{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T10:27:48Z","timestamp":1791282468198,"version":"4.1.0"},"reference-count":72,"publisher":"American Spinal Injury Association","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The collaboration with individuals regarding their sexual health is an important component of patient-centered health care. However, talking about sexual health in primary care settings is an area not fully addressed as a result of time limitations, medical task prioritization, awareness or knowledge deficit, and discomfort with the topic of sexuality. A critical shift in professional focus from disease and medical illness to the promotion of health and wellness is a prerequisite to address sexual health in the primary care setting. This article provides guidance for practitioners in primary care settings who are caring for persons with spinal cord injury. Clinicians should seize the opportunity during the encounter to reframe the experience of disability as a social construct status, moving away from the narrow view of medical condition and \u201cfind it, fix it\u201d to a broader understanding that provides increased access to care for sexual health and sexual pleasure.<\/jats:p>","DOI":"10.46292\/sci2603-144","type":"journal-article","created":{"date-parts":[[2020,11,2]],"date-time":"2020-11-02T13:59:40Z","timestamp":1604325580000},"page":"144-151","source":"Crossref","is-referenced-by-count":10,"title":["A Primary Care Provider\u2019s Guide to Sexual Health for Individuals With Spinal Cord Injury"],"prefix":"10.46292","volume":"26","author":[{"given":"Sigmund","family":"Hough","sequence":"first","affiliation":[{"name":"Spinal Cord Injury Service, VA Boston Healthcare System, Boston, Massachusetts"},{"name":"Department of Psychiatry, Harvard Medical School, Boston, Massachusetts"},{"name":"Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colleen Clemency","family":"Cordes","sequence":"additional","affiliation":[{"name":"College of Health Solutions, Arizona State University, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lance L.","family":"Goetz","sequence":"additional","affiliation":[{"name":"Spinal Cord Injury and Disorders Service, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia"},{"name":"Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Kuemmel","sequence":"additional","affiliation":[{"name":"Psychology Service, Louis Stokes VA Medical Center, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse A.","family":"Lieberman","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation\/Spinal Cord Medicine, Carolinas Rehabilitation, and Carolinas Medical Center, Charlotte, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda R.","family":"Mona","sequence":"additional","affiliation":[{"name":"VA Long Beach Healthcare System, Long Beach, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchell S.","family":"Tepper","sequence":"additional","affiliation":[{"name":"The Sexual Network, Inc."