Accessible Sex Toys for People with Disabilities

 Written by Dr. Breanne Grasso

Illustration by Aleksey Sergienko

Sexuality, disability, and occupational therapy are three words that I spend a lot of time thinking, writing, and talking about.

These three words are my passion. To truly delve into these three subjects, we need to start by defining sexuality, discussing its intersection with disability, and then understanding how occupational therapy practitioners fit into this conversation.

Sexuality and engaging in sexual activities are critical components of every human’s overall quality of life. Sexuality can include a myriad of activities such as sexual feelings, gender identity, holding hands, flirting, touching, kissing, masturbating, and having sexual intercourse. Engaging in sexuality also has many benefits, which include: improved immune system, decreased blood pressure, increased women’s bladder control, exercise participation, decreased heart attack risk, decreased pain, and decreased risk of prostate cancer.

Sex, sexual behaviours, and sexuality can be negatively affected by a disability, acute illness, or chronic disease. Sexual dysfunction can affect a person’s confidence, physical capabilities, emotions, cognition, and opportunities to participate in sexual activity. Impairments to a person’s ability to engage in sexual activity and express their sexuality can have devastating effects on their quality of life.

So how do occupational therapy practitioners fit into these concepts? 

Occupational therapy practitioners (OTs) are rehabilitation professionals who work on improving client’s activities of daily of living (ADLs) to increase their quality of life. Activities of daily living include toileting, bathing, dressing, feeding, walking, work related tasks, and even sexuality. According to the American Occupational Therapy Association, helping clients with acute or chronic disabilities engage in sexual function is within the domain of occupational therapy. I am an occupational therapy practitioner who believes sexuality is and important ADL that needs to be addressed.

And one way that OTs can work with clients to help them return to sexual function is to embrace sex toys and sexual positioning aides as adaptive equipment. Some of the common barriers to participating in sexual activities are decreased mobility, increased sensation, decreased sensation, and fatigue. Sex toys and positioning aides can be utilized to overcome these barriers.  

So... let’s discuss these barriers to sexuality and some sex aides that can help clients overcome them!

DECREASED MOBILITY

Decreased mobility can involve any limbs or body areas, including impaired hand function, arm strength, arm reach, leg mobility, and trunk control. When recommending sex toys for impaired mobility issues, we should consider: remote control vibrators, hand strap vibrators, the use of a Universal cuff, long handled vibrators, hand-less toys after placement, positioning aides, straps and slings, and tongue vibrators.

Here are some sex toys from the XES website that might be helpful to people with decreased mobility:

• Bonbon Sex toy mount
  • This mount offers hands free control. Once a toy is mounted into the pillow mount, the user does not require hand or arm mobility to hold it in place. 

• Ruby Glow
• This toy only requires placement either on the user or on a nearby service the user can access. Therefore this toy works well with those who have limited hand or arm function for holding a toy during use

• Enigma
• The Enigma is long handled and ergonomic making it easy to use if you have hand or arm mobility concerns.

• Doggy Rider
• The Doggy Rider works well for people with trunk control deficits. It can be used to help the client be held in position by their partner to increase stability in various sexual positions.

• Pulse Duo and Pulse Solo
• This product can be used with a flaccid or erect penis. It can be used hands-free meaning that after setup it can be used by clients who have decreased hand and arm mobility as well as decreased trunk control.

• and for solo pleasure...

• Moxie: controlled by phone app
• This product can be controlled by a cellphone. That means it can be controlled by a user or their partner for solo or mutual pleasure.
• One thing to keep in mind about this sex toy is that it can be placed in the underwear so for someone who has a caregiver who assists with sex toy positioning, this toy is discrete and does not require intensive setup. Once positioned, the user can control the toy themselves using the app. 

INCREASED SENSATION

Increased sensation can be a symptom or side effect of many disabilities. It can involve all erogenous zones, partial zones, and/or involve all touch. With increased sensation, a vibrator may be too much for a person. Therefore when recommending sex toys for increased sensation, we must consider: lubricants to decrease friction, plain silicon or smooth toys, and low intensity vibrators.

