If you are in a chair, people rule you out as a sexual possibility. I think the doctors did, too. My wife and I actually thought that our sex life was over. It’s better than ever. Really. It sounds impossible, but it is better because it is not genital, can’t be just genital.


The issue of spinal damage and sexuality has finally received more research attention. Anderson and Cole, in their book Sexual Options for Paraplegics and Quadriplegics, provide a list of guidelines for the physically handicapped that apply to all diseases. The list provides an excellent summary of the points that I have been making in this chapter.

1. A stiff penis does not make a solid relationship, nor does a wet vagina.

2. Urinary incontinence does not mean genital incompetence.

3. Absence of sensation does not mean absence of feelings.

4. Inability to move does not mean inability to please.

5. The presence of deformities does not mean the absence of desire (interest or arousal in my response system).

6. Inability to perform does not mean inability to enjoy.

7. Loss of genitals does not mean loss of sexuality.

There are so many different forms of spinal-injury impacts that I cannot discuss each specific type, but the rules above apply to each.

There are, of course, other diseases that I cannot discuss in this book. I have included the information I collected from the marital couples group and other patients with whom I have worked. One husband’s statement has stayed with me as the best summary of the relationship between disease and sexuality. He is a mentally impaired man who has been married two years. He was engaged for sixteen years because, by his report, “Nobody thought we should or could get married. They thought it was a joke.” He describes his love with his wife as follows:

“I know that people get divorced. I know I’m not as smart as most people. I’m not as smart as people who get divorced. But I can say I am smart enough to know something they don’t know. I can say it. I can say that since I’m not so smart as they, maybe I am not as busy with all those other thoughts. Maybe I can love more because I don’t think more, I’m not distracted from love. I’m not always thinking, but I’m always loving. Loving is easier than thinking because you have someone else to help you. Maybe people think too much and love too little.”


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