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Sex with Disabilities or Chronic Illness – With Dr. Lee Phillips (Episode 8)

Nov 15, 2021

Open Google, search “couples”, click on images and then see just how far you have to scroll down before you find a picture showing persons with disabilities expressing physical affection towards one another.

The reality is that, despite the fact that we live in an, arguably, sex-obsessed society, enjoying a healthy sex life is still perceived as being almost exclusively the preserve of the young, the conventionally attractive, and the able-bodied.  This perception needs to be challenged – not only is it discriminatory towards differently-abled people, but it’s also false.

People with disabilities are, first and foremost, people. This means their ability to experience and desire sexual arousal, pleasure, and gratification is the same as a person without disabilities. The sexual identities, tastes, sexual activities, and sexual lives of people living with a disability are as varied and multi-faceted as people who don’t identify as disabled.

Here we debunk seven pervasive (and totally inaccurate) myths that surround sexuality and disability, hopefully empowering able-bodied and differently-abled people to see sex and sexuality as a key part of everybody’s identity.


Myth One – Differently-Abled People Aren’t Sexual Beings

This is clearly incorrect. Differently-abled people experience the same spectrum of sexual desire as the rest of the population. Some people with disabilities may be asexual, but that is down to their individual sexual preferences rather than their disability.

The idea that because someone needs assistance with some aspects of their life they are sexless, childlike, or incapable of intimate relationships is just not true.

This myth is particularly dangerous because it may result in caregivers and health professionals not considering or facilitating the sexual health of differently-abled people. Ready access to contraception, sexual health screening and treatment services, terminations, and sex education is as necessary for people with disabilities as it is for anyone else.


Myth Two – Differently-Abled People Can’t Have Sex

This is an odd myth, perhaps perpetuated by a narrow view of sex (if it’s not heteronormative, penetrative intercourse then it’s not sex), and an inability to recognize that differently-abled (and able-bodied) people are capable of living and loving in a wide variety of ways.

Not only can physical barriers to penetrative sex be overcome through measures such as specialist equipment, thoughtful positioning, and a willingness to think outside the box, penetration is just one choice amongst hundreds of others when it comes to sexual pleasure and fulfillment.

The use of sex toys, masturbation (mutual or otherwise), non-penetrative kink, or other forms of stimulation are all valid, satisfying forms of sex. Many couples (whether one, both, or neither of the parties is differently-abled) don’t define the success of their sex lives by whether penetration occurs!


Myth Three – Differently-Abled People Can’t be LGBTQA+

Again, this myth ignores the individual and focuses on the disability. Individuals with disabilities love in many different ways. People with disabilities may be sexually attracted to men, women, or both sexes. They may also identify as queer, trans, asexual, pansexual, non-binary, or with one of the many other genders out there.


Myth Four – Differently-Abled People Don’t Experience Sex in the Same way Able-Bodied People Do

The reality is that everyone’s experience of sex is slightly different. What gives one person enormous sexual pleasure may leave someone else completely cold. A person with a disability may not experience sexual pleasure in the way that an able-bodied person does, but this is as likely to be down to sexual preference as it is to the nature of the disability.

In some cases, a disability may mean that some avenues of sexual pleasure aren’t readily accessible. For example, neuropathy (nerve damage) and/or a spinal cord injury may mean that some parts of the body don’t register sensation. Muscle wastage, balance, coordination issues, and/or side effects of medication may also make some forms of sexual expression challenging or unsuitable.

In such circumstances, simply selecting a way of loving that provides satisfaction and pleasure to both parties ensures that physical disabilities aren’t a barrier to a full, satisfying and adventurous sex life.


Myth Five – The Dynamics Between “Mixed” Couples are Unhealthy

Able-bodied apartheid is an unhealthy prejudice that needs to be quashed. Relationships between two people can be coercive, controlling, or otherwise abusive whether both, one, or none of the parties are differently-abled.

