Pillow Talk for Wheelchair Users with Dr. Mitchell Tepper
Editor’s Note: Fifty-three year old Dr. Mitchell Tepper, has his Ph.D. in human sexuality education from the University of Pennsylvania, is certified by AASECT (the American Association of Sexuality Educators, Counselors and Therapists) – (www.assect.org) in education and counseling and has served on the faculty of the Morehouse School of Medicine.
Dr. Tepper answers questions this week that many individuals are afraid to ask. “Your own sexuality is as unique as your fingerprints,” Dr. Tepper says. Most people are afraid to bring up sexual issues with their doctors but are secretly wondering and worried about their sexual future. When asked, they would like their doctor to bring up the issue and to discuss their problems or concerns.
After doing research for his master’s thesis, Tepper realized there was very little information on this subject, although there were mountains of questions. Tepper set out to develop a new field of study in human sexuality as it related to pleasure in spinal cord injury and any type of physical or mental disability. He recently published a new book, “Regain That Feeling: Secrets to Sexual Self-Discovery,” that deals with this subject.
Will I Be Able to Have Children?
The number one question asked by people with spinal cord injuries or many other types of injuries is: “Will I be able to have children?” I asked myself that question when I was 20 years old, even though I wasn’t thinking about having children at that time. I’d just broken my neck at C6-7 and been told I’d be a quadriplegic. The question I asked, and the question most people really were asking was: “Can I have sex and be intimate with my partner?” When we dig deeper, men want to know will they be able to father their own children. Women want to know if they can get pregnant and carry a baby to full term.
My answer for the men is that usually there are five different ways we can help you to become intimate with your partner. A man who wants to father children can be helped three different ways to accomplish that goal. We tell the women that most spinal cord injuries or other types of injuries don’t prevent them from getting pregnant or carrying a pregnancy to full term. Most injured people are not precluded from having children because of their injuries.
The second question often asked is, “If I have a child, how can I care for that child, if I’m in a wheelchair, on crutches or on a walker?” Many kinds of adaptive equipment are available, and we can keep you very active in parenting your child. After we assure many of our patients that they can have children and care for them, the next question often asked is, “Will intimacy be the same as it was before my injury? Can I experience the type of pleasure I had before?” My answer generally is, “Yes. It will likely not feel the same initially and will take some learning, however, there may even be greater pleasure than you’ve had previously.”
Since there was so little information on sexuality education for people with disabilities, I recognized a need to research, study, learn and write about these very important questions. First of all, I had a spinal cord injury. As I studied and learned while working on my master’s thesis at Yale University, I decided to do a research project with 500 people from the National Spinal Cord Injury Association www.spinalcord.org.
The primary question I asked was, “How much sex education and counseling did you receive when you were in rehabilitation?” Only half the people that I surveyed reported getting any sexual education while in rehab. Most of them said the sex education and counseling they received in rehab didn’t meet their needs. I realized there was a tremendous need in the spinal cord injury population and also in many other areas of disabilities for sexuality education. So, I wanted to learn all I could about this subject and help provide this information to people just like me.
You Have to Inoculate Yourself Against Rejection
Sexuality is more than the act of having sex and having children. Sexuality is biological, psychological/emotional, sociocultural, relational and spiritual. Biologically when I’m counseling with a person, that individual wants to know if they can physically have sex and produce children.
This is called biological function, but the ability to be intimate is more than whether a person can function biologically to have sex and have children. The psychological effects of an injury relate to whether the individual still feels desirable after an injury. The social effects relating to sexuality relate to whether the individual still feels that he or she is capable of carrying out their roles as men and women.
The emotional effects relating to sexuality include whether the individual thinks he or she is still loveable and capable of being a good partner. Sexual-esteem is different from self-esteem. We’ve found that people with disabilities’ sexual-esteem generally lags behind their self-esteem, because of lack of sexuality education and counseling in combination with a lack of images in the media of people with disabilities as sexual beings.
When we deal with an individual’s sexuality, we also have to deal with his or her perception of what’s acceptable, what’s moral based on his faith and religious beliefs, and what’s acceptable to his spiritual beliefs. Often, a person’s religious value system plays a role in their treatment and determines what they’re willing to try and not try.
So, as you can see, counseling people with disabilities on intimacy and sexuality is much more than helping them determine if they can have sex and produce children.
I counsel and speak to numbers of wounded warriors. When we’re counseling with soldiers who’ve stepped on land mines and been blown up, the first thing they always ask their doctor is, “Doc, do I still have my junk (male organs)?”
These guys generally have lost all or a portion of their lower limbs. So, we know that often wounded warriors are first of all most concerned about their sexuality after their injuries than they are any other type of function.
Often, the number one question that women ask after a spinal cord injury or any other type injury is, “Is any man ever going to love me like I am (with my injury)?” Of course, they also ask about their ability to have children and to take care of those children, if and when they have them. Generally, my answer is, “Your injury won’t prevent you from having children, carrying that pregnancy to full term, taking care of your children or being loved by someone.”
When counseling men and women, one of the first things I tell them is that they have to inoculate themselves against rejection. We have to recognize that in the world of dating and in the world of marriage, people often will reject other people for a wide variety of reasons. A person’s disability is only one of these reasons.
