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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 Match.com 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.
 Most 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.
 What 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.
 As 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.
Conclusion
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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