Seven Ostomy Intimacy Fears Smashed!

“How do I loathe me? Let me count the ways.”

I used to think that being a stripper is what made me confident about my body. All the appreciation and adulation I received dancing provocatively on stage, made me feel very powerful indeed. Then, when I lost my flat, perfect stomach to an emergency ostomy surgery in 2012, my stripper confidence worked against me, because I had developed unrealistic beauty expectations for myself.

Once completely comfortable being nude in front of whole strip clubs full of people, I was now fearful of showing my body or engaging in intimacy. I thought my scars and deformed stomach were hideously ugly. I used those exact words to describe them. Hideously ugly. And the bag that I'd had for a few months was "a shit bag that I will kill myself if I ever have to have one again."

I became obsessed with healing my body to prevent ever facing ostomy surgery again. But ten years of suffering later, my biggest fear was realized. I had failed at healing what was left of my large intestine and now it had to be removed, along with my diseased rectum. Fear descended on me, then. It paralyzed me. I had bouts of weeping throughout each day. I attempted to hide my emotional displays as much as possible, but my family could feel my fear. It affected us all.

But one day, I heard an inner voice asking me, "What are you specifically afraid of?" I realized that I hadn't put names to any of my fears. I'd had visions of terrible things happening after ostomy surgery. For instance, I had visions of the bag farting in the middle of sex; never feeling sexy again in lingerie; and never having the privilege of being desired by my partner or any man for that matter, ever again.

But to my surprise, once I really examined them one-by-one, my fears weren't as scary and life-destroying as I had imagined. In many cases, my fears could be dismantled or handled, simply by doing research and purchasing the right ostomy gear and clothing. And as I began to dismantle my fears, I became less paralyzed by them. That's when I began to have hope.

You know the old adage “Keep your friends close and your enemies closer.” Well, we have to get to know our fears if we want to dismantle them. And for most of us, the bag is just one aspect of the baggage (pun intended) that we bring when it comes to intimacy.

So, ask yourself: "What are MY specific fears?" Then read the next section to learn about the most common fears we have when it comes to intimacy after ostomy surgery.

Understanding Your Fears So They Stop Controlling Your Intimacy

Fear #1 – “My partner will find my body unattractive.”

• My partner will think my stoma looks disgusting • My partner will be turned off by the ostomy bag • My partner will notice my scars immediately • My stomach looks deformed or uneven • I lost my belly button and my stomach looks strange • My abdomen is misshapen from surgery • My body looks “damaged” • My partner will compare my body to how it looked before surgery • My partner will compare me to people without ostomies • I don’t feel sexy anymore • I no longer look like a “normal” woman/man • I can’t imagine someone finding my body attractive again • My partner will lose desire once they see my stomach • I need to hide my stomach during sex • I must keep the lights off • I should stay partially clothed during intimacy • I feel ashamed of my body

One of the scariest things about going through ostomy surgery is wondering how it will affect our relationships or our potential to get into relationships. As humans, a large part of attraction is physical and having an ostomy bag or two attached to our stomachs doesn't make us feel very beautiful.

But attraction is far more complex than having a perfect, flat stomach. People are attracted to energy, warmth, confidence, vulnerability, humour, presence, and connection. In other words, if someone finds you attractive with your clothes on, they will find you attractive with your clothes off.

Instead of worrying about the bag(s), ask yourself: Am I groomed and hygienic? Do I dress well and treat others with kindness and respect? Am I a good partner, friend, and lover? These are some of the things that really do matter when you're assessing your attractiveness. Your prosthetic device(s) doesn't define who you are but your character does.

Fear #2 – “Something embarrassing will happen.”

• The ostomy bag will leak during sex • Output will come out unexpectedly • The bag will detach from my body • Stool will appear on the bed • My partner will get stool on them • The stoma will make loud noises • Gas will escape unexpectedly • My bag will inflate with gas during intimacy • My partner will smell stool • I will smell bad • My appliance will rustle or crinkle • My partner will accidentally bump the bag • My partner will touch the stoma accidentally • The bag will be visible in an awkward moment • I will feel exposed or humiliated • If something goes wrong, I will never recover from the embarrassment

The bag will fart when my husband is going down on me. What if there's a leak, right in the middle of making love? Do I smell? Can she smell me? What if my stoma gets active when I'm making out with my new crush?

