Hesperian Health Guides
Sexuality and Sexual Health
HealthWiki > Where Women Have No Doctor > Chapter 9: Living with Disabilities > Sexuality and Sexual Health
You deserve a partner who respects, cares about you and treats you well. For information about protecting yourself against violence and abuse, see Chapter 18, “Violence Against Women.”
Many people believe that women with disabilities cannot have, or should not have, sexual feelings. They are not expected to want to have close, loving relationships or to become parents. But people with disabilities do have a desire for closeness and sex just like anyone else.
If you were born with a disability, or it happened when you were very young, you may have been taught you were not and could not be sexually attractive. Talking with other women who have disabilities about their own feelings is often the best way to learn to feel differently about yourself. Remember, it can take time to change beliefs that have been held for a long time, even when you are the one holding them.
If you are someone with a new disability, you may already be used to thinking of yourself as a sexual person. But you may not realize that you can continue to enjoy sex. You may think you are not sexually attractive any more and feel sad that sex may be different now.
All people with disabilities can be helped by reading or discussing the same information about sexuality that those who are not disabled read or discuss. Try to talk about sexuality with trusted teachers, health care workers, and others with disabilities.
You and your partner will both need to experiment with how to please each other. For example, if you have no feeling in your hands or genitals, during sex you can find other body parts that will create sexual feeling, such as your ears, breasts, or neck. This can also help if a disability has made sex in the vagina uncomfortable. You can also try different positions, like lying on your side, or sitting on the edge of a chair. If you and your partner can talk together honestly, a satisfying sexual relationship can happen. Remember, you do not have to settle for less than you would like. You do not have to have sex with someone who does not care about you.
Family planning
Many people with disabilities grow up with no information about sex or family planning. Yet if you have a vagina, womb, and ovaries, you can probably become pregnant—even if you have no feeling in your lower body. So if you plan to have sex and do not want to become pregnant, you will need to use a family planning method.
Here are some guidelines for deciding which family planning method might be best for you:
If you have had a stroke, or cannot walk and you must sit or lie down all the time, do not use hormonal methods that contain estrogen, like combined birth control pills, combined injections, the patch, or the vaginal ring. These make blood clots more likely.
If you have no feeling or only a little feeling in your belly, it may be harder for you to use an intrauterine device (IUD). You may not be able to feel the signs of complications or check the strings regularly to make sure the IUD is in place. If you feel comfortable, ask your partner to check the strings for you.
Condoms not only prevent pregnancy, they keep you from getting STIs or HIV.
If you have difficulty using your hands, it may be hard for you to use barrier methods, including the diaphragm, the internal (female) condom, or spermicide. If you feel comfortable, ask your partner to put them in for you.
If your disability changes over time, you may need to change your family planning method as your disability changes.
Pregnancy and Disability
If you have a disability, you can become pregnant and have a healthy baby. Here are some things to consider, especially if you cannot move your body very much, or if you use a walking aid:
- As your belly gets larger, your balance changes. Some people use a stick or crutch to prevent falls. Others use a wheelchair while pregnant.
- Since many people have trouble with hard stools (constipation) during pregnancy, you may need to do your “bowel program” to remove the stool more often.
- During labor, you may not be able to feel the birth pains (contractions). Instead, watch for the shape of your belly to change, and use this to count the time between contractions.
- To prevent stiff joints (contractures) and to keep your muscles strong, exercise as much as you can. Try to do the exercises that prevent contractures.
- For more general information, see Chapter 6, “Pregnancy and Birth.”