People are sexual beings by nature.
Sexuality is not just about the physical act of sexual intercourse, but also includes emotional, intellectual, social aspects and other forms of sexual expression.
Spinal cord injury may alter certain physical and emotional aspects, but in spite of this there are still many ways that a person can express their sexuality.
Listen in as Minna Hong discusses your sexual options after a spinal cord injury.
Expressing Sexuality When Living with a Spinal Cord Injury
Featured Speaker:
Minna Hong, SCI Peer Support Supervisor
Minna Hong is the Spinal Cord Injury Peer Support Program supervisor at Shepherd Center, where she has worked since 2000. Minna, the mother of two young adults, has been living with a spinal cord injury 1999. She is a guest lecturer at Emory University, Georgia State University, the University of Georgia and Mercer University, speaking about on treating patients with a disability. Minna has served as a distribution board member of the Georgia Brain and Spinal Cord Injury Trust Fund since 2009. She has also contributed as a member of Delta Air Lines’ Disability Advocacy Board since 2011 and served as a member of the company’s Disability Resource Group from 2009 to 2013. Minna has been featured in various publications, including New Mobility, Jezebel, the Atlanta Journal Constitution and Spinal Column magazine. She is an artist, exhibiting at Coca-Cola Headquarters in Atlanta in 2014, and her work is featured in a 2015 AT&T calendar. Transcription:
Expressing Sexuality When Living with a Spinal Cord Injury
Melanie Cole (Host): People are sexual beings by nature. Sexuality is not just about the physical act of sexual intercourse, but also includes emotional, intellectual, social aspects and other forms of sexual expression. Spinal cord injury may alter certain physical and emotional aspects, but in spite of this, there are still many ways that a person can express their sexuality. My guest today is Minna Hong. She’s a peer support manager in the Transition Support Program at Shepherd Center. Welcome to the show, Minna. Tell us a little bit about spinal cord injury and what sexual functions are typically lost or gained during spinal cord injury.
Minna Hong (Guest): First of all, thank you so much for the opportunity. When you talk about spinal cord injury, there are lots of different levels. Depending on what level of injury that your injury occurred, that’s where the deficit would be. If it’s a complete injury, that’s whatever your level of injury is; whether it’s on the cervical, thoracic, or lumbar or sacral, anything below that injury doesn’t communicate well. For an average person, if they have a level below the injury of their waist per se, they may have some sexual function back, some may not. It may be impaired, so it’s all of the above, and there are no black and white lines in that, if that makes any sense.
Melanie: It makes perfect sense. And we certainly know that it does depend on the type of spinal cord injury, but in general, when you’re working with people, let’s start with the emotional factors. Because I imagine that they feel like right away, this is something they’re never going to be able to experience again. How do you work with spinal cord injury patients and their loved ones to let them know there are still stuff out there they can do?
Minna: With spinal cord injury, if you look at the population of people that get injured, they’re relatively young. This is not an old person’s injury. If you look at statistics, the most common level of injury is around C6 and C7, which means that you may have a little bit of finger dexterity potentially. That’s the most common level of injury, and the most common age level is around their 20s. During those years, I think sexuality is a huge component of one’s being. It is a huge thing. One of the things that we hear a patient say over and over again is “It’s true I can’t move my legs, but can I get a hard on?” That’s one of those things that comes up over and over and over again, because sexuality is such a huge part of our individuality, our life, you know, and all of that good stuff. Because having a fully realized life, a lot of it includes sexuality and in that, that is a huge problem that we have. And yet, is it different? Absolutely, it’s different. We can’t deny the elephant in the room. So, what’s more important is how do we explore into the different parts of our bodies that work to make sexuality more interesting and exciting? That is the million-dollar question. At the front end, most people don’t want to hear that, because we’re used to what we know. To kind of rethink what sexuality is, it’s hard for some people, especially the younger folks. When they’re used to doing something and doing it really, really well, and now we’re saying, “Hey, there’s a shifting of the paradigm. You can’t do it this way anymore, but there is some other opportunity of doing it.” They may not be up to it, especially in the front end. So, all of those things are true.
Melanie: How do you get them to realize this and speak about the other things that they can do? Is this an uncomfortable conversation or are they pretty open to discussing it because it’s so important?
