Sex as an ADL
There are many forms of sexual expression which include actions such as kissing, hugging, and intercourse. Sexual activity occurs across the adult lifespan and may be with an intimate partner or with oneself. Engagement is often a positive experience; however, occupational therapy practitioners must consider any negative or traumatic sexual experiences of their clients.
Sexual activity & sexuality
Although engagement in occupations is generally considered a positive outcome of the occupational therapy process, it is important to consider that a client’s history might include negative, traumatic, or unhealthy occupational participation (Robinson Johnson & Dickie, 2019).
For example, a person who has experienced a traumatic sexual encounter might negatively perceive and react to engagement in sexual intimacy. In addition, some occupations that are meaningful to a client might also hinder performance in other occupations or negatively affect health.
Sexual activity should not be confused with sexuality and gender identity which may include personal factors like sexual orientation, preference, and sexual identity.
AOTA practice resources
Use AOTA's resources on sexual activity for your practice.
Occupational Therapy Practice Framework: Domain and Process—Fourth Edition
Gender Affirming Language
Caring for transgender and gender diverse individuals: ADLs and IADLs
Sexuality and Intimacy
Research on sexual activity
Stay up to date on research for your practice. Check out the latest book on sexuality edited by Kathryn Ellis and Joseph Christian Ungco, which provides a comprehensive and holistic occupational therapy approach to sexuality on practices related to sexual occupations.
Addressing Sex in Occupational Therapy: A Coconstructed Autoethnography
In this article, the authors explore how occupational therapy does or could address sex and sexuality through the use of a coconstructed autoethnography.
Sexual Activity of Young Adults With Cerebral Palsy
The knowledge gained from this study, including the diversity of sexual activities, gender identities, sexual orientations, and relationships of young adults with CP, can be used in practice by occupational therapists and other professionals.
Effects of Chronic Neurological Conditions on Sexual Activity Participation, Satisfaction, and Quality of Life
This study explores the impact of chronic neurological conditions (stroke and Parkinson’s disease) on sexual activity participation, satisfaction, and quality of life and seeks to better understand current practice regarding communication with health care providers.
Addressing OT Practitioners’ Knowledge and Attitudes About Older Adult Sexual Health and Sexual Activity Through Continuing Education
This research study investigates to what extent education in older adult sexual matters affects OT practitioners’ knowledge, attitudes, and clinical practice in the Occupational Therapy Practice Framework: Domain and Practice (4th ed.) activity of daily living of sexual activity.
Sexuality Post–Spinal Cord Injury
The impairments associated with spinal cord injury (SCI) can impact participation in ADLs and personal relationships (Tonack et al., 2008).
Sexuality and intimate relationships in a psychiatric rehabilitation program
Occupation-based groups, focused on relationships and intimacy, are appropriate for the mental health population as they can address relevant ADLs and IADLs while providing access to sexual health education.
Sexual Health: Addressing Identity, Expression, and Function in Occupational Therapy Practice
The occupational therapy profession aims to uphold the values of holistic, client-centered care that supports individuals engaging in a full range of meaningful occupations.
We’re old enough to be your parents!” How to make everyone comfortable talking about sex
This article explores working with older couples about their sexual issues related to erectile dysfunction and easing their concerns when interacting with younger practitioners.
The OPISI also serves as an excellent educational resource to inform practitioners, consumers, physicians, other professionals, and the public about the distinct role and scope of occupational therapy practice in this area.
The Occupational Performance Inventory of Sexuality and Intimacy (OPISI)
The OPISI (Oh-Pee-Zee) includes a screening tool, an in-depth self-assessment, and a performance measure related to the complex occupational nature of sexuality and intimacy.
The OPISI is based on the Occupational Therapy Sexual Assessment Framework (OTSAF) and comprehensively addresses and measures performance across five categories of occupation (Sexual Activity, Sexual Expression, Intimacy, Sexual Health, and Family Planning) and four client factors (Sexual Knowledge, Sexual Self-View, Sexual Interest, and Sexual Response).
Available for free download with user registration, the OPISI is currently offered in English and German (OPISI-DE), with French (OPISI-FR), Spanish (OPISI-SP), and Italian (OPISI-IT) versions coming soon. Used with permission from Beth Ann Walker, PhD, MS, OTR, FAOTA, University of Indianapolis.
Standards of Practice
The Standards of Practice for Occupational Therapy provides requirements for occupational therapy practitioners for the delivery of occupational therapy services addressing physical, cognitive, psychosocial, sensory-perceptual, and other aspects of clients' performance in a variety of contexts to support their engagement in occupations that affect physical and mental health, well-being, and quality of life (AOTA, 202).
Explore continuing education courses on sex as an occupation
Stay connected with networking & professional opportunities
Communities of Practice allow AOTA members to network and expand their knowledge in a social learning environment. Connect with the Communities of Practice to further explore specific topics that address the needs of clients across the lifespan.
Resource
American Occupational Therapy Association, Inc.
The American Journal of Occupational Therapy, 2021, Vol. 75(Supplement_3), 7513410030.
https://doi.org/10.5014/ajot.2021.75S3004
Robinson Johnson, K., & Dickie, V. (2019). What is occupation? In B. A. B. Schell & G. Gillen (Eds.), Willard and Spackman’s occupational therapy (13th ed., pp. 320–333). Philadelphia: Wolters Kluwer.