From Invisibility to Equity: Redefining Spinal Cord Injury Rehabilitation Through the Lens of Women's Unique Needs

Women with spinal cord injury (SCI) experience persistent disparities in rehabilitation and healthcare access, particularly in reproductive health, sexual wellness, safety, and autonomy. Existing care models remain predominantly gender neutral and fail to address the full continuum of women's health needs. In response to these challenges, we propose a multifaceted rehabilitation framework that integrates an interdisciplinary approach to address the comprehensive needs of women living with SCI. Through the collaborative efforts of the SCI Model Systems (SCIMS) Women's Health Special Interest Group (a multidisciplinary working group composed of clinicians and researchers) and in consultation with women with SCI, key recommendations were synthesized into the W-CARE Framework (Women-Centered Accessible Rehabilitation & Equity) comprising 7 pillars: (1) system redesign, (2) equity and safety benchmarking, (3) lifespan-based centers of excellence, (4) peer co-leadership, (5) inclusive data and intersectionality, (6) telehealth and digital access, and (7) provider training. The Women's SCI Equity & Safety Index is provided as a proposed quality improvement guideline. To achieve equitable SCI care, rehabilitation systems must integrate gender- and disability-informed approaches that support women's health and autonomy across the lifespan. This article serves as both a call to action and a proposed framework for system-level transformation of SCI rehabilitation services.