Thrive Rehab is excited to sponsor Professor Beth Ann Walker (creator of OPISI), in addition to Associate Professor Jenn Soros and Clinical Assistant Professor Karla Reese (co-creators of the "OT After Dark" podcast) for exclusive full-day training events in Australia. LIMITED TICKETS AVAILABLE - purchase here . About the Training The training will focus on the Occupational Performance Inventory of Sexuality and Intimacy (OPISI)—a world-first OT assessment tool designed to address sexuality and intimacy within occupational therapy. The OPISI was created to comprehensively screen, assess, and measure performance related to the complex occupational nature of sexuality and intimacy. Additionally, attendees will gain insights from the internationally recognized "OT After Dark" podcast, which explores sexuality and intimacy in OT practice. Beth Ann, Jenn and Karla will also be attending the World Association for Sexual Health (WAS) Conference, where they will highlight the crucial role of Occupational Therapy in the field of Sexuality. Our Brisbane training is scheduled just before the WAS Conference , offering an opportunity to connect, learn, and network with international experts before the event. For those unable to attend the conference, we are also hosting the same full-day training in Melbourne on June 21st. Training Dates & Locations: Sunday, 15th June – Brisbane (Venue: Cliftons Brisbane) Saturday, 21st June – Melbourne (Venue TBC based on numbers) Cost Brisbane: $550 (inclusive of GST) – Includes lunch, morning, and afternoon tea. Cost Melbourne: $495 (inclusive of GST) – Includes lunch, morning, and afternoon tea. For queries about this training, please email: admin@thriverehab.com.au Please note: Exclusive discounts available for training packages. See here  for details. Student discounts available for people currently enrolled in OT university programs - email us at admin@thriverehab.com.au  to apply for your discount. Thrive Rehab is a private Occupational Therapy practice with over 10 years of experience providing training for OTs and other health professionals on addressing the occupational aspects of sexuality and intimacy for individuals of all abilities. We offer a range of education sessions , with special bundle pricing for those attending the OPISI training. About our guest presenters: Dr. Beth Ann Walker is an Occupational Therapist and professor at the University of Indianapolis. She teaches within the School of Occupational Therapy and the Master of Public Health Program. She developed the Occupational Therapy Sexual Assessment Framework (OTSAF) and the Occupational Performance Inventory of Sexuality and Intimacy (OPISI). In 2021, she was named a Fellow of the American Occupational Therapy Association for her work in "Breaking the Global Silence in Addressing Sexuality and Intimacy." Through WFOT's recognition of her research expertise in OT and public health, she contributed to the World Health Organization's (WHO) Package of Rehabilitation Interventions and advocated for the inclusion of sexual functions and intimate relationships as a functioning domain. During the pandemic, she also collaborated with WHO to develop content clinical management guidelines, self-management resources for adults and teens with long COVID, and rehabilitation practitioner training modules. Moreover, as a neurodivergent scholar, she values the richness that diverse perspectives bring to education, research, and practice. Her lived experiences have heightened her commitment to fostering an inclusive environment that promotes equity and accessibility by actively challenging systemic barriers and advocating for marginalized voices. Dr. Jenn Soros is an Occupational Therapist, researcher, and educator specializing in sexuality and intimacy across the lifespan, serving as an Assistant Professor in the Doctor of Occupational Therapy Program at Cleveland State University and executive board member of The Network for LGBTQIA+ Concerns in Occupational Therapy. Her influential work includes co-authoring chapters on sexual activity and pleasure in "Sexual and Intimacy: An Occupational Therapy Approach" (AOTA Press) and publishing groundbreaking research on bisexuality and gender modality in the International Journal of Transgender Health. Her recent international Delphi study with Dr. Beth Ann Walker, published in The Open Journal of Occupational Therapy, established crucial priorities for education and practice in addressing sexuality and intimacy within the global occupational therapy profession, providing a framework for advancing clinical competency in this area. As the co-founder of OT After Dark, an international podcast advocating for addressing sexuality and intimacy in OT practice, and an experienced clinician in private practice, Dr. Soros combines practical, evidence-based approaches with a deep understanding