Contemplating sex after paralysis can seem like a daunting task, especially when your paralysis reaches the level of quadriplegia. And yet sex is very often the first question on our lips after the paralysis. Mitchell Tepper, a clinical sexologist and quadriplegic for more than thirty years, remembers that “when I woke up in the hospital, I was still in intensive care and as soon as they took my breathing apparatus out, the first thing I asked was if I could still have children[.] I was 20 years old, kids weren't on my mind yet, but instinctively when you're in this position, [you think] ‘What’s my sexual future?’”
The path back to healthy sexuality may be complex, but just as when we were discussing intimacy after back injury and amputation, quadriplegia doesn’t have to prevent you from having an active and full sex life. Tepper says that it is the people who push past the question of “why bother?” who “are able to rediscover their sexuality and find satisfaction.”
- Take your partner to the doctor: It’s not possible for every sexual partner or relationship, but if you feel comfortable taking your partner to the doctor it can be a very reassuring experience for both partners. They may have important questions that you have overlooked or concerns that have been rolling around the back of their mind. Indeed, your partner might even be afraid of hurting you or exacerbating your injury—they may need to hear from your doctor that sex is possible before they truly feel comfortable.
- Reframe how you see your body: Paralysis is, of course, a major change to your physical well-being and it undoubtedly will reach into all corners of your self-worth and identity. The physical challenges and frustrations that accompany paralysis can make it easy to view your body as worthless or ugly. It is not and you are not. Your body can make you feel exceptional, sexy, and whole, but you should actively work to frame your body in positive, sexy ways.
- Find clothing that makes you feel sexy! Maybe that means clothes that you feel good in throughout the day, or maybe that means a sexy outfit like lingerie and a mask. Remember that taking the time to feel good about how you dress (and undress) your body is part of creating your sense of self-worth and sexual identity. It can be too easy sometimes to fall into a trap where you stop dressing like you see the value in your own body.
As a quadriplegic, foreplay will be even more necessary and essential to your sexual experience than before. Why? Isn’t foreplay always an essential part of sex? (It really is, tell your friends!). Of course. But when dealing with paralysis, the path to arousal may be slower and more complex. Foreplay is a vital part of building intimacy between partners, and building your level of arousal for each sexual act. Even if your sensation levels have changed, becoming turned on is a physical and a mental process. We engage in foreplay because the little pleasures hint at larger ones to come, and because in a broad way, it signals that we see our bodies as worthy of feeling good. Be sure to demand that for yourself as you have sex as a quadriplegic.
- Make a list of your favorite body parts. Celebrating what you like about your body is especially necessary after paralysis. For example, your partner can trace their favorite parts of your body with a feather spanker. Some people find that wearing a blindfold not only increases their arousal, but also helps them focus less on how they look and more on what they are feeling.
- Take sexy selfies (or have your partner take them for you!)
- Enjoy a finger massage: paralysis can diminish some sensations, but as we discussed when exploring sex as a paraplegic, some paraplegics and quadriplegics report increased sensation in other areas of their body after the paralysis. A finger massager kit will let you and your partner gently explore new erogenous zones.
The more effort you put into seeing your body as sexy and sexual, the more agency and power you will claim back from the paralysis. Your sexual identity exists as a quadriplegic, but it will really blossom when you insist on and foster its presence.
Paralysis often impacts erections, but many people make the mistaken assumption that quadriplegics can no longer have erections. Quite the opposite—many quadriplegics will experience reflex erections when the penis is touched and stimulated (even if sensation is diminished), and sometimes medications are effective for others. Inexpensive toys such as cock rings can be a boost in strengthening and maintaining reflex erections. If you are finding it difficult to get or maintain an erection, you should also consider a hollow dildo and harness. The hollow space within the dildo holds a soft, hard, or semi-erect penis, and allows you and your partner to sustain penetrative sex for as long as you desire. Since it straps to your hips, a harness is ideal for quadriplegics—it requires no positioning or holding once it has been strapped on.
We are always fervent proponents of using lube in any and all situations, and this is no exception. Just as paralysis effects erections, it can also alter the body’s natural process of lubrication. Your vagina may stop lubricating or become less wet than you are accustomed to, so plan ahead and prepare with lots of extra lube.
When your exploration leads you towards more adventurous sex, sexual positioning aids will dramatically increase the choices and options available to you. I think that many quadriplegics and paraplegics worry that they have lost their sexual agency—that even if you can still have sex, it will only be in a limited way. But as should be abundantly clear by this point in our post, that’s definitely not the case. An effective aid will not only increase your mutual pleasure, but give you a greater sense of control and choice in your sexual identity as someone with paralysis.
- The Sportsheet: The Sportsheet is unique from other bed restraint systems, in that the detachable restraints can be anchored to the bed at any place. It can hold all four limbs in secure positions, individually suited to your body and your positioning needs. If you are just starting to have sex after paralysis, the Sportsheet is an effective all-in-one item for restraining and positioning yourself on the bed.
- G-Spot Link: Another option is a smaller, slightly more portable positioning aid or toy, which can still help you keep your limbs secure in one position. A G-spot link (or the similar spreader bar) can help you keep your feet spread apart, while a sex sling allows you to lock your feet and legs into a spread-eagle position.
- Bondage Set: The cuffs and ankle straps in a bondage set can be used individually or all together to position and stabilize your legs, feet, arms, and hands.
Experimentation is your lifeline after paralysis. You are going to have to try different positions, activities, and even sensations to truly determine what pleases you now (and how you can please someone else). But don’t let that seem daunting, or like a chore. The experience of discussing and exploring the possibilities with your partner can be an adventure—one that will draw you closer together and increase the intimacy and satisfaction for both of you.