Sexual adjustment and quality of relationship in spinal paraplegia: a controlled study

To identify determinants of sexual adjustment by persons with spinal cord injury (SCI) and quality of the relationship compared with persons in the general population.

Controlled survey.

Postdischarge community setting.

A consecutive series of 252 persons admitted to our spinal unit between November 1982 and July 1991 with traumatic SCI were contacted, 85 of whom persons were excluded: 36 were dead, 37 had recovered, 5 could not be located, 4 were younger than 18 years, 2 had language difficulties, and 1 had a psychiatric illness. Of the remaining 167 persons with SCI, 85 had a stable partner relationship, 75 of whom (88%) completed and returned the questionnaires (median age, 33 years; range 19 to 76). An age- and sex-matched control group was randomly selected from the general population. Of the 264 respondents, 155 (59%) had a stable partner relationship.

The 80-item questionnaire addressed experiences concerning sexual functioning, desire, and activity, sexual behavior, satisfaction with sex life, and aspects of the emotional quality of the relationship.

Sexual activity and satisfaction was lower among persons with SCI compared with the controls; the emotional quality of the relationship did not differ. The most important correlates for sexual fulfillment in both groups were found to be the use of a varied repertoire of sexual behaviors and the perception that the partner enjoys and is satisfied with the sexual part of the relationship.

Psychosocial rather than physical factors were important for a satisfying sexual life and relationship. A qualitative study should be undertaken to further explore the complexity of sexual adjustment after SCI.