of occupational science, focusing on establishing global priorities for sexuality and intimacy education in occupational therapy practice. Her research and presentations emphasize the intersection of sexual health with occupational justice, particularly focusing on underserved communities and promoting inclusive healthcare practices, making her a sought-after speaker and trainer who helps practitioners develop competence and confidence in addressing sexuality and intimacy within their practice settings Dr. Karla Reese is a Clinical Assistant Professor and Doctoral Capstone Coordinator in the Department of Occupational Therapy at Cleveland State University, United States. With over 20 years of clinical and academic experience, she has emerged as a leading voice in expanding occupational therapy's role in addressing sexuality and intimacy across the lifespan. Her work includes co-authoring key chapters in "Sexual and Intimacy: An Occupational Therapy Approach" (AOTA Press) and "Adult Physical Conditions: Intervention Strategies for Occupational Therapy Assistants" (F.A. Davis). She is also the co-creator, co-producer, and co-host of OT After Dark, an internationally recognized podcast exploring occupational therapy's role in addressing sexuality and intimacy. As the inaugural Diversity, Equity, Inclusion, Justice, Access, and Belonging (DEIJAB) Liaison for the Ohio Occupational Therapy Association's Board of Trustees, Dr. Reese actively works to advance inclusive practices within healthcare education and delivery. She holds a Professional Certificate in Diversity, Equity, and Inclusion and a Global Citizenship Certificate, reflecting her commitment to creating more equitable and accessible healthcare environments. Dr. Reese frequently presents at national and international conferences on topics including sexual health, occupational justice, and inclusive healthcare practices. Her scholarship and advocacy work focuses on addressing sexuality as a fundamental human right and promoting occupational justice for marginalized populations. She has been recognized with multiple awards for her contributions to occupational therapy education and practice, including the 2024 Model Practice Award from the Ohio Occupational Therapy Association.

In a groundbreaking and truly special event, The State Library Victoria (Melbourne, Australia) presents an opportunity for people to “question, navigate and engage with information more critically and confidently.” We are thrilled to be involved in Make Believe: Encounters with Misinformation and congratulate the curators of this brilliant exhibition. If you happen to be visiting Melbourne this year, please drop into State Library Victoria to indulge in this fascinating collection of case studies. “Collectively, these case studies ask: how do our own perspectives and experiences influence what we accept to be 'true'? and why do we keep falling for misinformation? At the same time, they reveal how curiosity and thoughtful research can help us question, navigate and engage with information more critically and confidently .”                                                                                State Library Victoria, Melbourne. Make Believe: Encounters with Misinformation exhibition at State Library Victoria, Melbourne, Australia “Misinformation filters our view of the world. Whether it arises from simple mistakes, misinterpretations or deliberate deception, it can profoundly influence our thoughts, opinions and actions. One of the most harmful examples in Australia's history is terra nullius, the false claim that the land was uninhabited, which was used to justify the dispossession of Aboriginal and Torres Strait Islander peoples of their lands.”                                        State Library Victoria, Melbourne. CASE STUDY 3: Anatomy, biases and understanding the clitoris We invite you to watch this short video, created by State Library Victoria, featuring the incredible Professor Helen O’Connell and Dr Jennifer Hayes along with our very own Anita Brown-Major. To be in the same room as Professor O’Connell and Dr Hayes is truly mind-blowing! This video describes the biases affecting the anatomical understanding of the clitoris. “Despite having more access to information than ever before, we continue to be seduced and duped by mistruths. These falsehoods can completely deceive us or subtly draw us in, even when we know they are untrue. They appeal to our biases and beliefs, using beauty to beguile us and making it easier to ignore uncomfortable truths.” State Library Victoria, Melbourne Cliterate, an interactive vulva model designed to educate all bodies and learning styles. Labia diversity study created by Charlie Richardson and Cara Jordan-Miller. Two of these models were selected and have been manufactured in silicon for use in the Cliterate vulva model.

