War and disability: how Ukraine supports veterans' sexual rehabilitation while Russia stays silent

As wars produce growing numbers of people with disabilities, societies worldwide have had to confront the question of sexual rehabilitation. Ukraine has launched structured programmes to support veterans' intimate lives after injury, while in Russia the topic remains a near-total taboo, suppressed by censorship, conservative ideology, and an overwhelmed rehabilitation system.

Wars have always created large numbers of people with disabilities. But one consequence rarely discussed in public, the impact of serious injury on sexuality and intimate life, is now drawing growing attention in Ukraine, even as it remains buried under silence in Russia.

How the West confronted the issue

The idea that people with disabilities have the same rights as everyone else, including the right to a sexual life, emerged slowly in the West, shaped largely by post-war social upheaval. After World War II, liberation movements of the 1960s and 70s pushed the concept of "normalisation": that life for people with disabilities should be organised around their needs, not their limitations.

The Vietnam War proved a turning point in the United States. Young men returning with paralysis, amputations, or the inability to achieve erection were suddenly visible in mainstream society in a way that people with congenital disabilities had never been. Films like Coming Home (1978) and Born on the Fourth of July (1989) brought the sexuality of disabled veterans to cinema screens.

«If we look at the history of the disability rights movement, we see that progress always happens after wars,» says Vera Shengelia, a lecturer at the Smolny Without Borders project. «The shifts happen for and because of white men who were recently healthy and have lost their functionality, their sense of manhood, and want it back, including the right to sexuality.»

Denmark leads, Sweden hesitates

Different countries have since taken divergent approaches. Denmark formalised support for the sexual lives of people with disabilities as early as 1989, with official guidance that their sexuality was a natural and protected part of life. By 2001, the Danish Ministry of Social Affairs had published comprehensive guidelines stating: «Sexuality is an integral part of any person's identity», and that social and medical workers should not control this sphere but create conditions for its safe and dignified expression.

Sweden, by contrast, treats sexuality as too intimate and complex for external regulation. As Shengelia explains, it reflects a core dilemma: freedom versus safety. In countries like the Netherlands and Germany, where sex work is legal, people with disabilities may access such services on equal terms. In Australia, the United States, and Israel, so-called surrogate partners, specialists working alongside therapists, help clients with disabilities explore intimacy and may engage in sexual contact as part of therapy.

Ukraine moves forward

Ukraine moved quickly after the full-scale war began. The Recovery rehabilitation network and the Elena Pinchuk Foundation jointly created the "Recovery. Sexual Life" programme to train specialists supporting veterans after injury. The programme includes 11 instructional videos and a Telegram bot explaining how various traumas and PTSD affect sexual function, including suggested positions.

In spring 2025, the foundation opened a free sexual rehabilitation clinic in Kyiv for military personnel and veterans, with online consultations available later. Ukraine also runs the "Wounds War Silences" project, offering free reconstructive surgery on urogenital organs for soldiers.

«Ukrainians are being rehabilitated using modern Western approaches, first restoring self-respect,» says Shengelia. «That's the key requirement, because no rehabilitation works if the person doesn't want it. And to make them want it, you have to show them that what they dream of most is still possible, that they can still have children, or have sex. Then they gain some sense of themselves and start taking those difficult rehabilitation steps.»

Russia: a topic that cannot be named

In Russia, the situation is fundamentally different. Hundreds of thousands of soldiers have returned home with serious injuries, amputations, and trauma. The rehabilitation system is severely overburdened, according to the publication Verstka, many veterans wait months for prosthetics or face bureaucratic obstacles at every turn.

Russian propagandist Anastasia Kashevarova wrote in March 2025: «There are many letters from our fighters and their families saying it is impossible to get rehabilitation... They report to the President on the construction of new rehabilitation centres, on how many prosthetics were supplied. But they stay silent about what percentage were not helped.»

Sexual rehabilitation does not appear in official Russian medical guidelines or government orders. The topic is absent from academic research and almost entirely absent from media, with only occasional pre-war blog posts and a handful of private clinic representatives willing to discuss it openly.

Pelvic therapist Anna Grikevich noted in an interview that people with severe injuries do not even know they can discuss sexual questions with a medical professional. «Unfortunately, in our country this is rarely talked about, and doctors do not ask patients about their sexual lives,» she wrote.

Ideology forecloses the conversation

The deeper obstacle in Russia is ideological. «In a country where the LGBTQ+ community is banned, there will be no healthy development of sexuality in connection with disability,» says Shengelia. «What we will see instead is the glorification of a machismo idea of what a 'real man' is.»

She argues that many Russian soldiers brought deeply distorted ideas about sexuality into the war, «a mix of courtyard and prison concepts of sex: masturbation is shameful, women are objects, homosexuality is forbidden, any sexual expression equals homosexuality.» Returning to civilian life with serious injuries and no support system, those attitudes are unlikely to improve.

«There are no platforms, no language to speak openly about this,» Shengelia concludes. «A huge number of expressions of freedom are banned by law or censorship. All of this would work well if any of it made sense in a country that has slammed shut in terms of freedom. But I don't know of an authoritarian society in which we could speak about sexual freedoms.»

The contrast between Ukraine and Russia in this area mirrors a broader divergence: one country investing in the human wholeness of its wounded fighters, the other unable or unwilling to acknowledge that wholeness exists.