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jithin G.","family":"Varghese","sequence":"additional","affiliation":[{"name":"Centre for Family Medicine-Family Health Team, Kitchener, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"25425","reference":[{"key":"i1082-0744-26-3-144-b1","series-title":"Spinal Cord","first-page":"911","article-title":"Pharmacodynamics and effectiveness of topical nitroglycerin at lowering blood pressure during autonomic dysreflexia","volume":"55","year":"2017","unstructured":"Solinsky,\n\t\t\t\t\t\t\tR,\n\t\t\t\t\t\tBunnell,\n\t\t\t\t\t\t\tAE,\n\t\t\t\t\t\tLinsenmeyer,\n\t\t\t\t\t\t\tTA,\n\t\t\t\t\t\tSvircev,\n\t\t\t\t\t\t\tJN,\n\t\t\t\t\t\tEngle,\n\t\t\t\t\t\t\tA,\n\t\t\t\t\t\tBurnes,\n\t\t\t\t\t\t\tSP.\n\t\t\t\t\t\n          Pharmacodynamics and effectiveness of topical nitroglycerin at lowering blood pressure during autonomic dysreflexia.\n\t\t\t\t\tSpinal Cord.\n\t\t\t\t\t2017;\n\t\t\t\t\t55:\n\t\t\t\t\t911\u2013\n\t\t\t\t\t914."},{"key":"i1082-0744-26-3-144-b2","article-title":"Pleasure ABLE: Sexual device manual for persons with disabilities","year":"2009","unstructured":"Krassioukov,\n\t\t\t\t\t\t\tA,\n\t\t\t\t\t\tMacHattie,\n\t\t\t\t\t\t\tE,\n\t\t\t\t\t\tNaphtali,\n\t\t\t\t\t\t\tK,\n\t\t\t\t\t\tMiller,\n\t\t\t\t\t\t\tWC,\n\t\t\t\t\t\tElliott,\n\t\t\t\t\t\t\tS.\n\t\t\t\t\t\n          Pleasure ABLE: Sexual device manual for persons with disabilities.\n\t\t\t\t\tFunded Project: Disabilities Health Research Network;\n\t\t\t\t\t2009.\n\t\t\t\t\thttps:\/\/sci-bc-database.ca\/wp-content\/uploads\/PleasureABLE-Sexual-Device-Manual-for-PWD.pdf. 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wisdom","volume":"23","year":"2017","unstructured":"Alexander,\n\t\t\t\t\t\t\tM,\n\t\t\t\t\t\tCourtois,\n\t\t\t\t\t\t\tF,\n\t\t\t\t\t\tElliott,\n\t\t\t\t\t\t\tS,\n\t\t\t\t\t\tTepper,\n\t\t\t\t\t\t\tM.\n\t\t\t\t\t\n          Improving sexual satisfaction in persons with spinal cord injuries: Collective wisdom.\n\t\t\t\t\tTop Spinal Cord Inj Rehabil.\n\t\t\t\t\t2017;\n\t\t\t\t\t23(\n\t\t\t\t\t1):\n\t\t\t\t\t57\u2013\n\t\t\t\t\t70."},{"key":"i1082-0744-26-3-144-b11","series-title":"J Spinal Cord Med","first-page":"665","article-title":"Secondary conditions in a community sample of people with spinal cord damage","volume":"39","year":"2016","unstructured":"New,\n\t\t\t\t\t\t\tPW.\n\t\t\t\t\t\n          Secondary conditions in a community sample of people with spinal cord damage.\n\t\t\t\t\tJ Spinal Cord Med.\n\t\t\t\t\t2016;\n\t\t\t\t\t39:\n\t\t\t\t\t665\u2013\n\t\t\t\t\t670."},{"issue":"6","key":"i1082-0744-26-3-144-b12","series-title":"Am J Men 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Rehabil","first-page":"732","article-title":"Training rehabilitation team was in sexual healthcare: The description and evaluation of a multidisciplinary intervention","volume":"40","year":"2018","unstructured":"Pieters,\n\t\t\t\t\t\t\tR,\n\t\t\t\t\t\tKedde,\n\t\t\t\t\t\t\tH,\n\t\t\t\t\t\tBender,\n\t\t\t\t\t\t\tJ..\n\t\t\t\t\t\n          Training rehabilitation team was in sexual healthcare: The description and evaluation of a multidisciplinary intervention.\n\t\t\t\t\tDisabil Rehabil.\n\t\t\t\t\t2018;\n\t\t\t\t\t40(\n\t\t\t\t\t6):\n\t\t\t\t\t732\u2013\n\t\t\t\t\t739."},{"issue":"1","key":"i1082-0744-26-3-144-b29","series-title":"Top Spinal Cord Inj Rehabil","first-page":"49","article-title":"A multidisciplinary approach to sexual infertility rehabilitation: The sexual rehabilitation framework","volume":"23","year":"2017","unstructured":"Elliott,\n\t\t\t\t\t\t\tS,\n\t\t\t\t\t\tHocaloski,\n\t\t\t\t\t\t\tS,\n\t\t\t\t\t\tCarlson,\n\t\t\t\t\t\t\tM..