The human fingertip has approximately 3,000  nerve endings, allowing us to detect texture, temperature, and pressure with incredible precision. These nerve endings make fine motor skills like playing an instrument or typing possible. The human penis, long studied in medical research, has around 7,700  nerve endings.   So, how many nerve endings does the human clitoris have?   Reputable medical sources such as the Cleveland clinic echo a commonly quoted figure of 8000 – a number which happens to come from outdated studies on animals. Until 2023, no research had been conducted to quantify the number of nerves in the human clitoris. Where did this data come from?   In a groundbreaking 2023 study, researchers Dr. Maria Uloko, Dr. Erika P. Isabey, and Dr. Blair R. Peters revealed that the human clitoris contains an average of 10,280 nerve endings —far exceeding the long-quoted number and surpassing even the fingertip and penis.   The methodology  of this study is one of the most revolutionary  aspects of this research. Rather than relying on cadavers (as is common in anatomical studies), the nerve samples were generously donated by transmasculine patients undergoing gender-affirming surgery . During phalloplasty  (the surgical construction of a phallus), only one  of the two dorsal nerves that innervate the clitoris is needed for the procedure. This meant that one could be donated from each patient —allowing researchers to analyse and accurately count the number of nerve endings. This study not only advances medical knowledge but also highlights the invaluable contributions of trans patients to science—work that benefits everyone cis individuals and trans individuals alike. Why Is This Important?   Understanding the true complexity of clitoral innervation is a major step forward in sexual health, medicine, and surgery. Here’s why this study is so important: Medical Advances:  With precise knowledge of nerve distribution, surgeons can improve reconstructive procedures for trauma, injury, and gender-affirming care. Sexual Health Education:  The clitoris plays a central role in sexual pleasure , yet has been historically overlooked  in medical research and sexuality education. This study reinforces the urgent need for better representation of the clitoris  in textbooks, research, and public discourse.   REFERENCES: Uloko M, Isabey EP & Peters BR (2023). How many nerve fibers innervate the human glans clitoris: a histomorphometric evaluation of the dorsal nerve of the clitoris. The Journal of Sexual Medicine 20, 247–252. Cleveland Clinic (2022). Clitoris: Anatomy, Location, Purpose & Conditions. [online] Cleveland Clinic. Available at: https://my.clevelandclinic.org/health/body/22823-clitoris . Ferrin, P., Uloko, M. and Peters, B. (2024). (067) How Many Nerve Fibers Innervate the Human Glans Penis: A Histomorphometric Analysis of the Human Dorsal Nerve of the Penis. Journal of Sexual Medicine, [online] 21(Supplement_1). doi: https://doi.org/10.1093/jsxmed/qdae001.063 .

Cliterate's spherical, pull-apart design explains the relationship between the clitoris, vulva and pelvis. Are you Cliterate?  Vulva Basics Scroll over the images and learn about vulva anatomy. Click on the labels for more info. Explore Are you Cliterate? Are you Cliterate? Psychogenic and Reflexogenic Pathways Learn more about the Sexual response system's psychogenic and reflexogenic pathways. Explore The History of the Clitoris – a timeline The clitoris has a very interesting past. It’s been discovered, misunderstood and forgotten many times. What’s the story? Explore The History of the Clitoris – a timeline The clitoris has a very interesting past. It’s been discovered, misunderstood and forgotten many times. What’s the story? Explore Labia Diversity Unique as fingerprints, distinct as faces. There’s no such thing as “normal”. Explore Psychogenic and Reflexogenic Pathways Learn more about the Sexual response system's psychogenic and reflexogenic pathways. Explore

In a world fuelled by online opinions and more misinformation than we’ve ever seen before, looking to evidence based research is essential. It’s alarming to learn that “in Australia, between January 2011 and December 2021, 23.5% of vulvoplasty and labiaplasty procedures were performed on girls and women aged 25 years and under”. 1 Let’s talk about Labia Diversity In a world fuelled by online opinions and more misinformation than we’ve ever seen before, looking to evidence based research is essential. It’s alarming to learn that “in Australia, between January 2011 and December 2021, 23.5% of vulvoplasty and labiaplasty procedures were performed on girls and women aged 25 years and under”. 