Dr. Linda Mona: Digital Dating With a Disability & Sex Toy Recommendations
Podcast Transcript Season 2 Episode 27
Interviewer: Liz Goldwyn
Illustration BY Black Women Animate
Our guest this week is Dr. Linda Mona, a highly honored clinical psychologist specializing in patients with chronic health conditions and disabilities. Dr. Mona works as a consultant to healthcare service providers, in addition to her private practice, where she focuses on the importance of sexual health as a means of improving overall quality of life. Dr. Mona and Liz talk about digital dating with a disability; her favorite sex toy recommends and how a disability can in fact make you MORE creative in the bedroom.
The following is a transcript of the interview from the episode:
Liz Goldwyn:
Thank you for being here with me today Dr. Linda Mona.
Dr. Linda Mona:
Yes, I'm excited to be with you all.
Liz Goldwyn:
You work a lot on framing disability as a life experience similar to the way we think about gender, ethnicity, and sexual orientation.
Dr. Linda Mona:
Correct. Right. So, I think of disability as a diverse identity as a world view that all inclusive of a physical, mental, psychiatric, or cognitive difference, but it's the way in which the person moves around their life with that difference that creates that world view. So it's not one or the other, it's all of those things. If that makes sense.
Liz Goldwyn:
Right because if we look at wellness, we need to consider physical, mental, and sexual health.
Dr. Linda Mona:
Right, and sexuality, sexual expression, the way we see each other. It's all mind, body experience, right, and so if we take one part away from that then we're losing the sense of erotic feelings, of sexual expression with one's self, or with another person. So a lot of times what happens when somebody has a physical disability, many times the message that will be given is "you know, you're still the same person, right? You have the same mind, the same way that you think about things, you just have a few things that are different." And that might be well true in someone else's eyes, but it's certainly not the way most of society sees that person, and it's likely not the way that that person sees themself.
Everything changes, right, so somebody could be living their life in one way and their life changes in seconds. They're plucked out of their life, put into another life. Or it might be their experience that they've grown up with some sort of disability and their world view has been shaped in that way. But, whether it is somebody whose grown up with a disability or acquired it later in life, that experiences changes who they are with everything that they do, inclusive of the way they see themselves sexually and their sexual expression with other people.
Liz Goldwyn:
Is sexual, so we know already that in general sexual health is something that's overlooked by most therapists and doctors who do not specialize in that area because it's not something they're given specific training for in medical school. Do you find, in your work, that it's even more overlooked when therapists and doctors are dealing with disabled clients?
Dr. Linda Mona:
I think that's a great question. I think it depends upon who you see and where you go. So, let me elaborate on that. So, I think in general awareness around sexual health assessment in all primary care settings has increased. And it's increased because we've looked more at the whole person, and I think you had mentioned earlier the concept of wellness, right? And wellness is whole person health. And the question that often happens is 'what happened to you?' or 'what's going on with you?' instead of saying 'what is important to you, and what's meaningful to you, and what's not going right about your life?' And so I think while it has improved over the years, that it is still the most under discussed topic in all of primary care and all of even rehabilitation care.
And I think that is because of the fact that sexuality is unique in that it sits in this domain of personal beliefs and value systems, religious thoughts, and those areas that have been somewhat taboo to some people throughout their lives, or they've been given a certain prescription around that. So, even though you have these really well trained doctors, psychologists, physician assistants, you name it; people have been schooled on diversity and inclusion, probably more so than they will ever use, and yet when it comes to that topic they will have a hard time asking those questions, even if it's printed on the assessment in front of them. So if people are running, like, low on time, what's the first thing they're gonna skip, they're gonna skip that, but that's probably also the chapter that they skipped in their book in training or its the lecture that they decided they didn't really need to go to. So, I think it's a combination of a fear or learning those things and actually just a deficit in skills in trying to ask those questions.
So, for example when I'm doing training for healthcare professionals, the first thing you want to do is give permission for people to feel uncomfortable with it, and to really self assess. You know, what is it that's preventing you from asking those questions? And let's think about what your thoughts are about sexuality, let's think about what your thoughts are about disability, and how do those two things kind of face off each other when you're looking at somebody and needing to ask that question.
