The impact of acquired communication impairments on sexuality and intimacy: A scoping review.

The search terms required studies to mention communication, which likely excluded many sexuality studies that ignored communication barriers entirely, thus underestimating the total number of studies that exclude people with communication impairments. The review is descriptive (scoping) and does not evaluate the quality of the included studies or provide effect sizes for interventions. The literature is heavily skewed toward aphasia; there is almost no data on the sexual impacts of other acquired communication disorders like dysarthria or apraxia. Many studies did not report key demographics such as age, gender identity, or relationship structure, limiting the generalizability of the findings to diverse populations.

The first author is a certified member of the American Association of Sexuality Educators, Counselors, and Therapists and has given talks on the topic. The last author has ongoing grants from the Stroke Foundation and the Agency for Innovation NSW for sexuality research and is an author of e-learning modules for the Stroke Foundation.

Do not assume that general guidelines for discussing sexuality after stroke apply directly to patients with aphasia. The review shows that most existing research excludes people with communication impairments, so the 'standard' evidence base may not reflect the specific intimacy barriers your aphasic patients face.