The Ultimate Guide to Sex and Disability (9 page)

These orgasms from penetration are also sometimes called "G-spot orgasms" because it is thought that they are the result of stimulation of the G-spot through penetration. Another type of orgasm occurs from fantasy alone. Some women with spinal cord injuries are able to have orgasmic response in their bodies without any form of physical stimulation. While this is probably not common, it is important to be aware of the possibility.

Several recent studies, in fact, have documented that some people with severe neurological impairment, including complete spinal cord injury, can experience orgasm. One team of researchers proposes the existence of a nerve pathway bypassing the spinal cord and accounting for women with complete spinal cord injuries experiencing orgasm through penetration (to be specific, induced through cervical stimulation). These reports dispel the myth that only certain kinds of nondisabled people can experience orgasm and that everyone else should just give up. The reality is that some of us won't be able to experience an orgasm, and some of us may choose not to experience them. But we ought not be told what is and isn't within our sexual sphere.

Many people report experiencing multiple orgasms, either as a series of orgasms in rapid succession or a series of mild orgasms building up toward a really powerful orgasm. Yet another type of orgasm people

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report is sometimes called a "whole body" orgasm or "extended" orgasm. When people describe these kinds of orgasms, they don't focus on genital muscular contractions or one particular part of their bodies.

The first time I had what I would call a "whole body" orgasm it was as if the sex had lit a fire in my body and even though we were finished fucking I was still burning, but in a good way The kind of orgasm I usually feel only in my hips and head was running up and down my body and it was like waves rolling over me. I was way more relaxed after that experience than I usually am after sex, and I know the relaxing effects lasted a lot longer also.

Living with a disability or chronic illness can impact our experience of orgasm in all sorts of ways. For many of us (regardless of disability), orgasm doesn't come "naturally." Not having orgasms can result from difficulties at any stage of the sexual process. It can relate as much to how you feel about your body as to the actual sensation you have in your clitoris or penis. If you're having difficulty experiencing orgasm it may also be related to medications (a side effect doctors often forget to mention). You owe it to yourself to find out.

Kegel Exercises

Many people have discovered the orgasm-enhancing benefits of exercising their pelvic muscles, particularly the pubococcygeal (PC) muscle, a sling that provides support for the genital area and is the main muscle we tighten when we want to stop the flow of our urine. Kegel exercises increase blood flow to the genitals and can restore vaginal muscle tone that has been lost. They heighten our awareness of the entire genital area. Positive sexual effects can include stronger orgasms as well as increased control over ejaculation. Many people who have incontinence when they cough, sneeze, or laugh can gain control over it using these exercises.

Kegel exercises involve squeezing the PC muscle. To find the PC muscle, try to stop the flow of urine while you are peeing. (You might not be able to feel your PC muscle the first time you try.) Tighten the PC

Illustration 6. Products to Use for Kegel Exercises

muscle and hold it for a few seconds, and then release. You can do this anywhere—on the bus, in a meeting (imagine the possibilities!), or lying down. If you can work up to squeezing for ten seconds, try this: Squeeze

.

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and hold for ten seconds and then release. Do this ten times and then stop. If you can repeat these exercises three times a day that's great, but just do as much as you can.

Another kind of squeezing exercise is to tense up your PC muscle and release as quickly as you can. Again squeeze and release quickly for a thirty-second workout. Do this several times a day. Eventually you will feel more control, and the feeling of tightening and releasing will become more defined.

Resistance Kegels involve "pulling up" or sucking in the muscles and then pushing out or bearing down. This is easier for women to do with something inserted in the vagina that they can try to draw in or push out. Men can imagine trying to draw their testicles up nearer to their body when "pulling up."

Kegel devices can make the exercises easier for women, but they aren't necessary. Most of these toys are cylindrical with a series of different-size, ball-shaped grooves in them. Women insert the ball into their vagina and then squeeze down on the ball itself. Or they can insert the toy a bit and then pull it out gently while trying to hold it in with their muscles.

Things to Consider About Your Own Sexual Response

It takes energy to feel sexual and to explore our sexuality. When we aren't interested in sex (professionals call this "reduced libido"), it may be that we simply lack the energy to feel sexual. Still, we remain sexual beings even when our interest or energy is low. A variety of other factors, both internal and external, may influence our level of sexual energy and interest, although they may not necessarily affect our experience of sexual pleasure.

Pain

What I hate is that sex is supposed to be something you just throw yourself into, but I have to plan almost every second of it to make sure that I don't end up in a position that makes my pain worse. Even when I stick with what I think are safe positions, I can still get

pain from it. I masturbate in the bathtub. There isn't the same pressure on my body and I can just float away on the experience. But unless I find a rich lover who has a swimming pool, I don't think I can translate this into a sexual experience with someone else.

Pain can take over both our bodies and our lives, making it hard to focus on anything else. Those of us living with chronic and debilitating pain think ridiculous the very idea that we can experience an idyllic moment of physical pleasure. We can find it hard to understand the often patronizing self-help language that encourages us to "embrace" our bodies, "open ourselves up" to experience. Pain can have an impact every step of the way along the sexual response continuum. In some obvious ways it can dampen our ability to feel sexual pleasure, and our energy to do the work involved. It can also suppress our motivation. When any amount of energy results in some pain, even desire can end up being something worth avoiding. On the other hand, recent studies show distraction is an important tool in dealing with pain, and if we can allow ourselves to get to the point of sexual pleasure, it can be a powerful tool for pain relief. Since we are clever in finding ways to avoid or minimize pain with all our other activities, we can apply these to sex play as well. If ecstasy turns into agony after a minute of writhing your hips during sex, it may help to use different muscles, or toys, or positions.

