woman helpin gman in wheelchair cross a street

Disabilities never preclude great sex. With the will, there’s always a way. In the 1978 Academy-award-winning film Coming Home, a paraplegic Vietnam veteran (John Voight) is a bitter, depressed wreck—until a chance reunion with an old high school acquaintance (Jane Fonda) turns romantic. Despite his major disability, they discover how to enjoy lovemaking. In one scene, Fonda goes down on Voight and asks, “Can you feel this?”

“I can see it and I love what I see.”

Illness and disability complicate sex but never preclude it. Touch is the only sense we can’t live without. Virtually everybody—every body—enjoys sensual touch. When there’s a will, when there’s erotic desire, there’s always a way. Even those with severe disabilities can enjoy erotic pleasure. Of course, for disabled people to enjoy sex, partners must be patient and flexible, coaching is always necessary, and erotic adjustments must be made. But satisfying sex is always possible.

According to Census data, 19 percent of Americans—50 million people—suffer disabilities. The many sexual challenges disabled folks face begin with toxic myths about their sexuality:

Myth: Disabled people are not sexual.

Truth: Everyone has handicaps. Some are just more visible and limiting than others. Except for the asexual 1 percent, everyone is sexual and enjoys erotic pleasure. Even severe handicaps don’t negate sexuality. Disabled people often face serious obstacles in expressing their sexuality. But they’re as sexual as everyone else.

Myth: Disabled people are not desirable.

Truth: Everyone is attractive to someone. If you’re able-bodied and feel an erotic spark with a disabled friend, feel free to say so. And if you’re disabled and feel romantically attracted to a friend, speak up. Of course, attraction may not be reciprocated. That’s life. But silence means that nothing happens.

Myth: Disabled people have so many problems, they don’t have the time or energy for sex.

Truth: Sex is not a luxury some can’t afford. It’s one of life’s greatest pleasures. Disabilities don’t change that.

Myth: Disabled people can’t have “real” sex.

Truth: Some disabilities make vaginal intercourse difficult or impossible. But there are many other satisfying ways to make love. Even those who have no genital sensation can enjoy erotic pleasure and orgasms

Myth: Sex is private and serious disabilities preclude privacy.

Truth: People with severe disabilities may need round-the-clock attendants and may not have the privacy able-bodied folks take for granted. But that doesn’t cancel their sexuality. Attendants can position the disabled to enable masturbation or partner sex.

Myth: Disabled sex can’t be great sex.

Truth: Actually, after several years, some people who suffer disabling injuries report sex more enjoyable than what they had before they became disabled. Compared with able-bodied sex, disabled lovemaking requires much more discussion of what feels good and coaching to accomplish it. That deepens intimacy and enhances sexual enjoyment.

Of course, disabled sex is no bed of roses. Many disabled people feel undesirable. Disabilities complicate finding partners. Mobility limitations may interfere with solo sex and partner lovemaking. Many disabilities cause chronic pain and/or fatigue, which interfere with sexual energy and responsiveness. Many disabled people take medications, notably antidepressants, which may cause sex-impairing side effects. Some disabilities interfere with genital sensation and orgasm, for example, spinal cord injuries. And disabled people who require attendants may have difficulty negotiating the assistance they need for enjoyable solo or partner sex. But with sufficient stimulation, many men with spinal injuries can raise erections and around half of all people with spinal injuries can have orgasms.

Sexual suggestions for those with disabilities:

  • You can be as sexual as you have the energy to be.
  • Focus on your abilities, the pleasure you can enjoy and provide.
  • If chronic fatigue is an issue, schedule sex when you have the most energy.
  • To whatever extent possible, enjoy masturbation. Solo sex does not require much mobility or genital sensitivity. Self-sexing is not second-best sex. It’s the very foundation of sexuality. When you have physical challenges, it becomes even more central to erotic satisfaction.
  • For many people with disabilities, shower massagers can be great boons to self-sexing. The spray’s intensity can be controlled, and directed at nipples, genitals, or other enjoyable spots. For those who need attendants, shower massagers may also allow privacy. Attendants can set up in the tub and direct the spray, then leave.
  • Solo sex can be enjoyed with others. Partners can self-sex in each other’s presence or over the phone.
  • Orgasm is not necessary for erotic enjoyment. If it happens, great. But try not to view sex without orgasm as “failure.” The goal of sex is not orgasm, but pleasure—and in an erotic context, any sustained, gentle touch can provide it.

Surrogate Partners for People with Disabilities

The 2012 film, The Sessions, is based on the true story of a Berkeley, California, surrogate partner (Helen Hunt) who helps a quadriplegic (John Hawkes) enjoy sex—though all he can move is his head. Surrogate partners working in coordination with sex therapists can bring joy to those with disabilities who have no other partner options. Visit the International Professional Surrogates Association (IPSA, surrogatetherapy.org).

Are You the Parent of a Disabled Child?

  • Everything in this post goes double for parents of children with disabilities. My suggestions:
  • Your children are sexual. Please don’t deny that.
  • All disabled children can experience sensual pleasure. Look for ways to encourage this: vibrators, other sex toys, shower massagers.
  • Discuss sexuality with them as you would with able-bodied children—see the post How to Discuss Sex With Young Children.

Of course, it’s not easy discussing sex with kids. When I had children, I’d been a sex educator for a decade and still sometimes felt tongue-tied. Fortunately, you don’t have to be an expert. Or super-articulate. All you have to do is try. And keep trying. Once disabled kids become teens, you might watch Coming Home and The Sessions with them and use the movies as springboards for discussions of their hopes and needs.

  • Some children with severe disabilities require a great deal of care and may not have much opportunity for private self-exploration and masturbation, let alone partner play. To whatever extent possible, grant them privacy and opportunities to explore their sexuality by themselves and with special friends.
  • When disabled teens want to lose their virginity, surrogate partners can help. Visit the International Professional Surrogates Association.

For more

The best book I’ve found is The Ultimate Guide to Sex and Disability: For All of Us Who Live with Disabilities, Chronic Pain and Illness, by Kaufman et al. It’s available wherever books are sold.

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