1 So, what is the labia minora? Labia minora comes in countless shapes, sizes, colours, and textures. This body part is as unique as a fingerprint and as distinct as a face. Labia minora 2 Can be long or short, wrinkled or smooth, dark or light More common to protrude More common to be asymmetrical Has a role in sexual pleasure (it has erectile tissue) Protects the vagina from drying out and funnels the urine stream from the urethra Back to Quiz Media representation of “normal” Societal pressures, fuelled by media and cultural taboos, often turn this natural diversity into a source of insecurity. Media rarely represents labia realistically, and when they do appear, they’re often altered to fit a narrow, unrealistic standard. In fact, Australian media laws (Guidelines for the Classification of Publications 2005 3 ) state the following for unrestricted publications: Realistic depictions of sexualised nudity should not be high in impact. Realistic depictions may contain discreet genital detail but there should be no genital emphasis. Prominent and/or frequent realistic depictions of sexualised nudity containing genitalia will not be permitted. Cultural silence adds to this issue, leaving many to question if they’re “normal.” Cosmetic procedures like labiaplasty have further reinforced harmful ideas about how labia should look, perpetuating the idea that some appearances are preferable over others. The result? Some people feel self-conscious or dissatisfied with their anatomy, even when there’s nothing medically or functionally wrong. This can impact body image, intimacy, and overall confidence. But we can change this narrative by embracing education, challenging societal norms, and celebrating the natural diversity of our bodies. Further info The Labia Library The Labia Library is an initiative of Women’s Health Victoria (WHV), an independent, feminist, not-for-profit women’s health promotion, advocacy and support service with a proud history of more than 30 years. Visit website The Vagina Museum The world's first bricks and mortar museum dedicated to vulvas – founded with the intention of busting the stigma of the gynaecological anatomy and be part of a societal shift from bodily shame to celebration. Visit website References: 1. Australian Government, Department of Health, Medicare Item Report, accessed June 2022. 2. Hayes, Jennifer A., and Meredith J. Temple-Smith. “What is the anatomical basis of labiaplasty? A review of normative datasets for female anatomy”. Australian and New Zealand Journal of Obstetrics and Gynaecology (2020). 3. Australian Government, Federal Register of Legislation.

The sexual response system is fascinating and incredibly complex. It has been somewhat researched and is subject to ongoing research which we will continue to follow with interest. Sexual Arousal Pathways The sexual response system is fascinating and incredibly complex. It has been somewhat researched and is subject to ongoing research which we will continue to follow with interest. We are not attempting to explain the whole system here! In this section, we are focussing on the Psychogenic and Reflexogenic Sexual Arousal Pathways as a means of explaining how these neural pathways coordinate the body's response to stimuli. Psychogenic Pathway The psychogenic pathway in sexual response is all about how the brain and emotions influence arousal—without any direct physical touch. It’s different from the reflexogenic pathway, which kicks in when there’s actual physical stimulation. How it works 1. It Starts in The Mind Thoughts, fantasies, and memories can trigger the arousal process. Sensory input from all five senses—things you see, hear, touch, taste, and smell— also play a big role (like noticing an attractive person, watching a steamy scene in a movie or eating a food that reminds you of a positive sexual experience). A person’s emotional state—feeling relaxed, excited, or turned on—also plays a big role. 2. The Brain Gets to Work The limbic system (the brain’s emotional centre) processes those emotional and sensory signals. The hypothalamus , especially a part called the medial preoptic area (MPOA) , helps turn mental arousal into a physical response. The dopamine system (the brain’s pleasure and reward network) releases dopamine, the “feel-good” hormone, which drives continued attention or engagement. 3. Signals Travel Down Spine The brain sends messages through the nervous system (T12 to S1 region of the spinal chord) to the genitals. This happens through both the sympathetic and parasympathetic nervous systems , which control things like blood flow and sensitivity. 4. The Body Responds For people with vulvas: The clitoris and vaginal tissues get more blood flow, causing swelling, lubrication, and increased sensitivity. For people with penises: More blood flows into the erectile tissue of the penis, leading to an erection. Why it matters Thoughts, fantasies, and memories can trigger the arousal process. Sensory input from all five senses—things you see, hear, touch, taste, and smell— also play a big role (like noticing an attractive person, watching a steamy scene in a movie or eating a food that reminds you of a positive sexual experience). A person’s emotional state—feeling relaxed, excited, or turned on—also plays a big role. Back to Quiz The animation below illustrates the Psychogenic Pathways Response, where seeing, thinking, smelling, touching or tasting sends information from the brain down the spinal cord and results in engorgement of the clitoris. Reflexogenic Pathway The reflexogenic pathway is all about how physical touch and stimulation trigger the arousal process. Unlike the psychogenic pathway, which starts in the brain, this one happens automatically when certain areas of the body are touched—especially the genitals. How it works 1. Touch Sends Signals When the genitals or surrounding area are touched, the skin’s nerve endings pick up on it. This can include sensations like light touch, pressure, temperature, vibration or any other physical stimulation. Internal sensations can also send signals, such as movement of internal organs such as the uterus or ligaments during intercourse or pressure from the bladder. 