Every genital injury has the potential to permanently alter how a person has sex. The fear of no longer being able to have sex after a genital injury, combined with the fear of losing part or all of the bits that many men feel define their gender identity, has led some soldiers to say they’d rather die than live without their penis or testicles.

[M]ost IED-related genital wounds are messier than the genital injuries that civilians sustain in accidents, fights, and other everyday tragedies, and so are harder for medical experts to treat or repair.

Social taboos around talking about sex after sustaining a genital wound, as well as the fairly limited amount of medical expertise on this topic, can pose serious barriers to people’s efforts to navigate physical intimacy in the wake of a serious genital injury. However, losing part or all of one’s genitals to an IED blast is not necessarily a death sentence for one’s sex life.

VICE recently spoke to Aaron and Kat Causey, who advocate for open acknowledgment and discussion of all aspects of life after genital injuries, including sex and intimacy, by sharing their own experiences.

Read more in Vice.