Well, it is time to end the silence. The Doctor is IN, and he is taking questions:

What is your audience mostly consisting of? Baby boomers? SCI, Elderly?

The insights I gained into pleasure and orgasm from my personal and professional research is beginning to cross over to people without disabilities who are looking for more out of their sexual relationships. In my coaching practice I have helped people with various, sometimes rare, disabilities.

What are some of the most important aspects of a healthy sexual relationship? Emotional depth? Vulnerability?

I think the most important aspects of a healthy sexual relationship are trust, safety (emotional and physical) and a sense of connectedness, all of which I expand on in my forthcoming book, Regain that Feeling: Secrets to Sexual Self-Discovery. Then I would add creativity, adaptability, and a sense of humor.

What percentage can achieve orgasm? General population vs. SCI.

I try to avoid answering questions about percentages. They are good for describing the overall picture but are not that useful to an individual. If a client came to me and said I haven’t experienced an orgasm since my injury, and I responded to that only about 50% of people with spinal cord injuries experience orgasm, how helpful is that? They might assume they are not one of the 50%. However with education and learning new ways to access pleasure, they may be able to relearn orgasm..

Is an orgasm necessary for a fulfilled sexual relationship?

The standard answer is no. However, it depends on how important it is to the individual or to their partner. If orgasm was a regular and cherished part of your sexual experience, you might feel fulfilled at first. Likewise, you might feel fulfilled but your partner may feel selfish if they are experiencing an orgasm and you’re not. Pleasure and orgasm after spinal cord injury is the result of a process of sexual self-discovery takes many people a lifetime to figure out without guidance.

What about Love? Necessary? Optimal? Sustainable?

Love is such a multifaceted word. It can be an emotion or an action. Some people fuse love and sex well, while others are quite split, as in whom they love and who turns them on sexually can be mutually exclusive. If we’re talking about a healthy long-term relationship, I’d say respect for individuality and uniqueness is more reliable than love.

We currently have a series on online dating with Woman with Disabilities. What type of partners do we as SCI attract? Do Studies show a profile?

I think people with spinal cord injuries attract all types of partners. The assumption may be that we only attract caretakers and devotees or people who idealize us for being so strong or independent. However, I don’t think a broad survey of partners would support those assumptions. I know in my case; my wife wasn’t interested in being a caretaker when she met me, nor did she give me extra credit for living well in a chair.

How is real intimacy achieved?

Real intimacy is achieved when you are able to reveal to your partner those aspects of yourself that you are not so proud of. Many people withhold sharing details that they are afraid would scare their partners away. This can be the source of continued loneliness despite constant companionship and sex.

How is fear of loss and self-esteem addressed for those with SCI?

If you’re asking how is fear of loss of a partner you had before your injury addressed, I would first say by recognizing it’s a possibility. Next I would say that your fear needs to be verbalized to your partner. Their response may alleviate your fear or may confirm your concern that they’re not interested in maintaining a relationship.

What can a partner do to help the other to feel more desirable?

I think the number one thing a partner can do to help the other feel more desirable is to pay sexual attention to them. That doesn’t just mean initiating sex; it means touching them in a loving way, kissing them passionately, flirting with them, and sharing with them what you find sexy about them.

Sex occurs one way pre-injury. Now it is different. How do both partners adjust? How do you deal with the expectations of what is “normal?”

A common sentiment I hear from people after their injuries is that sex is not the same, not normal anymore. What’s normal for people is relative to what was normal for them before they crashed their car, got shot, or fell off a cliff. The sad news is that both partners don’t always adjust. Sometimes a person with a spinal injury has an experience with himself or herself or a partner that makes them come to the conclusion that sex is pointless, why bother, and they give up. Sometimes a partner leaves, avoids sex or finds sex somewhere else. These live experiences are often very difficult to get by without support from others who have been there and eventually came out whole or professional support. If both partners are committed to continuing their sexual relationship, then adjustment happens over time with education and experimentation. That’s why you always hear me talking or writing about sexual self-discovery.

Dr. Tepper has been married 28 years to his wife Cheryl, and they have one son Jeremy, who just turned 18. Dr. Tepper’s new book, Regain that Feeling: Secrets to Sexual Self-Discovery shared by People with Spinal Cord Injuries, will soon be available on Amazon.com in multiple formats. Regain that Feeling offers profound insights on the importance of trust, safety, and connectedness to pleasure and orgasm for everyone.

You can follow Dr. Tepper on his Facebook, or at mitchelltepper.com. Contact: [email protected]