Let’s Talk about Sex after Disability

The longer you remain on this planet, the more changes your body and brain will experience. Part of being human is accepting the fact that as we age and experience life, there may come wisdom, but also physical changes can/will happen. The fact is, the human body ages, and regardless of age, can acquire a disability at any point. 

However, society really doesn’t talk enough about the sexual changes that occur after people acquire health conditions like depression, brain injury, cancer, heart attacks, and strokes. What about accidents or illnesses that result in removal of body parts or limbs? These changes that alter your mind, body, and presence impact the expression of sexuality.

I learned this first hand in 2004, when I acquired a physical disability from the surgical removal of a birth defect that was beginning to rupture inside of my spinal cord, while I was pregnant with my son.  

As an inpatient for several months at an amazing neurological trauma rehabilitation hospital, learning how to adjust and take care of my new body entailed getting extremely thorough lessons from occupational and physical therapists. I learned about handling bowel and bladder needs, temperature regulation, transferring myself from one place to another, and checking my body for scrapes and sores. I made art, cooked food, and folded laundry. I even learned about accessible services available on airplanes. However, when it came to sex ed patients were separated by gender, and shown a 45 minute film, 15 minute discussion . . .  that taught nothing. It basically said “Hang up having a sex life—you can cuddle, though!” I knew this was untrue, and it became the catalyst for my future work in disability and sexual health education.

People need open and accessible sexual education when acquiring an injury or chronic condition that results in disability. Sexuality is an important and natural part of our humanity. Sexuality and sexual dysfunction in patients with physical or neurological disabilities are often overlooked by medical personnel, but they are topics of great importance to the person and to those with whom they share significant relationships. 

Before I go any further, let’s dispel some myths related to sex and disability:

Myth: Disabled people don’t have sex.

The biggest myth to dispel is that disabled people don’t have sex or less sexual. There are able-bodied and disabled people who identify as asexual, but it an absolute myth that it’s how all disabled people identify.  

Newly disabled people find themselves confronting what it means to be sexual. Due to ableism (discrimination and bigotry towards disability and disabled people) being such a prevalent part of society, people find themselves having to redefine what having sex actually means, and dispelling the common myths and misconceptions out there surrounding disability and sex.  

Myth: Sex should be spontaneous. 

The idea that the best sex happens when people are overcome with sudden desire and rip each other’s clothes off only holds up in the movies. 

Myth: Sex means intercourse with penetration. 

With some disabilities penetration may no longer be possible or pleasurable, but that doesn’t mean sex will be any less hot or intimate. 

Myth: Satisfying sex requires a firm penis. 

For some people with penises, disability can lead to losing the ability to achieve or maintain an erection. But that does not mean the end of satisfying sex for you or your partners.

Myth: Good sex ends with an orgasm.

Everybody loves orgasms, but don’t let the pursuit of them ruin all the other great parts of sexual experiences. If disability makes it harder or impossible for you or a partner to reach orgasm you can discover new ways to emphasize and enjoy arousal and sensual touch, even if it doesn’t lead to a climax.

Re-Educating Yourself About Sex After Disability

So, now that we’ve dispelled some myths, let’s talk truths about sex and disability. If changes to your body have meant changes to your sex life, learning to redefine what activities feel sexually pleasurable and connective is the first step. To help figure it out what this means for you means answering: 

• What’s the impact of experiencing this change in your physical body on sexual expression and desire? 
• How do you mentally adjust and adapt to the differences? 
• Where do you find supportive and factual information about strategies, and supportive products are out there to help maintain pleasurable sexual connection and intimacy?

Explore your new normal. 

Your body may work differently now. For example, parts of your body may not move, look or feel the way they did before the injury or accident. Building your confidence is key. Focus on the parts of your body that you feel good about — maybe buy lingerie or sex toys that emphasize or maximize your confidents in those body parts. Make time for activities that make you feel happy and confident. Sometimes the body changes themselves can cause a lot of anxiety about how others might view it.  For instance, some cancers, surgeries, or chronic illnesses affect your biological needs, such as having to wear an ostomy bag to collect body waste. If so, you can cover it with a special pouch or wear a shirt over it during sex if it makes you self-conscious. If incontinence is a problem, go to the bathroom before sex. The better you feel about yourself, the more you’ll be able to relax and enjoy having sex.  

As for sex itself, plan for when you are well rested and have enough time. Start with activities you think may be easiest and progress to more challenging things as your confidence increases.

Address your mental health.

If you think depression or anxiety is changing how you feel about sex, speak with your doctor or a health professional.  Your doctor may have some advice you haven’t tried yet. You can talk with a therapist or licensed counselor if you want to work out how to emotionally process how you feel about your body. There are also peer support groups for various conditions, such as heart attack, spinal cord injury, cancer, etc. where people who have similar experiences discuss and support living and functioning with conditions, including sexuality and relationships. There are also a wealth of resources online, with digital forums run by and for peers with various illnesses, conditions, and disabilities. Many have dedicated spaces for discussing sexuality, and offering advice or an ear.

Talk about it.

Depending on what has occurred, your desire, arousal, and sexual response may also be different than what it was previously. If someone is partnered, you might be concerned with how this may affect your relationship(s). Open communication between you and your partner is an important step towards getting back your sexuality. Partners may be confused or unsure of the best way to show support and affection. They may retreat or wait for cues from you about when to resume an intimate or sexual relationship. Discussing each person’s fears and hopes and comforting each other can help you and your partner have a satisfying sexual relationship. Remember, talking about sex is sexy.

Get outside advice.

Learn how to adapt to physical changes. You may need to find new positions and ways of doing things. There is information available that can help provide advice on positioning and help you practice moving into awkward positions. There are sexual products and aids that make engaging in sexuality more accessible. If you experience problems with erections, lubrication or reaching orgasm your doctor will be able to advise you. Do not stop taking any medicine without the advice of your doctor, nor start sexual assistence medication (like erection pills).

About the Author

Robin Wilson-Beattie (she, her) is a speaker, writer, and advocate for disability and sexuality as well as one of the first people to talk about disability, sexuality, and marketing to adult product retailers and manufacturers. She combines years of personal experience with medically sound research to provide a unique perspective on how life and identity impacts one’s sexual expression. Her speaking engagements include multiple keynotes and panels, including three consecutive years speaking at the  Adult Video News convention in Las Vegas. 

Her work has not only helped tens of thousands of disabled people, but also inspired many others to become advocates for sexuality and disability education, an incredibly underserved area.

Robin is a member of the Association of American Sexual Educators, Counselors and Therapists (AASECT), the Women of Color Sexual Health Network (WOCSHN), and a graduate and member of the San Francisco Sexuality Information Training (SFSI). Committed to writing her memoir in 2021, she looks forward to sharing her wild journey of Blackness, acquiring a disability via rare illness while pregnant, motherhood, sexuality, and her experiences searching for answers. Robin is a deep-fried Southern woman, mid-century buff, and proud Mama of one son.