Sexual Services

There is a wide range of sexual services provided for disabled people in different parts of the world, and various provisions for disabled people to hook up with these services. Services are generally shaped around what the local law allows. We aim to cover the best examples here.

by Tuppy Owens

Tuppy2Low res

Until 2015, it has always been legal in the UK to buy and sell sex. Now, Northern Ireland has banned the buying of sex and there are often threats of this happening in other parts of the UK. Disabled people get very worried and upset. TLC was set up in 2001.

An idea of setting up an institute in London for sex workers to learn how to provide services to disabled people began as a result of the 2000 Sexual Freedom Coalition Conference I put on in London, entitled Let’s Start the Real Sexual Revolution. One of the speakers, a disabled man, James Palmer revealed his sadness at being a virgin in his mid 40s. When his speech ended, he was surrounded by a sea of loving arms, and a promise from the lesbian commune Rockbitch that he would be a virgin no longer.

A group of interested parties including myself, the founder of IUSW, the International Union of Sex Work Projects, Ana Lopes, Professor Petrouska Clarkson and James Palmer met in Petrouska’s Harley Street house to discuss the Institute. We were enthusiastic about starting TLC as an educational academy, which would raise funds to train sex workers and disabled people. A pilot study was launched and it became immediately obvious that sex workers are not at all willing to be told how to work. Nor were there likely to be any funds forthcoming. The group dissipated, and TLC was left with just a website and a skeletal team.

But, in fact, the website does the job. The disabled men and women find the sex workers all over the UK, and the organise their own arrangements. I ask the female clients to call me to discuss their needs and I suggest suitable service providers for them. The website provides guidelines for everyone.

It works incredibly well and was featured on television’s Helen House, with a young man with Duchenne muscular dystrophy, Nick Wallace, who was staying in a hospice run by nuns, hooking up with a TLC sex worker.

The website attracts wonderful sex workers from all over the UK who love working with disabled clients and some even only accept clients who are disabled. The only complaint we have ever received was from a sex worker about a disabled client! So I feel training is quite unnecessary, except for specialists such as Tantric practitioners and sexological bodyworkers.

Service providers put their profiles on the website, having viewed a template which I created to demonstrate the kind of language and detail we require. The profile is checked by Pru, who has been on the website since the beginning. She turns away people who sound unsuitable and unprofessional.

The website provides a wide range of advice to disabled clients, their carers and sex workers. Perhaps the most useful and unique is the guidance given to potential clients about what to expect from a service, as many people (disabled and not) have unrealistic expectations. It provides them with a list of questions to ask to ensure they acheive what they want.

The testimonies published on the website are extremely moving and help the reader realise the importance of this work.

We have had four webmasters and currently use the daughter of an old friend and colleague of mine, Gillian Ray. She is adding Tantric practitioners and sexological body workers to the list ot people providing services. This is a great addition. I was delighted to have been able to use three wonderful disabled designers for the new website.

Some of the sex workers say they are invited to speak at local homes and groups of parents. I have personally taken a sex worker to visit a college for students who are learning disabled – to meet the staff and governors. The governors failed to attend the meeting, and now I advice staff not to inform such people in advance on who will be in attendance so they actually meet a sex worker and learn what lovely people they can be. It is essential that the trustees and governors to give their (and sometimes the parents’) approval before the staff can allow sex workers to see their students.

One of our sex workers of the past, Ariana Chevalier was asked to speak in various establishments. She stressed the importance sex is for a person’s health (using a flip chart) and described her services. She made the suggestion “Just as a residential home or college for disabled people has written in its brochure “priest available to visit” so should it have ‘sex worker available to visit.”

Some have told us that the care workers of a client have been forbidden from opening the door to a sex worker by the local social services. We advice that the client hire a private care worker or advocate for the time the sex worker will be arriving.

