The long-term consequences of burn injuries can vary substantially based on their bodily locations, extents, and severity, as well as the age when a person sustained them and treatment they received. But in many cases, they leave prominent visible scars, which can change the way others look at people with burn injuries, and the way they look at themselves, almost overnight. Many people with such injuries say that they fear rejection by established or prospective partners because of their burned skin.
In some cases, burn scars can also create new physical challenges during sex. Tight scar tissue can cause pain when overstretched or limit a person’s mobility, making once-standard positions more difficult. Scars also have differing levels of sensitivity than skin. Sometimes, they’re so numb that people can’t feel any stimulation on or around them. Sometimes, they’re so sensitive that even gentle touches can cause discomfort. Learning to navigate new constellations of sensitivity in any part of the body during sex can be difficult. Dealing with the hyper-sensitizing or desensitizing effects of burns on one’s genitals or other erogenous zones can be even more challenging. The medications people take to control everyday scar pain can lower their libidos, as well.
Even as people live with more and more severe burns because of advances in treatment, burn care advocates and doctors reportedly do not often talk to people who’ve recently sustained burns about how their injuries could affect their sex lives. Nor do burn care researchers or communities of people with burn injuries spend much time discussing or investigating this topic.
Granted, burns are so diverse that everyone’s experience of and process of coming to terms with them will be unique. Recent studies suggest most people with burn injuries do eventually rebuild their self-esteem, form or maintain meaningful relationships, and have good, fulfilling sex lives by one means or another. Greater acknowledgement and general support around the sexual effects of burn injuries would make that process easier for many people.
In recent years, several people with burn injuries have shared their experiences with sex and sexuality, both right after getting burned and throughout the rest of their lives, in public venues. A few burn injury communities have also started to share general advice on how to approach sex and sexuality with a new or old burn. VICE spoke to Cindy, who sustained third degree burns over 85 percent of her body in a house fire when she was six years old, and her partner over the last year, Geoff, about their relatively new sex life.
This interview has been edited for length and clarity. Cindy and Geoff’s last names have been withheld to protect their privacy.
Cindy: When I was 14 or 15, I started thinking about relationships and what my injuries might mean for them. I had to get dressed in front of other girls for P.E. classes, and they’d look at my body. My burn scars are usually covered, except for a few on my face and upper arms. But if I’m wearing shorts or short sleeves, and when I’m changing, there’s no hiding them. There was some bullying. I really struggled with my own body image related to my burns, especially as a young teenager. I worried about how potential partners would perceive them.
When I was 16, I became pretty promiscuous. A part of me felt that I needed to prove that I could be desirable, and to do that, I thought I had to be with someone sexually. That would mean I could be accepted. I engaged in unprotected sex with multiple partners until I was about 18.
Through those sexual interactions, I learned how my altered sensitivity, and the way my skin feels to the touch, could affect sex. I’d known that my body had different sensations, based on my own touch in the shower, or feeling hot water on my body. I hadn’t connected that to sex and intimacy until I was actually with someone. I learned that certain parts of my body were either hyper- or hyposensitive. My breasts, for example, are completely burned. I have breast tissue, but I don’t have nipples, so my sensation there is very different—limited.
The breast issue was usually a bone of contention with partners. We place so much emphasis on a woman’s breasts. It took me a long time to come to terms with the fact that my breasts, and those burns, don’t define me as a woman. Often, I’d take off my shirt, but not my bra, so that I wouldn’t have to deal with my breasts when I was having sex.
My scars run up my legs and onto my tush, but none of my genitals got burned. Now, while some of my scars are tight, they’re mostly old enough and I’m active and stretch enough that they’re pretty flexible. So, I’ve always done OK with most positions. I’m pliable.
Geoff: Yeah, she is…
Cindy: At 19, I married a man who accepted me for who I was. My burns were never an issue for us. In that relationship, I learned that I was entitled to enjoy my sexuality—to feel good—and to communicate what felt good or bad.
I also started working as a burn unit nurse, and I heard over and over from burn survivors that they felt uncomfortable with their sexualities. So often, people said, ‘Nobody’s ever going to want me, to want to touch me, to want to be with me.’ The topic wasn’t discussed much in the burn community. I wanted these people to be comfortable, and to know they were still entitled to a joyful sex life—that their burns didn’t mean their sexuality was gone. That made me slowly more comfortable discussing my own sexuality with other people.
