How Disabling Challenges Can Enhance a Couple's Sex Life

A beautiful, petite woman named Anne Shelley was one of the stars my gynecologic oncologist, Saketh Guntupalli, and I wrote about in Sex and Cancer. This year is the tenth anniversary of the life-saving operation he performed that could have killed her sex life with her husband Chuck. It didn’t. Instead, Anne and Chuck have created a vibrant new normal—without a vagina and with attached bags to collect waste.

Saketh performed a surgery “of last resort” called a total pelvic exenteration. To save Anne’s life, and with Chuck's permission, he removed all the organs from the pelvic cavity—urinary bladder, urethra, rectum, anus, and female organs.

Thinking about Anne and Chuck and the loving and playful way they restored their sex life, I decided to write this post with a focus on men who face an analogous challenge. I learned about what some couples face when the man has a suprapubic or penile catheter from one of my clients, Mathius Marc Gertz, who seriously injured himself in a fall. He found that his healing involved ten months with a catheter, first a penile catheter and then a suprapubic one. His book of survival tips for men faced with the same challenge is forthcoming and entitled Men and Suprapubic Catheter Survival Tips. After getting straight to the point with advice about hygiene, dressing, and more, he concludes this practical little book with insights about intimacy.

For the most part, he is hilarious as well as empathic and helpful.

In a short piece about introducing your kids to the idea of daddy having a catheter, he says his son wasn’t freaked out at all. In fact, he looked at the catheter and declared: “My dad is a Borg!” He was referring to the cyborgs from "Star Trek" who assimilate other species in an effort to achieve perfection. They commonly open with, “Resistance is futile.”

That Borg label—sort of like your son calling you Superman—gave Marc some provocative ideas about intimacy with his wife as well as advice he could give other men in his situation.

"It’s important to not see yourself as damaged or ugly. How about different or exotic? Reframe who you are in your eyes and your lover will be able to do the same. When you bring adult toys into a relationship, the first thing couples do is touch them and experiment. If you think of your catheter the same way, then you will help your partner not to avoid it but to embrace its being there."

That’s Marc just warming up. Continuing with the Borg theme, he then shares this with his readers:

"If you enjoy fantasy role play, incorporate the catheter into it. Make it whatever you want it to be. Become a 'Star Wars' or 'Star Trek' alien character. Perhaps you are outfitted with this special hose to overhear conversations or record fingerprints from a database. Maybe, you are into Steampunk and you are half-machine, or from the future like The Terminator. Perhaps now you are a sexual God? Or perhaps an escaped prisoner who has invaded a suburban home. The sky is the imaginative limit with your new built-in sex toy."

Michael Castleman is a San Francisco-based journalist who has written about sexuality for decades. In a 2019 blog post for Psychology Today, he offered this important thought:

"Touch is the only sense we can’t live without. Virtually everybody—everybody—enjoys sensual touch. Even those with severe disabilities can enjoy erotic pleasure. Of course, for disabled people to enjoy sex, partners must be patient and flexible, coaching is always necessary, and erotic adjustments must be made. But satisfying sex is always possible."

In the case of Marc Gertz, the disability turned out to be temporary. To clarify, by “disability” I mean a condition that limits a person’s movements or senses, so this is a term that could apply to most of us at some point in our lives. COVID-19 has disabled millions of people for days, weeks, or months. For some people, of course, “disability” will always be part of daily life.

No matter how long we face a disabling challenge, one shift in perspective we might make is to see it as an opportunity to create a new normal in the way we seek pleasure—including intimacy of all kinds.