Minna: It’s a combo platter. I think in the beginning, they may not want to have a conversation about it. And, you know, with rehabs, they’re not in here for two days or three days. Usually, a patient’s inpatient stay is around 50 days, so within that time, lots of conversation is had. Education is a huge component of spinal cord injury because it’s emotional, it’s psychological, it’s physical; it affects you and it impacts all the people that love you. It may include your partner because they may have to do things a little bit differently, too. It’s a question that comes up. If it doesn’t, they’re thinking about it. Within Shepherd Center, we have a class that deals with sexuality. Again, during that time, lots of information is given in terms of how to do it in a creative way, along with the different things that are available for them, such as different enhancement medications. It could be oral, injection, and so on and so forth. All of those are put into its context. Again, it’s not to make sexuality be the same, because physically it will be different. I’d be lying to you if I say it’s the same, but what’s wonderful is that different doesn’t mean it’s worse. Different just means it’s different. It’s a way of embracing that and working with that that becomes really, really important, and figuring out what your sensitivities are because it changes. For example, if somebody is newly injured, their sensation right above their injury, it’s much more sensitive than it was before, so maybe you can utilize that in one of your sexual plays or what have you. You kind of have to think about it differently and be open enough to explore, dive with the curiosity and interest to make sexuality exciting anew.
Melanie: How do you help them use their senses, their sight and sound and touch and smell, to enlighten their sexual experience and their sexual pleasure even if they can’t get an erection or have an orgasm? And along that, Minna, how do you help them to pleasure their loved one as well because it’s got to go both ways?
Minna: It’s absolutely. Communication is the key. That’s no different than it was before. One of the things that we do is the messenger has to be correct. I think with the department in which I work in, we speak the language and we sort of, no pun intended, we walk the walk. By using personal experiences, I think it really helps them out to look at things a little bit differently. Do you need positioning aids? If they complain about all that, “I can’t lift or I can do a certain kind of positioning,” they need to know that there are options for them so they could be creative. If they’re missing a component or sensitivity or lack of grip or what have you, there are things that are available out there. Our goal is to say “one size does not fit all.” These are many, many ways of handling this situation. It’s up to you to take the information that’s given to you and make it your own. As it is in the bedroom, I don’t think any two people have sex the same way. Our goal and our job here is to kind of let them know that there is no one way of doing something, but one of these things may work for you. If you learn something new from it, share with us so we can pass it on.
This is a huge topic and it’s different. Again, I can’t emphasize how sometimes different it is. Isn’t it different every time you have a new partner? Do you know what I mean? Or as we age, sexuality becomes different. Or sexuality can become mundane if you’re with the same person all the time and then you have to kind of recreate the mood or that. It’s similar to that. More than anything else, you have to have the communication open. You have to have a little bit of humor and the openness and the willingness to experiment.
Melanie: I’m glad you mentioned the word humor, because I think that that’s probably a big part of that emotional communication and dealing with all of the mental aspects that go along with sexuality with spinal cord injury. Now, Minna, what about with women? If they have no feeling below the waist, but their partner – men, they can do whatever it is they want to do, as long as the woman is like letting them and up for it. How do you work with partners in that case to say, “Well, you got to make sure that she is enjoying it as well”?
Minna: If the woman has the spinal cord injury, there are a lot of things that are similar to what was… because women, we don’t have to have an erection to have wonderful sex because we don’t have …
Melanie: That’s what I’m saying.
Minna: The other thing is whatever you lack in sensation, you can absolutely supplement. For instance, visualizing things are very, very important, you know, and then actually having that communication with your partner to say, “This feels good, that feels good, try this. Maybe we can wedge and have a different positioning that would be more comfortable for both of us.” A lot of people think, “Oh, my God! Am I gonna hurt you?” No. You know how you bring a new baby at home and you think, “Oh, my God! You know, am I gonna hurt this child or not?” It’s not like that. We don’t break. I think people with spinal cord injury, we’re not that fragile. I think that’s kind of a fear that people have. That’s a misnomer. Absolutely, you should be in good shape. Do your stretches. You need to take care of your personal things like, you know, number one and number two, like anyone else would. Again, be the authentic you. Have the sense and the know-how to know what you like and what you don’t like and have that open communication and the ability to take some risks.
Melanie: In just the last minute, Minna, if you would, give the listeners your very best advice about sexuality with spinal cord injury and why they should come to the Shepherd Center for their spinal cord injury rehabilitation.
