Men on What Sex After a Spinal Cord Injury Is Like

SPINAL CORD INJURIES (SPIs) are varied and complex. The amount of sensation and mobility a person has in their body is highly dependent on factors like where on the spine the injury occurred, whether or not the injury was “complete” (a.k.a. to the total area), and how long it’s been since the injury. However, SPIs do frequently come with—at least initially—some level of sexual dysfunction.

Significant progress has been made to improve sexual satisfaction in people with SPIs, but sexual health is often overlooked by medical professionals who treat them. There has also historically been very little representation of disabled people having hot, pleasurable sex in the media. People with SPIs, who often have limited sensation and mobility, have found themselves left out of sexual discussions and depictions, as if their sex lives or desires are nonexistent post-injury, which is not at all the case.

To prove this, Men’s Health spoke to three men with SPIs about sex post-injury, including what’s changed physically and mentally when they’re aroused, and how they’ve learned to adapt to their new bodies in the bedroom.


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What has changed for you about sex post-injury?

“Sex really does require, on both ends, more communication and more planning. I have a catheter installed so there are things like STIs and UTIs that I have to be much more careful about because my system isn’t flushing like someone with a normal urethra is. Some of that spontaneity shift was hard to process. It’s not necessarily lost, but it’s changed.” —Ezra,* 37, Seattle, WA, T3 spinal cord injury, no sensation from nipple level downward

“Sex now is definitely more deliberate, and that’s a problem sometimes because women can get skeeved out when you’re planning it and stressing over it. I feel like they can sense that.” —Andy,* 39, Bridgeport, CT, paralyzed in a car accident from chest down

What about your erections specifically?

“My penis was part of me that became hypersensitive in a way. I’d get an erection and start having sex and then the stimulation would be overwhelming and I’d lose it. Or there were times where I felt like I might have what we call an internal orgasm, where my body felt like it was orgasming, but I couldn’t ejaculate and then I’d lose my erection. So I started using Viagra because it meant I could last longer.” —James,* 46, Hong Kong, C5 and C6 injury after being tossed by a wave into a sandbar. Has sensation everywhere but not all muscle function below the injury

“What I can achieve now is called a reflexive erection. I tend to just about every morning get an erection of some sort, on par with what occurred pre-injury, but I have not been able to achieve an orgasm through physical touch.” —Ezra

Do you still get turned on by the same things?

“Pre-injury, I was pretty easily visually stimulated to the point of orgasm; that was really all I needed. I didn’t care about the details as far as porn was concerned. Post-injury, I have a lot more interest in dialogue, in certain kinds of emotion as opposed to just the raw sexual acts. While I did lose sensation to some things I was accustomed to having pre-injury, I gained some areas that are now particularly sensitive. My collarbone, which I still have normal sensation on, is now incredibly sensitive. I would loosely compare it to when you lose one of your senses, the others become heightened. So since I’m not receiving sensation in places like my penis, I’m much more aroused by smells and tastes and textures. My fingers became sort of an extension of that because it’s somewhere I still have sensation and full function.” —Ezra

“My arms in general are really sensitive. Like if someone’s touching me there, it kind of gets me going. Anywhere I can feel, like my neck—I like attention in those areas.” —Andy

“After I was injured, the places on my body where I could feel became hypersensitive. So certain times, like even when I was at the hospital right when I was injured, a social worker or a nurse would come up and put their hand on my shoulder or my neck and it would be nearly orgasmic for me. I felt really dirty or creepy because I wasn’t trying to do anything, but they’d rub my shoulder and I’d be like oh my god, that feels really nice. It was something I had to get used to.” —James

“Since I’m not receiving sensation in places like my penis, I’m much more aroused by smells and tastes and textures.”

What’s been the most challenging part about sex post-SPI?

“Honestly, my biggest concern whenever I would have a new partner is that in order to pee at night, I either have to pee in a jar or get out of bed. And it just takes a while to get out of bed. This might not seem like a big deal, but to me it’s embarrassing. Even though they were perfectly open to having sex with me, I wouldn’t want them to stay over because of the way I pee at night.” —James

“Positionally, you want to do doggy style, it’s like well, that’s gonna be tricky now. That’s gonna require ropes or something. The picture your mind paints as far as your own sexual health is not providing the feedback it previously got. I still go through spirals where I feel shameful about it, and then I’m more positive about it. A lot of times, it’s just readjusting my expectations of what healthy sexual intimacy is and trying not to [have the same expectations I did] pre-injury.” —Ezra

“It’s super frustrating when you’re ready to go and then they’re not because you’ve planned this; you’ve got your Viagra ready. There’s a whole bowel routine I do when I’m going to have sex. When I’m washed up and ready to go and in the mood and then it’s a no that sucks.” —Andy

“There was a time soon after I was injured that I couldn’t get anybody to get me to orgasm, and I went to a lot of sex workers thinking they might be able to. And that was frustrating because they couldn’t. I’d go to another one and another one like, why isn’t this happening? Ultimately, I think the frustration of not being able to orgasm led me to skip from partner to partner. I was like, I’m going to make this happen. I replaced the excitement of an orgasm with the excitement and novelty of a new person.” —James

“There have been times where I was invited over to a girl’s house and she’s got stairs so I can’t go there. It’s hard to get someone back to your place always because they often feel more comfortable at theirs. So that’s been a challenge. I worked hard to get my own place and my own van. I’m in a wheelchair so it’s hard for me to use someone else’s car.” —Andy

Do you masturbate? If so, how has that changed after your injury?