Liz Goldwyn:
What do you find to be, like, the most common, like, preconceptions that people have when you're doing these trainings about that intersection of sexuality and disability?
Dr. Linda Mona:
That it's not as important as other things in their life. And so the misconception in rehabilitation is that, well people are much more concerned about walking, they're much more concerned about being able to have adaptive equipment perhaps to see, or to hear, to get around, to navigate curb cuts, and you know sex or relationships that's something that's not as important, and that really is just not true.
Because if you look at data and you look, and clinically when you speak, especially to people who have newer injuries in their life that affect their sexual functioning, the two first things that come out of their mouth are "Am I going to walk again?" And the second is "Will I have sex again?" And "Will I have sex again?" Usually means will I be able to have the sexual functioning, or the plumbing if you will, to engage in the sexual behaviors that I've engaged in before. And it is very hard, as it is with anything for medical doctors to give information or even psychologists to give information that's not always so great all the time.
It's hard to give bad news to people, but there's something uniquely different with looking at somebody in the eye and saying "You know it's likely not going to be the same that it used to be. It's going to be different. Different doesn't necessarily mean bad or worse, but it's going to be different." So that you start to kind of get this person to start re conceptualizing sexual expression all together because people need to redefine what they see everybody else and non-disabled people engaging in sexual activity the way that people are, perhaps, looked at or sexualized. People with disabilities get that much less. So it's very much not common for somebody to roll down the street, or walk down the street with crutches, and have somebody look at them and them feel that they're desired by them. And that's because we don't, and I'm saying we as a disabled woman myself, I mean we don't really fit into traditional conceptualizations of what it is to be desirable and sexual.
Liz Goldwyn:
How did you decide to specialize in this area?
Dr. Linda Mona:
You know, what a great question. You know and it goes back to way back in Dr. Linda Mona high school years, when I was a weird person at the age of 14 when the yearbook asked me "What do you want to do?" And I said "Oh you know, I want to go to UCLA as an undergraduate and then I want to get my Ph.D. and then I'm gonna study clinical psychology and I'm gonna work with people with disabilities." And that's actually what I did. That was the path that I knew that I wanted to do at the age of 14.
I didn't know so much about sexuality, but I engaged in this peer program as a teenager and I started to realize, like, all of these teens they're experimenting with sexuality, and I'm thinking about people with disabilities that I knew, and I'm like, this is so not the same life. And so at a young age that whole conceptualization of there's something different here and people aren't really talking about this so much, and it's so important to well being and connection and relationships that, you know, I found my clinical psychology track heading in that direction.
Liz Goldwyn:
So when someone comes to you with a client, or when you're doing these trainings, I know you focus a lot on ways to bring dating, romance, and sexuality into people's lives, where do you start with, with like reframing what that looks like? With reframing, well as you said, you know people are saying "Will I be able to walk?" Or "Will I be able to function the way I've functioned?" And "Will I be able to function sexually the way I've functioned?" So, where do you sort of start with?
Dr. Linda Mona:
So, well, let me tease that apart. So where I would start with providers is very different than where I would start with clients with disabilities.
Liz Goldwyn:
Of course.
Dr. Linda Mona:
So, with clients with disabilities I, first and foremost, would give them education that they may not have received from their medical doctors around how their specific difference, or disability, may or may not impact their sexual functioning, and may or may not affect their ability to engage in any kind of sex play. Right, so physically if somebody has a hard time getting into positions, or if somebody has loss of sensation what that might be like. If somebody nobody sees or hears, what is sex like when you don't see someone or you don't hear someone. So, try to like give the information first and foremost because some people are very big information copers, it somehow alleviates some stress and anxiety. And so I start with that, but no, even before that step, the minute you ask about it or you acknowledge it you've already given that person a huge gift, because that person has already either felt it or has really kind of thought that their sex life is over, and they're humanness is often taken away because nobody cares about that anymore. Nobody asks them about it. Nobody thinks that it's a priority. So, I'll give that information.
