Enjoying sex when you have a disability

There are many, many fabulous ways to enjoy sex – desire, masturbation, a deep relationship, online flirting, erotica, striptease, outdoor sex, threesomes and group sex. Just writing this article is giving me enormous satisfaction and fulfillment, hoping that I am conveying to you information and tips that can make your life more sexy and happy – it is, in its own way, a sexual act.

Image by David Steinberg, www.davidsteinberg.us 

I find it shameful that disabled people get such poor sex education, especially specific sex education about their disability – stuff they can relate to and can put into practice. It is also sad that so many disabled people have been sexually abused and have to struggle to overcome all the damage done in order to start enjoying sex.

What I am going to do here is go through some disabilities and impairments, in alphabetical order, to help you understand some things that may have been troubling you, and give tips on how to overcome them. I am aiming to give advice you won’t find anywhere else. Obviously, this could fill several books, and is only a quick summary, so I am supplying resources at the end.

Disabled people complain to me that they see everybody else having a great sex life, but this is just not true. Many people in this world don’t have much sexual fun. So stop feeling that you are the only ones missing out, and concentrate on having pleasure – your way.

It’s often important to spend time with self discovery. For example, learn more about Big Boy Sweeties, a.k.a. Viagra, and the right dosage for you. People who cannot reach orgasm from their penis or pussy, and indeed everybody else, can discover all kinds of other sources of orgasm and sexual pleasure by becoming more acutely aware of their body and by stimulating their prostate, G spot, cervix, nipples, mouth, testicles, neck, ear lobes, anus, thighs, feet and buttocks, as well as less obvious areas, using lubricants, dildos, vibrators and fantasy.

The more you gain pleasure from your body, the more you will love it and the more receptive you will be to other people loving it. Once you have done this “ground work”, you can then teach your partner/s.

Autism

Lots of autistic people enjoy sex quite happily. Some fall in love with objects instead of people, and may have a slight problem having a happy sexy affair with, say a vacuum cleaner, but the biggest problem is probably other people’s attitude to it. Try to surround yourself with people who accept and understand you. There is an Autism Island on Second Life where you can enjoy meeting others.

Aspergers Syndrome

Aspie people can enjoy sexual relationships but may be confused or have their own ideas about what it is, or should be. Just hearing someone say that “sex is dirty” can put some Aspergers people off. They often find it very difficult to find a partner. Social un-awareness and difficulty in comprehending the needs of a partner, taking things literally instead of in the way they were meant, can lead to relationship difficulties. Realising that you will make mistakes and trying to double check that you have understood and got it right can help diffuse situations. Ask your partner to guide you, and not just hope you will work things out for yourself.

Arthritis

Painful joints don’t feel sexy, so try to plan to have sex when there is less pain. Have a bath and a rest beforehand.

Arthritis in the hands may stop you wanting to use them in sex, so don’t worry – you still have your lips, your eyes and your smile. Splinting, compression gloves, heat treatment, TENS and Capsaicin ointment can sometimes help with pain in the hands. Ice treatments are sometimes recommended for after sex, to ward off an inflammatory response. Discuss these options with your partner and GP, and speak quite openly without embarrassment if you can.

Women with Sjogren’s syndrome or systemic lupus erythematosus (SLE) may need extra vaginal and anal lubrication which your GP can help you with.

Making love to someone with arthritis requires gentleness and tenderness, rather than hard sex with sudden jerks. Explain this to your partner. Negotiate with your partner so you don’t have to put weight on your joints or stay in one position for too long. Use cushions to support, massage to relax, and be soft and sensuous.

Probably the most important thing for a couple is to reinforce the feelings of attraction and love, because many people with arthritis stop liking the way they look and become too depressed to feel horny. People with arthritis who have not yet found a partner need to find other ways to boost their self esteem.

People who have hip replacements are often not advised sensibly about sex after the operation and there is a good leaflet about this on the Outsiders website.

