehabilitation Journal 2026; 24 (1) :113-122
URL: http://irj.uswr.ac.ir/article-1-2565-en.html

Objectives: This study aimed to explore the sexual challenges faced by individuals with spinal cord injuries (SCI) and their spouses in the Iranian socio-cultural context, where sexuality is often considered a taboo and remains under-discussed, especially in rehabilitation settings.
Methods: This qualitative study used conventional content analysis and included 25 participants (15 women and 5 men with SCI, 3 spouses, and 2 social workers). They were selected through purposive and snowball sampling in Tehran City, Iran. Data were collected via semi-structured in-depth interviews and analyzed using Lundman and Graneheim approach. Credibility, dependability, confirmability, and transferability were ensured to enhance the rigor of the findings.
Results: The main theme that emerged was “turbulent sex life,” comprising 3 main categories and 13 subcategories. Key findings included emotional intimacy replacing physical intercourse, sexual dysfunction (e.g. erectile issues, loss of orgasm), insufficient sexual knowledge, passivity in sexual activity, and the use of alternative sexual behaviors. Spouses experienced emotional burden, unmet needs, and sometimes abandonment. Cultural taboos, economic pressures, and family interference amplified challenges. Children of individuals with SCI also faced psychological and social vulnerabilities due to stigma and familial tensions.
Discussion: SCI profoundly disrupts sexual and emotional relationships, necessitating comprehensive rehabilitation that includes sexual health education, spousal support, and culturally sensitive counseling. Addressing these issues can improve quality of life (QoL) for individuals with SCI and their families. Policy changes, family-centered interventions, and public education are essential to reduce stigma and foster inclusive support systems.