\n\t\t\t\t\t\n          A multidisciplinary approach to sexual infertility rehabilitation: The sexual rehabilitation framework.\n\t\t\t\t\tTop Spinal Cord Inj Rehabil.\n\t\t\t\t\t2017;\n\t\t\t\t\t23(\n\t\t\t\t\t1):\n\t\t\t\t\t49\u2013\n\t\t\t\t\t56."},{"issue":"1","key":"i1082-0744-26-3-144-b30","series-title":"Curr Sexual Health Rep","first-page":"19","article-title":"Sexuality and physical disability: The disability affirmative approach to assessment and intervention within healthcare","volume":"7","year":"2015","unstructured":"Eisenberg,\n\t\t\t\t\t\t\tNW,\n\t\t\t\t\t\tAndreski,\n\t\t\t\t\t\t\tSR,\n\t\t\t\t\t\tMona,\n\t\t\t\t\t\t\tLR.\n\t\t\t\t\t\n          Sexuality and physical disability: The disability affirmative approach to assessment and intervention within healthcare.\n\t\t\t\t\tCurr Sexual Health Rep.\n\t\t\t\t\t2015;\n\t\t\t\t\t7(\n\t\t\t\t\t1):\n\t\t\t\t\t19\u2013\n\t\t\t\t\t29."},{"issue":"1","key":"i1082-0744-26-3-144-b31","series-title":"J Sex Educ Ther","first-page":"1","article-title":"The PLISSIT model: a proposed conceptual scheme for the behavioral treatment of sexual problems","volume":"2","year":"1976","unstructured":"Annon,\n\t\t\t\t\t\t\tJS.\n\t\t\t\t\t\n          The PLISSIT model: a proposed conceptual scheme for the behavioral treatment of sexual problems.\n\t\t\t\t\tJ Sex Educ Ther.\n\t\t\t\t\t1976;\n\t\t\t\t\t2(\n\t\t\t\t\t1):\n\t\t\t\t\t1\u2013\n\t\t\t\t\t15."},{"key":"i1082-0744-26-3-144-b32","series-title":"Sexual Disabil","first-page":"135","article-title":"The extended PLISSIT model for addressing the sexual well-being of individuals with an acquired disability or chronic illness","volume":"25","year":"2007","unstructured":"Taylor,\n\t\t\t\t\t\t\tB,\n\t\t\t\t\t\tDavis,\n\t\t\t\t\t\t\tS..\n\t\t\t\t\t\n          The extended PLISSIT model for addressing the sexual well-being of individuals with an acquired disability or chronic illness.\n\t\t\t\t\tSexual Disabil.\n\t\t\t\t\t2007;\n\t\t\t\t\t25:\n\t\t\t\t\t135\u2013\n\t\t\t\t\t139."},{"issue":"9","key":"i1082-0744-26-3-144-b33","series-title":"Am Psychol","first-page":"1000","article-title":"Disability culturally competent sexual healthcare","volume":"72","year":"2017","unstructured":"Mona,\n\t\t\t\t\t\t\tLR,\n\t\t\t\t\t\tCameron,\n\t\t\t\t\t\t\tRP,\n\t\t\t\t\t\tClemency Cordes,\n\t\t\t\t\t\t\tC..\n\t\t\t\t\t\n          Disability culturally competent sexual healthcare.\n\t\t\t\t\tAm Psychol.\n\t\t\t\t\t2017;\n\t\t\t\t\t72(\n\t\t\t\t\t9):\n\t\t\t\t\t1000\u2013\n\t\t\t\t\t1010."},{"key":"i1082-0744-26-3-144-b34","series-title":"Sexual Res Social Policy","first-page":"15","article-title":"The sexual lives of lesbian, gay, and bisexual people with disabilities: Psychological perspectives","volume":"4","year":"2007","unstructured":"Fraley,\n\t\t\t\t\t\t\tSS,\n\t\t\t\t\t\tMona,\n\t\t\t\t\t\t\tLR,\n\t\t\t\t\t\tTheodore,\n\t\t\t\t\t\t\tP..\n\t\t\t\t\t\n          The sexual lives of lesbian, 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application","volume":"35","year":"2012","unstructured":"Hess,\n\t\t\t\t\t\t\tMJ,\n\t\t\t\t\t\tHough,\n\t\t\t\t\t\t\tS..