There is a growing body of SCI literature on aspects of sexuality beyond genital sexual functioning and fertility. A large scale (350 respondents over 4 European countries) cross-sectional questionnaire identified sexual activity as the area of greatest unmet need for persons with SCI (Kennedy 2006). This is even more disconcerting given the importance placed on sexuality by men and women with SCI (Anderson 2004). Sexual rehabilitation is recognized as an important component of the overall rehabilitation program for patients with SCI; however, retrospective studies identify a gap between services desired by patients and the services actually provided (White et al. 1993; McAlonan 1996; Tepper 1999). As far back as 1982, Schuler compared five sexual rehab programs for persons with SCI, and urged clinicians to evaluate the sexual rehab services provided (Schuler 1982)

Few intervention trials exist in this area, but a number of observational studies offer insight into post-injury sexual adjustment in terms of sexual behaviour and sexual satisfaction, as to what factors are perceived as contributing to or hindering sexual satisfaction. A summary of these findings follows.