TLC is proud that our service providers performed at the Royal Society of Medicine in London on 13th November 2008, to an audience who were moved to tears. Tantric sex worker Sue Newsome made love to quadriplegic Dominic’s head. He then spoke about why this has been so important to him. Having been promised help with sex at his spinal unit some 14 years previouus to this, which never came, it was through contacts in the Outsiders and myself, that he first booked a session with Sue. Sue talked about how important this work is for her, and their sessions are all about Dominic. Their performance was followed by Solitaire stripping for deaf-blind Jimmy, whilst the action was described to him via finger language by jj. Once more the audience were captivated. See
When the the Criminal Justice and Immigration Bill 2007 came out, and we saw that the buying of sex was to be criminalised, disabled people, academics and sex workers decided to demonstrate against this. Our demo took place in the sunshine on Tuesday 26th February 2008. There were cameras galore, with a TV documentary team and journalists fighting to interview demonstrators. Placards included “Don’t Disable My Libido” and “Disabled and Horny”. Women wearing Gordon Brown masks carried placards saying “‘We will do everything in our power that…the needs of disabled people are properly recognised’ Gordon Brown PMQs 23-01-07”. That afternoon, the clauses that would have banned people using sex workers were dropped from the Bill. The battle was over but sadly the war was not won.

Following this, we were applauded in the press: “Organisations such as The Outsiders and TLC (Tender Loving Care) do invaluable work to recognise the sexual needs of disabled people, and do what they can to help — campaigning in a pretty forthright way.”
Bel Mooney in the Daily Mail, 18th August 2010
In June 2008 I spoke at the UK Network of Sex Workers’ Conference in Manchester. My talk was about the sexual needs of disabled people and was very well received. Several delegates promised to take my stories to the Home Office. Catherine Stevens of IUSW spoke from the audience in support of TLC. I spoke again at the Sex Workers’ University Conference in Glasgow in spring 2014.
TLC gets many more hits than our other websites: around 200,000 a month, so I know there is much interest in this subject out there.

We are happy to include listings in other countries so long as there is local person to vet the new profiles.

Touching Base
Sydney NSW Australia

Touching Base Inc is a charitable organisation, based in Sydney NSW Australia, which has been active since October 2000. Touching Base developed out of the need to assist people with disability and sex workers to connect with each other, focusing on access, discrimination, human rights and legal issues and the attitudinal barriers that these two marginalised communities can face.

Currently, Touching Base does not receive any government funding. Volunteers, in-kind donations from organisations, membership and training fees and donations from the general public allow the organisation to continue to deliver services and resources to the community.

Touching Base is run according to World Health Organisation standards of respect. Its Committee of Management comprises of sex workers people with disability, representatives of Family Planning NSW, People with Disability Australia Inc, the Cerebral Palsy Alliance and other dedicated individuals offering a wealth of knowledge and expertise. The Touching Base constitution requires that the majority of positions on its Committee of Management are reserved for sex workers and people with disability, as are the positions of President and Vice President. This ensures that there are no barriers to peer representation, even at the highest levels of the organisation.

In 2014 Touching Base was honoured to introduce five eminent Australians as patrons. They include two of Australia’s most well-known human rights campaigners, The Hon. Michael Kirby AC CMG and Eva Cox AO, along with esteemed academic researchers Professor Basil Donovan and Associate Professor Helen Meekosha, and Peter Woods OAM, an elder statesman in the area of Local Government within NSW, Australia and internationally.

Touching Base is involved in a wide range of activities including:
~ Researching the attitudes of disability service providers towards supporting people with disability to access the sex industry
~ Marching in the annual Sydney Gay & Lesbian Mardi Gras Parade.
~ Creating an accessible website to provide information, support and resources
~ Developing training workshops for sex workers: Professional Disability Awareness Training (PDAT)
~ Developing training workshops for disability service providers (carers / health care professionals / parents): Service Provider Awareness Training (SPAT)
~ Creating a referral list of willing & experienced sex workers, and accessible sex industry establishments.
~ Presenting at numerous conferences, lectures and workshops.

The work of Touching Base was also featured in Scarlet Road (2011), a documentary that followed one of the co-founders, Rachel Wotton and her clients with disability (

SPAT workshops are aimed at service providers and carers to allow them to explore the issues they may face when assisting people with disability to access the sex industry. For many participants, the workshop is the first place they have ever met a sex worker or spoken openly about sexual matters in regards to people with disability.

PDAT workshops are specifically for experienced sex workers who are wanting to upskill and increase their knowledge and understanding of the issues people with disability may face. It also allows them to learn aspect of how to best meet the needs of clients with disability. Some of the topics and issues discussed include history of people with disability, values and attitudes, communication, medical aspects, access, occupational health and safety, the role of parents and carers in the lives of people with disability & legal issues.


