Sex, spinal cord injuries, and queerness: Critical narrative review of sexual experiences of Queer people with vaginas who have spinal cord injuries

Abstract

The experiences of straight, cisgender “women” constitute nearly all of the research on sex and sexuality in people with vaginas (PWV) who also have spinal cord injuries (SCI). This critical narrative review aims to explore the sexual experiences of Queer people with SCI, particularly Queer PWV, an underrepresented group in existing literature. PWV who have partially or completely severed SCI can experience sexual arousal through both bottom-up and top-down neural processing pathways. Pleasure is defined similarly among Queer and non-Queer PWV. However, Queer self-identifying women experience more sexual satisfaction with self-stimulation than non-Queer PWV, and self-identified lesbians experience greater sexual satisfaction. Higher rates of sexual satisfaction for Queer PWV can be explained in part by the expectation of partnered orgasm, depth of cognitive and behavioral engagement in sexual activity, less incongruities in reading body language cues, and a congruent conception of the factual influences on sexual arousal, compared to heterosexual PWV. The outcome of internalized homophobia on sexual activity ranged from avoiding sexual activity to engaging in sexual activity under the influence, with both commonly leading to a mental disconnect between the brain and the body. This mental disconnect impacted the ability for a person to communicate their needs with a partner, as well as the ability to reach orgasm. Lastly, this narrative review serves as a reminder that ableist, patriarchal, and heteronormative epistemologies must evolve to better capture the experiences of diverse populations.