I had to drop eye contact before asking the question. Then I just had to name the uncomfortable degree of shyness I was experiencing. “I can’t believe I’m asking this, but it just seems to me like an orgasm is a direct shot of electricity to the brain, and probably a really bad idea?”

He responded calmly: “A lot of people have questions about sex at this point in recovering from a concussion.”

Phew. It’s not weird to ask questions about sex! Especially to doctors! I was also impressed that he proceeded to answer my question without using any pronouns that would assign a gender to my hypothetical sexual partner. Way to make no assumptions, doc.

He told me that first, I would need to discuss two strict guidelines with a potential partner:

  1. If my head started to feel worse at any point, I had to stop immediately.
  2. If my head felt worse the next day, I couldn’t do it again for a while.

These were, in all fairness, the basic guidelines he would give me for any activity. Then we would discuss the likelihood of the activity making me feel worse. Sex is very stimulating (to say the least), and any increase in heart rate is also stressful for a concussed brain. So that makes it relatively likely that No. 1 or No. 2 would indeed happen, but he didn’t tell me not to try.

Still. Something about those guidelines felt really hard. I might have to stop my partner mid-action if my headache got worse? I might open up the possibility of sex, and then need to take it off the table again? I felt like that would add too much stress to the entire process. Also, my head hurt already, and I didn’t really want to do anything that might make my head hurt more, even if it would feel really good in other ways. Pretty overwhelmed, I decided not to test it out.

I thought to myself that it seemed like something people could maybe do if they had a serious partner, if they were living together or if the person was taking care of them. Someone already invested in their health and healing, someone already attuned to their moods and pain levels, someone who had sex with them in the past and knew they were likely to have lots of great sex with them again after the recovery process was complete. I get it; I could see it working out, but it’s definitely not where I’m at right now. I’m not connected deeply enough with anyone to take on that kind of risk together, as a team. I’ll wait.

But what makes this night different from all other nights? How are those guidelines any different from the basic consent guidelines I talk about all the time? As in:

  1. Consent to sex can be withdrawn at any point in sexual activity. If either person says “stop,” for any reason, then you stop.
  2. Consent to sex one time does not mean consent to sex any time. Having sex today doesn’t mean you have to have sex tomorrow or the day after. If either person says “not today,” for any reason, then you don’t have sex that day.

Obviously, right?

Yet these familiar consent guidelines suddenly felt so difficult in my new context. Here are some of my guesses about why:

  • Desire vs. consent: Desiring sex, wanting to have sex and consenting to sex are all distinct. Feeling sexual desire may or may not lead a person to want to have sex at a particular moment; a person may want sex for many reasons other than sexual desire. Consent means clearly communicating a choice (wanting) to have sex. Withdrawing consent when my desire changes has lots of its own difficulties already, but withdrawing consent because brain-pain changes my decision-making, even as my desire persists, feels quite daunting.
  • Physical vs. emotional risks: After negotiating protection from sexually transmitted infections and unwanted pregnancy, consent has a lot to do with negotiating emotional risks. Taking care of each other. Attending to each other’s feelings within the experience. I’m pretty attuned to my own emotional risks in different sexual contexts, but I’m not confident I have the wherewithal to manage an entirely new and unfamiliar set of physical risks.
  • Short-term vs. long-term costs: The decision to have sex is often about potential short-term gains (physical or emotional) and potential long-term costs (physical or emotional). However, I face a very clear short-term cost. To my brain. And yeah, that tips the scales. Wait a while, and I can get the same gains without the short-term risks. Seems good to me. Seems much better.

Not to mention the fact that I’m operating on impaired brain functioning, including emotions soaring all over the place and limited access to my usual coping mechanisms.

But even though I’m not having or pursuing sex, I’m deeply engaged in sorting through the various folds of my own desires, fears and priorities. I’m developing angles of awareness that I will bring with me as I make different sexual choices in the future. I’m active in my own sexuality, although not exactly sexually active.

In case you were wondering about what my sex life has looked like while I’ve been cooped up in my apartment for two months recovering from a concussion, now you know. Any other questions?