Disability or illness can potentially impact on any aspect of our sexuality. We may wonder whether we can still have children, whether our sexual partners will stay with us, whether anyone will find us sexually desirable, or whether we will ever enjoy sex again.

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Our sexual-esteem or positive regard for and confidence in our capability to experience our sexuality in a satisfying and enjoyable way may be shattered. For example, we may assume sexual pleasure is no longer possible for us because of loss of sensation in our genitals. As a result, some of us may decide to ignore issues regarding sexuality because we believe they no longer apply to us; others will seek out any opportunity to restore sexual-esteem.

Questions, concerns and feelings of anger about our sexuality are natural after disability or illness. Concluding that our sex life is over makes sense based on myths about sexuality and disability most of us have learned from television and movies, and what we have not been taught in school. For example, people with spinal cord injury (SCI) are often portrayed in movies as sexually frustrated men and women who either have to rely on buying sex from a prostitute or have to go without. At the same time, schools often focus on only the dangers of sex and fail to educate us about the human sexual response cycle and our potential for sexual pleasure from many sources.

Doctors don't always know
Even much of the medical profession is misinformed about the sexual potential of people with disability or illness. Many medical professionals still believe orgasm is not possible for people with complete SCI, that men with SCI cannot have children, and that women with disabilities should not have children. The South African Sexual Health Association aims to dispel myths about sexuality and provide the most accurate information about sexuality and disability or illness possible.

If you want to have sexual intercourse (vaginal, anal or oral) you still can, despite problems with erections, lubrication, positioning or other physical management issues such as bowel and bladder management. Sexual pleasure, even orgasm, is still possible, no matter what disability, illness or the level or completeness of injury.

If you're a woman and want to have a baby, you still can in most cases. If you are a man and what to have a baby, you may still be able to. Adoption is also an option. If you want to be an active parent, you can. If you don't want to have a baby there are contraceptive or birth control options available. If you want to find a sexual partner, it's still possible. If you are already in a committed relationship, it is possible to still maintain that relationship. An understanding of human sexual response cycle from a physiological, psychological and social perspective, innervation of the genitals, and the possible effects of disability or illness on sexual functioning, are helpful in learning to adapt successfully to changes resulting from disability or illness. – (Dr Elna McIntosh, Health24 sexologist)

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