Brittle bones (osteogenesis imperfecta)

Typically, having been disabled from birth, most people with brittle bones are comfortable with their disabilities and enjoy life and sex to the full.

Cerebral Palsy

The classic difficulty in sex is not being able to spread your legs easily, although some people have an operation to cure the problem. Some couples find they prefer to use sex positions where the legs are not spread, like entering from behind when you both lie on your sides. Relaxing your body before sex can stop spasms.

Uncontrollable movements (athetosis) will decrease after orgasm and this will even help speech, so start the sex with orgasm so you can enjoy it more. Kissing and licking can be spectacular – find things you are good at that your partner also enjoys.

Cystic Fibrosis

Coughing can be a problem so explain that this is normal to your partners. Having someone lie on top of your lungs can make the coughing worse, so it to be avoided. Learn how to enjoy low-energy sex – talking to your partner to turn them on, instructing your partner to do things that excite both of you, and wallowing in smoochy pleasure. Women may need lubricants to enjoy intercourse more, and there are lots of lovely ones on the market.

Deaf / hearing impaired

It’s bonding and sexy to have a conversation between two of you that nobody else can understand, by signing, lip reading or writing, especially if the conversation is about sex. Deaf people often form relationships together and develop their own sexual language. This may be dynamic or limiting. DeafBunny is a website which aims to expand communication amongst deaf people. Deaf people naturally prefer sex with the lights on, so they can communicate, and most people find this extremely exciting.

Deafblind

Deafblind people may have led sheltered lives and many are dying to burst out. You may not have all the information but are eager to learn, so collect as much as you can. If sex instruction books and information about forming relationships are not available in braille or the medium you use, request them.

Communication through naked skin and hot passion is worth aiming for – focussed and intense, so do your best to find a partner you can share these pleasures with. Communication via finger language can take place in the dark – very sexy.

Epilepsy

Don’t worry about having seizures during sex or orgasm, as worry itself is most likely to cause one. Remember that anxiety and stress are known seizure “triggers”, and sex can reduce stress, and help relax you.  Be sure to let your partner know you are epileptic though, just in case. Sometimes people with epilepsy experience sexual problems such a low desire or not getting the usual genital response and this might turn out to be a result of medication – so ask your GP for advice.

Head injury

Frontal brain injury can either inhibit or disinhibit sex. The latter can change a normally sexually placid person into Mr or Mrs sex-crazed hotpants. Neither is usually a welcome change for the spouse or family, but you have your rights to be whatever you want. So long as you don’t touch up and try to shag strangers in the street, which can attract unwanted hostility and the police, you can adapt your life to suit your new desires, or lack of them. Headway is there to help you, your partner and family so seek all the help and support you want.

Kidney failure

People with renal failure may experience a wide range of sexual problems for an even wider range of reasons, and there are so many complications and side effects that sex tends to get left out. Even more important that you don’t leave the subject out of discussions with at least one member of your renal team.

You may experience low self esteem due to invasive treatments, and shyness about your puffy face and the tube inserted into your body or horrendous scars where a tube has been. Don’t get overwhelmed with negativity – keep your sense of humour and enjoy sex whichever way you can.

Learning disabilities

People with learning disabilities suffer more stigmatisation than other disabled people and get shunned as partners. This is a shame as you can be extremely affectionate and sexy. The problem lies in the fact that you can also be vulnerable to abuse from predatory people, you may, perhaps more than others, forget to use safer sex. You may find relationships hard to keep going, especially because of the fact that couples often live under the eye of critical parents and prudish care staff. Fortunately, there is a lot of support out there, discos, clubs, dating agencies such as Stars in the Sky, and a wonderful organisation called Respond which deals with problems such as abuse and bullying.

