For many years I was consulted by an amusing, witty and entertaining old journalist who had been famous (or infamous) for his womanising. Old age and disability curbed his physical prowess, but his vitality remained undiminished.

I also occasionally bumped into him lunching in fashionable restaurants. He was usually accompanied by a beautiful, intelligent and successful woman, sometimes 40 years, if not more, his junior. I assumed, because I knew he was impotent, that these were asexual relationships and that the women were merely luncheon partners who were captivated by his charm and intrigued by his intellect.

In a confiding mood, he told me one day that, although impotent, his lunches or dinners à deux often ended up between the sheets: “I may be incapable but I still obtain great pleasure from skin-to-skin contact. It is amazing how many of the women I know are happy to go to bed with me.” He added that many others of his female friends made it plain to him that, as much as they enjoyed his company, now that physical frailty had triumphed their meetings would end by them going their separate ways.

Recent German research has indicated that although many women may prefer non-penetrative to penetrative sexual activities they don’t like going to bed with a man knowing he is impotent. My practice in Norwich was close to a home for the chronically disabled. Some of the residents were my patients and I was all too aware of the severity of their disability, and the problems their deformities must have presented in their sex lives. I also knew that many had happy relationships with satisfying sex, even if, for some of the severely disabled, penetrative sex must have been difficult, if not impossible.

Sexual desire and sexual activities often, perhaps usually, survive disabling conditions, and even the drugs prescribed to treat them. Nor is being disabled always a turn-off; for some people it may increase attractiveness.

The term co-dependency is not some meaningless term from the world of psycho-babble — this has been made obvious to me by patients. A co-dependent person is often someone who has had to be exceptionally caring and prematurely responsible. This can give them a lifelong desire and deep-seated need to care for people who find it hard to cope either physically or mentally. Fifty years ago there was a part of Italy that was well known for having an unusually high incidence of congenitally dislocated hips. At that time, in a rural area, this left many children crippled and with a bizarre gait.But research suggested that women with a congenitally dislocated hip were more likely to find a man than their able-bodied contemporaries.

Some people who are severely disabled prefer to use sex workers. But most are advised to mix with as many people as possible. You will find that, wheelchair or not, organisations will welcome you and some of their members will even find that your wheelchair enhances your sex appeal. Once you have found a partner, total honesty about your desires, sexual proclivities and how these can be met is essential.

Like the old journalist, it may be that you will obtain all the relief you need through sensual contact, or that sex may be restricted to masturbation or oral sex. But take heart, most of my patients who were chair-bound, but potent, found positions that made full sex possible.

SUZI GODSON

Though all human beings, whether on two legs or four wheels, are equally entitled to try to find love, emotional intimacy, physical closeness, marriage, sex and parenthood, sadly, as George Orwell pointed out, some are more equally entitled than others.

Despite the fact that there are 750,000 wheelchair users in the UK, the words “disability” and “sex” sit together uncomfortably in the English psyche. Political correctness means that disabled people are integrated just as much as is necessary to appease public conscience, but enabling them to have sex appears to be a bridge too far. The subject is ignored by everyone from the Government and the health service to the mainstream media and the public.

Only disabled people, naturally enough, try to raise the subject, but Spod (the association to aid the sexual and personal relationships of people with a disability) closed in 2004 because of lack of government funding. And although a survey by Disability Now, the UK’s biggest selling disability-related newspaper (www.disabilitynow.org.uk/timetotalksex/index.htm), recently revealed that more than 70 per cent of disabled people think that the Government should fund a specialist psychosexual counselling service, last year sexual surrogacy (the practice of using trained workers to help disabled people to experience sex) was deemed unethical.

Surrogacy wasn’t a perfect system by any means. It favoured men because there were so few male surrogates, but it was, at least, regulated to some degree. The current situation leaves disabled men who pay for sex with a commercial sex worker in a vulnerable situation. And disabled women don’t even have that option.

People who use wheelchairs need practical help and assistance when it comes to sex. But who should do the helping? Some carers will get involved, but it is a grey area and could never be put in a job description. A friend who uses a wheelchair told me that when she lived with her mother, her much-loved carer helped her to buy a vibrator for her 18th birthday. Two years later, when her carer moved to another job, her mother hid the vibrator in a shoe box on top of the wardrobe and she never had the nerve to ask anyone to get it down. As a male wheelchair user, you have a better chance of attracting an able-bodied partner than a woman in a similar position. This makes the logistics slightly easier, but not necessarily the quality.

You may find that in the long term you have more in common with someone who possibly shares the day-to-day difficulties that you experience and, fortunately, the internet provides disabled people with unparalleled opportunities to meet each other. Whether you are a Jewish Single with Special Needs (www.jswsn.org) or you want “contact with a wonderful Russian amputee lady to marry” (www.frantana.ru), there is someone for everyone online.

Sex Matters (£9.99, from the Spinal Injuries Association, www.spinal.co.uk) is an up-to-date look at sex and spinal-cord injury, including intercourse positions and socialising and dating.

Outsiders (www.outsiders.org.uk), a social group for people with disability, has more than 600 members nationwide. For £25 membership (£12 unwaged) you receive phone support, dating advice, mags, books, a free forwarding service, a full list of member contact numbers, invitations to body-image workshops, lunches, parties and events. So what are you waiting for?

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