The Ultimate Guide to Sex and Disability (7 page)

many women find the lubricating fluids increase. Stimulation also enlarges the vagina. At the top of the vagina lies the cervix, which is also the bottom part of the uterus. Unlike the vagina, the cervix has many nerve cells. The cervix and uterus both swell during sexual excitement. The opening in the cervix becomes bigger and stays open for up to half an hour after orgasm.

44 • THE ULTIMATE GUIDE TO SEX AND DISABILITY

pubic hair

penis

scrotum

Illustration 4. Male Anatomy, External

Pen is/Scrotu m/U reth ra

The penis has neither bone nor muscle in it. But at its very base it does have a few muscles (called bulbar muscles). The shaft of the penis is made up of two cylinders of spongy, erectile tissue. This tissue fills up with blood during sexual excitement, causing the penis to get bigger and harder, which is what an erection amounts to: blood-swollen tissue. A third cylinder on the underside of the shaft surrounds the urethra, the

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tube that carries both urine and ejaculate out of the body. Some men find having their urethra stimulated very pleasurable, while others find it uncomfortable. This stimulation may be intentional as a form of sex play or may be a side effect of having a catheter removed. The urethral opening is in the head of the penis, org/ans. The underside of the glans, called the frenulum, contains the largest concentration of nerve endings. Men with genital sensation often find this area responds to stimulation the most intensely. Other areas along the shaft of the penis may also be highly sensitive to touch.

Some men are "uncut," while others are "cut," meaning that they were circumcised (their foreskin has been removed). The foreskin is a piece of skin that at birth covers the head of the penis and that can be pulled back to urinate, or pulled back and forth by pleasurable friction during sex. One of the main functions of the foreskin is to protect the head of the penis. Some parents have their male infants circumcised for a variety of reasons, medical, cultural, and religious.

At the base of the penis is the scrotum, a fleshy sac that holds the testicles outside the body. While this area can be very sensitive to pain, many men enjoy both the feel and the look of having their scrotum pulled down or squeezed (in fact several toys let men do just this, which we cover in chapter 9). The main function of the scrotum is to protect the testicles from injury and also to regulate their temperature, important for sperm production. During sexual arousal, the scrotum gets thicker and the testicles move up closer to the body.

Perineum

In women, the perineum lies between the vaginal opening and the anus, while in men it lies between scrotum and anus. Some men get pain in this area during arousal, in which case a gentle massage of the perineum can make the difference between a pleasant and a painful sexual experience. One reason for this might be that when a man's perineum is massaged, the prostate gland is also gently pressured. Rubbing this area is also sometimes called doing an external prostate massage. Other men, and women, enjoy having this area stimulated.

vas deferens

bladder

seminal vessicle

rectum

prostate gland

Illustration 5. Male Anatomy, Internal

Ass/Anus (and Prostate for Men)

In case you hadn't noticed, the ass has a great shape for being cupped in someone's hands. It also often comes in contact with other surfaces, and if you have feeling in that area but can't reach it with your hands, you can try sitting on textured surfaces (silk, fake fur, wood...) and rub-

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bing back and forth. If you can reach the area, you can also explore the crack between the ass cheeks.

One of our favorite sex educators, Dr. Carol Queen, says the thing she loves about assholes is that everybody has one! This is almost always true, even if some of us have some differences in how they look or feel, or whether we can use them for elimination. People who don't have sensation around their penis, labia, clitoris, and other parts may well have lots of sensation around or in the anus, which can be a wellspring of sexual feelings.

The anus and rectum form the last part of the gastrointestinal (Gl) tract. The very strong muscle of the anal sphincter surrounds the rectum. The anal opening (or anus) leads to the rectum, which curves to meet the sigmoid, which in turn leads to the colon and intestines. The delicate rectal tissue is made of blood vessels, nerves, and smooth muscle and is lined with cells that are in the same family as skin cells. The rectum, unlike the vagina, has no natural lubrication; like the vagina, it can expand, just not as much. The outside of the anus has lots of nerve endings around it. Many people with no genital sensation still are quite sensitive around their anus, thus this area can provide intense pleasure.

/ can tell you it took me a while to get comfortable with it, and it's not like I like anything really big up there, but I find the area around my bum still has a lot of sensation, and I never knew before that it could feel so good. Now we've tried toys and other things and it's really a whole other feeling.

Internally, the other significant sexual part of the body for men is the prostate gland. The prostate can be felt through the rectum, toward the front of the body. It produces most of the fluid in ejaculate. Some men like to have their prostate directly stimulated with a finger, toy, or penis. As a result of medical conditions or medications, some men will have enlarged prostates that can be a source of pain or discomfort, yet for others it is a marvelous sex organ.

Sexual Response

When I was thirteen, the only time I knew I would be alone was on Sunday afternoon. My sister went to a church youth group, my father got together with a group of friends, and my mother would cook a huge Sunday dinner. I'd be in my room doing "homework." I'd masturbate as the house filled with the smells of my mother's cooking. Even now, when I smell a roast in the oven, I get a hard-on. I guess I'll never be a vegetarian.

