Hesperian Health Guides

Hesperian Health Guides

Different ways of having sex

There are many different ways people have sex and share pleasure together. People often think of sex as only between a man and a woman, and only with a penis in a vagina. But there are many other ways people have good sex and express their love with another person. Sex is not just about a person's genitals. Kissing, hugging, and talking are part of having sex. Touching a person's face, hands, back, and neck are also good ways of being sexual. Having oral sex (when one partner—or both—puts his or her mouth on the other's genitals and licks or sucks) may be pleasurable. Touching and rubbing each other's genitals (mutual masturbation) may be another way to give and get sexual enjoyment.

Touching oneself for pleasure (masturbation)

a woman touching her genitals while lying on her back near a pair of crutches.

You can touch yourself in a way that gives you sexual pleasure. This is a good way to learn about your body and what kinds of sexual touch feel best. It can also help you feel more confident and good about your own sexuality. Many communities have beliefs that touching oneself is wrong or harmful, so sometimes people feel shame about doing it. But touching yourself does not cause harm or use up sexual desire. It can be a good way to feel pleasure and satisfy desire whether or not you have a partner.

Sex in a relationship

Most women want to have a close and loving relationship with someone who cares for them. These relationships may be with other disabled persons, or with non-disabled persons. Some disabled women are married, and others are not. Many disabled women have relationships with men, and some have relationships with other women. Some are mothers, others are not.

For women with disabilities and their partners, sex is often more enjoyable for both people if they are willing to experiment and find new ways of doing things. Instead of focusing on things you cannot do (or things that are hard to do), build on things you can do that bring pleasure to both you and your partner.

Talking with your partner

Many women are ashamed to talk about—or feel—their desires. But it is natural to feel desire and to want a relationship that makes you feel good. If you plan to have sex with someone, it will help to talk with that person ahead of time about things like safer sex and family planning.

a man and a woman in wheelchairs hugging each other.

Talk with your partner about any limitations in your movement and about ways in which your body may respond to sexual stimulation. Sometimes a partner worries that sex will hurt a woman or be dangerous because of her disability. This can lead to lack of desire. When each partner knows the kind of sexual talk and touch the other likes, they can both enjoy sex more. Each person’s desires are different, so the best way to learn what another person likes is to talk with one another and experiment.

Good things to talk about are:

  • where it is easier to have sex. For example, on the bed, in your wheelchair, in a chair, or on the floor.
  • what position hurts or could be more comfortable.
  • how your disability affects how your body works.
  • how you can give each other pleasure, and what does not feel good.
  • if you tire easily, what times of the day or week you may have the most energy for sex.


If your partner is also your caregiver, it can be helpful to talk about the difference between the time you spend together for care and the time you spend together as sexual partners.

IMPORTANT! Whether a woman has a sexual relationship with a man or another woman, it is important to practice safer sex to prevent sexually transmitted infections, including HIV. If you or your partner have had sexual relations with someone else, it is also important to go for an HIV test before having sex with your partner. Also, if you want to have sex but do not want to get pregnant, see information about family planning and emergency contraception.





Sexuality for women who become disabled

A woman who becomes disabled due to an accident or illness may find that her sexual feelings change. Some women have fewer sexual feelings or are not interested in sex for a while. Sometimes women think they are no longer able to experience pleasure or enjoy sex. Every woman needs information about how her disability affects her sexuality. And if she has a partner, they both need information about how sexuality can be affected by disability.

a man and a woman eating while each of them thinks.
I’m very sad that
Sok Chhim was so badly hurt by the land mine. But my family wants me to take another wife. They say that now she will bring bad luck, and she won’t be able to have children any more.
I hope Hem Kiri will want to stay married to me. The health worker says I can still have sex and have babies.

If you were in a sexual relationship before you became disabled, you may be afraid to try having sex again. You may be concerned that your partner will not find you sexually attractive anymore. Or both you and your partner may be concerned that you will not be able to satisfy each other any more. It is helpful for you both to talk about your feelings and the changes you may need to make. The way you have sex may be different, but like most other couples, you will find ways to have sex and please each other. This is especially true if you had a trusting relationship and good communication before the disability.

Privacy

an older woman speaking to a young woman who uses crutches.
Let’s go together to speak with your mother-in-law. We will tell her that when your husband comes home, you would like to spend some time alone with him in a private place.

Finding a good time and place to have sex can be hard for women with disabilities, especially if they need someone else’s help to get ready for sex. It can also be hard for women who live with their parents or other relatives.

There is no easy answer to this problem, especially if your family or caregivers do not think you should have sex. Sometimes, it can help to talk with the people who are helping you. Or you can try talking with another person you trust, who can then talk to your family or helpers. It is also helpful to talk with other women with disabilities, and to share experiences.

Some people find ways to manage on their own. For example, a woman can have sex with her partner while she is in her wheelchair. Then she does not need another person to help move her to a bed. And some people find that their helpers are sensitive to their needs and want to support their relationships.

Finding a comfortable position

If you have limited movement you may have to experiment to find a comfortable position to have sex. Women with cerebral palsy, weak muscles, tight or spastic muscles, or arthritis, and women whose disability causes pain or weakness, may need help from a partner to find a comfortable position. It may help to use pillows or rolled-up cloth to support your legs or hips. Also, if a partner’s weight causes pain, try a position where you both lie on your sides, or sit in a chair together. Kissing and touching may be easy to do, but having sex with a penis in the vagina or anus may be difficult. Oral sex is easier if both people can get their bodies into the right position.

a woman in a wheelchair speaking.
I feel like a queen now because I am always in my chair when we have
sex. It adds to the
excitement.

If you are paralyzed, you probably know how much you can move and what body positions are possible for you. Depending on how much of your body is paralyzed, it may be necessary to ask a partner or trusted caregiver for assistance.

The positions used for having a pelvic exam can also be used for sex. And the “safer sex” positions may also be helpful.


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