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Sex & Chronic Illness

At first it may not be obvious how sex and chronic illness are related: what context could they possibly share? Yet spend any time at all not feeling well, or worse, and you’ll know intimately how sex and illness both depend completely on the body. And how, paradoxically, when the body is ailing, a desire for pleasure, any desire at all, can feel impossible. 

As Wendy has written, “Our body condition is our first reality and the one that supersedes everything else.” This is easy to forget when we feel healthy, because being healthy means we don’t have to think about our body — it’s simply there, effortlessly responding to our desires. It’s only when it stops responding, or when its systems go rogue, that we notice it. And usually, in my experience at least, the attitude with which we notice a sick body is rarely a loving, accepting one; my response to being sick, to my body not doing what I want it to do, is usually to get angry, resentful, hateful, crabby, punitive, desperate. Not a single one of these mind states is conducive to desire. Rather, each is conducive to desire’s opposite: to pushing away, resisting, denying.

When the body is very sick — feverish, nauseous, unable to accept nourishment or rest — it is just not possible to be anything but sick until the immune system has rallied. Of course sex is out of the question if even turning over in bed is a struggle. And it makes biological sense that we resist sex when we are feeling weak: reproduction takes a lot of energy. It also dramatically increases the likelihood that we will create another being whose body will have the conditions afflicting our own.

Scientific studies on sex and illness have borne out the hypothesis that parents in good condition, based on health, size, dominance, or other traits, would invest more in producing sons, whose inherited strength and bulk could help them better compete in the mating market and give them greater opportunities to produce more offspring, has been reinforced by experiments. According toan article in the Stanford medical journal, in 1984 a seminal paper was published inNature by T.H. Clutton-Brock at the University of Cambridge, who found that among wild red deer, dominant mothers produced significantly more sons than deer who held a subordinate position within the herd. A study of pedigrees of multiple species of mammals at the San Diego zoo “found that when females produced mostly sons, those sons had 2.7 times more children per capita than those whose mothers bore equal numbers of male and female offspring.”

Not much is understood about how deer, and possibly other mammals, control the sex of their offspring. According to the Stanford article, “one theory holds that females can control the ‘male’ and ‘female’ sperm, which have different shapes, as they move through the mucous in the reproductive tract, selectively slowing down or speeding up the sperm they want to select.” (Apparently this isn’t as far-fetched as it sounds; in the insect world, yellow dung flies collect sperm from different mates and then selectively choose the “best” sperm for the environmental conditions (dung) of each clutch of eggs laid.)

Chronic illness puts us at odds with our biology in a number of ways. There is the reproductive risk of sex, which increases when you barely have the energy to take care of yourself. When energy is low, it can be difficult to do anything, even the things that will make us feel better. This can seem like an insurmountable obstacle, but in practice it isn’t — it’s only difficult. Something I’ve found that has been immensely helpful ismindfulness meditation. A lot has been said about the benefits of mediation; in the realm of chronic illness, I’ve found it has helped me to distinguish between my thoughts and emotions about my body and my actual experience of my body. The two are often very different. Even in moments of acute physical pain, if I can keep my attention more on the pain than on my reactions to the pain, the pain is much more bearable because I can see that it is made of moments of sensation (even if those sensations are “throbbing,” “burning,” “stabbing”), and that moments of sensation are not something to fear.

Metta practice has been the most helpful meditative practice, for me, because it has helped me to approach difficult mental and physical states with love and acceptance rather than fear and avoidance. There is more and more scientific evidence for why metta meditation makes us feel better. According tothis article, “in apilot study of patients with chronic low back pain randomized to loving-kindness meditation or standard care, loving-kindness meditation was associated with greater decreases in pain, anger, and psychological distress than the control group.” The article goes on to discuss persuasively a number benefits of metta meditation.

Through my own metta practice, I am learning to recognize all the ways I push against experience as habits that can be seen and accepted. This is slow work; metta practice doesn’t translate directly into better sex, or better anything else. But by turning toward the most difficult parts of my sex and illness experience, rather than turning away, I am learning to cultivate a new habit: love. And love seems like the best habit of all.