These are absolutely valid fears that can deter us from engaging in intimacy. But they don't have to control us. In fact, we can learn how to control them by learning how to manage our ostomies. Later in this book, I will share an entire chapter dedicated to managing stoma activity, reducing bag noise, minimizing risks of leaks, and other ways to feel more confident about being naked with your lover.

The strategies I share will empower you to enjoy intimacy more fully and feel more present with your lover. But I still want you to remember that embarrassing things happen during intimacy even without an ostomy. The best way to handle anything, whether it's ostomy-related or not, is to act like it's no big deal, because it is no big deal.

Many ostomates have experienced all of these things as one time or another and it was rarely the catastrophe we expected it to be. So, have a sense of humour and be gentle with yourself and your partner. You will get through this.

Fear #3 – “My partner will reject me.”

• My partner will stop wanting sex with me • My partner will feel disgusted • My partner will secretly resent my body • My partner will stay but stop being sexually interested • My partner will feel forced to have sex out of obligation • My partner will pity me instead of desiring me • My partner will lose attraction over time • My partner will avoid touching my stomach • My partner will look uncomfortable when they see the bag • My partner will eventually leave the relationship • If I start dating again, no one will want me • Someone will reject me once I disclose my ostomy • People will see me as damaged or unhealthy • Dating will be impossible now • I am too much for someone to accept

Before my severe illness and subsequent ostomy surgery, my sex life was exciting and kinky. My partner and I were adventurous and open-minded. Then my rectum became so diseased that penetrative sex really hurt. For several months before and after my permanent ostomy surgery, my partner and I did not engage in intimacy.

I tried to draw him in with naked hugs and flirting. But he resisted my efforts to be physically intimate without penetrative sex. He was incapable of engaging in physical intimacy that did not include putting his penis into my vagina.

As an intimacy coach, I knew that he was not rejecting me because of my illness before the surgery or the ostomy bag after the surgery. He was simply waiting for me to be healed enough to "fuck" again because intimacy without penetrative sex was too vulnerable for him. His traumas, hang-ups, and insecurities prevented him from having the capacity for non-penetrative intimacy.

I will tell you that it broke my heart, weakened our bond, and led to the ending of our relationship but that would be simplifying it too much. The truth is, our intimate relationships are not one-dimensional. They are multi-layered intricacies of desire and denial. And we are all at a different place in our intimacy evolution.

If your partner rejects you, do not internalize it as being about you or your bag. Understand that we are all at different levels in our intimacy evolution and some people just can't handle change unless it is forced upon them, like it has been forced upon us, as ostomates.

Along with the fear of being rejected by a current partner or a future, potential partner is the fear of dating and disclosing to someone you're dating that you have an ostomy. In a later chapter, I will teach you how to have these difficult conversations and give you tools to make them easier and more constructive. But for now, just know that if someone rejects you because of your bag, they are not evolved enough to be in a relationship with you.

Fear #4 – “Sex might hurt or be dangerous.”

• Sex will hurt my stoma • My partner might injure the stoma • Pressure on my abdomen will damage something • My surgical scars will tear or hurt • My stoma appliance will rip off • I might develop a hernia • My body is too fragile for sex • My doctor never told me what is safe • I might cause complications • Penetration might hurt after surgery • My pelvic nerves might be damaged • I might not function sexually anymore • I don’t know which positions are safe • My body might fail me physically

Our bodies have been altered on the inside even more than they've been altered on the outside. For that reason, penetrative sex can be painful and it can even be impossible for a time, even after the wounds from your surgery have closed. My ostomy nurse once told me that "the inside" takes about two years to heal from the time "the outside" has healed. Since my wounds took many months to close and heal; that set my two years of inner healing back considerably.

We are right to go slow with caution when introducing penetrative sex back into our lives, however we must also experiment to see how far we've come. I was "experimenting" with a vibrator about 16 months after my surgery. I'd never had an issue using this vibrator in the past. I called it my "g-spot vibrator."

