There was something about the way her fair skin had gone slightly rosy that made Lila think she was talking about something beyond braiding her hair or singing karaoke. She’d mentioned her period. “Are you talking about having kids? There’s nothing at all in your records that makes me think you would have a problem. Even with a complete spinal cord injury, most women can still have children. Yours is much less severe. It didn’t harm your internal organs. Is your period regular?”

She waved that off. “Yeah, it’s fine. I didn’t want my dad to think he could come back here. He’s nosy about the medical stuff. I get some privacy if I mention the girl parts. But honestly, I did want to talk to you about my girl parts. Will they work? Not my ovaries.”

“Oh.” She hadn’t expected that. “Are you talking about your clitoris?”

She nodded. “If I fall in love with a boy, a man, can I have sex?”

Ah, now she understood why Noelle had been desperate to not have her father in here. She was sixteen. Lila was surprised this hadn’t come up. “Have you tried?”

“Having sex with a boy? No. My dad pretty much watches me twenty-four-seven, and when he’s not someone else is. And it’s not like there’s a boy I would want to do that with. I don’t know yet. I’m asking because I might want to someday, but what if I can’t? There’s this guy in my physical therapy group. He asked me out. I said no, of course. It’s too soon. I’m not looking to have sex with him.” She struggled for words.

Lila understood, and she was a woman who planned ahead. “But you want to know if it’s possible for the future because you don’t want to get into something that can’t possibly work.”

She nodded. “I know that sounds dumb.”

“That is the smartest thing I’ve heard all day. The short answer is you can absolutely have sex, but depending on what’s going on down there, you might have to make some adjustments. How do you feel when you masturbate?”

She went still.

“Sweetie, have you ever masturbated?”

“I’ve tried.” Noelle had gone a bright pink, but she soldiered on. “It’s hard for me to touch it. It. I mean my clitoris. I can’t arch my hips. I can move side to side, but not up. And my arms are freakishly short. It’s hard. I feel warm down there sometimes.”

“That’s normal when you see something that arouses you. Or you think about it. There’s nothing to be embarrassed about, Noelle. This is a normal part of life. Sex and intimacy are a necessary part of the human experience. It’s good that you have those feelings, because they’re normal.”