Hello! I intend to write a main character who is a wheelchair user due to an accident that was fatal to others but not them. I have a problem with deducting the limitations of the disability. Theyre an artist but after the injury they lost some mobility with their hands and since theyre a main character i will give them a romantic interest but im not sure how to make the genitelia function. The hands being limited mobility is important but also their ability to have sex is too. Is this possible or if someone has partial feeling in their hands the genitelia also has problems or can it function fully, would there be other problems regarding sex? How long would the physical therapy period be after the injury? Would they be able to use a regular computer mouse easily or would they need another device? They dont live in an accessible state so what type of chair would they use? Can they transfer from their chair by themselves perhaps? Would they experience chronic pain anywhere in their body or would there be no feeling at all? I want to write the character right so i would appreciate it very much if you answered my ask, thank you
It depends on what the accident actually did. I'm gonna assume quadriplegia since that's what it sounds like, but I could be wrong. Since we don't currently have quadriplegic mods I'll just answer for the technical parts but if this is an important character to the story I recommend you get a sensitivity reader if you want to get it right and not just "not medically incorrectly".
Is this possible or if someone has partial feeling in their hands the genitelia also has problems or can it function fully, would there be other problems regarding sex?
Generally speaking, most quadriplegics will have their genitals affected fully or partially depending on the completeness of their injury. However, working 100% as before the injury would be rare.
The one problem that affects all quadriplegics (and some paraplegics) is autonomic dysreflexia, which is essentially a sudden medical emergency caused by a blood pressure rise from too much stimulation. Genital stimulation could potentially cause this and your character would be aware of if they have any knowledge on their condition.
Another problem that will affect the extreme majority will be absent/significantly decreased sensation. That doesn't mean that they can't have sex, but they might not feel anything at all there or not feel enough for the entire thing to be pleasurable.
For more specific problems, you'd have to consider what set of genitals your character has. People with penises are more likely to cause issues that complicate things a lot (complete erectile dysfunction, inability to ejaculate), than people with a vulva (inability to lubricate). The one exception would be if they have vaginal spasms, which might make penetrative sex physically impossible and/or very painful. Again, this doesn't mean the inability to have sex in general, just requires some changes. Changing focus from genitals to other erogenous zones etc.
You can read about it more here and here. This is also useful but long and uses medical language. Just be aware that it doesn't really factor in trans people and potential differences people on HRT may have.
How long would the physical therapy period be after the injury?
This depends on a lot of things. Depending on what you consider physical therapy, they might do PT indefinitely. SCI is a permanent injury and if it's complete, PT is good to keep it from getting worse (e.g. preventing muscles from contracting), and if it's incomplete then it can also be about potentially restoring more function (how some paralyzed people are eventually able to walk again, it's not a miracle, it's PT).
PT can be the in-patient kind that they would probably spend a few months in, out-patient which could be months to a few years, and simple at-home exercises that they could probably do indefinitely (as mentioned), for example passive range of motion exercises.
If the character has specific goals, they will probably go to therapy longer for that specifically. It could be PT, but it could also be occupational therapy. You can read more here or here.
Would they be able to use a regular computer mouse easily or would they need another device?
They probably could. (I recommend this guy's channel for other similar questions like this, he explains them very well).
They dont live in an accessible state so what type of chair would they use?
The type of chair would depend more on their actual needs than the accessibility of the environment. However if you want to specifically factor that in, a light-weight wheelchair would be better so it can be physically moved up the stairs, transported by car, etc.
Can they transfer from their chair by themselves perhaps?
At the start almost definitely no, after some rehab, maybe. If you have your character's level of injury figure out you can search (e.g.) "c6 sci transfer" and see how various people do it. Some can do it by themselves, others need a sliding board, and many can't do it at all. It also depends on factors like weight and age.
Would they experience chronic pain anywhere in their body or would there be no feeling at all?
They would definitely experience at least some chronic pain. It'd be very unusual if they didn't (without being strongly medicated). They'd almost definitely have back pain at the very least.
These two are also not exclusive - you can absolutely have pain in areas without actual sensation (I do). It's because of nerve damage and the nerves firing off incorrectly, so a light touch could be unperceivable, but cause shock-like pain.
I know this wasn't one of the questions, but they could still be an artist as a quadriplegic. They could potentially paint with their mouth or tape a brush to their hand in order to draw.
