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Life with an SCI: Exploring your Sexuality

Sexuality is about who we are, our gender, identity, orientation and how we interact with the world. One’s sexuality does not change after a spinal cord injury; you remain a sexual being with wants, desires, thoughts and needs.

Sex is how we express our sexuality. The broader one’s definition of sex, the greater the likelihood of sexual satisfaction. For some, kissing is sex. As is touching, hugging, talking dirty or even flirting. Does every intimate encounter have to involve some form of penetrative sex? You decide.

Sex may change after spinal cord injury. Your ability and ways of expressing your sexuality may require modifications because of the challenges imposed by the injury. The way in which your body responds to a sexual stimulus will vary depending on the level of the injury, the completeness of the injury and medication.

The spinal cord is the highway between the brain and the rest of the body, including the genitalia. During any sexual encounter, two areas along the spinal cord are responsible for the way in which the body responds. Messages that derive from our thoughts, memories and the five senses travel along the spinal cord and exit at the lower thoracic level of the spine and elicit a response of the genitals – for men, erection and for women, lubrication. This is referred to as the mental or psychogenic response.  Direct stimulation of the genitals, with sexual and non-sexual contact, will also elicit a response. The messages travel from the genitals to the sacral area of the spinal cord and right back to the genitals. These messages do not travel up the spine to the brain. This is referred to as the touch or reflexogenic response. Both of these response pathways need to be intact and functioning in a co-ordinated manner for the body to respond adequately for intercourse. But that, as we know, is only one way to enjoy sex.

Generally, if you have changes in bladder or bowel function and changes in sensation, you may also experience changes to the genital sexual response. Before considering introducing aids, toys or enhancers, it is imperative to get to know how your body responds to different forms and intensities of stimulation. One way to do that is body mapping, which is an explorative exercise that allows the person or couple to determine how the body reacts and to discover new erogenous zones because of change in sensation to areas of the body.

Remember, the ultimate goal and purpose of any intimate encounter is not necessarily orgasm but rather pleasure, to feel closeness, touch, the ability to please one’s partner, to feel loved and relaxation.

Even if the traditional responses to stimulation are challenged, the ability to have a fulfilling intimate relationship and satisfying sex life can be very much a part of the life of someone with spinal cord injury.

Tracey Palmer is a renowned sexual health troubleshooter, who specializes in providing guidance to persons living with a physical disability.

Looking for more info on sex and disability?
Check out Cortree Disability Education Centre.

Tracey Palmer | Winter 2020

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