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Thursday, June 2,2011

Beyond intercourse

By Dr. Jenni Skyler

Dear Dr. Jenni,

I just started dating a man in a wheelchair. He’s a wonderful man, but I’m nervous about approaching sex. I don’t believe he has sensation from the waist down, so I’m not sure how sex will even work. Any ideas on how to make this work or even approach this conversation?

—Wheelchair Curious

Dear Wheelchair,

What a wonderful question. Your scenario obliges you to ask, what is sex? For those who use wheelchairs or identify as having a disability, sex often becomes so much more than intercourse.

Often, people with disabilities get stigmatized as non-sexual beings, especially if they have limited to no sensation in the genitals. However, if you let go of the social script where sex is intercourse only, and substitute “sex” as activities that enhance intimacy and pleasure (and reproduction if that is your agenda), then you are left with a wider world of options and fun for the whole body and mind. In fact, many wheelchair users who do not have genital sensation report having orgasms in other parts of their body, such as neck, nipple and head.

As for this new man you are dating, as with any man you might date, I would ask: What does sex mean to you; what is the status of your sexual health; and what are your thoughts on when to get physical? These are not necessarily easy questions for any new relationship, but they are essential for your physical and relationship health, and can open the door to conversations on how sensation and sexuality work for your partner.

Keep in mind for that it is really easy to get trapped in a social script where the only thing that qualifies as sex is penis-vagina intercourse. However, we can learn so much from people with disabilities on how to be open to the many facets of sexual plea sure found in the whole body and mind.

Dear Dr. Jenni,

My girlfriend and I are starting the rhythm method. She is allergic to latex, and we do not support spermicidal lubrication or any other unnatural contraceptive method. She takes her temperature every morning and takes a LH surge test in the morning as well. The LH test says that if the line is dull compared to the one next to it, it’s not a surge. The line has been just a bit duller for two days and it is very hard to tell if her temperature spikes because it is about half a degree to one degree different every day. We’re a bit confused. The only thing I can think of doing is keeping this up for a few months until more patterns show. Do you have any advice or direction with this?

—Rhythm Riding

Dear Rhythm,

The rhythm method is a learned art that takes time to hone. So, yes, if you are starting this method, then certainly consider the next few months for practicing the temperature readings to fully understand her patterns. Basic rule of thumb: If you feel confused at any point, don’t take a risk when you are not comfortable with the consequence.

That said, have you tried non-latex condoms like lambskin? These are not quite as effective as latex, but they are better than nothing when in doubt. I also encourage you to consider other forms of sexual pleasure. As I discussed in the answer above, intercourse is but one of many sensual and pleasurable activities couples can share. Take the opportunity when your girlfriend is ovulating to explore supplemental ways to engage in mutual pleasure.

Send questions for Jenni Skyler, Ph.D., to drjenni@theintimacyinstitute.org. Skyler is a sex therapist and board-certified sexologist who runs The Intimacy Institute in Boulder, www.theintimacyinstitute.org.

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