I'll be, obviously, supportive and encouraging, and then start to figure out what that person's goal is. What is it that you're concerned that you might be prevented from doing at this point in time? What did you do in the past? What did you like? Right. People who have had really hot sex lives before disability are likely to have it afterwards because it is their value, and it is something that's important to them. So, keeping in line with that person's energy, what they're looking for, what they may or may not be able to do, and really trying to build up their bag of tricks.
So, and preceding that of course, that's mostly for partnered people, for people who are not partnered we talk about how you talk about your disability on a date. What do you say? How do you bring it up into conversation? I think there's often a push for people to feel like they need to disclose everything on a first date, and so in general I'll say "You know, we've all had these experiences where too much information has come out all at once. You don't need to do that. You're going to meet somebody. Disability will naturally come up in that conversation."
And then I might give examples about how to do that. So, it's information, it's support, tips and tricks on dating, about what you might say, how you might test trust with somebody, right. So, if you go out to dinner with somebody and that person's really uncomfortable with you parking in the disabled spot in the parking lot, or the stigma that comes along with dating somebody who has a visible difference, then that's important information, right. That might not be somebody you're gonna be investing time in. And the reality is people with disabilities do get rejected based upon disability status, and there's some people who don't wanna be around that and there's some people who do, and the job becomes finding out the people who are open to the disability experience, and not who can see beyond it, because that's part of life, it's you with that and everything else. So it's inclusive of that. Does that person want to be with you and to date you?
Liz Goldwyn:
Based on what you were just talking about about dating. Cause I know you have been doing this a long time, and you've seen, you know, dating happen now digitally. Has that changed this conversation that you're having around what to say about themselves on a first date, and how much to share about their bodies? Like, if it's not meeting face to face but meeting online?
Dr. Linda Mona:
So, yeah. So that answer is yes, but let me elaborate. So when I started doing this work 20 years ago it was a very different type of conversation because there was less, actually more than 20 years ago, there was less emphasis on how you meet people online or what you do digitally, it was about what are the environmental barriers in place to get you to the social arena because if you can't get transportation or you don't have an assistant and you can't get from point A to point B, how can you get there, right?
So with the digital age this has lifted completely, and now we're in a whole different arena with navigating all of this. And so, what I will do is discuss with folks about how, what they feel comfortable putting on a dating, their dating profile, or some kind of their online information. What does that look like? I will tell you some people disclose disabilities status and they want to do that online, and some people don't want to disclose it until they have an initial conversation with somebody. And it's not my job, right, as a clinician to say "I think you should do this", right. That's a huge misconception about psychologists. We don't really give advice. We listen to what is important to that person and we help to guide their decisions in that direction. So, right, so there's that. There's, like, the testing out of disability status in that way, which some people find is much safer to do than in person. And there's always safety issues, right. So, all people should be thinking about safety issues when meeting with folks, you know, online or within social media.
That argument often gets played up more so with people with disabilities. And so, we shouldn't put people with disabilities, they're already vulnerable, we shouldn't put them in a more vulnerable position. Well, you know, isn't it that person's choice to make that decision? And we have to trust and help people figure out what's safe and what's not safe, right. So do you go out on a first encounter with somebody when you go out in a group, or go out in numbers, the same way we would advise people without disabilities. So, I think there always has to be an acknowledgement of vulnerability but that should not be in place of experimenting and trying to figure out how you want to navigate your dating life, whether it's online or in person, it's that person's choice to do that.
Liz Goldwyn:
I would imagine that you also get a lot of, it's not like in general that most of the population is really familiar with sex therapy or you're having these kinds of conversations, or you know, being asked "What did you like to do?" Or, you know, really consider that their sexuality could be evolving so, in a way it's an interesting position to have to look at your sex life and look at some things that you maybe have always gotten you off, and all the sudden have to consider a whole new bag of tricks to play with.
Dr. Linda Mona:
Correct. Right. And that, it is easier for some people than others. So my clinical experience has been that people who have been, kind of, more open minded to trying a variety of different types of things within their sex play, they're a little bit more open. They're, you know it really, you know, when you encounter disability and it's something new in your life it calls for a, like, you re-explore your values, right. So, it may be that somebody, for example, in the past like "Oh I don't use sex toys. I don't need them." And, or "I don't really need that to be aroused." What if it helps a whole heck of a lot now that there's a difference? So that person might need to say well, might I try this. Maybe it didn't work before, but maybe it will work now. So there's something about what we call in psychology that cognitive flexibility to be able to kind of, you know, try different things.
