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Fucktionality: Why Sexual Function Should Be Part of Occupational and Physical Therapies for Disabled People

Physical therapy often focuses on strengthening and training people with disabilities to be more independent. Shouldn't sexual function be included?

Ever since I was 6 years old, I've worked with physical and occupational therapists. I never really liked it when they came around. They would make me do exercises that strengthened my abilities, but took me away from my friends and playtime. Ugh. As I got older and began to understand how important physical and occupational therapies were in my life, I did my best to do the work so that, as they put it, I could “normally complete the activities of daily living.” I learned that I could open doors, hold a fork, and do other tasks to assist in my daily life. Everybody seemed very pleased that I was gaining my independence in this way. As a wheelchair user with disabilities resulting from cerebral palsy, I was happy that I had the freedom to do some things myself … except fucking.


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My Personal Experience With Sexual Function

I was with a new lover one night, and we were engaged in a pretty hot session. Amid the moans of agreement and pleasure, my lover yelled out: “Put it in me and thrust it deep!” I paused (froze in terror is a more accurate description). I wanted to oblige him, and I definitely wanted to fuck him. I told him to guide me in (read: put me inside himself, because my spastic body couldn’t). Once inside, he looked at me expectantly, waiting for something to happen. I tried as hard as I could to thrust myself into him; I used all my spasticity in an attempt to propel my cock forward, all while maintaining a sexy, satisfied composure.

OK, if anybody had been watching or filming this scene, it would have looked ridiculous and impossible to replicate. There we were; me beneath him, grunting and flailing about trying desperately to do him, while he looked down at me with the unmistakable disappointment on his face because it had finally dawned on him that I was “actually disabled.” I remember that even though we finished playing, he wasn’t happy with the outcome by any means, and neither was I.

A New Goal for Occupational Therapy

At my next occupational therapy appointment, I was meeting a new therapist. I was kind of excited this time around because she was young, and I felt as though maybe I could be honest with her about what I really wanted help with. We went through the typical roster of questions about my disability, my function and my abilities. Finally, we came to the question about what I wanted from our time together. What were my goals? As she asked this, there was a glint in my eye – I had to go for it. I told her that I wanted to gain functionality in one very specific area: I wanted to learn how I could, as a disabled man, thrust. I was about as frank as that with her, so that there was no confusion as to what I was after.


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Her face went beet red and I could tell that this was entirely out of her wheelhouse. She admitted that she had never been asked this before, and didn’t know if there were any resources available for me. Our session ended quickly, and I never brought it up with her again. I felt as though my sexuality had been denied, and I had no place to turn.

Sexual Function Is Often Ignored in People With Disabilities

Experiences such as this happen to the disabled community on a daily basis. The systems that we rely on the most to thrive and function in society; the people who first begin to show us how our bodies actually work and what they are indeed capable of, fail to see as full, vibrant beings. They, like so many others, don’t consider that for us to be fully functional, we may want to learn how to fuck, felate, or fist our partners as the sexy, seated sensual lovers that we are.

It is really unfortunate that the sexual education for the disabled community (if there is any offered at all) doesn’t even explain how sexuality and disability are intertwined within each other. There is no guidebook or seminar on how a wheelchair user engages with their own body or others, or what going through puberty as a Queer Cripple is like. The sexual health component that talks about disability begins and ends with the risks associated if we engage in sexuality as members of a vulnerable population. As we all know, there are so many more layers to it than that.

We must start engaging with occupational therapists and physical therapists to give them the tools to educate the disabled community on how their bodies work in the bedroom. We ought to have seminars, videos, books and classes that prepare all up-and-coming therapists (who have been bludgeoned by the medical model of disability) that prepare them for what living with a disability is actually like in and out of the bedroom. Trust me, it would have been super helpful when I started fucking other people to know what my actual abilities were, rather than to find out by consistently feeling ashamed and unworthy in the moment itself. I would have had so much more sexual confidence if my occupational and physical therapy team had opened up the possibilities for me as a disabled man.


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I want all occupational and physical therapists - as well as soon-to-be students to know one thing: I am very happy that because of you I learned to hold a spoon all by myself when I was younger. Now that I am a (sort of) well-adjusted Queer Cripple adult, I’d like to learn how to position myself to spoon with someone, and I’d like to be able to ask you about it. My “fucktionality” should be just as important as my functionality.

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Andrew Gurza

Andrew Gurza is the Founder/Co-Director of Deliciously Disabled Consulting, where he strives to make disability accessible to everyone within pop culture and intersectional communities. His written work has been highlighted in Out Magazine, The Advocate, Huffington Post and The Good Men Project, where he candidly discusses the realities of sex and disability as a Queer Cripple. He is also host of the “Deliciously Disabled” podcast on iTunes where he makes sex and disability accessible to...

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