Asger Persson, Denmark

Handisex deals with all aspects of the sexuality of people with disabilities, their families, support staff, and professionals. They have vast experience in assisting people with disabilities to manage and express their sexuality in a natural and practical manner, as well as preparing professionals to govern the sexuality of their clients, patients or citizens within the legal boundaries of their field. Handisex was founded by certified sexologist and massage therapist Asgerbo Perrson in Denmark in 2010, but due to the fact that sexuality is a universal need, their knowledge and expertise is increasingly in demand internationally.

In 2011 they won the “The Flying Penis” Erotic Award for innovation of the year for their assisted masturbation technique – a hands-on approach helping physically disabled achieving sexual pleasure through sex-toys.

Asgerbo explains: “During my study of sexology, I met a 25-year-old woman. The woman is just like most women her age with passion and desires – except she hadn’t had any sexual experiences for the last six years. Not because she didn’t not want to, but because muscular dystrophy, had disabled her possibilities for sexual pleasure – including masturbation. Her frustration and unmet needs made a strong impression and presented the question of how to deal with this situation as a professional. Abled bodied people can at least masturbate if so desired – disabled people should at least have that opportunity too. So I decided to start Handisex to give people with special challenges the possibility of an active sex and love life.”

But is not an easy task with simple solutions. Creating equal opportunities raises many practical, ethical and moral questions. At the moment disabled people all over the world are either forced into involuntary celibacy or rely on prostitution. So what do we do, how do we do it and who does it?

Asgerbo: “Sexuality is, of course, much more complex than assisting someone in achieving an orgasm – which can be complicated enough. Sexuality is inborn and does not go away just because someone has a disability. It is a strong desire in some people and part of life fulfilment which can lead to abuse and inappropriate acting out on caretakers, fellow disabled people, children and others if these needs are not met or ignored. Different issues require different approaches. Behind any unwanted behaviour is an unmet need – so it is all about exploration of what the person really need and how to fulfil it.”

One of the tools to experience ones sexuality without actual sex is massage therapy and tactile stimulation.

“It is a great tool and is for everyone – including those bodies that don’t quite fit into the socially accepted stereotypical ideal of beauty. The need for nearness, intimacy, connection and not least caring touches are basic needs in any human beings. Body language is the first language we learn and the last one we lose. Sometimes we just forget to listen – or rather feel – what we need, what we miss or lack and what we don’t feel like,” says Asgerbo.

Some people prefer massage to seeing a sex worker, as there is a taboo about sex work in Denmark, even though it is legal. Guidelines have been changed and now health professionals are allowed to refuse to support disabled people to buy sex.

Asgerbo believes that we have a societal and professional responsibility to address the needs of people with disabilities and our mission is to ensure that people with disabilities, the elderly and the sick, have equal opportunities to live out their sexual needs, in a way that enhances the quality of life for the individual and in a way that does not harm others or themselves.

What started out finding an acceptable solution to a practical problem – how to get sexual release if you are too disabled to manage it yourself – has now expanded into a more complete approach on human sexuality.

For people with disabilities:
Assessment of sexual needs
Sexual guidance
Sexual training
Sexual education
Intercourse and masturbation assistance
Sensual massage

For professionals:
Disability and sexuality
Working with sexuality
Law, rights, and duties
Identifying clients’ needs
Boundary setting and abuse
Practical sexual assistance
Sexual policies

For elderly & people who are sick:
A sex life with illness
A sex life regardless of age
Overcoming psychiatric challenges
Overcoming physical challenges
Couple counseling

You can read more on handisex here (in English also):

Phone: +45 30 13 18 11

Examples of his work:
Case 1 – A female client in her 50’s with multiple sclerosis had never had an orgasm. Asger worked with her using a sex aid which he had to hold in place. During the first session she was able to have one orgasm, then multiple orgasms for a whole hour, during the second session. This showed that her sexual centre was still intact even though the rest of her body had been affected by her condition.

Case 2 – A couple with cerebral palsy who were gay and into fetish wanted help with their sex life. The couple didn’t want others to know about their sex life. Asger was able to work with them to help fulfil their sexual needs.

Case 3 – A young man with cerebral palsy could have an erection and ejaculate but could not feel the orgasm. However Asger helped him discover that he could feel an anal orgasm using a small vibrator.
Case 4 – A male who got regular erections but did not want to touch himself. Asger showed him how to use an aid called a ‘fleshlight’. This was attached the wall by suction, and he could relieve himself without touching his penis.

Working with people with cognitive difficulties:
Denmark has sexual counselling for people with disabilities which includes guidance on helping people with cognitive difficulties to masturbate.

