Applying an Occupational Lens to Thinking About and Addressing Sexuality

  • Claire LynchEmail author
  • Tracy Fortune
original paper


A person’s sexuality exerts a powerful influence on their needs, desires, roles, social relationships and personal identity. This study, explored occupational therapists’ reasoning and practice in relation to the work they do (or do not do) with clients for whom sexual expression has become problematic. The lens used to explore reasoning and practice was a key conceptual framework adopted by occupational therapists, the occupational perspective of health, which considers humans need to do, be, become and belong. Using a qualitative, phenomenographic approach, 16 occupational therapists from across Australia were interviewed to understand the qualitatively variable ways in which they reasoned about practice in relation to the sexual needs of their clients. Four related, layers of ‘conception’ are presented. At a foundational level, we describe how participants conceived of their practice role in relation to assisting people in the doing aspect of sex(uality). At the next, more complex level, participants appeared to conceive of practice in relation to their clients’ being as a sexual person. The next conception related to how therapists think about their clients in their becoming as a sexual being and finally, in their belonging as a sexual being. These conceptual categories, derived both theoretically and empirically are presented as a hierarchically aligned framework, the occupational perspective of sexuality (OPS). While generated from a study of occupational therapists’ reasoning, the OPS has potential to enable a broader, more holistic consideration of sexuality, assisting health care professionals and educators to better understand the ways in which they may address their clients’ needs to do, be, become and belong to their sexuality.


Sexuality Sex Sexual identity Occupation Occupational perspective Relationships Sexual function Australia 



This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Standards

All research procedures reported in this thesis were approved by the La Trobe University Faculty of Health Sciences Human Ethics Committee. No. FHEC 14/209.


