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Intimacy and Sexuality with an Ostomy Bag

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13 Apr 2023

We had people submit their personal questions to our Resident Sexual Health Clinician, Dr. Kathryn Ellis, OTR/L, OTD, AASECT-SC, an occupational therapist and American Association of Sexuality Educators, Counselors, and Therapists Certified Sexuality Counselor. We hope that this information helps improve your wellbeing and always feel free to submit your own questions to 

Intimacy and Sexuality with an Ostomy Bag: ostomy bag with a gradient red to yellow background


How do I find my sense of sexuality again now that I have an ostomy bag? 

Dr. Ellis: An ostomy bag is a bag that's worn on the stomach as a way to collect stool or urine for folks with gastrointestinal conditions, such as Crohn’s Disease, vaginal cancer, and cervical cancer.

An ostomy bag can influence a person's body image. Working to move from a negative body image towards a more positive body image can be difficult and suggestions are all establishing a practice versus something you can do and get an immediate fix. Below are 3 different approaches that might be helpful for you.  

Approach #1

Consider that receiving sexual pleasure is completely unrelated to our physical form. As in, the shape of our body and what we have attached to it, does not limit our sensory system’s capacity to feel pleasure. So when you center pleasure (instead of how you look), it can help to deprioritize the way we look. I am well aware that body image impacts a sense of sexual self, but that is very socially driven. From a biological perspective they aren’t related. 
The actual physical structure of the body and what it has attached to it, how it's changed and its physical form – the wrinkles, the fat rolls, the bags under our eyes – those things are not barriers to your body receiving pleasure. Pleasure is a sensory experience that is received through the skin and perceived in the brain.

What is a barrier to receiving pleasure is the messaging that people receive about bodies such that all of our bodies are judged to an impossible standard. Instead of focusing on appearance, focus on the pleasure you’re feeling in your body.

Approach #2

Another important approach when it comes to body image and getting used to the way that our bodies have changed is doing mirror work. Stand in front of the mirror, view your body, and offer positive appreciation or compliments to different parts of your body. As this becomes easier for you, try doing it naked or try providing positive appreciation to all of your parts versus just some of them.

Approach #3

Perhaps it might be easier for you to wear a t-shirt when you have sex. Do you feel better about yourself when parts of yourself are covered during sex? If that is the case, and that frees you to feel more comfortable during sex, then do that. 

The reality is, you don’t need to be naked to have sex. Think about what you need to feel more comfortable and just meet yourself where you’re at.

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