Sex With Others

'In most movies they make sex look so clean and controlled, it makes me realize how much I'm not represented in what I see in the world.'

FromThe Ultimate Guide to Sex and Disability, ed. Kaufman, Silverberg and Odette, 2003

Question1 I've never had penetrative sex before. How does it work, and will it hurt?

Penetrative sex generally means inserting something into your vagina. It can involve fingers, hands, objects, or a penis. Though penetration is not necessary for a pleasurable sexual experience, many women enjoy having sex in this way. Penetrative sex between a man and a woman can lead to pregnancy.

Many women worry that penetration for the first time will be painful, but it isn't always so. Some women worry that the penis may be too big for a small opening like the vagina, but the muscles in the vagina expand during penetrative sex to accommodate all sizes. Take time to get aroused so the vagina becomes wet, use lubricants, and focus on foreplay to get you in the mood. Rarely, women have an extremely painful reaction to vaginal sex called vaginismus External Website that opens in a new window, where the muscles in the vagina spasm, making penetration difficult or impossible. If this happens, consult a gynaecologist.

Penetration is not the only way to have sex. If you are in a wheelchair, have spastic (or extremely tight) muscles around your vagina, have no sensation in your genitals, or enjoy types of sensation other than penetration, there are many different ways you can have sex. Touching, caressing, kissing, giving oral sex (stimulating your partner's genitals with your mouth), having your breasts, ears, neck, anus (or any other body part that turns you on) caressed or stimulated can all be incredible sexual experiences. Sex is about a connection and attraction between two (or more) people, and each and every person defines (and has) sex in her own way.

Question2 Apart from penetration, what other ways are there to have sex?

There are many ways in which people have sex, and what's good is whatever works for you and your partner. Here are some pleasurable sexual activities:

Kissing. There are so many different ways to kiss, and it is a sexual act you can perform without even taking your clothes off! Kissing can involve just your lips, or even your tongue and teeth. When two people use their tongues to explore each other's mouths, it's called French-kissing - and just because both of you are in wheelchairs or you are blind and can't see each others face, that doesn't mean you have to miss out on it!

Touching. We all crave to be touched, and there are many types of sexual touch that people enjoy. Massaging muscles, stroking the face, neck or ears, or caressing and fondling sensitive areas can all be sexual activities. Even if you have no sensation in your body, you can be turned on by watching someone touch you, or by touching them.

Masturbation. Having sex with yourself doesn't always have to mean that you are by yourself! Watching each other masturbate can be pleasurable as a shared activity, and can be a way to show your partner what you like, as well as learn what turns the other person on. If your impairment means you can't reach your genitals, fantasy can be a pleasurable substitute.

Oral sex. Oral sex involves stimulating your partner's genitals or anus with your mouth and tongue. Because there is often a lot of shame and secrecy associated with these body parts, it can take some time to get used to the idea of this. If you have issues with incontinence (loss of bowel or bladder control), empty your bowel or bladder before receiving oral sex. If you or your partner suffers from spasticity (extremely tight muscles or involuntary muscle reactions), low energy, or low lubrication, oral sex can be a great way to get around these issues.

Anal Sex. This is something that many people are initially hesitant to explore, because the anus is seen as 'dirty'. But both men and women can enjoy stimulation and penetration of the anus. If you don't have anal sensation, you need to be more careful, because the lining of the anus is very sensitive. Putting anything that has been inside the anus into the vagina can lead to an infection.

Question3 Are there positions in which I can have penetrative sex despite my disability?

There are many positions in which a couple can engage in penetrative sex. Some of them are:

One partner on top. If you have a bad back, try lying on your back with pillows under your knees or lower back to help you keep your legs apart. Or lie on your front with a pillow under your hips or stomach. If you don't have much strength below the waist but have a strong upper body, use your arms to press against the bed and create pelvic movement.

In your wheelchair. If your wheelchair has removable arms and you can support your partner's weight, he or she can sit on your lap (either facing you or with their back to you), with their legs on either side of you. If your wheelchair doesn't have removable arms, it's most comfortable if your partner sits on your lap facing away from you.

Lying on your side. If you wear a catheter or have hip problems, you can be penetrated from behind while lying on your side. You can also lie on your side facing each other, which means that either or both of you can create a hip thrusting movement (as opposed to when the partner on top has to provide most of it). If you have tight leg or hip tendons or muscles, you can lie on your side with your partner lying perpendicular to you with their legs over your waist.

