OT: First of all, you need to know that sexuality refers to the natural capacity to experience pleasure from sexual activity. And, for disabled people with physical or cognitive handicap, enjoying sexuality positively contributes to physical and mental health. But then what is sexual dysfunction for you?

TN: Umm. I don’t know. It can be anything.

OT: Well, it’s when you’re facing important challenges related to your ability to experience pleasure even if you’re physically, cognitively or neurologically disabled.

TN: Therefore, we need to consider that people with disabilities are sexual individuals with desires like anybody else.

OT: Exactly, and in that sense we should bear in mind that there is not one and only criterion for sexual pleasure. For example, talking about sex is natural, men do not always initiate sexual activity, and a firm penis is not a requirement for satisfying sex. Also, the sexual activity may not be spontaneous and doesn’t have to be through sexual intercourse and end with an orgasm. Here, concerning our subject, the sexual function is as important as any other aspect in the process of rehabilitation from a disabling disease, symtom or injury. And when impaired, the person may experience depression from altered body image and social distance with the others, but also from fear of rejection, inadequate performance and pain.

TN: From what you’ve just said, I guess that the issue of sexuality must be handled with care and compassion to help avoid reduced self-esteem. But then, what solutions do we have at hand?...