Abstract Introduction Spinal cord injury (SCI) entails physical, psychological, and social consequences that profoundly affect individuals’ daily functioning and their experience of sexuality. As a key dimension of well-being and quality of life, sexuality is often undervalued in clinical rehabilitation. Despite the high prevalence of sexual dysfunction following SCI, evidence shows that sexual satisfaction is more strongly influenced by psychological, relational, and social factors than by biomedical variables alone. Considering the human right to sexual health and the World Health Organization’s recognition of sexual health as central to overall health, it becomes essential to understand the biopsychosocial determinants of sexual well-being in this population. Objective This study aims to: 1) Assess the perceptions of people with spinal cord injury (SCI) regarding their sexuality; 2) Uncover the influence of biological (sex, age), medical (level, extent, and duration of injury), psychological (sexual distress, psychological flexibility, body image), relational (relational satisfaction), and social (ableism) factors on sexual functioning and satisfaction in SCI; 3) Explore the role of sexual functioning and satisfaction in quality of life. Methods A mixed-methods, cross-sectional design is being implemented, using a non-probabilistic convenience sample. Inclusion criteria: adults (≥18 years) with acquired SCI for at least one year, residing in Portugal, able to read and write in Portuguese. Exclusion criteria: moderate to severe psychopathological symptoms, cognitive impairment, or inability to provide informed consent. The qualitative study includes semi-structured interviews with at least 15 participants to explore experiences of sexuality and ableism. Data will be transcribed verbatim and analysed through reflexive thematic analysis (Braun & Clarke, 2021). The quantitative study involves a minimum of 120 participants completing an online survey (Qualtrics) with validated Portuguese measures of sexual distress (SDI-R), psychological flexibility (AAQ-II), body image (BIS), relational satisfaction (GMREL), sexual functioning (FSFI/IIEF-15), sexual satisfaction (GMSEX), and quality of life (WHOQOL-BREF). Statistical analyses will include descriptive statistics, Pearson’s correlations, and hierarchical linear regressions to test the predictive contribution of biopsychosocial factors to sexual satisfaction and quality of life. Results The data collection and analysis are currently ongoing. Psychosocial and relational variables are expected to play a more significant role in predicting sexual satisfaction and quality of life than biomedical factors. Conclusions By adopting a biopsychosocial perspective, this research contributes to a deeper understanding of sexuality and quality of life in people with SCI. Beyond its scientific contribution, the project is anticipated to generate meaningful clinical, social, and policy implications: Clinical: promotion of lifelong sexual health and well-being, and development of evidence-based sexual education and intervention programmes tailored to the needs of people with SCI. Social: advancement of social inclusion by reducing stigma and ableism surrounding sexuality and disability. Policy: integration and valorisation of sexuality within public health and social policies addressing a growing and often stigmatised population. The study’s findings are expected to inform clinical practice, guide inclusive health policies, and foster the development of interventions that recognise sexuality as a fundamental component of human dignity and well-being. Disclosure No
Coelho et al. (Mon,) studied this question.