Talking to your partner about what positions will suit you both is the best way to discover new and pleasurable ways of having sex. Sex is all about trying new things, so don't be afraid to experiment!

(Source: The Ultimate Guide to Sex and Disability,ed. Kaufman, Silverberg and Odette, 2003)

Question4 Impairment-specific sex tips

Spasticity External Website that opens in a new window (extremely tight muscles). The effects of touching, stroking and foreplay can help relax your muscles. If you find it difficult to straighten your legs during penetration, then lie on your back with your partner assuming the 'top' position. Your lover can then lean back onto your bent legs. If you have multiple sclerosis or spastic thigh muscles, vaginal penetration from behind can allow your legs to stay together.

Incontinence (loss of bowel or bladder control). If you suffer from bowel or bladder incontinence, sexual activities can increase the chances of this happening. If there is a time in the day when you are more likely to have sex, plan your bowel movements for earlier. If you have issues with bowel or urinary functioning, you can use a side-by-side position during penetration to avoid putting pressure on the bladder. Sex in the bathtub or shower can be a good way to deal with bodily fluids. For tips on how to talk to your partner about bowel and bladder control, check out the Talking About Sex page. For more information on bowel and bladder control during sex, check out this website External Website that opens in a new window

Arthritis. Taking a hot bath before sex can help ease your pain. Careful positioning using pillows and stopping for breaks can help during sex. Some women find both penetration and oral sex easier if they are lying down with their legs hanging over the bed and their partner kneeling on the floor. Check out this Relationships, Intimacy and Arthritis booklet External Website that opens in a new window for more tips and positions.

Spinal Cord Injury. If you have decreased vaginal lubrication, using lots of lubricants during penetration can help prevent vaginal irritation or tearing. Many women experience orgasms after injury, especially through cervical stimulation. You may feel the effects of the orgasms in places other than your genitals, like your breasts or stomach. Visit this website External Website that opens in a new window for sex tips and positions for women with spinal cord injury.

Cerebral Palsy. Many of the positions listed in the question above may work for you during penetration. Sexual activities that involve large movements rather than small manipulations may be easier for you, and more pleasurable for both you and your partner. An athetotic tongue (that sometimes moves beyond your control) can be great for kissing, oral sex, and stimulation of the nipples.

(Source: The Ultimate Guide to Sex and Disability,ed. Kaufman, Silverberg and Odette, 2003)

Question5 My partner was recently raped. Should we wait until we have sexual contact again?

Survivors of rape or sexual assault often feel confused, betrayed, ashamed, guilty, or frightened. Some women may want absolutely no physical contact, while others may want to 'prove' that the incident didn't affect them by continuing with their sex lives as before. Other women may want to take it one step at a time.

The best way to see if your partner is ready to be physical is to ask her. One of the most traumatic parts of a sexual assault is the feeling of losing control. By always asking her before touching her, she will be able to tell you what she is comfortable or uncomfortable with. Don't assume that the types of touch that were okay before are still okay now. If at any point she asks you to stop, you should do so straight away. She may not yet have realised that there are certain sexual intimacies she is not ready for, and may react very badly to them. Remember that this is not directed at you. Asking her what she is feeling and thinking can help both of you understand what is triggering her reactions. If she suffers from panic attacks, ask her how she would like you to react and support her through them.

Don't feel rejected if she is not ready. She is probably going through many conflicting emotions that she cannot understand or distinguish, and the best thing you can do is give her the time and support she needs.

My Story

Orgasms, An Added Bonus!

  • 'My arms and legs don't always do as they're told, so I need help with all sorts of things and I use crutches or my electric wheelchair to get around. I also can't wear shoes very often or do anything strenuous; every sensation hurts.

Feel-good Positions

  • 'I rarely do intercourse ... I guess the positions that feel good are the ones where I'm being comfortably stimulated or am comfortably stimulating someone else. I love lying on my side kissing and hugging my lover - my left side is best to lie on so I can use my long right arm to touch them.

Stimulating Each Other

  • 'Depending on what sexual positions we do, it can cause him pain later, or pain during that is difficult to ignore, no matter how much fun we're having at the time. A lot of the medications he's on have an effect on his ability to sustain his erection, although not on his ability to get aroused or sexually stimulated.

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