Fatigue

If I goto a dance, when it is over I know lots of my friends are going to have sex. But I have spent the afternoon in bed storing up energy just to be able to dance for part of the time. I'm dead by the end. So for me the choice is, have sex or go to the dance. I hate this because I don't want every date to be just one or the other. And, like, I'm supposed to say to my boyfriend, "Let's have sex instead of going out"? I guess he could go to the dance alone afterward while I sleep.

Fatigue is part of many chronic conditions and can also be caused by a condition that requires a large expenditure of energy just to attend to

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daily tasks. Fatigue is a combination of reduced energy and a physical feeling of weariness. It may be predictable or come on unexpectedly and can interact with your sexual response in a variety of ways.

Many people believe that sex is supposed to be a super-duper workout each and every time. But unless you're bound for the Olympics sex does not have to be gymnastic, so you can take slowly the things we traditionally call romance, flirting, foreplay. Sex for us may not ever look like the beautiful people in the movies who are jumping each other's bones in fancy hotels, but our taking sex slow can be liberating, giving us the time to go easy and really feel what is happening.

This is great, of course, if we can find the energy to put these desires into play. Planning to have sex at a time when you are rested can be very helpful. Timing sex play to make sure you've got the energy to do what you want is also a good idea. Sometimes it takes creative thinking to fulfill your desires in ways that match your energy levels. Some wise people say that once you tap into your sexual energy you'll find energy you didn't know you had.

Mobility Considerations

Whether you're a quadriplegic and need assistance with positioning before you can have group sex, or someone with carpal tunnel syndrome who gets shooting pains when trying to masturbate, we all have different needs based on the kind of mobility we've got to work with. Many people think that a mobility restriction means no sex. We hope the ideas people with all sorts of mobility impairments share in this book will begin to dispel this myth, as it's one that not only the nondisabled buy into. Mobility restrictions mainly have an impact on the sexual behavior part of sexual response. They needn't have any impact whatsoever on arousal, desire, and fantasy. Fantasy can actually be used as a tool to problem solve mobility issues.

Communication Considerations

Not being able to communicate as "expected" means having to be a lot better at communicating than most people who don't live with a

disability. Communication considerations include not only people who use augmentative communication, but also the vast range of language issues that can result from fatigue, medication, or cognitive disabilities. Having difficulties finding the right word, or trouble processing what we hear, can become a real challenge when it comes to sex play. Much "sex education" (a misnomer if ever there was one) comes from overhearing people talking about sex. If we can't hear what is said, or we can't put it into context, then we don't know as much about sex and sexual relationships as other people do. Written resources may be hard to understand, not available in Braille or on tape, or inaccessible to people who can't turn the pages, not to mention the fact that disability is seldom talked about in most basic materials. On the other hand, those of us who have had to maximize our nonverbal abilities can have an advantage with a partner. Many people find it hard to use words to communicate what they want sexually, and use their less developed nonverbal skills to try to tell their partners what they want.

Cognitive Considerations

Cognitive is just a fancy way of saying "thinking." Each of us has our own way of thinking. When something changes how we think, it can have an impact on our sexual fantasies, motivations, and feelings. Many things can interfere with your ability to think clearly, and everything that happens to you affects what you think about and often even how you think. Depression is one factor that can have a major impact on thinking. This illness can have devastating effects on a person's sexuality. It's essential to find ways of coping with cognitive issues that impede your connection to your sexuality. Cognitive issues can prevent you from even wanting to explore your sexuality. They can also be a problem during your exploration, as sexuality is such an intrinsic part of us that it invariably triggers things in us we weren't expecting.

Privacy

Environmental factors, particularly privacy, can also figure in sexual response. We find it difficult to allow ourselves to be relaxed and in a

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state where we can actually explore our sexual feelings when we know at any moment an unwanted person may intrude into our space. Other limits on privacy may influence our ability to create a space that's comfortable for exploration, or we may find limits on the kinds of explorations we can do unless we are given space of our own.

Sensation

Our ability to perceive stimuli is called sensation. It colors whether we feel a pinprick here or there, whether we're aware when our bladder is full, how much we can see or taste or hear. Sensation is involved with our sexual response in terms of what we can sense that turns us on. Sometimes we can "feel" something in a part of the body that lacks working nerve connections. This may be through fantasy or memory. Regardless of why we are feeling it, we think the feeling part is the most important. Every part of our bodies is represented somewhere in the brain. When an area that has no feeling has its brain part next to an area that does, sometimes stimulation of a feeling area can create a kind of sympathetic sensation in the unfeeling area as well.

Medications

/ started a new pill and within about two weeks I was feeling very unhappy about my work. I also wasn't thinking about sex at all. I didn't connect it to the medication. It seems silly but because it was a tiny pill and I only took one a day it didn't even occur to me to think that it could be causing these things. But then I got changed to a different pill and within a couple of weeks I was back to my usual self, thinking about sex a lot, liking most parts of my job. So then I thought "Oh! That's what it was." I asked my doctor and he said, "That's a pretty rare side effect."