When a clinical judgement has been made that someone with learning disabilities does not have the mental capacity to consent to sex, that person is condemned to a life without sexual contact with other people. It has been argued by lawyer John Blandford that if somebody has the ability to express sexual feelings and desires something other than masturbation, then they would have sufficient capacity for a sex worker to be booked. As the current law stands, however, they may even be deprived something as harmless as an anal dildo, which puts them at risk because, without it, they might shove something dangerous into their backside, which could disappear up inside, and/or cause damage. All learning disabled people have access to advocates who can speak on their behalf, and all advocates should be trained to include speaking up for sexual rights. People First can advise on this.

ME

The onset of ME brings extreme tiredness which will dramatically interfere with relationships and friendships. Sometimes it leads to a complete physical breakdown and unless the ME sufferer has a very supportive partner, they have to return to live with their parents or go into care, and relationships break down. Sadly, emotional and sexual problems usually don’t get addressed by occupational therapists or support workers, and it’s a long haul back. It’s very important to find new ways to enjoy sensual and sexual pleasures, and tantric massage might be a good option.

Multiple Sclerosis

Slowly, people with MS are finding out more about what is behind their unpredictable sexual changes as the MS Society and Trust become more open to the subject. Keep communicating with your partners and others who have MS to swap notes. Keep trying things that may not have worked before. Not being able to feel your genitals or experience genital orgasm can be compensated for by concentrating on other parts of the body, and / or switching to a more powerful vibrator.

The MS Trust runs an online forum, Open Door, twice a year and includes discussion of sex. Nicki Ward’s new book on “Sexuality and Intimacy for Women with MS” is also recommended.

Muscular Dystrophy

This progressive disability requires awareness of the increasing lack of independence and privacy as you require more and more help, and a knack of dealing with that. The biggest challenge is always holding your own to keep other people’s moral judgements away from restricting your freedom. Just considering the fact that a large proportion of able bodied people have affairs and visit sex workers without the knowledge of their spouses makes a very good example of how you may easily resent lack of privacy. Continue to spend time with your friends, and make sure you experience all the sexual pleasure you can; after all your disability in itself is a hard enough challenge.

Enjoying sex with your partner needs a tremendous amount of trust and level of communication. It is much easier when your partner is not your carer and when you direct your own personal affairs using PAs.

Motor Neurone Disease

Having weak muscles obviously causes sexual difficulties and many with MND feel highly frustrated, unless they have a sexually confident and active partner. Health visitors often complain of their male clients living alone, that they seem desperate for physical contact. It is important that this is recognised in a positive light, and respectfully. Speech problems often make it difficult for the person with MND to complain and ask for sexual help, but do persevere, and be sure to work something out, as sex is a very important source of pleasure and mental health.

Parkinson’s Disease

Weakness and shaking can make it difficult to enjoy sex in the same way as before but the biggest problem can be the medication which can cause hypersexuality. If this is a problem for you, ask your GP to switch medication and take you seriously.

Polio

It may be a matter of Ingenuity over Lack of Mobility. Some men experience retarded ejaculation. It’s important to not let that worry you: become less orgasm-oriented or use a strong vibrator. Men sometimes complain their partners want them to ejaculate, and feel denied without. The best way round this is to make the partner so carried away with their own pleasures that they don’t notice. Or keep a hidden jar of hair conditioner by the bed and use dobs as a secret substitute!

Restricted growth

Many people with restricted growth manage to form relationships and experience a good sex life. Sex is good for them as it keeps the heart and lungs in shape, helpful when they are constricted by being inside a small chest. If you have difficulty breathing and use a respirator or breathing apparatus at night, it’s good to join an online group of people who need this, so you can chat about finding a new partner and bringing your machine along, and other practicalities. Some people with small stature seem extremely horny, which could be because their normal size genitals and quantity of sex hormones is out of proportion to the size of their body.

Speech impairment

Speech impairment due to Cerebral Palsy and some other conditions can become lessened through sex and orgasm, so try having an orgasm quickly before getting into verbal intercourse and loveplay. Otherwise, get prepared for talking without your speech machine, using a speech board, pen and paper or have special signs for things you often want or need to say during sex. Ask your partner to be on the look-out for these signs, so you can trust them.