I could tell almost immediately that the toy was causing pain and inflammation. But I thought if I could just hold on a few more minutes, I would be able to climax. Unfortunately, I was not able to climax and even worse, my vagina swelled up and felt like it was on fire for the next two days. I regretted not stopping immediately. I share this story to warn you: stop immediately if whatever you're doing is hurting.

It was about 2.5 years after ostomy surgery that penetrative sex became comfortable for me without pain, but I could still feel a pressure. The pressure was a result of scar tissue buildup in the area where my rectum used to be. Over time with repeated penetrative sex, this scar tissue became less stiff and the pressure lessened until it disappeared.

But what if your situation is different and penetrative sex will never be comfortable or possible for you again? That is the big question that many of my coaching clients have come to me with. I will share an entire chapter on this subject with you later in the book. But for now, just know that intimacy without penetration is not only possible, it is amazing (maybe even better than penetrative sex – but I'll get to that later).

Whether you are plagued by fears about pain and damage during intimacy or whether you have no fears at all, the best advice I can give you about reintroducing penetrative play is to go slowly by yourself or with a partner who understands and is willing do whatever you need to feel safe and sexy.

Fear #5 – “My partner will be uncomfortable touching me.”

• My partner will be afraid to touch my stomach • My partner will avoid touching near the bag • My partner will feel like they might hurt me • My partner will feel anxious during sex • My partner will see me as medically fragile • My partner will treat me like a patient • My partner will become overly cautious • My partner will feel awkward or unsure • My partner will feel responsible for protecting me • My partner will stop being playful or passionate • My partner will not know how to touch me anymore • My partner will see my body as a medical problem

"Why aren't you touching me anymore?" I asked my partner.

"I'm afraid I'll hurt you," he replied. I knew that he was talking about penetrative sex. He usually had difficulty achieving climax during sex. It took a lot of effort and he was worried he would cause damage to my body. On a deeper level, I think he worried that I would endure the pain without saying anything.

At the time, I wasn't ready for penetrative sex yet. I just wanted him to hug me, hold me, caress me, and kiss me. I wanted him to make me feel sexy and beautiful again, like he used to before I had the bag. But even before the major sickness and surgery, it had always been a struggle to keep him intimately engaged.

And now, after months of medicalization and him being my caretaker, I wanted to be his lover and partner again. But he was too scared to hurt me. Occasionally, I wondered, was I unattractive to him now? Thankfully, I had done the inner work. If he wasn't attracted to me anymore, it was a him problem that would either be resolved in our relationship over time or it would lead to our relationship ending. Either way, it was out of my control.

My only power was to keep trying to reconnect with him until one outcome or the other occurred. We broke up 8 months after my surgery, in part because our bond had weakened without physical intimacy for so long. But the main reason was because of his addiction issues that prevented him from doing his own inner work. The breakup was necessary, as painful as it was.

The reason I share this story is to demonstrate the complexities that surround intimacy in a relationship that has been tested by medicalization and illness. Not only must we deal with the new realities of our changed bodies and lives, but there is all the baggage that each of us brings to the relationship as well. Nothing is black and white.

The key is to not take another person's level of intimacy evolution personally. We are not responsible for the emotional growth of our partners and their issues are not a reflection on us. It's possible that we have evolved beyond them due to our life experiences. It's also possible that our fears are driving the wedges in our relationships.

Be objective when assessing your own intimate relationship. Look at the shape of you and your partner's past experiences and present realities. If your relationship is strained, it is a combination of all these things. If, on the other hand, you are in a loving, supportive relationship with a wonderful partner; be not afraid. It has now become a numbers game. The more time you spend naked time with your lover, the more you will be comfortable spending naked time with your lover. So, get to work.

And remember that our partners often take their emotional cues from us. If we approach our bodies with shame or avoidance, they may mirror that uncertainty. But if we approach our bodies with acceptance and confidence, our partners will follow our lead.

Fear 6 – “Intimacy will never feel natural again.”

