Disabled people: sex therapists


by Vanessa Charles


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Nina de Vries, 42, has been travelling or receiving guests in her own home for many years. She provides erotic sensations to people with physical or mental disabilities. She massages, caresses, kisses and embraces people who are able to do the same with her, bringing them pleasure and even orgasm through masturbation. Penetration and fellatio are excluded from the services of this sexual assistant, whose services are subject to a fee.

Disabled people have the right to a sex life

When it comes to sexuality, the mentally challenged person doesn't do less, they do it differently," writes psychologist Denis Vaginay. Neither angel nor beast, but profoundly human, they have the right to fulfill themselves by living their sexuality to the full. This reality should no longer be disputed. Breaking a taboo, the Zurich branch of Pro Infirmis has asked Nina de Vries to train sexual assistants.

This profession has existed for years in Holland, Denmark and Germany, where associations put disabled people in touch with women capable of relieving their sexual needs. These are volunteers from the medical professions (nurses, care assistants), who have been sensitized to the problems of the disabled. They are trained to kiss, caress, undress or massage disabled people, who can also call them for a simple chat or a purely sensual relationship.
In Holland, these professionals go as far as full sexual intercourse. Health insurance reimburses their services at a rate of two sessions per month. Rates are around €120 per hour.

Intimate experiences

Based on the premise that people with disabilities are often at a disadvantage when it comes to sexuality, Pro Infirmis Zurich has decided to follow these examples and train sex assistants to work independently, offering intimate, sensual and erotic experiences to people with disabilities in return for payment: not only tenderness, but also body contact, advice on masturbation, sexual games and erotic massages.

Disabled people, especially those with mental disabilities, have few opportunities to discover, explore and experience their sexuality. Many obstacles stand in the way: insufficient mobility, limited communication skills, lack of information...

To help them live better, Pro Infirmis Zurich has developed a range of services: advice on sexuality, documentation and teaching materials, courses on love and friendship, and surprise parties. One of these offers is the training of sexual assistants. By the end of 2003, 8 to 12 of these people were working independently in the canton of Zurich. Preferably working in a profession related to the body, they were selected in advance and trained by Nina de Vries during an 18-day course. Ms. de Vries' many years of experience have enabled her to design a training program that prepares candidates for their delicate task with great care and sensitivity.

Coached and supervised

These sexual assistants will be coached and supervised. They undertake to provide the services agreed in advance at a fair price, to maintain a professional distance from mentally handicapped customers and to devote the necessary time to providing these services. Pro Infirmis asks them to be able to relate to people with disabilities on an equal footing, and to adapt their behavior to take account of the particular needs of people who think, feel and function differently.

Their addresses will appear on a list which the Zurich association will provide to interested parties on request. Another list containing the contact details of prostitutes will be made available to those wishing to have full sexual relations. This list will include prostitutes who comply with the rules laid down by Pro Infirmis.

What do parents, institutional managers and specialists think of this type of service?

For sex educator Catherine Agthe, direct sexual help is welcome. But it's only one of a number of offers, and can only be made on a case-by-case basis. The majority of disabled people live their sexuality for themselves or with a partner, and by far not all of them want this kind of service. Nevertheless! For the few who could benefit from it, because they experience a severe lack of physical contact, are unable to masturbate, or self-mutilate through masturbation, etc., it's a good idea to take advantage of the services offered.
The services provided by sexual assistants can contribute to a sense of well-being.

To trust

The sex educator is currently piloting three relationships between disabled people and prostitutes. Even if this goes well, it will always be preferable to use professionals trained in the fields of disabilities, relationships, sexology, sexual abuse and ethics, able to respond to specific needs with sensual and sexual approaches different from those, fairly direct, of prostitutes.

Is there a danger that the person with a mental disability will fall in love and not be able to handle the relationship?

There's no such thing as zero risk in this field, because that's life. But sexual assistants will be trained and competent to manage the relationship. And we could also sometimes put a little more trust in the disabled person, because who owns his or her desire? The disabled person, his parents, his guardians, his educators, the management of the institution? This raises the whole issue of the latter's dependence, and that of the third parties involved, with their values, morals and fantasies... It's often around the third party that all the fears, resistance, denials and silences nest.

Ms Agthe hails Pro Infirmis Zurich's "innovative and courageous" initiative. In French-speaking Switzerland, many people are thinking about these individualized offers, but few dare to talk about them. There is a growing awareness among professionals, and the stir caused by the Zurich breakthrough is helping to advance the cause. Even though enormous progress has been made in the last 20 years, it will still be some years before the usefulness of sex assistants is recognized here too, and institutions open their doors to them.

No to sex tourism

La Farandole, in Fribourg, accommodates 36 adults aged 18 to 60 with moderate to severe mental handicaps, in two homes, three apartments and one studio. The residents' right to sexuality is recognized. In fact, this is one of the quality criteria for obtaining OFAS subsidies. Homosexuality is not a problem, as long as the relationship is between two consenting people. Neither does masturbation, as long as it does not turn into exhibitionism and is practised in private.