Spina Bifida

There are many different ways SB can affect your sexual function. The obvious is having to use a catheter or having an ostomy. Discuss sex with your local ASBAH worker, your doctor. Some people with SB have reduced sensation even be unable to feel anything in their genitals. You need to learn how to experience pleasure and orgasm from other parts of your body: nipples, prostate, anus, neck, earlobes, lips. A neuological bypass operation is performed on men in Holland. This provides some sensation on one side of the penis, but the operation is not yet  available in the UK.

Many people with spina bifida still live comfortably at home with their parents in an asexual environment. Those who have broken free have often struggled for their independence and missed out on teenage flirting, fun and experiences. Sociability is a yahoo group run by a sexy SB woman, for people to discuss, flirt and catch up. The secret is to get out there, meet people, don’t be afraid of making mistakes and find out who you are and start enjoying your sex life.

If you have hydrocephalis as well as SB, and this effects short term memory, be sure to explain this to potential lovers so they don’t think you are stupid, and write things down to make a note of things your lover has said.

Spinal injury

The most important things are to keep communicating with other spinal injured people about sexual matters, and try to stop being orgasm and genitally focused, enjoying your body whichever ways you can. The area just above the level of paralysis can become ultra-sensitive and become orgasmic via sensory amplification. Some spinal injured people feel they no longer experience sexual release, but others find release from sensations in non-genital areas, including the brain.

Some spinal injured hanker for the pleasures they enjoyed pre-injury whereas others move forward to new discoveries. For example, women may crave pleasure from their genitals despite the fact they cannot feel them. Some succeed. For many years it is been known that the vagus nerve mediates a response to vaginocervical stimulation after spinal cord transection in the rat. This might not be a source of actual orgasms, but certainly strong sexual feelings can be gained from stimulation of the cervix and the g spot.

Men who put a high value on their erect penis may succeed by using medical appliances, such as implants, to help them function as before. If this is the route you want to take, you need to start with a visit to your GP. However, men who want to be sexual performance artists, and like to take care of the relationship, tend to have a more difficult time adapting to sexual enjoyment after injury because they may not be able to do many of the things they need to make that possible. 

The level of injury has some bearing on how much sexual function is affected but this can change over time. Some people can respond to touch rather than mental desire. All kinds of things may trigger a sexual response, e.g. bending a toe, so it is important to experiment and keep your mind open to possibilities. Use various levels of stimulation and different kinds of lubricants.

Autonomic dysreflexia is a worry for people with a spinal injury above T-6, symptoms being irregular heart beat, flushing in the face, headaches, nasal congestion, blurred vision, sweating above the level of injury. You need to stop the sexual activity at once and if symptoms continue, contact a doctor.

Spinal units don’t tend to be very helpful to their patients, concentrating on sports activities rather than sexual, and many spinal injured people feel sexually abandoned. Some try Tantra, some try a special vibrator made by Multicept in Denmark called the FERTI CARE personal which is designed to induce orgasm in spinal injured people.

As with Spina Bifida, bladder and bowel management can be an issue, but if you learn to manage things well, emptying before sex and having mop-ups at hand, these problems should not get in the way of sex.

Stroke

Stroke survivors tend to avoid sex, for fear of having another stroke, but sex is not a cause of strokes. Sometimes stroke survivors don’t realise that they are aroused sexually, so it’s good to get into the habit of having sex and learning how to enjoy pleasures which may not include intercourse. People who lose their speech can still enjoy physical contact and sex, which is very important because they may have few other pleasures open to them.

