The Missing Conversation in Burn Care: Intimacy and Sexuality

Intimacy and sexuality are essential components of quality of life after burn injury, yet they remain overlooked in burn survivorship care. Evidence demonstrates lasting declines in sexual satisfaction and relational well-being among burn survivors but discussions about these concerns are rarely initiated by providers and standardized approaches remain absent. Surveys of burn care professionals reveal widespread discomfort in addressing sexual health, despite consensus that patients should not be expected to initiate these conversations. In contrast, other specialties, including oncology and cardiology, have recognized sexual health as a core component of survivorship and have implemented structured screening tools, counseling pathways, and multidisciplinary models of care. Burn survivors face distinct challenges that extend beyond physiologic sexual function, including altered body image, visible scarring, psychological recovery, and changes in relational confidence and closeness. These factors underscore the need to expand burn rehabilitation to include both sexual health and broader intimacy concerns. This commentary urges development of provider education and accessible clinical resources to support these conversations throughout the continuum of burn care. By intentionally integrating these elements into care models, the burn community can move beyond survival alone and advocate for recovery that restores connection, identity, and the possibility of fulfilling intimate lives.