Now of course it's not in, we don't want somebody to go against their value system, so if somebody is really committed to a certain moral belief or religious belief then we figure out a way to work within that moral or religious belief about what might work for them now that they have a different body or mind. But it really, you know, it really does call for a complete re conceptualization. And we talk about, like, sex play with, you know, what is somebody's sexual script. Right. I'm sure you've thought of that or talked with other about that, right. And the sexual script is, you know, you ask any couple "What do you, you know, what do you do? How does it usually start off?" And people will say "Well we start flirting at a certain time, and then we start kissing, and then we move on, you know, to touching each other with our hands or we engage in oral sex", or whatever that might be.
So you want to start with somebody's previous script and say, "Okay, so what worked and what didn't work?" And we always hope people have more than just one script, right. Because most people have a usual script and then they have a vacation script or they have, you know, those scripts when they're not as in their daily routine, so you wanna like look at all their scripts and figure out what they can retain with their current mind and body, and what things we can add in to make it different. Right. So, especially for those folks who lose the ability to have a physiological orgasm. It is a huge thing to have to figure out, right. So you have to, people will say "Oh sex is all between the ears it's not between the thighs". Like, yeah right.
So you tell that to somebody who has had previous experience with experiencing a physiological orgasm, and then they no longer are able to do that, right. It's a huge loss. It doesn't mean that they're not going to have a great sex life again, but it is a huge loss and there has to be time to kind of mourn that loss and try to figure out, you know, well where is my finale now? What, how do I know when sex is over? Do I go by my partner? Do I think of a fantasy? Right. There's all different things that people can do in that moment, but it's very different. Very, very different.
Liz Goldwyn:
Right. I can imagine so. How, what are some of the best aids that you've seen or companies that are making aids or toys that are thinking about people with disabilities and functionality?
Dr. Linda Mona:
Well, yeah, you know, I have, I had been a huge advocate of sex devices and toys and products for way so many years, and I really think it's about, again looking at scripts and look at what we can incorporate. So, you know, I really like the products at Sportssheets, so I don't know if you know that company but, and I don't work for them and I'm not endorsing them, but I'm telling you there's a BDSM flare to most of their products, and what's interesting is if you look at those products sure, it's BDSM, but if you really look at them too there's so many adaptive products that can help to hold people in place, right, that have a hard time when they're not able to move their body or keep their body in one place or prop themselves up in a certain way. There's all kinds of, like, ticklers or feathers. So, for somebody who's not able to touch their partner any more and they might be able to have their hand with some velcro on the end of some kind of a tickler. That, you know, is it the same? No, it's not the same, but it is a way of engaging in that activity with somebody else. So, I think anything that can help enhance touching and sensation is pretty amazing.
Liz Goldwyn:
Are there certain positions that work better for example, with a wheelchair, that you can explore?
Dr. Linda Mona:
Yeah, you know, I wish I could just, I wish I had all, I wish I could just say "yes, absolutely, there's one." What I can tell you more is what people miss. So, no. The reason I can't give you one or two is that everybody is so different that you really have to work with that person and their partner. So does the, we often times assume that a partner is non-disabled. And if you have two people with disabilities then it presents itself even a bit more complicated issue. But, you know, certainly if one person is non-disabled and they can climb on top of somebody in a wheel chair, even for kissing and touching and whatever that might be.
You know, I will tell you the thing that most heterosexual men complain about when they have some kind of difference where they have loss of sensation in their pelvic area or they, you know, they're not able to, you know, achieve and sustain erections in a way that they would like to, that they will say "I miss the missionary position." So, as a sex therapist everyone's like get everybody out of the missionary position, spice it up and do all of these other things, and when people can no longer be in that face to face position, they miss it a lot, and they miss, you know, really kind of being able to look into somebody's eyes. And also it can be difficult for people to thrust, and so for people who are used to engaging in any kind of intercourse where they're on top, they will tend to miss that a lot. So, you know, again, it's about what loss is here? What can we change? And what can we not change? And how can we figure out a way to make this a little bit more spicy than it used to be?
