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Sex advice for the those with disabilities

By Rebecca Alexander
On January 25, 2012

Dear Sex Matters,

I have been dating this guy for about six months. We both have physical disabilities and therefore have very limited movement. However, we have complete sensation. We really want to have sex but are having difficulty with positioning. We have had two very unsuccessful attempts and are getting very discouraged. We really love each other, but are losing hope. Any ideas?

Wanting Help

Dear Wanting,

I'm so glad you asked this question! There are so many myths and stereotypes about sexuality and persons living with disabilities that simply are not true. Some of these include the incorrect stereotypes that people living with disabilities and chronic illnessess: not sexual, not desirable, can't have "real" sex, have more important things than sex to worry about and not sexually adventurous.

As your question lets us know, people living with disabilities are just as sexual as those of us not challenged in the same way.

While it can be common for people with both long-standing and recent disabilities to feel anxious and confused due to differences in their sexual abilities, all people may enjoy satisfying and exciting sexual activity or sensuality.

Figuring out what suits your needs sexually calls forth your courage to experiment, a degree of imagination and creativity to work around any obstacles.

While you and your partner may find sexual intercourse to be an important part of your sexual expression with one another, there are many other ways to express sexuality, too. For example, manual stimulation can be a huge turn-on, as well as oral play. Tapping into other sensory experiences, such as props for touch (feathers, silk), smell (incense, oils), sound (music), sight (setting the mood — candles, lighting, etc.) and taste (different foods) can enhance erotic energy. Reading erotica or watching erotic movies can add to creating sexual experience. Exploring fantasy through creative play can also support our sexuality. Our largest sex organ is, in fact, not physical at all — it is the brain.

There are a huge number of sexual positions, any of which may or may not be suitable for you, just as they may or may not be suitable for anyone without a disability.

If you try any of these positions and feel uncomfortable, stop what you are doing and try something else. Initially, you may want to start with sexual positions that don't require much effort or exertion. Here are some tips, which you may find helpful depending on the physical needs of you and your partner.

Relax. When you experiment to discover new forms of sexual expression, it's useful to be in a relaxed and sexual frame of mind. This will help you have a sense of humor when things don't go as planned, while gaining the maximum benefit from your exploration of the sexual possibilities open to you.

Stay within your natural range of flexibility. For example, if you have trouble straightening your legs, you can lie on your back with your partner assuming the "on top" position. Your partner can also lean back onto your bent legs for a slightly different sexual position for a different sensation.

Go easy on the bladder. If a partner is having issues with bowel or urinary functioning, he or she should be the partner on top. Side by side positioning is another way to avoid putting pressure on the bladder. Those who have stomas and those who self-cath (pass a catheter several times a day to drain the bladder) usually do so just prior to sex to avoid any unwanted urine leakage.

Support yourself. Try using pillows or rolled-up towels to help you get into or hold a sexual position. Pillows can also help those with hip problems (when placed between the receiving partner's legs during side-by-side position, where he or she is penetrated from behind).

Well-placed mirrors can also help with this strategizing (and help spice up the scene). Furniture around the house may also prove useful, like the use of a bed or chair as support for a sexual position involving kneeling. Sex furniture, like a swing, or blocks can also be used in helping a lover to assume good sex positions.

Tape down catheters. Suprapubic catheter (tube) users are free to engage in wheelchair sex, intimacy and sexual intercourse anytime. However, catheter tubing can cause blisters when pressed hard against the skin. You may want to tape your catheter and any tubing to your body prior to having sex. A sleeve of soft material slipped over the catheter or tubing can also help avoid blistering.

Communicate. It is important to communicate with your partner. Speak up about your concerns and needs, and be honest about what is and isn't working. Taking the time to sort out issues with your partner will not only increase success in your sexual intimacy efforts, it may also help the two of you feel more emotionally intimate as well.

Play with toys. Devices such as vacuum erection pumps can initiate erection, and tight rings or bands applied to the base of the penis will help maintain an erection. Vibrators, the power tilt on a wheelchair, and easily removable armrests can all increase pleasure possibilities (check out for products).

Slip and slide. Never underestimate the power of a good lube! Sex lubricants can help with positions, sexual penetration, manual sex and toy play. Moreover, massaging these gels and oils to areas where greater sensation exists can stimulate these erogenous zones.

On a side note, don't forget to use a condom! The risk of pregnancy and/or sexually transmitted diseases is always a possibility, so have a conversation with your partner about your sexual histories and practice safe sex.

You may also want to check out the following books for information on sex and disability:

The Ultimate Guide to Sex and Disability: For All of Us Who Live With Disabilities, Chronic Pain, and Illness by Cory Silverberg, Miriam Kaufman, and Fran Odette; Sexuality after Spinal Cord Injury: Answers to Your Questions by Stanley H. Ducharme and Kathleen M. Gill; and Enabling Romance: A Guide to Love, Sex and Relationships for the Disabled (And the People Who Care about Them) by Ken Kroll and Erica Levy Klein.

Remember, you and your partner are not alone. Although it may be a challenge, a large part of enjoying sex is figuring out the new ways in which your body works. While it may require a little creative thinking, you can find a way to be satisfied sexually, both alone and with a partner.

The questions published in the Sex Matters column are answered by Rebecca Alexander, a licensed counselor working with the Outreach & Advocacy: Sexuality Information for Students (OASIS). Questions may be e-mailed to

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