Minna: Well, one of the things that we do at Shepherd Center is a comprehensive rehabilitation. We try to do our very best to cover all ends. One of the things that we have available are lots of people that have rehab from Shepherd Center that actually do give that. That’s in terms of not only emotion, but physical support. For instance, if you had a specific need and if that need could not be met through a therapist, and if you wanted to speak to somebody with similar situations, your support comes in. I may not meet that need, but there are lots and lots of people that I can contact that can give that specific information, whether it’s sexuality or anything else. Again, our services don’t end when you discharge from the hospital. We’re open to make sure that their needs are met after on because life goes on after spinal cord injury and Shepherd Center is a jumping point. We want people to fly after they leave the hospital. We want this to be a starting jumping point.
Melanie: Thank you so much. What great information. You’re listening to Shepherd Center Radio. For more information, you can go to shepherd.org. That’s shepherd.org. This is Melanie Cole. Thanks so much for listening and have a great day.
Expressing Sexuality When Living with a Spinal Cord Injury
Melanie Cole (Host): People are sexual beings by nature. Sexuality is not just about the physical act of sexual intercourse, but also includes emotional, intellectual, social aspects and other forms of sexual expression. Spinal cord injury may alter certain physical and emotional aspects, but in spite of this, there are still many ways that a person can express their sexuality. My guest today is Minna Hong. She’s a peer support manager in the Transition Support Program at Shepherd Center. Welcome to the show, Minna. Tell us a little bit about spinal cord injury and what sexual functions are typically lost or gained during spinal cord injury.
Minna Hong (Guest): First of all, thank you so much for the opportunity. When you talk about spinal cord injury, there are lots of different levels. Depending on what level of injury that your injury occurred, that’s where the deficit would be. If it’s a complete injury, that’s whatever your level of injury is; whether it’s on the cervical, thoracic, or lumbar or sacral, anything below that injury doesn’t communicate well. For an average person, if they have a level below the injury of their waist per se, they may have some sexual function back, some may not. It may be impaired, so it’s all of the above, and there are no black and white lines in that, if that makes any sense.
Melanie: It makes perfect sense. And we certainly know that it does depend on the type of spinal cord injury, but in general, when you’re working with people, let’s start with the emotional factors. Because I imagine that they feel like right away, this is something they’re never going to be able to experience again. How do you work with spinal cord injury patients and their loved ones to let them know there are still stuff out there they can do?
Minna: With spinal cord injury, if you look at the population of people that get injured, they’re relatively young. This is not an old person’s injury. If you look at statistics, the most common level of injury is around C6 and C7, which means that you may have a little bit of finger dexterity potentially. That’s the most common level of injury, and the most common age level is around their 20s. During those years, I think sexuality is a huge component of one’s being. It is a huge thing. One of the things that we hear a patient say over and over again is “It’s true I can’t move my legs, but can I get a hard on?” That’s one of those things that comes up over and over and over again, because sexuality is such a huge part of our individuality, our life, you know, and all of that good stuff. Because having a fully realized life, a lot of it includes sexuality and in that, that is a huge problem that we have. And yet, is it different? Absolutely, it’s different. We can’t deny the elephant in the room. So, what’s more important is how do we explore into the different parts of our bodies that work to make sexuality more interesting and exciting? That is the million-dollar question. At the front end, most people don’t want to hear that, because we’re used to what we know. To kind of rethink what sexuality is, it’s hard for some people, especially the younger folks. When they’re used to doing something and doing it really, really well, and now we’re saying, “Hey, there’s a shifting of the paradigm. You can’t do it this way anymore, but there is some other opportunity of doing it.” They may not be up to it, especially in the front end. So, all of those things are true.
Melanie: How do you get them to realize this and speak about the other things that they can do? Is this an uncomfortable conversation or are they pretty open to discussing it because it’s so important?
Minna: It’s a combo platter. I think in the beginning, they may not want to have a conversation about it. And, you know, with rehabs, they’re not in here for two days or three days. Usually, a patient’s inpatient stay is around 50 days, so within that time, lots of conversation is had. Education is a huge component of spinal cord injury because it’s emotional, it’s psychological, it’s physical; it affects you and it impacts all the people that love you. It may include your partner because they may have to do things a little bit differently, too. It’s a question that comes up. If it doesn’t, they’re thinking about it. Within Shepherd Center, we have a class that deals with sexuality. Again, during that time, lots of information is given in terms of how to do it in a creative way, along with the different things that are available for them, such as different enhancement medications. It could be oral, injection, and so on and so forth. All of those are put into its context. Again, it’s not to make sexuality be the same, because physically it will be different. I’d be lying to you if I say it’s the same, but what’s wonderful is that different doesn’t mean it’s worse. Different just means it’s different. It’s a way of embracing that and working with that that becomes really, really important, and figuring out what your sensitivities are because it changes. For example, if somebody is newly injured, their sensation right above their injury, it’s much more sensitive than it was before, so maybe you can utilize that in one of your sexual plays or what have you. You kind of have to think about it differently and be open enough to explore, dive with the curiosity and interest to make sexuality exciting anew.