My first husband and I got divorced. I remarried, then got divorced again. That last relationship didn’t end well, so I thought, I don’t need this in my life anymore. I decided I was done with relationships, and for six or seven years, I didn’t date or have sex with anyone. When I met Geoff around Labor Day in 2019, I wasn’t looking to meet anybody.
Geoff: We met at a family getaway held by a burn foundation. She was a facilitator for some of the group events there, and I’d started volunteering with them earlier that year when one of my friends who’d worked with them for years suggested that I get involved. I started learning about burn injuries through the foundation that spring. Before I met Cindy, I hadn’t thought about what burn injuries could mean for sexuality. At the end of the getaway weekend, I asked for her phone number, and we just kept talking and texting.
Cindy: In the beginning, I thought, Oh, this is possibly a new friend in the burn community, great! The more I got to know Geoff, the more I found myself attracted to him. Later, I looked back on our texts and realized we’d started flirting and I hadn’t realized it at the time. There was no sexting or anything like that. We didn’t exchange pictures. But it was flirting.
Geoff: Once we started to share our feelings with each other and embracing the fact that physical intimacy would be part of our dynamic, Cindy asked if I knew the details of her burn.
Cindy: I figured he would have seen or heard something about me in the community. He didn’t have a clue how badly I was burned. Even though I was generally comfortable with my sexuality and used to talking about it, I still had some angst about getting intimate with him. He’d volunteered with a burn foundation, so I knew he’d at least seen burn scars before. But I just didn’t know how he’d react, or if he’d accept me when he learned about or saw all of my scars. I went back to the place of fear I’d known in the past—fear of having to explain myself, and of risking rejection. Part of that was due to the fact that I hadn’t been sexually active in a while. Still, it was unnerving.
Geoff: She framed a lot of these discussions with levity. Early on when she was telling me about her body, she said, ‘Look, if you’re a breast man, I’m not the person for you.’
Three months after we met, we set a date two weeks out to spend some time together in person. Still, a few days before we met up, Cindy got so nervous that she threw up.
Cindy: Geoff didn’t seem fazed by anything I told him, though.
Geoff: That breast comment helped me take care, when we got intimate, not to rip her clothes off and jump on her breasts right away. She helped me understand things like the importance of spending time touching her legs as a way of getting to know her body, too. But, no, it didn’t faze me.
I honestly don’t know if things would have been different if we’d gotten intimate sooner after meeting each other, or if I’d seen or heard about her full burns right away. But after three months of getting to know each other, nothing about her burn could change how I felt about her.
Cindy: When we met up, after we spent the day together, and when it seemed like we were getting ready to go to the bedroom—before the big reveal—I had Geoff read a letter I use when I talk to people with burns about sexuality that a man wrote to his burned girlfriend. In it, he talks about what it’s like to be with a burn survivor—seeing the dark parts of her skin, feeling the different textures of it, and all of the other sensations of exploring burn scars.
Geoff: The letter was phenomenal. It gave me not only some imagery and information, but some courage. I’m a very sensory person. Just knowing that I’d be able to discover Cindy’s body through touch was great. I don’t know if I would have had the same thought to explore her like that, or the same awareness of that tactile experience, if I hadn’t just read that letter.
Cindy: I was calmer by the time we’d actually gotten to the bedroom, but it was still nerve-wracking. I put on a nightie and came into the bedroom. The first thing Geoff wanted to do was look at my legs. I sat on the bed and he touched them. He didn’t seem to be freaking out about the scars that ran up them. He was just kind and gentle and loving. I felt that from him. I just knew my burns weren't going to be an issue for us.
So, we decided to keep the lights on during sex. That was unnerving, too. But, because of the intimacy we’d built over the weeks, talking about our feelings for each other, my nerves quickly went to sleep.
Our months of open conversation, and that first night we spent together, set the stage for a very communicative relationship. I always feel comfortable telling him when he’s touching me if it does or doesn’t feel good. Being able to communicate that eases things for me considerably.
Geoff: We’re just comfortable telling each other things and asking each other questions not by breaking up sex our sex, but as part of the sex itself, both verbally and through our bodily cues.
Cindy: That comfort and communication goes beyond things that have to do with burns directly. With positions, if one of us wants or needs to change things, we’re both comfortable just saying something about it. It helps us talk about what works for both of us to reach orgasm, too. Or, to talk about things we want to try in bed, like using sex toys to enhance the experience.
I hope that we can keep learning and talking about each other’s bodies and desires continually. I think that’s what keeps a relationship alive and going, whether you’re burned or not.