Disability and desire
"In some ways it's a shame that people rush to intercourse and skip all the courtship steps of sex," she says. "You don't learn to build and experience sustained arousal and you miss the chance to explore all the things you can do with each other's bodies that are pleasurable."

Pleasure, of course, doesn't have to be erotic.

"The bottom line is to accept some of the limitations that your health creates and know that you can have a full, loving relationship any way," says Kuriansky. "You're a whole person, not just your body. And while your body can have limitations, that does not mean you're tainted."

hstevens@tribune.com



Starting the conversation



We liked this relationship advice, from the American Cancer Society website and Amber Tresca on About.com, as it applies to those with cancer and inflammatory bowel disease, respectively. Though targeted to specific illnesses, it applies to anyone who needs to broach this delicate topic. For more information, both sites offer much more advice: Go to cancer.org (type "sexuality" in the search field) or ibdcrohns.about.com (click on "coping"). Here are just a few tips:

Tell a potential partner about your physical challenges when you feel he or she already likes you for who you are. In other words, this is not necessarily fodder before or on your first date. It's better to find out earlier in a relationship than later if the person can handle the challenges.

If possible, gauge how your date reacts to other people with medical conditions. It can reveal a lot.

Bring up the subject followed by an open-ended question that invites discussion. Start with what you like about the relationship, ease into your particular challenges, then ask if he or she thinks it could affect a future together.

Continue the discussion in more depth when the relationship starts to deepen, especially if you have life expectancy or fertility issues.

Be prepared for possible rejection, and consider how you would respond. If you are rejected, don't let it prevent you from pursuing another relationship. Rejection happens to everybody; do your best not to take it personally.

Work on all areas of your social life: close and casual friends, family, co-workers. You deserve a network of people who support and love you.