  1. 1.
    Parker, M.G., Yau, M.K.: Sexuality, identity and women with spinal cord injury. Sex. Disabil. 30, 15–27 (2012)CrossRefGoogle Scholar
  2. 2.
    Weeks, J.: Sexuality. Routledge, London (2003)Google Scholar
  3. 3.
    Sakellariou, D., Algado, S.S.: Sexuality and disability: a case of occupational injustice. Br. J. Occup. Ther. 69(2), 69–76 (2006)CrossRefGoogle Scholar
  4. 4.
    Hajjar, R.R., Kamel, H.K.: Sexuality in the nursing home, part 1: attitudes and barriers to sexual expression. J. Am. Med. Dir. Assoc. 5(2 Suppl), S42 (2004)CrossRefGoogle Scholar
  5. 5.
    Lever, S., Pryor, J.: The impact of stroke on female sexuality. Disabil. Rehabil. 39, 1–10 (2016)Google Scholar
  6. 6.
    Couldrick, L.: Sexual issues: an area of concern for occupational therapists? Br. J. Occup. Ther. 61(11), 493–496 (1998)CrossRefGoogle Scholar
  7. 7.
    Hyland, A., McGrath, M.: Sexuality and occupational therapy in Ireland: a case of ambivalence? Disabil. Rehabil. 35(1), 73–80 (2013)CrossRefGoogle Scholar
  8. 8.
    Chance, R.S.: To love and be loved: sexuality and people with physical disabilities. J. Psychol. Theol. 30(3), 195–208 (2002)CrossRefGoogle Scholar
  9. 9.
    Ostrander, N.: Sexual pursuits of pleasure among men and women with spinal cord injuries. Sex. Disabil. 27, 11–19 (2009)CrossRefGoogle Scholar
  10. 10.
    Vansteenwegen, A., Jans, I., Revell, A.T.: Sexual experiences of women with a physical disability: a comparative study. Sex. Disabil. 21, 283–290 (2003)CrossRefGoogle Scholar
  11. 11.
    Areskoug-Josefsson, K., Thidell, F., Rolander, B., Ramstrand, N.: Prosthetic and orthotic students’ attitudes toward addressing sexual health in their future profession. Int. Soc. Prosthet. Orthot. 00, 1–8 (2018)Google Scholar
  12. 12.
    Schmitz, M.A., Finkelstein, M.: Perspectives on poststroke sexual issues and rehabilitation needs. Top Stroke Rehabil. 17, 204–213 (2010)CrossRefGoogle Scholar
  13. 13.
    Beckwith, A., Yau, M.: Sexual recovery: experiences of women with spinal injury reconstructing a positive sexual identity. Sex. Disabil. 31, 313–324 (2013)CrossRefGoogle Scholar
  14. 14.
    Sakellariou, D., Sawada, Y.: Sexuality after spinal cord injury: the Greek male’s perspective. Am. J. Occup. Ther. 60(3), 311–319 (2006)CrossRefGoogle Scholar
  15. 15.
    Bergan-Gander, R., Von Kürthy, H.: Sexual orientation and occupation: gay men and women’s lived experiences of occupational participation. Br. J. Occup. Ther. 69, 402–408 (2006)CrossRefGoogle Scholar
  16. 16.
    Wilcock, A.A.: Reflections on doing, being and becoming. Aust. Occup. Ther. J. 46(1), 1–11 (1999)CrossRefGoogle Scholar
  17. 17.
    Klinger, L.: Occupational adaptation: perspectives of people with traumatic brain injury. J. Occup. Sci. 12(1), 9–16 (2005)CrossRefGoogle Scholar
  18. 18.
    Wilcock, A.A.: An occupational perspective of health. Slack Incorporated, Thorofare, NJ (2006)Google Scholar
  19. 19.
    Wilcock, A.A.: Occupation and health: are they one and the same? J. Occup. Sci. 14, 3–8 (2007)CrossRefGoogle Scholar
  20. 20.
    Hitch, D., Pepin, G., Stagnitti, K.: In the footsteps of Wilcock, part two: the interdependent nature of doing, being, becoming, and belonging. Occup. Ther. Health Care 28(3), 247–263 (2014)CrossRefGoogle Scholar
  21. 21.
    Bowden, J.: The nature of phenomenographic research. In: Bowden, J., Walsh, E. (eds.) Phenomenography. RMIT University Press, Melbourne (2000)Google Scholar
  22. 22.
    Svensson, L.: Theoretical foundations of phenomenography. High. Educ. Res. Dev. 16(2), 159–171 (1997)CrossRefGoogle Scholar
  23. 23.
    Penna, S., Sheehy, K.: Sex education and schizophrenia: should occupational therapists offer sex education to people with schizophrenia? Scand. J. Occup. Ther. 7(3), 126–131 (2000)CrossRefGoogle Scholar
  24. 24.
    Kingsley, P., Molineux, M.: True to our philosophy? Sexual orientation and occupation. Br. J. Occup. Ther. 63(5), 205–210 (2000)CrossRefGoogle Scholar
  25. 25.
    McGrath, M., Lynch, E.: Occupational therapists’ perspectives on addressing sexual concerns of older adults in the context of rehabilitation. Disabil. Rehabil. 36(8), 651–657 (2014)CrossRefGoogle Scholar
  26. 26.
    Marton, F., Carlsson, M., Halasz, L.: Differences in understanding and the use of reflective learning in reading. Br. J. Educ. Psychol. 62(1), 1–16 (1992)CrossRefGoogle Scholar
  27. 27.
    Säljö, R.: Talk as data and practice: a critical look at phenomenographic inquiry and the appeal to experience. High. Educ. Res. Dev. 16(2), 173–190 (1997)CrossRefGoogle Scholar
  28. 28.
    González, C.: What do university teachers think elearning is good for in their teaching? Stud. High. Educ. 35, 61–78 (2010)CrossRefGoogle Scholar
  29. 29.
    Dahlgren, L.O., Fallsberg, M.: Phenomenography as a qualitative approach in social pharmacy research. J. Soc. Adm. Pharm. 8(4), 150–157 (1991)Google Scholar
  30. 30.
    Chapparo, C., Ranka, J.L.: Occupational performance model. Occupational Performance Network, Sydney (1997)Google Scholar
  31. 31.
    Mahar, A., Cobigo, V., Stuart, H.: Conceptualizing belonging. Disabil. Rehabil. 35(12), 1026–1032 (2013)CrossRefGoogle Scholar
  32. 32.
    Hammell, K.W.: Quality of life, participation and occupational rights: a capabilities perspective. Aust. Occup. Ther. J. 62(2), 78–85 (2015)CrossRefGoogle Scholar
  33. 33.
    Marton, F., Booth, S.: Learning and awareness. Lawrence Erlbaum Associates, New Jersey (1997)Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Australian Catholic UniversityMelbourneAustralia
  2. 2.La Trobe UniversityMelbourneAustralia

Personalised recommendations