• Sex will always require planning • I will always need to empty my bag first • Intimacy will feel clinical • I will always worry about my appliance • Sex will feel mechanical instead of passionate • I will constantly be thinking about my bag • I will never be able to relax during sex • My body will distract me during intimacy • The moment will be ruined by my anxiety • Sex will always feel different from before • I will never feel carefree during intimacy again

As an intimacy coach and surrogate, I have so many things to say about scheduled intimacy vs. spontaneous intimacy. I know that a lot of people prefer spontaneous intimacy because it's exciting and you're already in the mood when it happens. Scheduled, planned, or methodical intimacy which requires preparation and maybe even a spot on the family calendar, sounds a lot less sexy, unless you do it the way that I like to do it. For me, scheduled intimacy is my favourite and I will share more about how to make scheduled intimacy amazing in a later chapter.

The main cause of our fears about intimacy feeling unnatural is that we, ourselves, have not accepted our stomas yet. If we had, we wouldn't have these worries. We would simply be making the necessary changes to our intimacy routines needed for maximum enjoyment. We would roll with the punches. By the end of this book, your fear of intimacy never being natural again will be replaced with an excitement for the new kind of intimacy you are capable of having now.

Fear 7 – “I’m no longer a sexual being.”

• My illness destroyed my sexuality • My body is no longer erotic • I am broken sexually • No one could desire me now • I don’t feel sensual anymore • My libido disappeared after surgery • My body doesn’t respond the same way • My partner will see me as a medical case • My sexual confidence is gone • I feel disconnected from my body • I feel numb emotionally or physically • My sexuality ended when my illness began

People with ostomies are not the only ones who go through this feeling of having lost their sexuality. It can happen to almost anyone with a disability, if they think their disability affects their desirability. It can even happen as people age or if they gain too much or lose too much weight. If they get an STI like genital herpes, which is with them for life, or a chronic illness that sends them to the hospital every other week. I'm sure some of us can relate to the last one, if not more.

The point is that feeling like "I am not a sexual being anymore" is not an uncommon way to feel when you've been through a crazy, health trauma. Society has conditioned us to believe that young, virile, unblemished, untarnished, able-bodied people who poop and pee the old-fashioned way are the only people deserving of sex.

This feeling of being unworthy of sex is not just emotional. It seems to have an "off" switch for many of us when it comes to our libido. If I am not a sexual being anymore, then I have no desire for sex. This is the mind blocking the body from feeling sexual arousal. It becomes a numbness where we used to feel a tingling anticipation.

Another common feeling is a disconnectedness from our bodies. It's possible that on some level, we really did become disconnected from our bodies when we were under anaesthesia. If you know me, I have more than a little interest in the science of our souls. Perhaps our souls leave our bodies during surgery, which causes a feeling of disconnection when reunited as one body and soul. I don't know but it's a theory.

My ostomy nurse assured me that it was normal to feel "protective" of the pelvic region of my body, when I shared with her how disconnected I felt from my lower body and how I blocked anything that came near my abdomen or groin area, including my partner. Biologically, it's natural for us to protect our fragile parts that have been through massive trauma. So, if you are "protecting" your body or feeling disconnected and numb right now; don't worry because this should lessen as your healing grows.

The Three Root Fears Behind Intimacy After Ostomy Surgery

When you step back and look at all the fears we discussed, something interesting appears. Most fears about intimacy after ostomy surgery collapse into three root fears.

1. The Fear of Rejection

At its core, this fear asks a very human question: “Will I still be wanted?” For many people, this fear existed before surgery but becomes magnified afterward.

2. The Fear of Embarrassment and Loss of Control

This fear asks: “What if something humiliating happens?” Embarrassment is powerful because intimacy already requires vulnerability. When someone feels their body might betray them, they may avoid intimacy entirely.

3. The Fear of Being Broken or Fragile

The deeper question beneath this fear is: “Is my body still capable of pleasure and connection?” And the answer is yes. 100% YES. And once you open yourself up to the possibility of intimacy, you will begin to attract it back into your life.

Conclusion

You are not broken for having these fears. After everything your body has been through, it would be strange if you didn’t feel vulnerable, cautious, or unsure about intimacy. But your fears are not facts. They are stories your mind has created to protect you from rejection, embarrassment, and pain. And while those stories may have helped you survive, they may now be standing between you and the intimacy you still deeply desire. You don’t need to eliminate fear before you move forward. You simply need to understand it well enough that it stops making your decisions for you.