Liz Goldwyn:
How can able bodied people better address their ingrained biases around sexuality and disability, especially when, you know, you're talking about dating or in partnerships where there is one person who's able bodied and one person who's disabled?
Dr. Linda Mona:
You know, I think, I mean the umbrella response with that is self assessment, and I think everybody says that but nobody tells you how to do it. Right. And so people will say "reflect upon your beliefs about disability?" And "What's your implicit biases may be about people disabilities?" "What are the misconception, or what are the stereotypes that you know?" I think, you know, I think it really calls to kind of take it a step further with that, and that is, you know, what is your, you know, what I will say in trainings is, "What is your first recollection of somebody with a disability? Were you a child? Was it somebody you went to school with? What did you first think? What did your parents or your guardian say about that person? What information did you learn about the world about disability?" And then furthermore, it's about spending time with people with disabilities. You know, like, seeing what their lives are like.
Many times, you know, the friends of people with disabilities, the lovers of people with disabilities, they often take on that same marginalized world view, because disability doesn't just happen to that person. It happens to all of the people who love them. And so if you're used to going out in public with someone who's a wheelchair user, uses a walker or cane, whatever that might be, you never quite look at restaurants the same way again. You never quite go to a parking lot and say "Oh yeah, oh really there's no disabled spot here." Or you go into a bathroom at a restaurant, "Oh, well my friend couldn't come here." Or "My friend could come here but they couldn't drink. They couldn't have any water. They couldn't have any wine. Because they wouldn't be able to go to the bathroom." Right. So that's where that world view shifts, and I think when you ask non-disabled people to reflect upon those things, they start to get greater insight into it.
And then I think fur-, so it's the implicit biases that might surround disability, but then it's also these hidden biases around, you know, sexuality. And, you know, what it means to be with somebody who has a different body, right. So, and non-disabled people who are the partners and lovers of people with disabilities will often get very interesting questions or comments like "It's so nice of you to be with him or with her. You're a really great guy." Right. You're put up on this pedastal that there's something so unique about it. And, you know, I think it requires a thick skin, and there are people who are called to do it, and they do it in a pretty awesome way. But I think it really is about self reflection and I think people, the message is also about people should be allowed to make mistakes, right. There's no problem with asking something that maybe might, you know, be out of line as long as you try to repair it. Right.
We should all kind of go through our situations. There's always going to be a difficult dialogue. Doesn't mean you shouldn't have the difficult dialogue, but it means that you need to create space to maybe tread in some pretty scary waters and be able to say "Oh is it okay that I asked you about your disability? Is it, you know, you know, I'm just thinking about what this would mean, if, you know, if I kissed you would it be okay to kiss you? Would it not be?" Right. We've gotta kind of encourage that open dialogue around that and give people the chance, obviously within reason, in a non offensive way to have those conversations.
And it can be challenging because very awkward questions will come to people with disabilities in general social situations, at parties, at a bar, somebody might walk up to somebody and say "Can you have sex?". You wouldn't walk up to, you know, it's like whoa, like are you asking me if I'm human? Are you asking me if, are you asking me to have sex with you? Like, what, where is that coming from? There becomes this approach that people feel like they don't, there's no privacy. That you can just invade someone's personal space and say "How do you go to the bathroom? How do you get in a car? How do you get into your house? How do you have sex?" And it's okay in those situations to say "That's an inappropriate question and I'm not gonna answer it."
Liz Goldwyn:
Well, I imagine just-
Dr. Linda Mona:
Right, so-
Liz Goldwyn:
Giving people the space to regain their privacy around sexuality is important, especially when sometimes they've been medically objectified-
Dr. Linda Mona:
Yes.
Liz Goldwyn:
Because of their disability. And then to enter into a social situation where once again you're, you know, you're sort of basic boundaries around your sexuality are being intruded upon by a strangers.
