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There is a growing body of SCI literature on aspects of sexuality beyond genital sexual functioning and fertility. A large-scale (350 respondents over 4 European countries) cross-sectional questionnaire identified sexual activity as the area of greatest unmet need for persons with SCI (Kennedy et al. 2006). This is even more disconcerting given the importance placed on sexuality by men and women with SCI (Anderson 2004). Few intervention trials exist in this area, but a number of observational studies offer insight into post-injury sexual adjustment in terms of sexual behaviour and sexual satisfaction, including what factors are perceived as contributing to or hindering sexual satisfaction. A summary of these findings follows.