Abstract

Combat-related spinal cord injuries (SCIs) pose long-term challenges that extend beyond physical rehabilitation. These injuries disrupt not only motor and sensory function but also the most intimate domains of human experience—sexuality, identity, and relational connection. While advances in trauma surgery and polytrauma care have improved survivability, providers often overlook the profound effect of SCI on sexual health and spousal intimacy. This article explores a real-world case of marital strain following paralysis and outlines a structured, ethical, and clinically informed approach to restoring intimacy in military couples, urging providers to integrate these considerations into comprehensive rehabilitative care.

Introduction

Military medicine has rightfully focused much of its effort on restoring functional independence after spinal cord injury, particularly following combat operations involving explosive ordnance. Yet the domains of intimacy, sexuality, and spousal identity—essential components of holistic recovery—often remain unaddressed or are deferred until the patient expresses distress. This reactive model fails to serve the emotional and relational complexity faced by veterans and their partners.

The estimated prevalence of sexual dysfunction in male veterans with SCI is as high as 90%, with accompanying declines in quality of life and marital satisfaction [1]. Among military spouses, caregiver role strain often supplants the intimate partner dynamic, leaving both individuals isolated in their grief and disconnected in their roles [2].

Sexual health is not optional—it is foundational to human connection, purpose, and healing. For our veterans and their families, it must be treated as such.