Dr. Linda Mona:
Yeah, that is an excellent point. Right. That whole point around medical objectification, right. And really, especially those people who are at teaching hospitals or training hospitals, there could be five or six people coming into a room and examining somebody. And really good medical doctors will, in fact, ask permission and say "Hey, I have some trainees with me, do you mind? Or I have a resident with me, do you mind?" And as long as the patient gives permission that's fine. But, there are many cases where that permission isn't asked of the patient, right. So, that objectification is huge.
And not only is it huge on that level, it's huge on an individual therapeutic level because people have felt betrayed by their bodies. They hate their bodies. They don't wanna look at their reflection going past a storefront. They don't, you know, it is something that they often times just don't, are not feeling in any way positive about. And so then I'm asking them to enter into this arena where they're gonna be looking into that space for pleasure. And so, there, you know, there are small steps that work with people around that. But that medical objectification starts from the very beginning of disability with anybody. So someone either has a lifetime of experience with it, or they're starting to have an experience of it. And as a mental health professional I have to be really aware of that going into it.
Liz Goldwyn:
Right. You run, I know you run intimacy clinics for veterans with spinal cord injuries and also therapy for people who've had undergone amputations.
Dr. Linda Mona:
Yes.
Liz Goldwyn:
So, you know, you must, that must be something that you're quite conscious of in running those workshops.
Dr. Linda Mona:
I have, yes. I have run those workshops and right, and with people who have a spinal cord injury, people who have amputations, right, it's there are issues around sensation that are different. There are issues around pain, physical pain. And so, it's always so interesting to me about "Well just take a pain killer and you'll be okay." Well, sometimes, you know, pain medication makes you drowsy. You don't really wanna have sex when you're sleeping. So, that's not always the best thing. So you have to figure out your pain, and when you're going to engage in sexual activity. Right. And that, you know, of course is another huge issue for people with spinal cord injury, amputations, and other disabilities. Like, all the spontaneity in my life is now gone. You have to plan everything. Right. Well, you know, in part that is true. There are more things that have to be planned because you have to depend upon other people and equipment, but we all know that most sex is planned. And so most people are not, you know-
Liz Goldwyn:
Especially if it's the kinkier sex too. Especially if it's kinkier sex you're definitely planning for it. It's not that, most kinkier sex you're not doing spontaneously.
Dr. Linda Mona:
Right.
Liz Goldwyn:
It's very interesting, cause I hear that a lot from people saying "Well if you talk about it or plan it then it makes it not spontaneous and spontaneous sex is the best kind." But spontaneous sex often leads to, you know, a lot of questions around consent, "are we using protection?", all of these things. Like, I mean I think the more discussion before sex the better.
Dr. Linda Mona:
I agree with that as well. And I think disability forces those conversations earlier. And so, I get what they're talking about, I mean it's, you know, the spontaneity issue is not just about sex, it's about everything in life, right. So people just kinda get up in the morning, get ready and go out the door and hop in their car. Where it might take some of us like two hours to get ourselves together because we're slower. Time is a huge accessibility issue. And that presents itself in the bedroom or wherever you decide to have sex as well. But, you know, I think it's about what, you know when can you plan spontaneity right, so if you know there's certain things that need to be in place for sexual activity, what are the things around that situation that might be unique or might be something that you can pull out that [inaudible 00:38:20] in your back pocket that is different or makes it spicy in a different way.
There's lots of, you know, I've said this before and I'll say it again that I think that people with disabilities make more creative lovers because they're forced to critically think about most things in life. And when you're constantly critically thinking about how you're gonna accomplish things and how many systems you have to deal with in order to get what you want in life, then you you take that skillset into your sex life. And you're able to brainstorm a variety of different ways to get the pleasure that you want.
Liz Goldwyn:
So it's about thinking outside of the box, which goes back to maybe your first sessions with some of your clients as sort of training people how to think outside of the box in which they've been approaching their sex life?
Dr. Linda Mona:
Right. Right.
Liz Goldwyn:
How do you work with clinicians then? In sort of the same situations?
Dr. Linda Mona:
Well, yeah, it, you know, it depends, right. So speaking to medical doctors is very different than speaking to psychologists. As it is the difference in speaking with nurses, right. So, the one thing that cuts across all groups is looking at, you know, where they prioritize these issues, right. And to engage in that self assessment. But, there's another thing that actually, you know, so that the self assessment thread weaves through all clinical providers.
