Assistive technology for sexuality

People with a spinal cord injury (SCI) may need support or modifications to engage in sexual activity, such as assistance with positioning or the use of pleasure aids. Health professionals can play a key role in supporting sexuality by assessing functional abilities, helping individuals understand their options, assess what is safe and practical, and explore what might work for them.

Health professional role

A health professional’s assessment may consider the following: 

  • Safety: Ensure any positioning or pleasure devices are used correctly according to manufacturer guidelines.
  • Device use: Consider how the person will prepare, apply, and remove devices.
  • Physical capacity: Look at hand function, trunk stability, sitting and/or standing balance, bed mobility and transfer ability. This helps identify risks such as falls or challenges using equipment.
  • Funding: Some people may be eligible for support through funding bodies or insurers to assist with professional assessments, assistive devices or modifications.   

Positioning aids 

Health professionals can recommend positioning supports based on the person’s physical abilities and their goals for sexual activity. Common options include:

  • Pillows or foam wedges
  • Electric bed features (e.g., head lift)
  • Wheelchair tilt or seat elevation
  • Straps for stabilising the legs or pelvis
  • Customised chairs with features to support positioning, movement or stability
  • Tip: Air mattresses are often unsuitable for sexual activity due to their instability. Encourage use of firmer, more supportive surfaces, while considering the risk to skin integrity on a firmer surface.

Wheelchair features 

If a person chooses to stay in their wheelchair during sexual activity, discuss simple safety strategies, such as:

  • Checking the weight limits for the wheelchair, cushion, and any attachments such as back supports or tilt mechanisms
  • Using anti-tip bars
  • Turning off the power on power wheelchairs
  • Positioning the wheelchair next to a wall or stable furniture for added support
  • Using the tilt feature for positioning
  • Removing armrests for better positioning

Sexual aids or pleasure devices 

Health professionals can provide information on the range of sexual aids that can assist with stimulation and pleasure, such as those available for viewing on the National Equipment Database (AskNED). When supporting someone with SCI, explore:

  • Control: Does the person want to operate the device themselves, or have a partner assist?
  • Power source: Battery-powered devices are usually lighter, while rechargeable ones often run longer.
  • Accessibility: Can the person hold and operate the device? Do they need help positioning it safely or turning it on and off?

Vibrator use

When discussing vibrators, consider:

  • The person’s hand function and how they will control or hold the device
  • Whether the device can be worn, strapped, propped, or supported in place safely
  • The level of sensation they have, and the intensity of vibration needed

Resources

Sexual aids
National Equipment Database (AskNED)

Adaptive devices – sexuality after SCI
Mount Sinai Hospital

pleasureABLE sexual device manual for persons with disabilities
MacHattie et al, Disabilities Health Research Network

The MA+ guide: a guide to more accessible sexuality-related assistive technology
Narelle Higson, the Multiple Sclerosis Society of Western Australia

Assistive tech unveiled: solutions for enhanced bedroom pleasure
Spinal Cord Injuries Australia (SCIA)

Understanding sexual dysfunction in spinal cord injury
Mens Health Downunder

The use of vibrators and clitoral stimulators
Mens Health Downunder

Sexual positions for women with paralysis: creativity, adaptability and sense of humour
Dr Mitchell Tepper, Regain That Feeling

SCI sexual health
Spinal Cord Injury British Colombia (SCI BC)

Sexuality following spinal cord injury
State of New South Wales Agency for Clinical Innovation (NSW ACI)

Sexuality and reproductive health in adults with spinal cord injury: what you should know
Consortium for Spinal Cord Medicine

Sexual and reproductive health following spinal cord injury
SCIRE Professional: Spinal Cord Injury Research Evidence

Social work and psychosexual therapy resources
Care Rehab

References

Agency for Clinical Innovation. (2017). Fertility following spinal cord injury. NSW Government. https://aci.health.nsw.gov.au/__data/assets/pdf_file/0006/600855/ACI-Fertility-following-spinal-injury.pdf

