Hi Alice,

I am a quadriplegic of twenty years and need help with a problem my girlfriend and I are having with our sex life. The main problem is she feels guilty because she is the only one that gets "physical gratification" when we make love. We can't have intercourse but we have tried several other methods that worked great as far as her getting an orgasm, but the guilt sets in a few minutes afterwards. I have tried many times to explain to her that I also get a lot of enjoyment from our intimate times together, but she does not believe me. She thinks the only reason I want to fool around is just to give her pleasure and this is not true. Some of it does have to do with making her feel good, but I also get much pleasure, in a more "mental" kind of way that she can not understand. We live together, love each other very much, and plan to marry in a few months, but I'm scared this problem is going to get worse if she never believes me. I feel bad about marrying her if we can't have a satisfying sex life because I feel like I'm cheating her out of that part of her life.

If there is any way you could help me with this I would really appreciate it. If you know of any books on this subject that would also be a big help.

Thanks and hope to hear from you soon!


Dear John,

The issue you speak about is actually something that a lot of couples, with or without disabilities, face. For many, it is confusing to figure out how to balance the individual needs of each partner with the mutuality of sex. Indeed, pleasuring a partner can be a highly gratifying emotional experience — one that is sexually satisfying in a unique way — and this can be difficult to communicate.

You and your girlfriend seem to have different ideas about how people experience pleasure, and there may be some additional nuances and meanings because of your quadriplegia. Your girlfriend may be focusing on physical sensations, as many do, and, therefore, assumes that you don't "feel good" when you are sexually intimate with one another. You, on the other hand, are appreciating what you do feel — the changes in her breathing, her special beauty, excitement at her enjoyment, and caring and loving thoughts about your relationship. In addition, your girlfriend cannot know what you physically feel in any part of your body, and this may be something you could talk with her about. You might consider your own behavior as well. Perhaps your girlfriend feels pressure to orgasm each time you are sexual, and maybe you can talk with her to see how this pressure might be reduced.

But this may not be the whole story. It's possible there are questions about how much you can trust each other's statements about how you feel. You may need to help each other understand your different ways of being sexual and learn to trust what the other says. Have you been able to describe to your girlfriend how you receive pleaseure they way you have here? Have you shared fantasies with her? Are there times when you wish you could feel certain sensations that you can't? If you are both able to talk openly about the great parts as sex with each other as well as the challenges, you may be able to build a foundation of trust and understanding that will help both of you feel more comfortable receiving pleasure in the future. It may take some time for your girlfriend to truly appreciate how sex for you is satisfying. Together, you can work on finding ways to communicate clearly and thoughtfully, so that each of you feels that your sexual desires are being met. Couples counseling and sex therapy are also options.

It might help to think through these issues, and try discussing them together, during times when you are not being sexual. A number of books and web sites also have information regarding sexuality for people who have a disability (and their partners) that may help along the way:


Ducharme, Stanley H. and Kathleen M. Gill. Sexuality after Spinal Cord Injury: Answers to Your Questions. Baltimore: Paul H. Brookes Publishing Co., 1996.

Klein, Erica L. and Ken Kroll. Enabling Romance: A Guide to Love, Sex, and Relationships for the Disabled (And the People Who Care about Them). Bethesda, MD: Woodbine House, Inc., 1995.

McDonald, Sylvia Eichner, Willa M. Lloyd, Donna Murphy, and Margaret Gretchen Russert. Sexuality and Spinal Cord Injury. Milwaukee, WI: The Spinal Cord Injury Center, Froedtert Memorial Lutheran, 1993.

Milligan, MS and AH Neufeldt. Postinjury Marriage to Men with Spinal Cord Injury: Women's Perspectives on Making a Commitment. Human Sciences Press, 1998.

Rabin, Barry. The Sensuous Wheeler: Sexual Adjustment for the Spinal Cord Injured. Malibu, CA: New Mobility, Miramar Communications, 1980.

Organizations and Web sites

It sounds like you and your girlfriend care a great deal for each other. Talking about sex and sexuality can sometimes feel awkward, but you can gain deeper connection and intimacy by sharing your feelings and thoughts. Best of luck as you continue the conversation and your lives together!


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