Sexual Self-Image


This chapter will cover the effect of spinal cord injury on self-confidence and self-esteem. It will provide you with suggestions on how to begin the process of redefining your sexual self.



Now that I have a spinal cord injury, I’ll never feel sexy again.


It may take some work, but you CAN feel sexy again.

What Is It?

Gila Shipiro (a psychotherapist and certified sex therapist) defines sexual self-esteem as “the feelings you have about your body and your confidence level in how you relate intimately to someone else. It’s what you bring of yourself, both emotionally and physically, to sex and relationships — what you do with that and how you share that with someone else. Sexual self-esteem affects every sexual choice you make.”

Sexuality can be influenced by many things, as illustrated in the image below.

What’s Different Now?

Typically, people don’t think about how they developed their sense of sexuality, it just happens through your lived experience. Most people don’t realize the importance of the different components that shape your own identity until a major life event happens. This event can impact things such as not being able to go to your favourite restaurant because it is inaccessible, not being able to hug your kids or your partner because of limited arm function, not being able to go back to the same job and feeling like you can’t provide for your family, or even just looking in the mirror and seeing a different body than you are used to seeing.

After a spinal cord injury you may experience some of these changes and ask yourself “who am I now?”. This is a very common question and can lead to moments of feeling sad, lonely, depressed, frustrated, and you may worry that your sex life is over. This can have an impact on your confidence and cause uncertainty in how you feel about yourself in relation to sex.


“Sex is what we do and sexuality is who we are”

What Can I Do?

Finding things that give you control of your life and give you a sense of accomplishment, purpose, responsibility, and routine can help boost your confidence and motivation. This means finding a reason to get up and get out into the world every day. This can include a hobby, a job, a volunteer role, schooling, an exercise program, social activities, whatever you want!

Once you are a little more confident, you will naturally become more curious about what’s possible and may become more open to trying different things. Positive experiences can help build your confidence further. Exploring your sexuality is a step by step process—here are some exercises and resources that can help you along the way.

Mindfulness & Sensate Focus
Sex Education
Peer Interaction



Sexual Self-Esteem video

What Do I Need To Know?

The path everyone takes will look different and everyone will build their confidence in their own way. Finding the resources that are available to you in your area and how to access them is an important place to begin. Here’s a start:

Spinal Cord Injury BC, Alberta, Manitoba, Saskatchewan, Ontario, PEI, Newfoundland, Nova Scotia

My Role

The process of regaining your sexual self-view, self-confidence, and boosting your self-esteem can seem very overwhelming at the beginning. These feelings are common especially soon after injury. To gain a better understanding of yourself and get back in touch with yourself takes time, a sense of openness, and support from peers, family, friends and health care professionals. But ultimately, no one can do this for you — it’s up to you to start the process.

Who Can Help Me?

Sexual Health Rehabillitation Service, SCI BC, peers, friends, family, counsellors, psychologists, other health care professionals


A Course on Sexuality and SCI


Redefining you sexual self after spinal cord injury can be a challenge. However, spinal cord injury does not limit your ability to be a sexual person. Despite your physical changes, it’s important to remember that sexuality comes from within. This process can often take a long time and can involve taking some risks and pushing yourself outside your comfort zone. You will likely experience mishaps, fumbling, setbacks, or disappointments along the way but keep in mind that risks often come with rewards! This is part of the journey towards growth and regaining a better sense of yourself.

Sexual Self-Image Resources

Peer Stories

SexAbility video - Stories about dating, intimacy and sex from couples living with SCI.

How I Overcame the Stigma of my Wheelchair - Man Repeller blog.

Blogs and Art

Access sex I-III photo series - photographer Kyla Harris' interpretation of sexuality after SCI.

Finding My Sexy Voice - Kristina Sheldon, SCI BC blog.

Mobile Women - an online support group for women with disabilities.

Clinical Resources

Depression: What Should You Know - Guide by the Consortium for Spinal Cord Medicine (USA).


Regain That Feeling: Secrets to Sexual Self-Discovery - Dr. Mitchell S. Tepper.


Sex After SCI: Sexual Self-Esteem - Spinal Cord Injury Research Evidence.

Confidence and Self-Esteem - Sexuality After SCI.

Check out our Video Playlist for this chapter!


Check out the video playlist for this chapter!