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Summary:
Sexuality belongs sometimes to medical domain. Physicians must know all these aspects and their different meanings for each individual. In case of a physical handicap as paraplegia, one has to care specialy for the signification of therapeutic's relation To ask the question of the relationship between intimacy and sexuality within a therapeutic relationship equals in our professional activity to analyze what can or cannot be done. ("what you cannot talk about, needs to fall silent") (4). This work will start with the analysis of different words and their meanings, as well as with the analysis of our medical experience in managing the sexual dimension of persons with paraplegia or tetraplegia (especially the male). Intimacy is "what constitutes the essence of a human being, what belongs to privacy, is secret, is personal" (French dictionary). Epithet of a close relationship between relations, friends which one could oppose to a professional relationship.

The notion of intimacy includes also the one of sexuality (intimate, intimate washing, intimate underwear, etc.). Etymologically, intimate (from the Latin root "intimatus") means : "to make known". The risk of having too much knowledge about the other one is a hazard/chance of the medical relationship (one knows people inside out and doesn't just see their nudity). This intrusion in ones domain should not be negative. Sexuality : "set of several modes of instinctual satisfaction linked to the reproduction of species" (from the Latin root "sexus"). Amongst the several sides of sexuality, satisfaction, pleasure, reproduction and fertility are approached by therapeutic treatment. It is important to note that the concepts of pleasure and satisfaction are different. Therapy : "part of medicine which relates to the way to cure diseases". In this definition, the notion of relationship is omitted. It is however important, since no medical treatment can have a meaning (and efficacy) without a therapeutic relationship.

This relationship is based on a tacit contract which is never defined. Another meaning which is not related to cure and which is more and more often used, is the notion of relieving or alleviating ("it is therapeutic"). In summary of this introduction, we could state that whenever a therapeutic intervention concerning a human's sexuality is necessary (i.e. in case of physical handicap), it is important to take care of the intervention methods and modalities because of proximity concepts of sexuality and intimacy. Our subject applies to the specific case of a physical handicap. This analysis however could be probably generalized to any report between a therapist and his patient's intimacy.