WASHINGTON, D.C. — Wounded troops arriving home from Iraq and Afghanistan face a problem so personal and intimate it's difficult to even mention — how to re-establish a sexual relationship with a spouse or partner.

"It's something that's taboo. We don't talk about such things," said Margaret Giannini, director of the Office on Disability for the U.S. Department of Health and Human Services.

Health professionals gathered at a conference in Washington this week billed as the first to draw attention to what happens when soldiers with severe wounds or disabilities resume life with the people they love the most. The conference was sponsored by the Center of Excellence for Sexual Health at the Morehouse School of Medicine in Atlanta.

A panel discussion featured the real-life example of B. J. Jackson, a double amputee from Des Moines, and his wife, Abby.

As the severely wounded Iraq veteran recovered in the hospital, Abby hesitantly asked a doctor when the couple could be intimate again.

It would just take time, the doctor told her, offering no additional advice.

B.J. was also reluctant to have sex.

Abby said she now wonders if it would have helped B.J.'s entire recovery if she could have done more to be intimate, maybe climbing into the hospital bed to hold him. That seemed impossible with technicians and nurses hurrying in and out. "I didn't know if I could just close the curtain, in the hospital," she said.

It opened her eyes to the realization that the professionals didn't know what to do, either.

The trauma of war leaves both visible and invisible injuries that then have an impact on families, children and society, participants said. Domestic abuse, divorce, suicide and other problems emerge.

Many wounded veterans are young, 18 to 24, and fear that they'll never again be loved or desirable. They question whether they will be able to attract a boyfriend or girlfriend, nurture a marriage or parent children.

Their sex lives affect everything else, and the silence has to be broken, said former Surgeon General Richard Carmona. "We have to talk about it because it's very much a part of our mental health and the mental health and physical health are very much tied together," he said.

Jackson, 26, who's become a national spokesman for veterans with disabilities, was deployed to Iraq with the Iowa National Guard in 2003.

A Humvee he was driving through Baghdad struck a land mine and Jackson suffered severe burns as well as losing his legs.

The couple talked about their difficult transition to a renewed relationship, beginning in the hospital when B.J. arrived from overseas. He was covered with burns and looked like "a barbecued chicken," said Abby.

But importantly, "she was right there when I woke up," said B.J.

A Vietnam veteran on the panel, Dave Roever of Fort Worth, Tex., told of how he was burned beyond recognition when a grenade exploded in his hand.

"I kissed my little teenage wife goodbye and that was the last time she ever saw me normal," he recalled. When he came home and saw himself in the mirror as "a freak, a monster," he unsuccessfully tried to commit suicide, convinced she would leave.

She stuck with him and they remain married today, with two children and grandchildren. "True love isn't about how you look," said Roever, who still bears scars.

Former Sen. Bob Dole, who serves on a commission on recent veterans, estimated there are 3,000 veterans of Iraq and Afghanistan who have survived with major disabilities.

Carmona said the war in Iraq and Afghanistan presents new challenges for sexual and mental health. There are more blast injuries, more amputations, more injuries to genitalia and more brain injuries not readily detected.

On a warm, sunny day, in front of Naval National Medical Center in Bethesda, Md., "there are rows of wheelchairs, with 18-, 19-, 20-year-old kids missing arms, missing legs," he said.

With advances in medical technology, they may be alive for another 50 years, "but what are we doing for their mental health?" Carmona asked.

The conference is meant to send a message to lawmakers and medical professionals that wounded troops and their partners need help, said former Surgeon General David Satcher of Morehouse, the organizer.

But the Jacksons said it's never easy to talk about sex, though they've shared their story with groups of other severely wounded veterans.

"The biggest breakdown is the communication of it all," said B.J.

War injuries

Past wars:According to the Department of Veterans Affairs, there were 153,303 troops wounded in the Vietnam War, and 671,846 in World War II.

Middle East: There have been 30,112 troops wounded in action in Iraq, and 1,961 in Afghanistan as of May 17, according to the Department of Defense.