For example, some people may reject me because I’m bald, since they’ve decided not to date a bald headed guy. Well, I know I’m bald, and I accept that fact, but I won’t let my baldness define me. There may be just as many women who think I’m sexy because I’m bald. Often, as I look at a group of bald men, I wonder how many men are shaving their heads, so they can look bald and sexy like me.
If you have a disability, you have to realize that some people will reject you because of your disability, but that doesn’t mean that you’re not a valuable or a loveable person. What this rejection actually means is that the person who rejects you falls short in his ability to see the good qualities in you. Sometimes individuals have to get out a bad relationship to blossom in their sexuality.
Sexuality in My Home Was Not Taboo
I grew up in a family that was accepting of sexuality. My relatives weren’t secretive about sex. In my home, my grandfather’s home and my uncle’s home, “Playboy” magazines weren’t hidden. They were in the magazine rack with all the other magazines. When I was young, my mother encouraged me not to be a wallflower. She explained the birds and the bees to me, using a book that she had purchased. In my family, the discussion of sex was not taboo, and the expression of sexuality (dating and dancing) was encouraged. In school, my buddies and I would go to the public library and get books about sex. We wanted to learn all we could about the subject. We wanted to be the guys who knew it all. I had a very active dating life until I got injured when I was 20.
When I broke my neck at C6-7, I was diagnosed as a complete quadriplegic, paralyzed from my neck down. However, over 7 months of inpatient rehabilitation, I regained much of my sensation and some voluntary muscle movement, primarily on my left side. So I actually had an incomplete injury. I was finally able to use a walker and move with braces on my legs. But primarily, I used a wheelchair to get around.
I learned on my own about sex for me as in incomplete quad, how to be intimate and how to father a child. When I went to college to get a master’s degree, I wondered what other people’s experiences were for getting sexuality education and counseling in rehabilitation, because I didn’t get very much of that kind of education and counseling in rehabilitation. Later I got married, and today I have an 18-year-old son.
I’ve continued to study and teach about human sexuality and rehabilitation. I teach health professionals, medical doctors, individuals and groups on these subjects. I conduct coaching sessions with clients over the phone, Skype, and in my home office. I’ve taught sexuality education for members of the National Spinal Cord Injury Association, the National Multiple Sclerosis Society, the American Diabetes Association, and for youths with disabilities.
Wounded warrior and their partners is another special population with whom I work. I’ve recognized a great need for sexual education, especially with disabled individuals.
People without disabilities usually can figure out or learn about their own sexuality. Often, people with disabilities aren’t taught or don’t learn anything about their sexuality, their functions and their responses. Not very many people are trained in the field of sexuality education for people with disabilities, and how to overcome the disability as it relates to sexuality.
People with disabilities are capable of dating, becoming intimate, having their first kiss and getting married after their disabilities. Most people who have some form of disability usually do find that intimacy, love and marriage for which they’re searching. But often, they discover this type of relationship much later in life than people without disabilities.
Learn More with Dr. Tepper
If you have questions or would like to know more about Dr. Tepper, his work, his book – “Regain That Feeling: Secrets to Sexual Self-Discovery,” and get more information about sexuality and disability, you can go to his website at www.mitchelltepper.com, or you can email him at email@example.com.
You also can check out http://www.regainthatfeeling.com, Dr. Tepper’s Facebook page about making love after making war – https://www.facebook.com/MakingLoveAfterMakingWar, or his personal Facebook page at: https://www.facebook.com/DrMitchellTepper?fref=ts.
To buy the book, go to http://www.amazon.com/Regain-That-Feeling-Self-Discovery-Relationships/dp/1505444993/.
Additional Resources From Wheel:Life on Relationships
Within Reconnecting: Relationship Advice from Wheelchair Users, readers will hear from people who use wheelchairs as they share their perspective on friends, family and relationships including dating, marriage and parenting.
Author Lisa Wells shares real-life examples and success stories throughout the book based on her lengthy career that includes ongoing interactions with disability advocates, non-profit supporters and peer support group members.
Reconnecting: Relationship Advice from Wheelchair Users features interviews with:
- Graduate student & quadriplegic Ather Sharif about connecting on a college campus
- Amputee Thomas Morris on connecting through his unique appearance and personality
- NSCIA [Buffalo, NY chapter] President Natalie Barnhard who connects Wheels with Wings
- Paraplegic Todd Robinson who explains his family connection through the joy of adoption
- Quadriplegic Ashleigh Justice who connects on the quad rugby field and as a young mother
About the Author: John E. Phillips
For the last 12 years, John E. Phillips of Vestavia, Alabama, has been a professional blogger for major companies, corporations and tourism associations throughout the nation. During his 24 years as Outdoor Editor for “The Birmingham Post-Herald” newspaper, he published more than 7,000 newspaper columns and sold more than 100,000 of his photos to newspapers, magazines and internet sites. He also hosted a radio show that was syndicated at 27 radio stations; created, wrote and sold a syndicated newspaper column that ran in 38 newspapers for more than a decade; and wrote and sold more than 30 books. Learn more at www.johninthewild.com.