Agency for Clinical Innovation. (2014). Sexuality following spinal cord injury: A guideline for health professionals. NSW Government. https://aci.health.nsw.gov.au/__data/assets/pdf_file/0004/349051/ACI-Spinal-sexuality-guideline.pdf

Alexander, M., Courtois, F., Elliott, S., & Tepper, M. (2017). Improving Sexual Satisfaction in Persons with Spinal Cord Injuries: Collective Wisdom. Topics in spinal cord injury rehabilitation, 23(1), 57-70. https://doi.org/10.1310/sci2301-57

Australian Government Department of Health and Aged Care. (n.d.). About sexual health. Retrieved May 24, 2025, from https://www.health.gov.au/topics/sexual-health/about

Bryant, C., Aplin, T., & Setchell, J. (2022). Sexuality Support After Spinal Cord Injury: What is Provided in Australian Practice Settings? Sexuality and Disability, 40(3), 409-423. https://doi.org/10.1007/s11195-022-09756-w

Bryant, C., Gustafsson, L., Aplin, T., & Setchell, J. (2021). Supporting sexuality after spinal cord injury: A scoping review of non-medical approaches. Disabil Rehabil, 44(19):5669-5682. https://doi.org/10.1080/09638288.2021.1937339 

Earle, S., O’Dell, L., Davies, A., & Williams, R. (2020). Views and experiences of sex, sexuality and relationships following spinal cord injury: A systematic review and narrative synthesis of the qualitative literature. Sexuality and Disability, 38(4), 567–595. https://doi.org/10.1007/s11195-020-09653-0

Elliott, S., Hocaloski, S., & Carlson, M. (2017). A Multidisciplinary Approach to Sexual and Fertility Rehabilitation: The Sexual Rehabilitation Framework. Topics in spinal cord injury rehabilitation, 23(1), 49-56. https://doi.org/10.1310/sci2301-49

Elliott, S., & Querée, M. (2018). Sexual and reproductive health following spinal cord injury. In J. J. Eng, R. W. Teasell, W. C. Miller, D. L. Wolfe, A. F. Townson, J. T. C. Hsieh, S. J. Connolly, V. K. Noonan, E. Loh, S. Sproule, A. McIntyre, & M. Querée (Eds.), Spinal cord injury rehabilitation evidence (Version 6.0, pp. 1–133). SCIRE Project. https://scireproject.com/wp-content/uploads/2022/04/SCIRE-Sexual-Health-Version-6-chapter_Nov.23.18-v.FINAL-2.pdf

Lynch, C., & Fortune, T. (2019). Applying an Occupational Lens to Thinking About and Addressing Sexuality. Sexuality and Disability, 37(2), 145-159. https://doi.org/10.1007/s11195-019-09566-7

Henke, A. M., Billington, Z. J., & Gater, D. R., Jr (2022). Autonomic Dysfunction and Management after Spinal Cord Injury: A Narrative Review. Journal of personalized medicine, 12(7), 1110. https://doi.org/10.3390/jpm12071110

Paralyzed Veterans of America. (2012). Sexuality and reproductive health in adults with spinal cord injury: A clinical practice guideline for health care professionals. https://pva.org/wp-content/uploads/2021/09/sexuality-consumer-cpg-2012.pdf

Parker, M. G., & Yau, M. K. (2012). Sexuality, Identity and Women with Spinal Cord Injury. Sexuality and Disability, 30(1), 15-27. https://doi.org/10.1007/s11195-011-9222-8

Taylor, B., Davis, S. The Extended PLISSIT Model for Addressing the Sexual Wellbeing of Individuals with an Acquired Disability or Chronic Illness. Sex Disabil 25, 135–139 (2007). https://doi.org/10.1007/s11195-007-9044-x

World Health Organization. (n.d.). Sexual health. Retrieved May 24, 2025, from https://www.who.int/health-topics/sexual-health#tab=tab_2