SCI Forum Reports
Sex and SCI
October 3, 1995
Our panel of 5 men and women with SCI and 2 of their partners offered tips on how to rediscover the joys of sex after SCI, and work around some of the pitfalls. "Sex is a very good thing postinjury," said Laura, a woman with paraplegia. "It's different but it can be very good...but it's not easy at the very beginning.
"When I was first injured, I went out on a date. I was worried about whether I would fall out of my chair trying to get out of the car. Then I had a bladder accident, and I wondered whether or not to tell the guy, 'I peed on your seat.'"
One of the biggest problems that many people have, especially shortly after their injuries, is their own self-image. "Loving yourself is one of the most important steps," said Steve, a man with paraplegia. "At first, you just want your body to function, and later you try to fit your body into society. At first I was very down on my injury and I really wasn't projecting who I was. But as I interacted with people and they kind of reflected who I was a little better than I did, my relationships improved."
"You're still a person," said Shannon, a woman with paraplegia. "You're sexual, you have feelings."
All the panelists agreed that the best way to put people (including yourself) at ease is communication. In a sexual situation, the partner with a disability usually needs to educate the other person about the ways in which his or her body is different, and both partners need to communicate about what they like, what seems to be working for them, and any problems they might be having.
Choosing the right partner is important. "It's easy to tell who's going to be comfortable and who's not," Laura said. "I didn't want to spend energy and time with someone who was going to have issues with my disability." "The chair can act as a screening device," Shannon said, explaining that some people see the wheelchair first, while others see you first as a person.
Amit, a man with paraplegia, said he had trouble figuring out how to initiate dating with people. "It's hard to make the first move," he said. "You're still caught up in that aggressor mentality." In time, however, he learned "little tricks for how to get somebody close to you. The biggest thing is to ease yourself in slowly and figure out what you want to do."
Practical advice for having sex included minimizing accidents by emptying your bowel and bladder first, being careful to position yourself in a way that avoids too much friction or pressure, and using humor to help you cope. "Because of my spasms, we call our bed at home 'the vibrabed'," Shannon said.
Men with higher injuries may need direct stimulation of the penis in order to have an erection and/or ejaculation, since the injury may impair the connection between the brain and sex organs while leaving the lower reflex system intact. Men with low injuries may need to use a vacuum device, an injected drug, or a penile implant to get or maintain an erection, since the nerves that actually go to the penis and prostate may be impaired.
"It's very important to explore," Steve said. "If you're interested in improving your sexual function, seeing a rehabilitation physician and getting a referral to a urologist who has a special interest in working with people who have SCI is a good idea."
"There's an advantage to having gone through spinal cord injury," he added. "There's a body focus that I didn't have before my injury. It gives you a great advantage as a partner. People find you quite open...creativity and romance and communication become a much stronger part of relationships with disability."
"You use what you have left," Laura said. "You do what you have to do, and it's OK."