\n\t\t\t\t\t\n          Impact of spinal cord injury on sexuality: Broad-based clinical practice intervention and practical application.\n\t\t\t\t\tJ Spinal Cord Med.\n\t\t\t\t\t2012;\n\t\t\t\t\t35(\n\t\t\t\t\t4):\n\t\t\t\t\t211\u2013\n\t\t\t\t\t218."},{"key":"i1082-0744-26-3-144-b1","series-title":"Spinal Cord","first-page":"911","article-title":"Pharmacodynamics and effectiveness of topical nitroglycerin at lowering blood pressure during autonomic dysreflexia","volume":"55","year":"2017","unstructured":"Solinsky,\n\t\t\t\t\t\t\tR,\n\t\t\t\t\t\tBunnell,\n\t\t\t\t\t\t\tAE,\n\t\t\t\t\t\tLinsenmeyer,\n\t\t\t\t\t\t\tTA,\n\t\t\t\t\t\tSvircev,\n\t\t\t\t\t\t\tJN,\n\t\t\t\t\t\tEngle,\n\t\t\t\t\t\t\tA,\n\t\t\t\t\t\tBurnes,\n\t\t\t\t\t\t\tSP.\n\t\t\t\t\t\n          Pharmacodynamics and effectiveness of topical nitroglycerin at lowering blood pressure during autonomic dysreflexia.\n\t\t\t\t\tSpinal Cord.\n\t\t\t\t\t2017;\n\t\t\t\t\t55:\n\t\t\t\t\t911\u2013\n\t\t\t\t\t914."},{"key":"i1082-0744-26-3-144-b2","article-title":"Pleasure ABLE: Sexual device manual for persons with disabilities","year":"2009","unstructured":"Krassioukov,\n\t\t\t\t\t\t\tA,\n\t\t\t\t\t\tMacHattie,\n\t\t\t\t\t\t\tE,\n\t\t\t\t\t\tNaphtali,\n\t\t\t\t\t\t\tK,\n\t\t\t\t\t\tMiller,\n\t\t\t\t\t\t\tWC,\n\t\t\t\t\t\tElliott,\n\t\t\t\t\t\t\tS.\n\t\t\t\t\t\n          Pleasure ABLE: Sexual device manual for persons with disabilities.\n\t\t\t\t\tFunded Project: Disabilities Health Research Network;\n\t\t\t\t\t2009.\n\t\t\t\t\thttps:\/\/sci-bc-database.ca\/wp-content\/uploads\/PleasureABLE-Sexual-Device-Manual-for-PWD.pdf. Accessed September 5, 2019."},{"key":"i1082-0744-26-3-144-b3","article-title":"Defining sexual health: Report of a technical consultation on sexual health 2006","unstructured":"World Health Organization.\n          \n          Defining sexual health: Report of a technical consultation on sexual health 2006.\n\t\t\t\t\twww.who.int\/reproductivehealth\/topics\/sexual_health\/sh_definitions\/en\/. Accessed May 1, 2019."},{"issue":"8","key":"i1082-0744-26-3-144-b4","series-title":"JAMA","first-page":"765","article-title":"Sexual health in America: Improving patient and public health","volume":"314","year":"2015","unstructured":"Satcher\n              D\n            ,\n\t\t\t\t\t\tHookEW,\n\t\t\t\t\t\tColemanE.\n          Sexual health in America: Improving patient and public health.\n\t\t\t\t\tJAMA.\n\t\t\t\t\t2015;\n\t\t\t\t\t314(\n\t\t\t\t\t8):\n\t\t\t\t\t765\u2013\n\t\t\t\t\t766."},{"key":"i1082-0744-26-3-144-b5","series-title":"Practical Psychology in Medical Rehabilitation.","first-page":"287","article-title":"Assessment and treatment of sexual health issues in rehabilitation: A patient-centered approach","year":"2017","unstructured":"Carcieri\n              EM\n            ,\n\t\t\t\t\t\tMonaLR.\n          Assessment and treatment of sexual health issues in rehabilitation: A patient-centered approach.\n\t\t\t\t\tIn:\n\t\t\t\t\tBuddM,\n\t\t\t\t\t\tHoughS,\n\t\t\t\t\t\tWegenerS,\n\t\t\t\t\t\tStiersW.\n\t\t\t\t\t,\n\t\t\t\t\teds.\n\t\t\t\t\tPractical Psychology in Medical Rehabilitation.Switzerland:\n\t\t\t\t\tSpringer Nature;\n\t\t\t\t\t2017:\n\t\t\t\t\t287\u2013\n\t\t\t\t\t294."