Visual impairment

The combination of not being able to read body language or engage in eye contact, cuts VI people off socially which makes finding a partner more difficult. You are also cut off from the huge amount of visual stimulation and imagery around you, so on one level, people with visual impairment tend to be sexually naive and deprived. A short-sighted person cannot go up close to people to see them, as that would be invading their space. There is no book (in print, braille or on disk) for blind people about sex, no mention of it on the RNIB website, or any specialist help. Having said all this, blind people can make amazing lovers and most of them enjoy sex whenever they can. This is because you tend to be bloody minded and sort things out for yourselves. Blind men visit massage parlours to “see” beautiful women by massaging them. Blind people blast through social restrictions, ask for help, get chatting and win people over by humour and sheer determination. Just be careful, in your determination, of not shouting at people. And practise your techniques in bed and out as much as possible, to become a maestro lover.

General tips

Disabled people can make the best lovers, because you know how to ask and you become ingenious at finding ways around all problems you face. I hope that some of the information above will help you out.

Quite often, it is your own body image and confidence that gets in the way of sexual pleasure rather than impairment or even pain. Body image and confidence  can be improved by activities – trying amateur dramatics, having some beautiful photographs taken, visiting a sex worker, doing voluntary work, joining a assertiveness group, a dance group, visiting a fetish club dressed up like a military dictator or a fetish diva, whatever. Whatever is right for you. And be prepared, with a sense of humour, to try things that may not work.

Disabled people sometimes say that their partner avoids sex because they are afraid of hurting them. You need to make it clear that you will speak out if you are feeling hurt or pain, but you would rather take the risk of suffering than have no sex at all.

If you suffer short term memory loss, be sure to explain this to new partners early on. Anything that they need to know in advance should be explained, simply and sweetly. Otherwise they might misunderstand, and desert you.

If you are not actually feeling very sexy, that can be OK. But it’s sad if this has been brought about by the way the people around you have focused on your disability, sickness, impairment etc, and wiping out any positive feelings you have about your body. It’s also very sad it your disinterest or dislike of sex is a result of sexual abuse. Ask your GP to refer you to counselling if you think there is any possibility that might apply to you.

Exercise helps to raise the libido and being fighting fit makes you seem more attractive. This might not be very easy for some disabled people, but get referred to a physiotherapist to get yourself sorted out.

There is a new move in the treatment in Cancer to keep the patient body-positive, including the sensual and sexual side. If having a low libido is worrying you, think about this. Visit your GP and discuss any drugs you may be taking to see if they are the cause. There is an option of testosterone patches which liven up with libido. However much you feel content without sex, once you have regained your libido, your body will thank you and the world will seem a prettier, more vibrant place.

The gateway to sexual happiness is sexual health so, if you are sexually active, remember to go for testing at your local sexual heath, GUM or STI clinic.

Some disabled people with nerve damage may find it useful to understand the difference between psychogenic and reflex responses. Psychogenic responses are when you get a physical sexual response (erection, balls tightening, arousal in clitoris, both the head and the area beneath the vulva, and vaginal lubrication) because of being turned on mentally. Reflex responses are the same responses as a result of touch, rubbing, kissing, vibrating, etc. Both are good. Some reflex responses come from the spinal nerves and others from the vagus nerve which is the only nerve that starts in the brain and independently of the spine, reaches the chest and abdomen.

If your arms are too weak to masturbate, whether you are male or female, try using a vibrator. Try the O-Max vibrator, which boasts it’d get an orgasm out of a stone. O-Max is cordless – no wires to inhibit, no batteries to keep buying and the charger is included.

If your arms are too short to reach, try a Wand Vibrator. These have a long handle with a head at one end of it and the electrical cord on the other end.

Those who cannot hold a vibrator can try a hands-free version which is put in place by your partner, PA or care worker. There are many types, and you can find them in catalogues or online.

For men who have difficulty in having an orgasm, the Vibrating Power Stroker might do the trick. It has a sleeve which holds a vibrating bullet close to your penis. Its great, it literally vibrates the crap out of your dick until you come! Want the feel of a vagina? The fleshlight might do the trick. Take a look in the Lovers’ Guide shop.