“I think I’m a little bit addicted to porn, but my porn habits have kind of changed. I mean, I’ve always been more into just pictures, not like hardcore stuff but fun, wild stuff. I’ll be on that for an hour. I don’t really masturbate unless it just happens. You can’t really get it going if it’s not willing; it kind of has a mind of its own. So if I notice it’s getting harder, then I’ll play with it. Just to keep it in shape, you know?” —Andy

“Early on, there were times I tried to force [an orgasm]. It would be furious masturbation, trying to watch porn, like something’s gotta work! And that was a tough hill to get over. I’ve had to process and understand the reality that there have been sexual changes. There are things that I ‘lost,’ but there are certainly places where I’ve gained things and I feel sexually satisfied. Trying to understand the changes and to choose what was there rather than leaning into what was missing was really important.” —Ezra

“There are things that I ‘lost,’ but there are certainly places where I’ve gained things and I feel sexually satisfied.”

How have partners responded to sex with you after your injury?

“I’m easy to flirt with and tough to pull the trigger; I have that experience a lot. But with the partners that I have been sexually intimate with, they’re open. I will say, it was tough at first because the onus is on me for a lot of stuff. I had to be more willing than I wanted to be at first to describe the lack of feedback I was getting. That’s one thing I had to learn about disabled life and disabled sexuality; it’s just that the things that come with a spinal cord injury are so not intuitive as an able-bodied person.” —Ezra

“I’ve had girls who wanted to show me a time and they’ve really gone all out, almost like they take it as a challenge to get me hard. Stimulation can happen, especially when I was younger, but it takes a while. It might take 15 to 20 minutes of playing with [my penis] and having me in a lying-down position to get the blood flowing.” —Andy

“I always had a dominant sexual personality, but after I was injured, I felt like that was gone. I know a lot of guys have nurse fantasies and I tried engaging in that, but it just didn’t do anything for me. I got frustrated because it seems like a lot of people think that a guy with a SPI becomes cared for a bit, or that they desire care. That became really frustrating for me because a lot of the sex that was available to me was from women who were like, ‘I will dominate this guy with a SPI.’

There was an article in the Washington Post a couple years ago about women who were wives of guys with SPIs and it was all about the women caring for the men and the men were cast as pitiable. But that’s just not me. I’d imagine there are a lot of sexually frustrated guys with spinal cord injuries because they think well, if I’m going to get any sex, it’s going to be through this ‘being cared for’ role. But there are other options.” —James

What are some things that have helped you adjust to sex post-injury?

“I got married seven years ago and we knew we wanted kids. We were trying to figure out how we were going to make that happen because I could make myself orgasm, but it could be months between. Or it would take me three hours and then maybe we can try to conceive on the day we have to. But my wife actually did a lot of research and found a vibrator developed specifically for people with spinal cord injuries or difficulty ejaculating called a Ferticare.

It’s basically a very high-powered vibrator and you hold it right on the glans of the penis. Some people actually use one on both sides. But it will induce so much stimulation that it causes an ejaculation. It’s like $700, and I didn’t know if I wanted to spend that, but we wanted a kid and I read a lot of stuff on spinal cord injury forums and people said it was miraculous. I could orgasm in a matter of minutes instead of days. I also tried the Hitachi magic wand and it was like $30 or $40. It actually works just as well, if not better.” —James

What’s your favorite sex act to do with your partner?

“I was fortunate in that pre-injury and post-injury I enjoy being the giving partner, so that softened the transition. Giving oral has always been one of my favorite things.” —Ezra

“My partner and I both like sex from behind. And I thought that was off the table after my injury. But my wife found something that another quad or para invented called an intimate rider, which is basically like a sex swing specifically for people that have spinal cord injuries. I’m eternally grateful to her for finding that. One thing about our relationship is that there’s a heavy power exchange going on; a lot of what happens in the bedroom isn’t her doing it to me, but me doing things to her and the fact that I can express myself and my desires in a way that’s satisfying to her is wonderful.” —James

“I have Viagra and things for the erection, but I really like using my fingers and my mouth and toys. Obviously, I would prefer to go back to how I was when I was 18 or before the accident, but it is what it is. It’s still intimate to be with someone.” —Andy

*Names have been changed to protect identity.

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Sophia Benoit is a sex, relationships, and culture writer,  with bylines in GQ, The Cut, The Guardian, Allure, and Bustle. Her book WELL, THIS IS EXHAUSTING is available now. You can follow her on Twitter at @1followernodad where she’s probably ranting about Fleetwood Mac or the Sixers.

This article was originally posted here.

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