Feeling frustrated about physical disability and sex


I have been dating this guy for ten years. We both have physical disabilities and therefore have very limited movement. However, we have complete sensation. We really want to have sex but are having difficulty with positioning. Since I have a little more movement than him, I am going to be the one who does most of it. We have had two very unsuccessful attempts and are getting very discouraged. We really love another, but are losing hope. Any ideas?



Dear RP,

Don't stop believing! It is common for people with both long-standing and recent disabilities to feel anxious, angry, and/or grief due to differences in their sexual abilities. However, all people may enjoy satisfying, exciting, and enjoyable sexual activity or sensuality. Figuring out what suits your needs sexually requires the following things: the courage to experiment, a degree of imagination, and creativity to work around any obstacles. 

There are a huge number of sexual positions, any of which may or may not be suitable for you, just as they may or may not be suitable for anyone without a disability. If you try any of these positions and feel uncomfortable, stop what you are doing and try something else. Initially, you may want to start with sexual positions that don't require much effort or exertion. Here are some tips, which you may find helpful depending on the physical needs of you and your partner:

  • Relax: When you experiment to discover new forms of sexual expression, it's useful to be in a relaxed and sexual frame of mind. This will help you laugh off anything that goes wrong, while gaining the maximum benefit from your exploration of the sexual possibilities open to you.
  • Stay within your natural range of flexibility: For example, if you have trouble straightening your legs, you can lie on your back with your partner assuming the "on top" position. Your partner can also lean back onto your bent legs for a slightly different sexual position for a different sensation.
  • Go easy on the bladder: If a partner is having issues with bowel or urinary functioning, he or she should be the partner on top. Side by side position is another way to avoid putting pressure on the bladder. Stoma and those who self-cath (pass a catheter several times a day to drain bladder) usually do so just prior to sex to avoid any unwanted urine leakage.
  • Support yourself: Try using pillows or rolled up towels to help you get into or hold a sexual position (for example, under one's lower back). Pillows can also help those with hip problems (when placed between the receiving partner's legs during side-by-side position, where he or she is penetrated from behind). Well-placed mirrors can also help with this strategizing (and help spice up the scene!). Furniture around the house may also prove useful, like the use of a bed or chair as support for a sexual position involving kneeling. Sex furniture, like the Intimate Rider, or blocks can also be used in helping a lover to assume good sex positions.
  • Tape down catheters: Suprapubic catheter (tube) users are free to engage in wheelchair sex, intimacy and sexual intercourse anytime. However, catheter tubing can cause blisters when pressed hard against the skin. You may want to tape your catheter and any tubing to your body prior to having sex. A sleeve of soft material slipped over the catheter and or tubing can also help avoid blistering.
  • Communicate: It is important to communicate with your partner. Speak up about your concerns and needs, and be honest about what is and isn't working. Taking the time to sort out issues with your partner will not only increase success in your sexual intimacy efforts, it may also help the two of you feel more emotionally intimate as well.
  • Play with toys: Devices such as vacuum erection pumps can initiate erection, and tight rings or bands applied to the base of penis will restrict blood drain from the penis once erection is achieved. Sex wedges, sex swings, vibrators, power tilt on a wheelchair, and easily removable armrests can all increase pleasure. You may even want to consider these features when purchasing wheelchair equipment.
  • Slip and slide: Sex lubricants can assist in achieving sexual penetration and increase enjoyment of wheelchair sex. Moreover, applying these gels and/or massage oils to areas where greater sensation exists may also prove pleasurable. Moreover, when a person experiences limited sensation below the level of spinal cord injury, he or she may experience heightened sensitivity above the level of injury. You may want to apply lubricant to these sensitive areas (such as nipples) to avoid chafing.

On a side note, don't forget the rubber! It is wrong to assume that a disability or injury makes a person infertile and/or incapable of catching and spreading sexually transmitted infections (STIs). Therefore, it is important to practice safe sex.

It always helps to be open to new ideas of sexual expression. A man with a disability may find that he achieves an erection through physical stimulus and touch, rather than erotic vision or thought. Such erections are not always sustainable or strong enough for penetrative sex. However, there's still plenty of room for other forms of sexual enjoyment, such as oral sex or the Karezza technique.

Remember, you are not alone! Although it may be a challenge, a large part of enjoying sex is figuring out the new ways in which your body works. There are tons of forums, websites, such as Sexuality and Disabilities, and groups for people in similar situations. These communities can provide practical advice, tips, and a place to talk to about your shared experience. 

While it may require a little creative thinking, you can find a way to be satisfied sexually, both alone and with a partner.

Last updated Jul 01, 2015
Originally published Dec 30, 2011

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