But I really think that this goes beyond, kind of, knowledge and skills and abilities. I actually think it's an ethical issue. So if we talk to our patients about the importance of whole health and how somebody is, you know, how they're gonna live their best life. Then we need to talk about intimacy and connection and sex. And so I really feel that it is an ethical issue. It's a professional issue.
And I really think that there need to be standards across all healthcare systems where people need to check off a box that they have discussed the topic and have given patients information on it. Does that make it so that everybody asks about it all the time? Probably not. But it brings it up a level. Right. It's a healthcare system saying "We think it's important that you discuss relationships." You know there's usually, like, a marital status, right, which bothers me, but, it should be partner status or are you in a relationship or whatever that might be. But that's usually on there. But then it doesn't really kinda go any further from there. So you need to ask about partnership questions, and they need to be able to ask about to what degree are you satisfied with your sex life? That's all you need to say. That's all you need to say. And to get that conversation going, and to acknowledge that you are a person who speaks that language. Because until you create that forum for that discussion, then that person doesn't know that you're a safe person.
Liz Goldwyn:
Right.
Dr. Linda Mona:
To bring it to. The minute that you create that forum then oh, okay, well this person mentioned sexual satisfaction, they might know something. And it may be that that patient is not interested in that at that moment. But, you know, a year down the line, two years down the line, they're gonna remember that you are the provider that asked that question. And that you might be able to help direct them in the right place to get the information that they need. So, I mean, I think it's, it is about, you know, self assessment, but you know, we all know that everybody has had all of this implicit bias training in healthcare settings on race, ethnicity, sexual orientation, gender, all of these things. And you really hope that education works, but there also has to be a behavioral action that comes in place of that. Right. So we need to be asking, when we ask about gender and we ask about sexual orientation, we have to have all those things in place with every single assessment that we do so that we show that patient that we're being inclusive of them. And so it's not just demographic information. We want to know their world view, and then we want to know how satisfied they are with the intimacy in their lives.
Liz Goldwyn:
Well we know that there is a lot of bias in the reproductive healthcare system, for example.
Dr. Linda Mona:
Yes.
Liz Goldwyn:
And I know that you yourself went through seven OBGYNs before finding one that supported your choice to have biological children.
Dr. Linda Mona:
I did. I had to divorce many of them, let me tell you. Right. I did. I went, you know, I knew that I wanted to at least try to have my own biological children. I have an arthritic condition, and so I felt like I was, I felt like I put this proposal together and I was, it was like, almost a professional deal that I was trying to strike with people. And I just was not about to have somebody who was not supportive of me.
I didn't necessarily need somebody who agreed with me or who, you know, I was fine with somebody saying "Well I'm concerned". Well, you know, I'm concerned too. And this is my choice, right. So are you willing to go along this journey with me? And so yeah, I mean it's, you know parents and want to be parents who have disabilities have many obstacles to navigate with reproductive healthcare. And I think that there are some really great healthcare systems that embrace that, and yet it really is provider specific. And sometimes you need to do that. Sometimes you need to move on from provider to provider to find somebody who says "Yes, I can support you in trying to help you with your plan."
Liz Goldwyn:
And you were successful in your plan.
Dr. Linda Mona:
I do. Now I have two teenagers so be careful what you wish for.
Liz Goldwyn:
Do you talk to them about-
Dr. Linda Mona:
Now I have a 13 year old and a 15 year. I have two boys. 13 and 15 years.
Liz Goldwyn:
Do you talk to them about, do they come to you with their sex questions?
Dr. Linda Mona:
Oh my gosh. Yeah, you know, it's very different right when you are very open minded and you know so much about sexuality. I mean, I think you start educating very differently from the beginning. So we have a very open household and, you know, actually their friends have also come to me with questions. So, you know, and all of that is very age dependent. So you start off giving a small amount of information when they're younger and then, you know, as they've gotten older they certainly have, you know, they have asked me questions which I'm happy to help with them but I also know that I'm their mom, right, and so there's certain things they're not gonna walk to their mom about which is totally appropriate.