All La Farandole residents of childbearing age voluntarily use contraception, whether or not they have sexual relations. The risk of pregnancy is to be avoided at all costs. The management did not object to a resident's desire to visit a prostitute he was paying for himself, but would not have tolerated the lady visiting him in the institution. The man in question had previously been duly informed by family planning and knew how to protect himself.

At La Farandole, we do not accept "sexual tourism" or "butterflying". One adult had to leave for another institution because he was forcing sexual relations on young women unable to defend themselves. On the contrary, we prefer stable partnerships. In fact, the studio is designed to accommodate a couple. It is currently occupied by two men, as none of the couples formed go beyond a few kisses and "I love you's" exchanged in front of the television... The institution works closely with the family planning service. The role of the educators is limited to detecting needs and reporting them. At La Farandole, we remain cautious about the "experiment" carried out in Zurich with sexual assistants. At present, no one in this institution would need their services. If this were to be the case, it would be necessary to establish a framework for their intervention and draw up a precise charter with them.

Don't whet the appetite

Marc, 33, has Down's syndrome and lives in one of La Farandole's homes. His mother is convinced that he is not sexually frustrated. This man is content to satisfy himself in his bedroom, and everyone respects his practices and privacy at such times. One or two friends from his household say they make love "on the mouth" with their girlfriend when they kiss her, but this friendship doesn't go beyond that. The needs of these people are not huge and do not extend to a full sexual relationship. Marc's mother would have nothing against her son having sex with a mentally handicapped person, provided they formed a stable couple and respected each other. If necessary, she would like to be informed and participate in the supervision of this relationship.

This mother condemns the initiative taken by a father who took his son to see prostitutes. In her opinion, we mustn't arouse desires and needs that don't exist. Introducing pleasure in this way runs the risk of whetting appetites that can later turn into obsession and addiction. It would also be wrong to overestimate the needs of the mentally handicapped, says our interviewee.

"I couldn't pay someone to have sex with my son," says Marc's mother. And the same applies to future sex assistants. At the very least, she could envisage using the services of these people for slightly handicapped people capable of discernment, able to express themselves and assess the situation. In this case, the intervention would have to be carefully prepared in conjunction with the psychologist, the various parties involved and family planning, not forgetting the parents. For the others, the risk of abuse seems too great. The mentally handicapped person will become attached and fall in love, because he or she won't understand that the good done to him or her is merely a paid service... Why go so far when many people with Down's syndrome are content to hold hands?

Prohibited to touch the breasts

Institution Homato, les Buissonnets, Fribourg. Some thirty severely disabled people of both sexes, aged between 18 and 38, live in total dependence in five apartments. Some of them have sexual needs, which they try to satisfy, often awkwardly, by masturbating.

How should an educator react when he sees that someone is hurting himself by masturbating and not getting his way? Should they help? If a resident were to ask to be masturbated - which has never happened before - we'd have to discuss it," say our contacts.

At Homato, questions relating to sexuality are discussed with parents and dealt with in collaboration with family planning. It's important that residents don't associate educators with physical pleasure. Certainly, affectionate bonds are formed on both sides and are necessary for daily care. The educators are often asked to cuddle, but they have to show by a clear physical attitude coupled with a verbal denial that certain gestures, such as touching the breasts, are not allowed. This is because educators have no business getting directly involved in residents' sexuality.

Taking parents' opinions into account

Could this be the role of sexual assistants from outside the institution?

Homato's managers are not convinced. They fear that the mentally handicapped person will misunderstand the true nature of his relationship with the sex therapist. People up to the age of three are unable to tell the difference between a pure service and love. To avoid falling into emotional dependence, it would be necessary to clearly separate physical pleasure from lovemaking, something which the Homato residents, according to the educators, are unable to do. Clearly, the new Pro Infirmis Zurich service does not meet the needs of people with severe multiple disabilities, according to our interviewees, who would like to know more before making a final decision.

When it comes to sexuality, Homato's managers always take parents' opinions into account, even if their child is an adult. Nothing is undertaken that would go against their values. Their trust in the institution is at stake. Sometimes, however, we need to have serious discussions with them. For example, when they want their child to take a drug that prevents all erections, because they cannot morally accept that their child should satisfy himself.

You may also be interested in

Ben Lewin's 2013 film release "The Sessions: see the trailer.

The film is based on the true story of severely disabled author Mark O'Brien, who survived polio as a child thanks to an iron lung and is now in a wheelchair. In his late thirties, he chose to consult a surrogate sex therapist in order to lose his virginity. John Hawkes plays Mark, and Helen Hunt deftly plays Cheryl, the extraordinarily sensitive and gentle therapist. William H Macy is Mark's Catholic priest and confessor, who cheerfully advises him to opt for the services of a sexual surrogate.

Vanessa Charles

A (very) close friend of Cupid and a true lover of relationships of all kinds, I am the main editor of Give Me Date. I answer your questions about couples, sexuality and dating and I test dating sites to give you a subjective opinion on how to find love or meet new people.

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