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Sex and the Single Guy with Spinal Cord Injury

by Stanley Ducharme, Ph.D.  

Meeting women and dating has never been easy for most guys. It can be an emotionally draining process. The internet however has changed the dating scene drastically in the last several years. Today young, single men meet other single people through internet or on social networking sites such as Tweeter, Facebook, and MySpace.  Dating sites such as E harmony or have become popular alternatives to the old ways of meeting single people at a bar at or other social gatherings.

For guys with spinal cord injury (SCI), these high tech dating services have made it much easier and far less stressful to meet a potential partner. Issues such as accessibility, having a bladder accident or transportation issues are generally not a source of anxiety. Concerns regarding the SCI can be handled gradually in a way that is comfortable and more relaxed. The man can often feel more in control.  However, even with all the advantages of internet dating, meeting a potential partner and establishing an intimate relationship requires a certain degree of confidence and courage.

CoupleMost single men, with or without a spinal cord injury, would agree that dating and establishing romantic relationships can be emotionally challenging. No one likes the possibility of rejection or having fears about being accepted, attractive enough or interesting enough. Studies show that single people want to be in a relationship but many people have had a negative experience with close, committed relationships. Today, people are often very cautious about entering a relationship.

As a psychologist working with people who have a spinal cord injury, many single men ask me how to meet women, how to talk to them and how to start a relationship. They fear that the “rules of the game” have somehow changed following the injury. In reality, the important aspects of a relationship haven’t changed a bit. Women still want to find a man who is considerate, honest and who has integrity. In their relationships, women want a man who can communicate and who is sincere.

Nowhere is communication and honesty more important than in the dating and sexual realm. Yet, nowhere is it more difficult to be honest, direct and forthcoming. Establishing a relationship requires that we put “ourselves on the line” and face uncertainty as well issues regarding attractiveness and appeal to another person. There is just no easy and painless way to meet a potential partner. For many of us, experiencing a failed relationship may be necessary over and over again before we meet someone with the right chemistry.

These failed relationships are painful at times but unfortunately are necessary especially when trying to meet a new partner. In reality, most relationships don’t pass the test of time. What’s important is how we handle these experiences and whether we tend to over personalize them. If we can learn and grow from these experiences, we are moving closer to a successful relationship.

No man likes to be in a relationship where the feelings are not mutual. However, the man who withdraws and isolates himself after these experiences will ultimately lose confidence and appeal to others. Without confidence, it becomes even more difficult to meet the right person. Attitude is everything!     

Honesty in Dating

For most single people, sexual encounters are far more causal than in years past. The whole definition of a sexual relationship has changed in recent years. Sexual pleasure is even sometimes seen as something to share with a friend. Hence the expression, “friends with benefits”.

All of this is true for men with SCI as well. Complicating this issue however, is the question of what to say about the injury and about sexual functioning after a SCI. This is a conversation that most men with SCI would like to avoid. Every man with SCI struggles with the questions of what to say, when to say it and how to discuss sex after injury.  In reality, there is no single answer that fits every occasion. Each relationship and each sexual encounter is unique.

CoupleWhat to share about the injury or about one’s feelings may, to a large part, depend on the nature of the relationship. Sometimes saying too much too soon can be as problematic as not saying anything at all about the injury. This is something that needs to be judged by the comfort level of the couple and by the response of a potential partner. Is your partner interested in learning about how you function sexually? The bottom line is that your partner and you must be comfortable and relaxed before an enjoyable sexual experience can unfold. Rushing sex without honest communication is a sure formula for disaster.

As difficult as it can be to discuss the mechanics of sex and personal issues about your body, it is absolutely essential that some of these issues be shared. If not, anxiety is a sure bet. Under these conditions, anxiety contributes to over thinking and negative self talk. It keeps us wrapped up in our thoughts rather than enjoying the moment. Anxiety and positive sex simply are not compatible and cannot occur simultaneously.   

The First Sexual Encounter after Injury

Deciding when to be sexual after the injury can be a very difficult and agonizing decision. There is no right time to start being sexually active after injury. It varies for each man depending on availability of a partner, confidence, depression, prior sexual experience, willingness to take a risk and many other factors.

coupleAs a sex therapist, I often encourage men to take things slowly as they initially become sexually active after injury. I would typically encourage men to avoid trying to have intercourse during those first few intimate encounters following an injury. Instead, enjoy the sensations of being touched, kissed or licked. Experience the closeness and connection that intimacy allows. Then, move slowly in trying new techniques or new experiences.

When men rush to have intercourse after injury, frustration and discouragement are usually the result. At this time, sexual discovery is something that must proceed gradually in a safe and trusting environment. Talking and sharing during these times can only enhance the experience.

Those first sexual experiences after injury are usually awkward, uncomfortable and embarrassing for many reasons. Things just don’t work the way they did before the injury. After injury, erections are unpredictable, movements are difficult, sensations are absent, bodily fluids are flowing, sexual noises are common and frustrations are high. These are all to be expected and should be planned for.

Unfortunately, planning for sex can easily detract from the spontaneity that most people enjoy with sex. With experience however, spontaneity is still possible and can add to the excitement of a sexual encounter. Over time and with practice and confidence, most people find that sex after injury can still be enjoyable and can still bring a sense of pleasure and a strong connection between two people.


In conclusion, being sexual initially after injury is a difficult and challenging experience for most men. With time however, most men find that sexual activity can be satisfying, rewarding and fun. It does involve taking a certain risk however and trusting one’s partner to be supportive and helpful. Most men find that some conversation about body mechanics and logistics is important with a new partner. Putting your partner at ease and establishing a relaxed comfort level will be a major factor in how successful the encounter will be.

Educate your partner gradually about the mechanics of sex. Pace the information that you provide on your partner’s response and her interest in learning more. Know your body before you start and know how your body will respond sexually. Over time, share this with your partner. Most importantly, realize that like all good things, a great sexual life following SCI takes time, patience and understanding.

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