If you don’t want anybody to hear you using your vibrator, try a coil vibrator. It’s not run by a motor, but an electromagnetic coil, so it’s almost completely silent.

If you cannot manage sex together un-assisted, ask for assistance. Some people find a rocking bed ventilator is enough, some use sex toys, others need enablers.

Spend spare time learning all there is to know about sex, and treating yourself to sensual pleasures. Any problems, give me a call on the Sex and Disability Helpline.

Dr Tuppy Owens

Outsiders and Sex and the Disability Helpline

Outsiders the website features leaflets, our book Practical Suggestions, copies of our magazine INSIDE which updates Practical Suggestions and resources. Our club is a self help group for physically and socially disabled people to find partners.  www.outsiders.org.uk Our group the Sexual Health and Disability Alliance campaigns for the sexual rights of disabled people, formulates policies and runs a conference.

Sex and Disability Helpline 0707 499 3527 11am – 7pm weekdays. Sexdis@outsiders.org.uk

Resources

Second Life a free 3D virtual world where users can socialize, connect and create using voice and text chat. www.secondlife.com

Freaks, Geeks and Aspergers Syndrome by Luke Jackson, a book in which he writes,  “Some people call Asperger Syndrome a disability. I call it a gift.”

Our Relationships, Our Sexuality: A Guide for People with Arthritis (Paperback) from Young Arthritis Care

Sexuality and Cerebral Palsy http://www.ofcp.on.ca/newbooks.html.

DeafBunny works towards breaking down communication barriers continually faced by hearing impaired people. www.deafbunny.com

Epilepsy – effects on sex http://www.epilepsytoronto.org/sex.html

Headway – the brain injury association, with local groups and a helpline 0808 800 2244 www.headway.org.uk

Sexual problems with kidney renal failure http://www.kidney.org.uk/Medical-Info/sex-problems/common.html

LD Pride Canadian site for people with Multiple Intelligence (MI) especially for people with learning disabilities and attention deficit disorder.  http://www.ldpride.net/selfadvocacy.htm.

Stars in the Sky Dating for learning disabled people in London and other parts of the UK. www.starsinthesky.co.uk/  www.starsinthesky.co.uk

Beautiful Octopus/ Heart’n’Soul disco and arts events by and for people with learning disabilities 020 8692 4446 info@heartnsoul.co.uk

Respond Challenging vulnerability and sexual abuse in the lives of people with learning disabilities. 0808 808 0700 www.respond.org.uk

People First (Self Advocacy)Hampton House, 4th Floor Albert Embankment, London SE1 7TJ. 020 7820 6655, general@peoplefirstltd.com

Shakti Tantra to help people connect up with their inner sexual selves.  07968 665729 info@shaktitantra.co.uk http://www.shaktitantra.co.uk

Sexual dysfunction in MS Open Door – August 2006 http://www.mstrust.org.uk/information/opendoor/articles/0308_08_09.jsp.

Sociability Sociability_Group-subscribe@yahoogroups.co.uk

Sexuality and Spinal Cord Injury – where we are and where we are going by Marcia L Spipski www.ed.gov/pubs/AmericanRehab/spring97/sp9707

Sexuality for Women with Spinal Cord Injury Spinal Cord Injury Information Network  http://www.spinalcord.uab.edu/

Sexuality Reborn – a film featuring couples about enjoying sex after spinal cord injury. The film was made by Alexander and Sipski in 1993. $39.95 plus $8.00 Available from Kessler Institute for Rehabilitation, 1199 Pleasant Valley Way, West Orange, NJ 07052, USA; (800) 435-8866.

ASBAH the Association for Spinal Bifida and Hysdrocephalus Helpline 0845 450 775 helpline@asbah.org

The Ultimate Guide to Sex and Disability by Miriam Kaufman, Cory Silverberg and Fran Odette

Posted in Sex, Sex And Disability