Background: In EULAR 2020, the results of our ongoing project Reumasutra were presented. The aims were to (i) understand the complexities and the difficulties of sexuality in people with rheumatic and musculoskeletal diseases (RMDs), (ii) offer a solution to the problems previously identified, and (iii) (un)validate the proposed solution using feedback of people with RMDs [1]. However, we were forced to pause the last phase of the project due to diverse challenges been the most influential the development of generative artificial intelligence and its potential use for creating deepfakes. This technology brought with it ethical challenges. Therefore, we wanted to be sure how we could best protect the dignity of the individuals who trusted us by participating in the explicit audiovisual shorts, which involved recreating adapted sexual positions for people with RMDs. While considering the best options available, we decided that the topic of sexuality and sex in RMDs was too important to be put on hold for an extended period. Therefore, we chose to expand Reumasutra by creating a documentary for people of all ages, aimed at making the taboo topic of sexuality and sex in RMDs visible and accessible to the general population.

Objectives: To create a documentary for the general population on sexuality and sex in RMDs in order to raise awareness of this taboo topic.

Methods: For this work, our ontological and epistemological assumptions stand by the constructivist/interpretivist paradigm which establishes that there are multiple subjective realities, each of which is socially constructed by and between individuals. The creation of the documentary was approached using qualitative research methodology and methods. Narrative interviews were used as the method of data collection. Interviews were moderated by the same researcher which was assisted by an audiovisual team in charge of recording the interviews and subsequent audiovisual editing of the final piece. A total of 10 interviews (eight with women), conducted in Catalan, Spanish, and English, took place in February 2024 in Barcelona, Spain. Seven of the interviews were with individuals with RMDs (such as axial spondylarthritis, fibromyalgia, rheumatoid arthritis, and pulmonary sarcoidosis, among others), and the remaining interviews were with health professionals or patient advocates. It is important to note that some of the individuals interviewed held more than one role, being both people with RMDs and healthcare professionals or patient advocates. After data collection, a qualitative content analysis was performed.

Results: Our main result is the documentary (approximate duration of 50 minutes) in which four main topics were generated and could be appreciated in more depth. Although sexuality and sex were the primary focus of our work, the narrative interviews revealed important issues that we were previously unaware of, which may also be invisible to the general population. The four main topics are: (i) structural violence and microaggressions against women, (ii) lack of education on diversity, equity, and inclusion (DEI) within the medical community, (iii) the formation of a new identity after diagnosis, and (iv) women’s bodies as factories for producing life.

Conclusion: There is an invisibility of women in medicine. Just as sexuality and sex in RMDs are not a local problem but a global one, we believe this invisibility is also a global issue. Sociocultural variables and dynamics (e.g., religious practices) play a role in the magnitude of this issue across different countries. Structural violence and various types of aggression were identified in the experiences of the women who participated, which was not the case for the men interviewed. DEI education is needed in medical training to counterbalance this violence. New meaning in the lives of the participants was found through collective activities that created bonds with different communities. However, there is a reproductive reductionism in rheumatology when the topic of sexuality and sex is addressed with women. Our results serve as an invitation for everyone involved in the diagnosis and treatment of RMDs to reflect on our practices, their origins, and ask ourselves: Are there better ways?

REFERENCES: [1] Negrón JB, Ponce L, Galega LLR, Catalana LLR. OP0309-PARE REUMASUTRA: Rethinking Sexuality in Rheumatic and Musculoskeletal Diseases. BMJ Publishing Group Ltd; 2020.

Acknowledgements: To all those who shared intimate aspects of their experience with the disease. Thank you for your vulnerability and for teaching us lessons that are not taught in textbooks or classrooms.

Disclosure of Interests: None declared.

© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.