A new international research protocol is shining a spotlight on a long-neglected aspect of patient care: the sexual health, well-being, and pleasure of individuals living with rheumatic and musculoskeletal diseases (RMDs). By proposing a sweeping review of global literature and lived experiences, this initiative aims to address both the clinical and societal fatigue around topics of intimacy for millions affected worldwide—a conversation now increasingly relevant to Thai patients and families seeking holistic chronic disease management [source: Wiley Online Library].
Rheumatic and musculoskeletal diseases, such as rheumatoid arthritis, lupus, and ankylosing spondylitis, are known for their debilitating joint pain, fatigue, and loss of mobility. But the impact reaches far beyond the physical—often resulting in emotional strain, diminished self-esteem, and strained relationships. Yet, as the new scoping review makes clear, the sexual health and rights of these patients are often excluded from mainstream clinical practice, despite being fundamental to quality of life.
For Thai readers, the issue is urgent and underexplored. Thailand has seen steadily rising rates of RMDs in recent decades, with estimates from the Thai Rheumatism Association indicating that some form of musculoskeletal discomfort affects nearly 30% of the adult population in their lifetime. However, open dialogue about sexuality, intimacy, and justice for disabled or chronically ill people remains taboo, both in clinical consultations and broader social settings [source: Thai Rheumatism Association]. The new review protocol argues that this silence is not just a personal hurdle, but a wider public health challenge.
The review lays out plans to systematically map the current landscape of research on sexual health, pleasure, and justice among those with RMDs. While earlier work has mostly focused on loss of sexual function due to pain and medication side effects, the new initiative seeks to broaden the lens, incorporating dimensions of pleasure, agency, and consent—elements that are often left out of medical textbooks. The review also gives special attention to justice: how age, gender, sexual orientation, and disability status intersect to shape access to care and social acceptance.
Expert voices in the field have begun to advocate for this wider perspective. A representative from the Thai Rheumatism Association, interviewed in a previous Bangkok Post feature, noted, “Pain and fatigue are only part of the problem. Many of our patients are too shy to ask their doctors about sex, fearing judgment or misunderstanding. We must make space for these conversations, or patients will continue to suffer in silence.”
International experts echo this sentiment. Dr. Tanja Stamm, a co-author of the review protocol, has written extensively on patient-centered care in chronic diseases. In a related commentary, Dr. Stamm stated, “Sexual health is a human right for all, including those with chronic conditions. It is time for health professionals to move beyond a purely biomedical approach and address the whole person” [source: Wiley Online Library].
For Thai patients, the cultural context presents unique challenges. Buddhism has long shaped attitudes towards sexuality, often emphasizing restraint and discretion. This can further inhibit conversations about intimacy, especially for older adults or those from rural backgrounds. “In Thai society, sex is often seen as a private matter, not a health issue to bring to the hospital,” explained a senior psychiatrist at a major Bangkok hospital, citing the need for greater sensitivity and training among healthcare professionals.
Despite these barriers, there are signs of progress. Patients’ rights groups in Thailand have started to demand more inclusive care, with some hospitals piloting counseling services that address not just physical, but emotional and sexual well-being. Globally, the World Health Organization has recognized sexual health as integral to overall wellness—a stance that advocates hope will encourage more supportive policies at the national and local levels [source: WHO].
Looking ahead, the results of the scoping review are expected to guide future research and clinical guidelines. “We need to understand not just the challenges, but the pleasures and desires of people living with RMDs,” argued Dr. Stamm. Thai rheumatologists are encouraged to follow these developments closely. Integrating sexual health into mainstream care would require adapting international best practices for Thailand’s unique social and cultural context—including more open patient-doctor dialogue, improved training for healthcare workers, and support groups that allow patients to share experiences and strategies for maintaining intimacy despite illness.
For Thai readers living with RMDs or caring for loved ones, the message is clear: sexual health is part of overall well-being and should be discussed openly with healthcare providers. Patients are encouraged to bring up their concerns during clinic visits, while families and caregivers should listen without judgment. Health professionals are likewise urged to create a safe space for these conversations, recognizing the cultural sensitivities involved.
As Thailand’s population ages and chronic diseases become even more prevalent, addressing the holistic needs of patients—including their sexual rights and desires—will remain a vital part of building a more just and compassionate health system.
For further reading, visit the full scoping review protocol on the Wiley Online Library or consult resources from the Thai Rheumatism Association. For general information on sexual health and rights, the World Health Organization maintains up-to-date guidelines.