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    SEXUAL ANATOMY AND SEXUAL RESPONSE • 29
    from that where I don't have much feeling, but I don't notice that during sex. When I was younger, I would have given anything to look normal. I still don't use the urinal, but always go into a stall so no one can see me. But now that I have a girlfriend who doesn't mind how it looks, what's important is that she and I both get pleasure from it.
    Your disability is part of who you are. Your chronic fatigue, mobility limitation, or lower body paralysis is as much a part of your sexual self as your enviable upper body muscles, sweet tush, gorgeous breasts, or graceful hands. Your body is the raw material you get to work with. You might as well get acquainted with the whole package.
    Barriers to Understanding Our Bodies and Our Sexuality
    Those of us who have been living with our disabilities from birth or childhood have had a lifetime to get to know our bodies, but may have missed out on basic sexual health education. People new to living with a disability may have to discover what this means sexually. People with progressive illnesses may have to constantly adapt to changes in sexual functioning. Also, people whose genitalia look fairly standard will have a different perspective from those whose genitalia don't.
    In addition to the negative beliefs many of us heard while growing up (sex is dirty, only bad people touch themselves, pleasure is suspect), anyone who has had prolonged contact with the health care system as a child has had their body treated as if it is a foreign object—something to be cleaned, prodded, exposed, or hurt, something that is the property of the people in the system. We can overcome this childhood training and learn more about how we feel, what excites us, what makes us feel good.
    Teens especially face a number of barriers as they work toward becoming sexually healthy adults. Medical appointments or hospitalizations may result in missing the few sex education classes that are given in early adolescence. Parents may assume that a child with a disability is not a sexual being, and the teen will pick up on that

    assumption and may come to believe it. Institutions and families may choose a prohibitive approach to risk taking, so teens are protected from risk and do not know how to judge levels of risk or how to protect themselves from harm in any way other than totally avoiding things that might be risky. A parent and a teen may both resist any separation from the other, whether emotional or physical, even though separation on some level is a key element in developing identity, exploring sexuality, and growing up.
    Differences in the rate of physical development can also make things hard for teens. Some disabilities are associated with early puberty, and may lead to feelings of embarrassment or shame. Other teens experience late puberty, and get treated as if they are much younger than their age, being seen as nonsexual.
    As adults, we face many barriers to exploring our bodies and sexual feelings, many of which result from issues of identity and self-esteem. One of the problems with addressing these concerns is that they usually take a backseat to more obvious, functional issues. So instead we might dwell on looking for partners, all the while ignoring the fact that we may have attached all our feelings of self worth to finding the partner in the first place. This is something everyone does, to some extent, regardless of disability. We don't need to "have it all figured out" before we go out and look for other people to be sexual with.
    One other barrier exists, particularly for people whose bodies and genders don't fit within the narrow definitions of male and female. Those of us who identify as transsexual or who are intersexed can be frustrated by the fact that most discussions of sexual anatomy and response force us to choose one type of gender identity (they tell us that if you're a woman you'll feel this way, or if you're a man you'll