But, you know, they, you know, they, it's also interesting watching people grow up around disability. Right. And how disability is different with them and their friends and people in the school system who have been around somebody who's a wheelchair user for quite some time. Right. It's an interesting way to see the way that this next generation is exposed to disability in a different way and how that kinda shapes their perceptions of themselves and their relationships with others.
Liz Goldwyn:
Do you think some of it has to do with how the media represents disability and sexuality? Does the media represent disability and sexuality?
Dr. Linda Mona:
Oh my goodness. Well they've done mostly a terrible job through the years on that. You know, I think there are those moments, right, where, you know, there's the sitcom Speechless which has been this, like, phenomenal disability representation. And, you know, having hired people with disabilities to play the disabled roles, and having this wider view of what it means to be a family dealing with disability. And they dealt with their sexuality, you know, tones in that program very well.
I mean, I, you know, I think it's limiting and those biases around people being damaged and nobody's ever gonna want me. And, you know, it would be different if we had just as many images of people not having those problems. Because the reality is there is a lot of despair. There's a lot of despair everywhere. But people, you know, are faced with unique stress, and they're faced with wondering what their life is gonna be like. And are they ever gonna be in connection, and will anybody accept their mind, body, and soul, right? So those things do happen, but those are the only things we see in the media, right?We don't see an equal amount of, you know, people engaging in, you know, more light hearted fun sexual activity or having a one night stand. We just don't see other images. So, I think that, you know, nationally the disability film advocacy groups have done an amazing job with getting better representation. But, it is, you know, it's always that moment where I'm in, you know I'm either at a movie theater or I'm somewhere and I'm just like "Oh God please do it right, please do it right" And sometimes I'm pleased and sometimes I'm not.
So, I think it's a struggle. I think it's ongoing. Right. I mean I've been having the conversation I'm having with you, although it was different 20 years ago, I'm still having it. And I think the reality is things have changed and it is different. But it's nowhere near where we wanna be.
Liz Goldwyn:
What are you still learning about sex?
Dr. Linda Mona:
I think as a provider and as a person I am always learning the power of intimacy and connection. And how being sexual with another person is so unique, right. We don't go around, well most of us don't go around having sex with everyone that we know, right. That there's something about whether its connection with one person or a couple of people. Whatever that person's choices that over time what a bond that is and how huge it is to exchange pleasure with people.
So watching, you know, my patients have, you know and I have had some patients for many, many years who come back to see me just for a tune up every once in a while to check in on things. And to watch those relationships grow and change over the years is powerful to me. So, I mean, I think I've always kind of known why I wanted to do this job. I wanna, you know, I'm not shy to difficult conversations or dialogues. I'm not shy to standing up for somebody that I need to stand up for in a team meeting about my patient when they somehow have lost the patient's needs at hand. So, you know, I'm not shy to that but I am forever learning the power of watching people in those intimate connections. And also I think the power around helping healthcare professionals to do a better job with this. Really feel like that's kind of what I've been called to do. And I also feel like I'm always learning that there are people who will put this on their agenda and champion it for others and will keep this conversation going.
Liz Goldwyn:
Thank you. That's great. I love what you're saying about intimacy. I believe that intimacy is the next frontier of sexuality, and a place that we need to get back to and explore more. That it's not just, you know, sex, it's so much more than penetration as it's so often portrayed.
Dr. Linda Mona:
Right. It's that special spark, right. And, you know, and I also I will tell you the other thing I've learned about intimacy because I have been honored to also help a lot of people die. And in their last couple days being with their partners and watching, kind of, that love in the final chapter. And people don't like to talk about all this so much, right. Everyone's so excited about talking about the beginnings of life, but we're less open to talking about the final chapters. And when you know that that couple has, you know, experienced some of the most intimate times together and that look that they have as one of those people is dying is pretty powerful, right. And it's sad and everything, I'm not trying to take away from the sadness and the despair around it, but there's something about that connection that is amazing to me. And that's that connection that's been built over years and it's been built through affection, and it's been built through sex and intimacy.
Liz Goldwyn:
And trust. Yeah.
Dr. Linda Mona:
Exactly.