The Ultimate Guide to Sex and Disability

Lou FCD's picture

The Ultimate Guide to Sex and Disability Full Title: The Ultimate Guide to Sex and Disability: For all of us who live with disabilities, chronic pain & illness
Miriam Kaufman, M.D., Cory Silverberg, and Fran Odette
Publisher: Cleis Press
Copyright: 2003, 2007 (2nd ed.)
ISBN: 978-157344-304-3
Pages: 334 plus index
Price: $18.95 (US)



The sexuality of disabled members of our society is perhaps one of the most closeted, or at least overlooked, topics in American public discourse. Rarely is the topic addressed even by the most strident of sex positive advocates. The Ultimate Guide to Sex and Disability was written to rectify this deficiency in our public square. The authors, Miriam Kaufman, M.D., Cory Silverberg, and Fran Odette, take a unique and personal approach to their mission by lacing the book with actual responses from a survey done by phone and internet. These survey responses faithfully guide the book toward its objective.

(The rest of the review is below the fold)


In tone, the book reflects the sex-positive attitude of its authors. In it, they set about de-stigmatizing sexuality in the disabled, and in so doing address many of the same issues in society in general. They are non-judgmental and inclusive, not shying away from topics such as S/M, Fetishes, or gender play. References throughout the book are made from diverse perspectives of gender, sexual preference and orientation, ethnicity, and disability. Survey responses are included throughout the book, and even the illustrations of sexual positions in chapter eight reflect a wide spectrum of real people. The authors earn extra kudos for going the extra mile to include such a varied mix, challenging norms of beauty for example with an image of a woman who doesn't shave, a range of body types, including wheelchairs and crutches, and challenging relationship norms with interracial and same sex couples in various images. Their effort helps make the book as accessible to as many people as possible through its inclusivity

There are three key themes that wind throughout the entirety of the book. The first such theme is communication. The authors discuss communication with current and potential partners, of course, but also remind us that some of us need attendants and we must be able to communicate with them about our needs as well. We might need to communicate something as simple as privacy or something as complicated as assistance with positioning. This requires self confidence, and a sense that we have a right to a sex life. (Perhaps the greatest contribution of the book is reminding us that we do have that right and giving us something to show our attendants as a way of opening the discussion!)

Equally as important is an emphasis on self-awareness and self-exploration. Getting to know oneself is essential in order to learn how to better communicate our needs to potential or actual sexual partners. The authors discuss masturbation frankly, explaining that this is as much a legitimate sexual activity as intercourse, that it is not a replacement for anything, and that masturbation is healthy, normal, and necessary. Hand in hand with this idea is that anything that gives us pleasure for its own sake can be viewed as masturbation, and that there is no ultimate goal beyond that. Orgasm is framed as a nice addition to the experience of self pleasure but not as the be all and end all of it.

The authors take the first two threads and weave them together into a message of self-empowerment and the need of the disabled to exercise their right to sexuality, which is really the basic premise of the book. This right for people with cognitive as well as physical disabilities is fundamental. Society takes a dismissive attitude toward the sexuality of the disabled resulting in yet more barriers we must face in developing our sexual expressiveness. The authors deftly navigate the waters of these barriers with an easy and logical flow that makes the book a pleasure to read, in addition to being insightful and informative.


The authors end the first four chapters with practical exercises of exploring our bodies to discover what we each find pleasurable, and gives helpful tips on creative positioning for a myriad of physical limitations. These exercises are referenced throughout the work, and their recurrent usefulness for purposes of explanation and demonstration nearly compels the reader to tab or dog-ear those pages for convenience.

The book is brimming with explicit advice to assist in making informed choices in purchasing sex toys, choosing to engage in penetrative sexual activity (or not), and the obstacles to sexual activities and some helpful ways to overcome or avoid them to better enjoy our sexuality. It presents specific assistance, emphasizing honesty and communication while discussing such diverse topics as anxiety and arthritis, fetish and fantasy, gender play and good positioning. Safer sex practices are laced throughout the book where necessary and appropriate, and chapter twelve is dedicated to the subject entirely.

The penultimate chapter of the book is an extensive collection of resources, sorted by topic and subdivided into Print, Online, and Organization sections. It is followed by a brief chapter of clear but concise definitions of a few gender and sexuality related terms. A common understanding of the definition of a given term is vital to the communication of an idea, and thus the chapter has a requisite role in our attempt to communicate necessary information about ourselves and our sexuality to those around us.


The book begins a bit slowly, taking a few chapters to really work up a head of steam. While the importance of breaking down barriers and dispelling myths about sexuality in the disabled can't be stressed enough, the first chapter in particular reads a bit like a litany of crimes fleshed out, followed by a sentence or two of rebuttal by assertion. Perhaps just a little more time given to these rebuttals, even via short anecdote or research evidence, or even quotes from their survey would greatly improve the interest level of the chapter.

The authors take up the proposition of assisting the disabled in knowing, exploring, and empowering our own bodies and our sexual needs. Since the purpose of the book is to look forward from this point, it is understandable that the authors did not dwell much on the pre-disability lives of those of us not born with our conditions. Still, in addressing past issues that may have led the congenitally disabled to the point where they need the authors' help, giving only the barest of nods to those of us who are needing to adjust to our new selves left me feeling just a little out in the cold. Transitioning from one life to the other raises its own set of psychological issues for the newly disabled person and also for partners who were part of that person's life pre-disability that might have been more explicitly acknowledged and addressed.

The book is practical and logical for the most part, sensible and well thought out. It is solidly grounded in the real world of real people who need real help. Then suddenly after the first few pages of chapter ten, which introduces generally useful information about the meditative benefits of yoga and tantra, I felt like I suffered neck-wrenching whiplash because of a detour into the mysticism of "Chakras" and "Energy Bodies". This felt like a major interruption given the general focus of the book on facts and evidence. The reader would lose little by simply skipping past it and moving straight to the exercise section of the chapter. Those interested in the benefits of meditation without the superfluous supernatural discussion would be served better to find a separate source.


In a time when the sexuality of the disabled is still a topic of discomfort to the extant that it often gets ignored in the conversations of even most activist communities, The Ultimate Guide to Sex and Disability is a desperately needed resource. It should be within easy reach of anyone who lives with a disability, as well as those who love, assist, and care for us. Share/Save