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Sexuality And Disabilty: Education, Advocacy & Support

What You Need to Know about Me and Sex:
A form to fill-out and share

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What You Need to Know about Me and Sex
Copyright 2003

Filling out this form is not a substitute for having a conversation about sex. It is designed to make it easier to have a conversation about the things you might forget to talk about and to learn about the things you might disagree about. (Feel free to use this for your personal use - but if you copy it for a class, newsletter, hand-out, etc. please email me about getting permission and giving me credit.)

Some of these questions are only for couples who are male and female, or have decided to have vaginal sex. Some questions will be questions for people who have never has sex before, and others for people who have had sex for many years.

If a question doesn't apply to you - just don't answer it or cross it out. If you don't want to answer a question - just don't answer it. This is just a tool to help you - it is not a test. If you have suggestions for changes, please email me.. Susan

These are the sex acts I am willing to do or have you do.

Nothing at all

Touching over clothes only:
Touching under clothes above the waist:
Touching under clothes anywhere:
Inserting finger into vagina:
Inserting finger into anus:
Oral sex on me:
Oral sex on you:
Vaginal sex:
Anal sex:
Ejaculation/ orgasm:
Spanking as part of sex:

Do I have any sexually transmitted infections ?

What? _______________________

I know I don't (or do) because?

I am willing to get tested: yes No

I have only had sex with a virgin:
I just know:

ans-serif">What do I plan to use for pregnancy and/or disease protection ?

If you want to be absolutely sure you will not get pregnant or get a disease, do not have sex. To be safer (not safe) from pregnancy use two forms of birth control as none are 100% efffective/guaranteed. Withdrawal or pulling out is not a good method and is impossible to do do right every time.

Dental dams:

The following are for pregnancy prevention only

Spemicidal inserts
Vasectomy, sterilization:


If we are using condoms or dental dams, who will buy them ?

If you have an allergy to latex, there are nonlatex condoms. Some condoms do not have spermicide - many people have bad reactions to spermicide.  If you have an allergy to corn/ corn starch or baby powder - many condoms do not have this - read the package ingredients. Diaphragms and cervical caps can be purchased in material other than rubber if requested.
Lubrication can have perfume or flavoring in it that a person can be allergic to. Nononxydal-9 has recently been demonstrated to actually make you more likely to get HIV from an infected partner and not less - many condoms manufacturers no longer use it.

: ____________________________________

If I am using a birth control pill or patch  - I have been using it for at least 4 months.
If you have been using birth control for less than 4 months, or you forget to take a pill, or you don't take your pill everyday at the same time, you should absolutely use another method in addition to the pill or patch.

Who will pay for over-the-counter pregnancy detection kits, or medical care that might be needed as a result off our having sex?
If you have a lot of pregnancy scares, or one of you has sex with other people - this could be a lot of money to some people, especially to teenagers.

We split it:

What do I want to do in the event of accidental pregnancy?
This needs to be discussed before you have vaginal sex. If one of you is absolutely against abortion and the other one absolutely refuses to have a baby - you need to know this before you have sex, not when one of you gets pregnant.

Single parenting:

These are the following ground rules I agree to:
As your relationship changes and grows, the rules might need to change, too.

I have the right to change my mind:
Just because we do it once, doesn't mean I will do it again:
We will have sex with each other and no one else:
My commitment to you is for this one time only:
If we have sex with others, it will be sex with condoms and /or dental dams only:
If we have sex with others it is OK, but we have to talk about it first :
If we have sex with others, it is OK, but I don't want to know about it:


These are the people I want to tell we are having sex:
It is important that you agree on this. Many relationship end because a person tells someone the other person did not want to know.

I want to tell everybody!


The thing that scares me most about sex is:
Being scared about sex is not unusual. Lots of people are scared, especially the first time with a new person, or the first time doing something new.

That you won't like me:
That I won't do it OK:
Losing control, feeling vulnerable:
People (my Mom or Dad or friends) will find out:

My sexual history is private, but I want you to know these things:
A person's sexual history is private. What happened to them before you met them is for them to decide what they want to share with you. You are entitled to know if they have a sexually transmitted disease now, but not if they have had one before. History is past - and your relationship starts now, not in the past. But history can have an impact on the present, so you may want to share information about your sexual past with someone you are going to have sex with now. It's your choice!


This is a question I want to discuss that isn't here:



After we have Sex Question Suggestions

What thing did you like best about the sex we had together?

What thing did you like least about the sex we had together?

If you could change one thing about the sex we had it would be?


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