2. The Spinal Cord Steps In The nerve signals don’t go straight to the brain first. Instead, they go to the S2 to S4 region of the spinal cord, which acts as a relay centre. The sacral spinal cord (in the lower back) plays a key role here—it processes the touch and immediately sends signals back to the genitals to trigger an automatic response. 3. The Body Reacts For people with vulvas: The clitoris and vaginal tissues swell, lubrication increases, and sensitivity heightens. For people with penises: The erectile tissue of the penis fills with blood, leading to an erection. 4. The Brain Can Join In (But It Doesn’t Have To) This process happens without conscious brain involvement—it’s a built-in reflex of the body. The brain can sometimes enhance or partly inhibit the response. If a person’s emotional state allows for psychogenic arousal to occur at the same time, the arousal process can become stronger. Emotions like stress of anxiety may partially inhibit the body’s automatic arousal. The brain’s ability to shut this reflex down is limited, and it is completely normal for the body to automatically respond to touch, including non-consensual touch. Why it matters It shows that the sexual response of the body isn’t just psychological —it can be an automatic reaction to touch. This explains why people with spinal cord injuries can still experience physical arousal, even if they’ve lost sensation. In non-consensual experiences of touch, it’s important to understand the body’s automatic arousal reflex, which is separate to conscious choice or enjoyment. The animation below illustrates the Reflexogenic Pathways Response, which takes place at the S2 to S4 part of the spinal cord. In response to someone being touched on the vulva, a message is sent to the spinal cord returning an immediate reflex response directly back from the S2–S4 region to the area, starting the engorgement process. This is an automatic response to sensation in the genital area – without involvement from the brain. The response is not under voluntary control and is not linked to consent or enjoyment. (Sexual non-concordance). An important note regarding consent: The physical arousal response of the body (an erect penis or wet vulva/engorged clitoris) does not require nor imply consent to be touched. This is super important for all people to understand. The only way to know if there’s consent is to ask and communicate. We encourage everyone to learn more about practicing consent, to ensure it’s present in all interactions. Arousal Non-Concordance Arousal non-concordance can happen when the brain finds something sexually appealing, but the body doesn’t respond by becoming physically aroused. This can be due to multiple factors such as stress, hormonal imbalances, trauma or shame. It can also happen during a reflexogenic arousal pathway, if the body becomes aroused automatically whilst the mind isn’t turned on. Research has shown that the concordance between genital response and subjective arousal within the brain to be different between people assigned male at birth (AMAB) and people assigned female at birth (AFAB). Arousal Concordance in People Assigned Male at Birth (AMAB) There is approximately a 50 percent overlap between what AMAB people’s genitals respond to as ‘sex-related’ and what their brains respond to as ‘sexually appealing’. Arousal Concordance in People Assigned Female at Birth (AFAB) There is approximately a 10 percent overlap between what AFAB people’s genitals respond to as ‘sex-related’ and what their brains respond to as ‘sexually appealing’. References: Elliott, S. L. (2008). Neurophysiology of sexual spinal reflexes. Springer EBooks, 2820–2823. https://doi.org/10.1007/978-3-540-29678-2_3936 Komisaruk, B. R., Whipple, B., Crawford, A., Grimes, S., Liu, W.-C., Kalnin, A., & Mosier, K. (2004). Brain activation during vaginocervical self-stimulation and orgasm in women with complete spinal cord injury: fMRI evidence of mediation by the Vagus nerves. Brain Research, 1024(1-2), 77–88. https://doi.org/10.1016/j.brainres.2004.07.029 Krassioukov, A., & Elliott, S. (2017). Neural Control and Physiology of Sexual Function: Effect of Spinal Cord Injury. Topics in Spinal Cord Injury Rehabilitation, 23(1), 1–10. https://doi.org/10.1310/sci2301-1 Rees, P. M., Fowler, C. J., & Maas, C. P. (2007). Sexual function in men and women with neurological disorders. The Lancet, 369(9560), 512–525. https://doi.org/10.1016/s0140-6736(07)60238-4