Whilst it is true that women with disabilities may be vulnerable to sexual abuse, this is more indicative of the wider abuse and discrimination differently-abled people and women experience.

Provided sex is legal and mutually consensual, it is up to each couple to define their own relationship dynamics, hopefully within a healthy framework.

Outdated stereotypes on relationship dynamics (women are always the less powerful parties, people with disabilities are vulnerable, submissive partners etc) are unhelpful and damaging when trying to form strong, healthy relationships.


Myth Six – Differently-Abled People Can’t Use/Be Sex Workers

People with disabilities can and do use sex workers. Some sex workers specialize in providing services to differently-abled people. Provided the sex is legal and mutually consensual, using a sex worker is an option open to all.

People with disabilities may choose to become sex workers if they wish.


Myth Seven – People With Disabilities Aren’t Sexually Adventurous

Many people have no desire to be sexually adventurous, which is absolutely fine. Others revel in a wide variety of non-vanilla activities, which, as long as they are safe, legal, and mutually consensual, are also fine. There is no “right” way to love, and that’s as true for differently-abled people as it is for everyone else.

In summary, it’s high time that a more sex-positive attitude towards the intimate relationships of people with disabilities became the norm. Everyone has the right to enjoy sex in a legal, consensual manner.


In this episode of Modern Intimacy, Dr. Kate Balestrieri talks with Dr. Lee Phillips, a certified sex therapist who often works with people with disabilities and chronic illness. Dr. Lee Phillips is in private practice in Reston, VA where he specializes in couples sex therapy. He is a Licensed Clinical Social Worker (LCSW) in Washington, DC, Maryland, Virginia, and Florida. Dr. Phillips is a Certified Substance Abuse Counselor (CSAC) in the state of Virginia. He is a Certified Sex Therapist (CST) by the American Association of Sexuality Educators, Counselors, and Therapists (AASECT). In addition, he is a Certified Sex and Couples Therapist (CSCT) by the Integrative Sex Therapy Institute. He has been in private practice for more than a decade, working with individuals and couples on sexuality after chronic illness.


He lectures on topics including sexuality, chronic pain, anxiety and stress management, caregiving stress, depression in the elderly, mindfulness and cognitive strategies for chronic pain, reclaiming sexuality for couples with chronic illness, ethical decision making, the assessment of mental disorders, and exploring sexual communication, freedom, and pleasure for gender minorities with chronic illness, pain, and other disabilities. He has published in the Journal of Baccalaureate Social Work, conducting a research study on LGBTQ-Affirmative Teaching at Historically Black Colleges and Universities: Understanding Program Directors Views.


He has been a featured expert in Teen Vogue, Healthline, and The Lily Newspaper. He writes for Psychology Today. Dr. Phillips is writing his first book, Sex and Love When You’re in Pain, which helps couples overcome shame and the sexual limitations caused by illness and gives strategies to create and reclaim a sex life that works. He is the host of the Sex & Chronic Illness Podcast. His podcast features stories from individuals, couples, and other experts in the field on overcoming shame and the sexual limitations caused by illness and disability. He holds a Doctor of Education (Ed.D.) degree in Organizational Leadership with an emphasis in Behavioral Health from Grand Canyon University in Phoenix, AZ. In addition, Dr. Phillips is an adjunct professor in the Master of Social Work Program with the School of Social Work at Western New Mexico University and he is an instructor for The Integrative Sex Therapy Institute and with Modern Sex Therapy Institutes. He can be found at www.drleephillips.com. Facebook: @drleephillips Instagram: @drleephillips Twitter: @Dr. Lee Phillips


This is the cover for the Modern Intimacy with Dr. Kate Balestrieri podcast.
Dr. Kate Balestrieri, host of Modern Intimacy, a licensed psychologist and certified sex therapist, helps people live more fulfilled lives by shattering stigma and erasing shame. Dr. Kate invites you to join her as she investigates the relationship between sex, mental health, relationships and modern society.


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