Melanie: How do you help them use their senses, their sight and sound and touch and smell, to enlighten their sexual experience and their sexual pleasure even if they can’t get an erection or have an orgasm? And along that, Minna, how do you help them to pleasure their loved one as well because it’s got to go both ways?
Minna: It’s absolutely. Communication is the key. That’s no different than it was before. One of the things that we do is the messenger has to be correct. I think with the department in which I work in, we speak the language and we sort of, no pun intended, we walk the walk. By using personal experiences, I think it really helps them out to look at things a little bit differently. Do you need positioning aids? If they complain about all that, “I can’t lift or I can do a certain kind of positioning,” they need to know that there are options for them so they could be creative. If they’re missing a component or sensitivity or lack of grip or what have you, there are things that are available out there. Our goal is to say “one size does not fit all.” These are many, many ways of handling this situation. It’s up to you to take the information that’s given to you and make it your own. As it is in the bedroom, I don’t think any two people have sex the same way. Our goal and our job here is to kind of let them know that there is no one way of doing something, but one of these things may work for you. If you learn something new from it, share with us so we can pass it on.
This is a huge topic and it’s different. Again, I can’t emphasize how sometimes different it is. Isn’t it different every time you have a new partner? Do you know what I mean? Or as we age, sexuality becomes different. Or sexuality can become mundane if you’re with the same person all the time and then you have to kind of recreate the mood or that. It’s similar to that. More than anything else, you have to have the communication open. You have to have a little bit of humor and the openness and the willingness to experiment.
Melanie: I’m glad you mentioned the word humor, because I think that that’s probably a big part of that emotional communication and dealing with all of the mental aspects that go along with sexuality with spinal cord injury. Now, Minna, what about with women? If they have no feeling below the waist, but their partner – men, they can do whatever it is they want to do, as long as the woman is like letting them and up for it. How do you work with partners in that case to say, “Well, you got to make sure that she is enjoying it as well”?
Minna: If the woman has the spinal cord injury, there are a lot of things that are similar to what was… because women, we don’t have to have an erection to have wonderful sex because we don’t have …
Melanie: That’s what I’m saying.
Minna: The other thing is whatever you lack in sensation, you can absolutely supplement. For instance, visualizing things are very, very important, you know, and then actually having that communication with your partner to say, “This feels good, that feels good, try this. Maybe we can wedge and have a different positioning that would be more comfortable for both of us.” A lot of people think, “Oh, my God! Am I gonna hurt you?” No. You know how you bring a new baby at home and you think, “Oh, my God! You know, am I gonna hurt this child or not?” It’s not like that. We don’t break. I think people with spinal cord injury, we’re not that fragile. I think that’s kind of a fear that people have. That’s a misnomer. Absolutely, you should be in good shape. Do your stretches. You need to take care of your personal things like, you know, number one and number two, like anyone else would. Again, be the authentic you. Have the sense and the know-how to know what you like and what you don’t like and have that open communication and the ability to take some risks.
Melanie: In just the last minute, Minna, if you would, give the listeners your very best advice about sexuality with spinal cord injury and why they should come to the Shepherd Center for their spinal cord injury rehabilitation.
Minna: Well, one of the things that we do at Shepherd Center is a comprehensive rehabilitation. We try to do our very best to cover all ends. One of the things that we have available are lots of people that have rehab from Shepherd Center that actually do give that. That’s in terms of not only emotion, but physical support. For instance, if you had a specific need and if that need could not be met through a therapist, and if you wanted to speak to somebody with similar situations, your support comes in. I may not meet that need, but there are lots and lots of people that I can contact that can give that specific information, whether it’s sexuality or anything else. Again, our services don’t end when you discharge from the hospital. We’re open to make sure that their needs are met after on because life goes on after spinal cord injury and Shepherd Center is a jumping point. We want people to fly after they leave the hospital. We want this to be a starting jumping point.
Melanie: Thank you so much. What great information. You’re listening to Shepherd Center Radio. For more information, you can go to shepherd.org. That’s shepherd.org. This is Melanie Cole. Thanks so much for listening and have a great day.