How to Orgasm with Spinal Cord Injury

(basically the same way you do without it)

Emily Nagoski


I’ve been a little bit obsessed with women’s masturbation lately — the data are just completely fascinating.

In particular, I can’t get over this 2001 paper, “Sexual Arousal and Orgasm in Women: Effects of Spinal Cord Injury.

There’s more recent work on, say, brain imaging during orgasm among women with spinal cord injury (SCI), fertility and pregnancy with SCI, and the effect of PDE5-I’s (erectile dysfunction drugs) in women with SCI. But none of this research offers such specific and personal descriptions of techniques and experiences of women with SCI masturbating to orgasm.

A quick review of women’s orgasm with SCI:

  • About half of women with SCI are reliably orgasmic — and that number can go up to 77% (PDF), if therapy is provided. And more women than men with SCI experience orgasm — though most men with SCI can ejaculate, even without orgasm, since’s that’s a spinal reflex.
  • A woman is more likely to have orgasms after SCI if she had orgasms before SCI, and if her injury doesn’t disrupt the “sacral reflex arc.” (If you touch your clitoris or penis, your anus will contract. That’s the reflex — it’s like when someone taps your patellar tendon and your knee kicks out.)

Okay. So in this particular study that I can’t stop thinking about, researchers measured the physiological responses of women with and without SCI as they masturbated in the lab. Then they asked about masturbation techniques, where the women felt the orgasm, and what the experience is like. (Note: “Able-bodied” and “SCI” are the terms used in the research to identify participants with and without spinal cord injury.)

So let’s look at what they found:

First of all, mostly the orgasms were the same. between the two groups. All physiological measures — heart rate, blood pressure, respiration — were indistinguishable between able-bodied and SCI subjects.

And all the women’s descriptions of where they felt the orgasm and what it was like were basically the same. Can you tell which of these are descriptions of orgasm from able-bodied women and which from women with SCI?

Felt in vagina — “Tension released”

Felt in vaginal and clitoral areas — “Pleasure, release”

Felt through vagina and legs — “Numbing of legs and up to stomach”

Felt in head — “Delight, relief”

Felt in stomach first, breast tingle, then vaginally — “Palpitation and tingly”

Felt in clitoris — “Heightened sensitivity followed by dullness”

I couldn’t tell which was which. Neither could the researchers.

(ANSWERS: “Tension released” — able-bodied, stimulated clitoral region with hand and vibrator; “Pleasure, release” — incomplete L5 injury, stimulated clitoris and vagina with hand and vibrator; “Numbing of legs and up to stomach” — able-bodied, stimulated clitoris with vibrator; “Delight, relief” — complete T6 injury, stimulated breast and clitoris with hand and vibrator; “Palpitation and tingly,” — able-bodied, stimulated clitoris with hand; “Heightened sensitivity followed by dullness” — incomplete T5 injury, stimulated clitoris and vagina)

Orgasm is orgasm is orgasm, however you stimulate yourself, whatever your spinal innervation, whatever it feels like.

There were some small differences. For example, average time to orgasm for able-bodied subjects was 16 minutes; for SCI subjects, it was 26 minutes.

And masturbation modality — though more similar than different — differed a bit between the groups. Here are the ways the able-bodied women described their masturbation techniques:

Clitoral area/hand; clitoral region/hand and vibrator; clitoris; clitoral area/vibrator; clitoris/hand; clitoral area/hand; clitoral region/hand; clitoris/hand;

And here are the ways the women with SCI described their masturbation techniques:

Breast and clitoral area/hand; clitoral area/vibrator; clitoris/hand; clitoral area/vibrator; internal and external area of vagina; breast and clitoris/hand and vibrator; clitoris and vagina; vagina/vibrator; nipples/vibrator; vagina, clitoris, and breast; clitoris/hand and vibrator; clitoris and breast/hand and vibrator; clitoris, breast, vagina/hand and vibrator; clitoris, vagina/hand and vibrator

As you can see, women with SCI were more likely to report breast and nipple self-stimulation during masturbation. With one exception, this was in addition to (rather than instead of ) direct genital stimulation.

I’m looking forward to a world where we’ve forgotten all about Freud and his stupid differentiation between vaginally- and clitorally-stimulated orgasms — as if how we get to orgasm had any significance at all.

Even if we have orgasms doesn’t matter so much as the really big key in this research:

What matters is whether or not we enjoy living our bodies. What the descriptions of orgasmic experience tell us — descriptions that are indistinguishable between the women with SCI and the able-bodied women — is that spinal cord injury doesn’t impact the pleasure a woman can have.

Can SCI impact sexual functioning? It sure can. But it doesn’t prevent a person from being fully sexually and living with confidence and joy inside her body. And that’s what I find so compelling about this research.



Emily Nagoski

sex educator, author, researcher, and activist. also: nerd. and @emilynagoski