Sexual response is a broad term referring to reactions to stimulation that you experience as sexual. You may respond to a touch from a partner, rain hitting your face, an arousing thought you have just before you go to bed, a sexually charged scene in a film you're watching, even an interview with a sex educator (or sex worker) on the radio. In short, you may respond to something not intended to be sexual.

Sexual response is, to our misfortune, considered the cornerstone of "true" sexuality in our culture. Whether or not you are responding in the right way, with enough oomph, often enough, and to the right sort of person (god forbid you sexually respond to someone of the same sex, or much older than you, or...well, the list goes on) is a topic of a seemingly endless stream of self-help books, fashion magazine articles, and radio call-in shows. Great research is being done by people like Beverley Whipple, who are taking the time to discover the different ways we all respond to sexual stimuli. (Whipple has been doing work inclusive of people with disabilities for years. She's also one of the initial documented of the famed G-spot.) The problem is that most of us confuse sexual response with sexual feelings and sexual pleasure. Sexual response is something that researchers try to measure in a somewhat objective way. But having sexual feelings, and feeling pleasure, is best defined subjectively by the individual caught up in the moment.

We distinguish between sexual response and sexual feelings because if your sexual response doesn't seem to match up "like it's supposed to," if you skip a stage, or if you don't seem to experience anything that's

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recognizable by the standard definition, it's assumed you are missing something. If you lack a classical sexual response you're usually branded someone who lacks sexual feelings, or someone who may be unable to feel sexual pleasure. But this is not necessarily the case. Below you'll find some very basic information about how doctors and researchers have characterized sexual response, along with some suggestions on using these definitions for your own exploration. You'll also find information on ways that living with a disability or chronic illness can affect sexual response. But we want to remind you again that just because something affects your sexual response, it doesn't necessarily also affect your ability to feel pleasure or to have sexual feelings.

As with most of the other accepted terminology around sexuality, the words we have for sexual response don't always jibe with real people's experience. If you live with chronic pain, the relationship between your desire and arousal will be something incomprehensible to a person who has never experienced such severe pain. If you live with post-traumatic stress disorder (PTSD) and tend to dissociate during sex play, your "response cycle" will likely be different—and that may be a healthy adaptation to your experience. (Chapter 13 will give more details about this.) So before we tell you how professionals explain sexual response, we want you to consider the following questions as a way of looking at your own sexual response.

How Do You Define a Sexual Feeling?

/ was pretty good friends with my male coworker and I remember one evening having to work with him on a deadline. We were sitting close to each other looking at some materials. As he got up from the table his foot caught on my crutch and he stumbled forward. He caught his balance before falling on me (which I wouldn't have minded) and brushed his hand on my shoulder. For the first time I felt this tingle in my stomach, and my crotch was throbbing. I remember my leg spasming under the table. I was sure he could tell. Later when I went to the bathroom I checked my panties and

they were soaked. I was surprised by my reaction as I never felt that way toward him before. I fantasized a lot about him later that night and played with myself before falling asleep —/ had a great night's sleep.

A lot of us think that sexual response is something that happens in a bed, with a partner, and probably involves some sort of enormous release. This can happen, but it is only one of many ways to feel sexually and respond sexually. Listening to music, having your hair brushed, gazing into someone's eyes without fear can all be incredibly sexual moments. What would you include on your list? Think about the last time you were aroused, whether you expected it or not, whether you thought it was "appropriate" or not. That was a sexual moment, and you had a real sexual response.

What Started It Off?

/ think my parents were pretty uncomfortable with talking to me about sex because they didn't want me to have expectations; however, my body had other ideas. I was thirteen and was in school and that was the first time I got a boner. I didn't know what it was. There was this pretty girl coming down the hall toward me. I was trying to look really cool and say "hi." As I was wheeling away from her I looked down and saw this huge bulge in my pants. I didn't know what to do. I don't have a lot of feeling in my legs and so sometimes I get a hard-on without knowing it...even today. It can be embarrassing so I keep my book bag on my lap just in case. Other times, it can be a great icebreaker when meeting someone new. ..only if she's got a good sense of humor.

The last time you felt sexy/aroused, what triggered it? Was it something external—a smell, noise, taste, or sound? Was it from the touch of another person, or something brushing against you? Was it from your own touch (which is also external, in a way)? Or was it triggered by something internal like a thought, a memory, or a dream?

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What Does It Feel Like?

It surprised me when I realized [after my accident] that I could still get turned on. Since I don't have any feeling down there, I had never noticed that when I'm excited I get this fluttery feeling in my chest. It's not new, I just never paid attention to it before.

We can throw the term sexual response around; we can talk about skin flushes, increased heart rates, erectile tissue, and on and on, but more important than the physiological process is your interpretation of it. How do you experience feeling turned on? Do you feel your heart race, does a part of you tingle, does it get harder to communicate verbally, is it always pleasurable? (Sexual response doesn't always feel good and doesn't always come as a result of things we are enjoying.) Pay attention to your own sensations and thoughts, and see if you can find your own descriptions for these feelings. There are as many ways to feel a sexual response as there are things to turn us on in the first place. You won't always respond the same way, even if it's to exactly the same sort of stimulation.