Overcoming problems with physical intimacy and sex if you have a visible difference

Intimacy and sex present challenges for most people. If you live with a visible difference, these hurdles can be heightened by the need to share your condition, mark or scar with another person, and because certain things can cause pain or difficulties.

On this page, we explore some of the problems with physical intimacy that you might have because of your visible difference, and look at the role of good communication when it comes to addressing these concerns.

What is intimacy?

As humans, we naturally need love and closeness. From babyhood into adulthood, loving relationships make us feel valued and cared for, help us to develop emotionally and give us confidence. As adults, many people feel the desire to develop loving and intimate relationships with others and eventually find a partner.

We all have our own thoughts about what intimacy means to us. Common understandings include some or all of the following:

• Having a deeper emotional connection to another person.
• Feeling love for and love from another person.
• Having a physical (e.g. touching, caressing, hugging) relationship with another person.
• Having a sexual relationship with another person.
• Feeling a spiritual connection with another person.

An intimate relationship doesn’t have to be any one of these things. Many people assume that an intimate relationship has to involve sex or touching, but this is not necessarily the case. There are no rules and we are all different.

Problems with physical intimacy and visible difference

Many of us feel nervous or worried about intimate relationships. This can be affected by our past experiences – with family, friends, previous partners and also strangers. Starting a relationship can feel challenging and scary. We may fear being hurt or rejected.

As people grow closer, this may mean sharing our private thoughts and feelings. This can make us feel exposed or vulnerable. It can also bring happiness, love, passion and security. Sharing our intimate selves with another person can be one of life’s greatest experiences!

Having a visible difference can mean that you feel more nervous about your body. In particular, you may feel anxiety about the area of your body that is affected by your condition, mark or scar.

What concerns might I have because of my visible difference?

Let’s consider some of the problems with physical intimacy you may have because of your visible difference. Continue reading for ways to address these worries.

I’m frightened of getting physically close to anyone

The thought of getting physically close can also be tough. You are not alone. Generally, many people worry about sex and physical closeness and find it difficult or embarrassing at times.

If you don’t like the area or areas of your body which your visible difference affects, you may be worried about a partner getting close to it or touching it or having to explain. You may imagine that a partner doesn’t like it either – or that it will put them off.

With the right preparation and the right person giving the right responses, many people have overcome this worry. It may seem hard to think about the first step, but take it in stages rather than worrying about the whole process at first.

I’m scared my condition will ruin my sex life

Having a visible difference can sometimes bring specific physical worries which create potential barriers to intimacy. For example:

• Functional difference or not being able to move in a certain way, such as not being able to open your mouth wide or limited ability to move your tongue.
• Limited sensation in some parts of your body, or you may wear a prosthesis.
• Previous surgery or medical treatments causing you to see your body as something painful and unable to experience pleasure.
• Sex may be painful for you.

These things may cause you to worry about the physical or sexual aspects of your relationship, or even make you see yourself as “unsexy”. These thoughts can affect your confidence and also your sex drive. It can also be hard, awkward or embarrassing to talk about these things, even with someone you love and trust. All this can make you feel pressured and worried when getting physically close to someone.

Honesty and communication are key here, even though this is not always easy. See our tips further down for some guidance on how you can approach these difficult conversations.

I’m worried about telling my partner about my condition

If you have a condition that is not visible when you are wearing clothes, or wear skin camouflage or a wig, you might be worried about when to tell your partner about your condition. You might be anxious about how to bring up the topic or how your partner will react the first time they see your visible difference. These concerns are perfectly normal.

You might decide to tell your partner at the beginning, before you are invested in the relationship – some people choose to do this so that they don’t become too invested in the relationship in case their partner has a negative reaction.

Other people wait to get to know their partner better and feel more comfortable. One reason for this is so that you don’t show a part of yourself to someone if you don’t think the relationship will progress.

Telling your partner prior to intimacy can help to reduce some of your anxieties as they already know, and you might have already shown them this part or parts of your body. It might be worth thinking this through at the beginning of a relationship, so you are comfortable you have done the right thing for you and are in control of how your partner finds out about your visible difference.

Talking about your condition

With each of the worries we have discussed above, we have advised that honesty, clear communication and preparation are the easiest way to overcome problems with physical intimacy.

What should I tell my partner about?

But what is it that you need to communicate and why? Here are some specific things you may want to tell your partner about:

• If you are self-conscious about your body say so. If you would rather your partner didn’t touch certain areas of your body say so. It can help you to feel less apprehensive about sex and enjoy it more.
• Don’t expect your partner to know everything about you and what might feel good or not.
• Don’t assume that your partner knows your condition, mark or scar has caused differences in the shape or texture of your skin, or if you have altered sensation.
• Your body or skin may be irritated, sore or highly sensitive – but how does your partner know this? Give them a chance to understand better by giving information.
• Try to be clear by using descriptive and neutral words to explain shape, texture and sensations.
• Encourage them to talk to you or ask you questions.

How do I say it?

Knowing that you need to communicate clearly is one thing – but when it comes to sensitive issues like sex and intimacy, that is often easier said than done.

Here are some suggested ways you can talk about potentially difficult topics:

• “I want to tell you about the scarring on my leg. It is dark pink and it is a little bumpy in places, but it doesn’t hurt me at all.”
• “Even though my birthmark looks different, I have the same feelings there as you.”
• “This part of my face is a bit sensitive, but it’s fine to touch everywhere else.”
• “This part of my body feels less smooth and sometimes it feels sore, but don’t worry, I will let you know.”
• If the shape or structure of your mouth is different, you might need to let your partner know about kissing: for example, “When you kiss me on that side of my mouth it feels great, but on this side I feel very little.”
• It may be the same for certain parts of your body: “I need you to take care when you touch me here… it’s very sensitive.”

Helping each other during sex

When it comes to sex, we all have to learn what feels good and what doesn’t. If you haven’t had sex before, it may be a case of trying things out and telling your partner how it feels. Everyone is different – with each new sexual partner, we have to learn about each other and what works best together as a couple.

If you feel uncomfortable or worried about something your partner is doing, explain this to them and try to tell them what does work for you. You might decide together that during sex you will guide your partner showing them what feels good and what doesn’t. This could be moving their hands towards or away from areas of your body. This works both ways.