Lived experiences that impede or facilitate sexual pleasure and orgasm in people with spinal cord injury

Mitchell Steven Tepper, University of Pennsylvania


There is a dearth of literature on pleasure and orgasm in people with spinal cord injury (SCI). Much of the orgasm literature rules out the possibility of “real” orgasm for this population. Recent neurophysiological studies confirm orgasm in women with SCI but do not explain why some people with SCI experience pleasure and orgasm while others do not. This study explored the problem of pleasure and orgasm by focusing on learning and lived experience of sex before and after injury, and by comparing sexual knowledge, sexual attitudes, and sexual self-esteem among participants. A purposive sample of 28 men and 19 women with SCI filled out a set of sexuality questionnaires. Of the total group, 24 experienced orgasm since injury and 23 never experienced orgasm since injury. Twenty-two of the participants, 12 men and 10 women, also participated in open-ended interviews. The research design was grounded in existential phenomenology and incorporated qualitative and quantitative methods. There were no significant differences in sexual information or sexual attitudes as measured on the Derogatis Sexual Functioning Inventory. Participants who experienced orgasm reported significantly greater years since injury and scored higher on sexual-esteem than those who did not. Emergent themes from the qualitative analysis included sexual response as “not the same” after injury, concerns about being sexual in the “normal” way, and masturbation as “pointless” leading to the conclusion “why bother.” There was also an expressed “need to be with a partner” for safe sexual exploration and to access optimal sexual pleasure and orgasm. A distinction was made between types of orgasms. The results led to the theory that the ability to experience orgasm in SCI is the culmination of a process of sexual self-discovery that is reflective of its pattern or expression before injury within the dominant sexual culture. Implications for rehabilitation professionals, people with SCI, DSM IV (American Psychiatric Association, 1994), sexology, and spirituality are considered.

Subject Area

Health education|Psychobiology|Rehabilitation|Therapy

Recommended Citation

Tepper, Mitchell Steven, "Lived experiences that impede or facilitate sexual pleasure and orgasm in people with spinal cord injury" (2001). Dissertations available from ProQuest. AAI3031730.