Abstract Sexual expression is a key component of physical and psychological well-being, yet people with physical disabilities (PwD), particularly those living in nursing homes, often face significant barriers in this regard. Despite increasing attention to disability and sexuality, research on this population within institutional settings remains limited. This exploratory qualitative study aimed to identify and understand the barriers to sexual expression experienced by adults with physical disabilities residing in nursing homes. Eighteen participants (mean age = 53 years, SD = 6.8) living in residential care facilities in Spain were interviewed. Half of the participants were men, most were single (72.2%), and participants presented both congenital and acquired disabilities, several involving severe functional limitations. Thematic analysis revealed multiple and interrelated barriers operating across different ecological levels. At the microlevel, participants described barriers related to functional loss, body image, self-esteem, and difficulties discussing sexuality. At the mesolevel, barriers emerged from family overprotection, professionals’ attitudes, institutional routines, and lack of privacy within residential settings. At the macrolevel, participants identified broader social stigma, infantilization, and cultural taboos surrounding disability and sexuality. The findings highlight the need to re-evaluate residential care models through rights-based and person-centered approaches that recognize sexual expression as an important dimension of well-being and dignity. Although the findings cannot be generalized to all PwD living in nursing homes, they are consistent with growing evidence regarding the persistence of structural, attitudinal, and organizational barriers affecting sexuality in institutional contexts.
Atencia et al. (Thu,) studied this question.