Here are some sex toys and accessories from the XES website that might be helpful to people with increased sensation:

• Astroglide Natural Lubricant
  • Lubricants can be very helpful for people with increased sensation because they decrease the feelings of friction against the skin and erogenous zones. When using lubricants with sex toys, be sure to know which ones are safe for the materials your sex toys are made of. This lubricant is water-based, water-soluble, and Latex safe.
• Enigma
• Since the Enigma is a smooth sex toy and it is mountable, it gives the user the ability to control how much pressure and friction occurs, making it a good toy for people with increased sensation.

• Limba Flex: M
• This toy is a waterproof silicone toy that can be customised to fit the body. Its smooth exterior and shape customisation make it a great toy for people with increased sensation. Users can bend the toy to apply as much or as little G-spot stimulation as they can tolerate. 

DECREASED SENSATION

Decreased sensation is a common barrier to participating in sexual activity. It is also the most dangerous barrier we are discussing today. Decreased sensation can be dangerous because if the client cannot tell how hot, cold, hard, or vigorously they are being touched, they run the risk of hurting themselves when using sex toys. However that does not mean people with decreased sensation cannot use sex toys- it just means that toys should be used with caution. I recommend all clients with decreased sensation place a toy on a part of their body with non-impaired sensation before use. (i.e. if clients have a spinal cord injury below the belly button, I may have them touch the toy to their nose or forehead, or arm.) When recommending sex toys for people with decreased sensitivity, consider: high intensity vibrators, ribbed toys, textured toys, and multi-sensation toys.

Here are some sex toys from the XES website that might be helpful to people with decreased sensation:

• Ruby Glow
• The Ruby Glow offers 10 powerful speeds that can be used to assist users with decreased sensation. This toy also has smooth and ribbed sections which allow different sensations within the same toy.

• Enigma
• The Enigma offers multiple sensory areas by stimulating both the G-spot and the clitoris simultaneously with 10 powerful vibration and pulsation levels.

• Bouncer
• This dildo has three weighted balls that bounce and roll inside, which increases the typical sensations of a silicone dildo. These balls increase the sensations experienced by the user making this a very pleasurable choice for someone with decreased sensation.

EASY TO FATIGUE

Fatigue is a major component of many disabilities. It can affect a client’s ability to hold sex toys in position for the duration of a sexual experience and/or their ability to hold their body in certain positions during sex. When considering recommending sex toys for clients with fatigue issues, consider the weight of a toy (the heavier the toy = the more fatigue it causes), and the way the toy needs to be held (if a person’s arm must be positioned away from the body to use the toy, their arm will fatigue sooner). Both sex toys and positioning aides can be used to address fatigue concerns. For positioning, consider using some pillows or specially designed sex furniture to hold a sex toy against the user, and/or consider sexual positioning pillows/ straps for trunk or limbs to reduce the need for a client to have to hold their body in a certain position.

Here are some sex toys from the XES website that might be helpful to people who fatigue easily:

• Doggy Rider
• Clients can use this positioning strap to have their partners help support them to decrease their fatigue in different sexual positions.

• Wedge
• Using a wedge, can improve access to erogenous zones or genitals resulting in the clients not having to use their trunk or core muscles to maintain positioning.

• Salto Slingback
• A sling can be used to position limbs and keep them in those positions throughout the sexual experience reducing the need for the client to use their muscles to hold limbs.

• Enigma
• Long handled sex toys help reduce fatigue by reducing the muscles needed to position and hold the toys in place.

This list of sex toys and their abilities to improve sexual participation by helping clients overcome physical sexual barriers does not include all of the options available. There are many more sex toys and more creative solutions that can be used to help clients return to sexual function. Each client is unique and therefore each solution to a barrier is unique. This list is to get people thinking and to hopefully help clients start to experiment with different sex toys as adaptive equipment to participate in sexual activity. I also hope this article helps people to understand just one of the many roles of occupational therapy practitioners in addressing sexuality and disability with their clients. 

For more information/resources from me, Dr Breanne G at Sexuality & Occupational Therapy, please see below:

EMAIL: SexualityandOT@gmail.com

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