Benching backdoor action may sound like little more than a minor coital inconvenience. But actually, “this belief can feel devastating for people who experience ass play as central to their erotic identity,” says mental health expert and sex therapist Jesse Kahn, LCSW, CST, director of The Gender & Sexuality Therapy Center in New York City. Those people include queer men, people with vaginal scarring or chronic pelvic pain who rely on anal play for pleasure, and individuals taking medications like SSRIs that dull other types of touch.
The key to pleasurable anal if you have UC is finding a treatment regime that helps you enter remission—then sticking with it. “Clear, proactive communication with your partner beforehand about what feels good, what’s off-limits, and how you’ll express a need to stop or slow down is also essential, because ulcerative colitis can involve fluctuating symptoms, and anal sex requires attunement even without a chronic condition,” says Kahn.
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More from G&STC director Jesse Kahn on this topic:
Believing that anal sex is automatically off the table if you have ulcerative colitis can feel devastating, particularly for folks who experience ass play as central to their erotic identity. When culture already stigmatizes both bowel illness and anal pleasure, the message can land as “your body is broken” or “your desires are inappropriate.”
That combination often fuels shame, but not because the desire is wrong.
Shame and grief can show up as avoiding intimacy, disconnecting from the body, bracing for embarrassment, or assuming rejection before it happens. Some people begin to see their body as unreliable or undesirable, which can shrink their sexual self-concept over time. Others may push past their limits to prove they’re still “normal,” which can also erode trust in their body. Healing often involves building or rebuilding a relationship with the body that centers consent, pacing, and self-compassion.
Clear, proactive communication is essential because ulcerative colitis can involve fluctuating symptoms, and anal sex requires attunement even without a chronic condition.
Green flags include: partners who ask about comfort levels ,respect boundaries without pressure, are open to adjusting plans, and treat bowel-related conversations as neutral and human.
Red flags include: minimizing symptoms, rushing, sulking when limits are set, or framing accommodations as burdensome.
Practical tips include:
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talking outside of sexual spaces beforehand
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naming what feels good and what’s off-limits during flares
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creating easy stop signals
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and normalizing check-ins so consent stays ongoing and collaborative.