},{"key":"i1082-0744-26-3-144-b6","series-title":"Primer","first-page":"23","article-title":"Let\u2019s talk about sex: A survey of patients\u2019 preferences when addressing sexual health concerns in a family medicine residency program office","volume":"2","year":"2018","unstructured":"Ryan\n              KL\n            ,\n\t\t\t\t\t\tArbuckle-BernsteinV,\n\t\t\t\t\t\tSmithG,\n\t\t\t\t\t\tPhillipsJ.\n          Let\u2019s talk about sex: A survey of patients\u2019 preferences when addressing sexual health concerns in a family medicine residency program office.\n\t\t\t\t\tPrimer.\n\t\t\t\t\t2018;\n\t\t\t\t\t2:\n\t\t\t\t\t23."},{"key":"i1082-0744-26-3-144-b7","series-title":"Spinal Cord","first-page":"1203","article-title":"Recommendations for spinal rehabilitation professionals regarding sexual education needs and preferences of people with spinal cord dysfunction: A mixed-methods study","volume":"54","year":"2016","unstructured":"New\n              PW\n            ,\n\t\t\t\t\t\tSeddonM,\n\t\t\t\t\t\tRedpathC,\n\t\t\t\t\t\tCurrieKE,\n\t\t\t\t\t\tWarrenN.\n          Recommendations for spinal rehabilitation professionals regarding sexual education needs and preferences of people with spinal cord dysfunction: A mixed-methods study.\n\t\t\t\t\tSpinal Cord.\n\t\t\t\t\t2016;\n\t\t\t\t\t54:\n\t\t\t\t\t1203\u2013\n\t\t\t\t\t1209."},{"issue":"6","key":"i1082-0744-26-3-144-b8","series-title":"South Med J","first-page":"613","article-title":"Why doctors have difficulty with sex histories","volume":"83","year":"1990","unstructured":"Merrill,\n\t\t\t\t\t\t\tJM,\n\t\t\t\t\t\tLaux,\n\t\t\t\t\t\t\tLF,\n\t\t\t\t\t\tThornby,\n\t\t\t\t\t\t\tJI.\n\t\t\t\t\t\n          Why doctors 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issues for women with physical disabilities","volume":"15","year":"1997","unstructured":"Rintala,\n\t\t\t\t\t\t\tDH,\n\t\t\t\t\t\tHowland,\n\t\t\t\t\t\t\tCA,\n\t\t\t\t\t\tNosek,\n\t\t\t\t\t\t\tMA,\n\t\t\t\t\t\n          et al.\n\t\t\t\t\tDating issues for women with physical disabilities.\n\t\t\t\t\tSexual Disabil.\n\t\t\t\t\t1997;\n\t\t\t\t\t15:\n\t\t\t\t\t219\u2013\n\t\t\t\t\t242."},{"key":"i1082-0744-26-3-144-b22","series-title":"Violence Victims","first-page":"581","article-title":"Violence against women with physical disabilities","volume":"18","year":"2003","unstructured":"Milberger,\n\t\t\t\t\t\t\tS,\n\t\t\t\t\t\tIsrael,\n\t\t\t\t\t\t\tN,\n\t\t\t\t\t\tLeRoy,\n\t\t\t\t\t\t\tB,\n\t\t\t\t\t\n          et al.\n\t\t\t\t\tViolence against women with physical disabilities.\n\t\t\t\t\tViolence Victims.\n\t\t\t\t\t2003;\n\t\t\t\t\t18:\n\t\t\t\t\t581\u2013\n\t\t\t\t\t590."},{"key":"i1082-0744-26-3-144-b23","series-title":"Arch Phys Med Rehabil","first-page":"107","article-title":"Sexual 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application","volume":"35","year":"2012","unstructured":"Hess,\n\t\t\t\t\t\t\tMJ,\n\t\t\t\t\t\tHough,\n\t\t\t\t\t\t\tS..\n\t\t\t\t\t\n          Impact of spinal cord injury on sexuality: Broad-based clinical practice intervention and practical application.\n\t\t\t\t\tJ Spinal Cord Med.\n\t\t\t\t\t2012;\n\t\t\t\t\t35(\n\t\t\t\t\t4):\n\t\t\t\t\t211\u2013\n\t\t\t\t\t218."}],"container-title":["Topics in Spinal Cord Injury 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