Welcome back to another edition of Caring About Sex and Disability!

Every March, we celebrate people with Cerebral Palsy (CP). As someone with CP myself (it really is the best of the palsies lol), I wanted to write a blog for psychosexual professionals who work with clients living with CP.

How can you help someone with CP have a fulfilling sex life while also understanding their unique needs and access requirements? Let’s explore that together.

1. Discuss/Work with Spasticity

Approximately 34,000 people in Australia have Cerebral Palsy, and I’d bet that most experience spasticity and muscle tightness. I deal with it daily, and it significantly affects my sex life. It can make it difficult to give or receive pleasure or even relax in the moment with a partner. Spasticity often feels like a bodily betrayal, and for me, it has sometimes led to premature ejaculation.

So how can a psychosexual therapist help?

Start by asking your client how their spasticity affects their daily life. From there, explore exercises that help ease tension. One technique I use is playing an imaginary piano, touching each finger to my thumb to loosen my hands before engaging in tactile play. Another helpful exercise is picking up and putting down objects, which improves dexterity. Spasticity can make it difficult to grip or release objects—something that can be particularly relevant in the bedroom. Encouraging clients to practise these movements may help improve their confidence and experience during intimacy.

2. Discuss Energy Levels and Rest

A few years ago, I saw a meme that said something like: “Did you know that people with Cerebral Palsy expend 3-4 times more energy just doing everyday tasks?”

At first, I was surprised, but the more I thought about it, the more it rang true. Sometimes, I feel exhausted after just one activity, and the idea of engaging with a sexual partner seems overwhelming.

Talk to your CP clients about their energy levels and daily routines. Those with more severe CP may use significantly more energy receiving care or managing daily tasks, which affects their capacity for sexual activity. Remind them that energy levels do not determine sexual worth, and it’s okay if rest takes priority over sex.

3. Address Depression and Mental Health

People with CP are at higher risk of depression and anxiety, partly due to brain damage at birth and partly due to social isolation from higher care needs. These mental health challenges can make intimacy feel impossible.

I recommend openly discussing how depression and anxiety impact your clients’ sex lives and body image. Ask them:

• What does your depression tell you about your CP and sex?
• How does that make you feel?

I never fully understood how my mental health affected my sex life. If I had been able to talk about it openly, things might have been different for me in the bedroom.

4. Work on Movement and Thrusting Ability

One of my biggest frustrations with CP and sex is that I can’t thrust my hips. This has bothered me for years, but there are ways to increase movement and control.

Depending on your client’s level of mobility, you might try:

• Butterfly sitting or cross-legged sitting (if possible).
• Bridging exercises while seated in a wheelchair to strengthen core and pelvic movement.

These small movements can make a big difference in their sexual experience

5. Reassure Clients That CP Doesn’t Diminish Their Sexual Value

Many people with CP, myself included, need extra reassurance about their sexual worth. My body looks and feels different, especially because I have severe disabilities, and that can be challenging to navigate.

Encourage your clients to identify what they love about their body and their CP. Ask them:

• How does CP enhance your sexual experience?
• What do you appreciate about your body?

Building sexual confidence is essential, and these conversations can help them feel empowered.

Final Thoughts

This list isn’t exhaustive, but it’s a starting point for understanding and supporting clients with Cerebral Palsy in their sexual journey. By considering spasticity, energy levels, mental health, movement, and self-worth, you can help your clients celebrate their CP and enjoy fulfilling sex lives.

Until next time!

Andrew Gurza