Asger worked with a client who had mental age of 4. He was trying to masturbate but was making his penis sore. He had very little language apart from four signs. Asger showed him lots of Danish films with sexual content. He also had a dildo with a foreskin so could show him the correct grip to masturbate.

Sexwork – a Caring ProfessionMattatLotusFaceShot1


Hello you, I’m Matt-at-Lotus, a strange name but it rolls off the tongue. I work in Manchester and London mainly and have been in the business – the sex industry – for coming up to 24 years. I do other stuff too, from therapy and counselling to intuitive healing and writing.

I have believed for many years now that sexwork is a caring profession. Often when I share this view it will be met with a raised eyebrow but that doesn’t stop me shouting it from the rooftops. Many sexworkers, regardless of whether or not they have other qualifications that inform their work – are natural healers. When you make love to someone, when someone touches you in an erotic and sensual way – you are healing.

How do you feel after an orgasm? (And remember you don’t have to ejaculate to orgasm. It’s different for everyone). This is a form of therapy in my opinion and before I go into the specifics of how I work, I really want to get the point across that there seems to be a sanitisation going on right now within the sex industry, workers are emerging with qualifications in sexology, sexual surrogacy and sexual massage and insisting that they are ‘not prostitutes’. I really want to tell you that prostitution is a valid profession with a caring element. Right, I’ll get off my soap box now and tell you how this job works for me….

When I first started in the business I worked in a gay brothel in Shropshire. It was possibly the only brothel for men who have sex with men in the country. A gay brothel is very rare. It wasn’t the best start in the business: I was paid very little and allowed myself to be exploited financially. I compare this to friends who have started work in McDonald’s when really they wanted to be a restaurant manager. It is important to compare the pit falls in prostitution to other occupations because otherwise we are in danger of reinforcing the stereotypes and stigma so often associated with the job. The point here is not about the bum start, it’s about how I worked in that brothel.

One day a middle aged gentleman came to the brothel to have a sensual massage. I was the chosen one to provide this so I took him into the massage room and gave him what he had asked for. This developed into sex, as it usually does. After his climax he snuggled into my chest and began to tell me about the death of his wife and how he felt lost without her. This then led, way before my training in counselling, to me giving him some tips and advice on how to process grief, how to enjoy his body and sexual needs without the guilt and also I gave him the names of some natural remedies that help to support someone through bereavement.

Fast forward to now: I market my business based upon the tagline because everybody needs to be held™ and although this is in part my business identity – no different from any other business identity such as ‘I’m Lovin’ It’ associated with the fast food chain – this runs much, much deeper and is very close to my heart. When we are touched there is so much going on emotionally, psychologically and bio-chemically. When I say bio-chemically all I am referring to are those happy chemicals that we all need to feel good. Being made love to, well: wow. The happy chemicals get aroused and then begin to course around our bodies like a very welcome sunrise.

Sexwork comes in many forms – from social escorting (where the client employs the escort to accompany them to dinner, events etc.) to hands-on sexual massage to escorting of a more personal nature or a full on BDSM (Bondage Domination and Sado Masochism) session. Whatever works for you and whatever you need to experience a release. It’s all healing when used properly.

Sure, now I have some qualifications and I even managed to do some nurse training along the way. I only consider these though, to inform my practice as a sex worker. I may know a little more about chemistry, I might perhaps notice when a client needs a hug rather than sex but any good sex worker will also know this. An experienced worker will be deeply intuitive. This is why you feel safer with a worker who has been around the block and who goes into more detail – on their website or online profile – about how they work and who they work with.

I’m not a great fan of making a big issue about working with disabled people. A great worker works with every – body. That includes yours and whilst being disabled might be a part of your identify – you’re human first yes?

We are all human and we all need to be held.

This is the start and end point to any session I do. Whether I am working as an escort, a sexual masseur, a naughty dom (dominant role in role play), a cheeky coach or qualified therapist – it’s all the same thing. It’s all done in absolute recognition that I am no different from you from the standpoint of needing human affection.

I passionately believe that many professional sexworkers approach their jobs like this.

I could have used this article to really big up my own business and tell you how fabulous I am, but I am just one golden sparkle within a mass of beautiful stars.

Prostitutes get a bum deal in many avenues in society and the world so to do this job we need support, solidarity and a whole heap of confidence. The by-product of this is that you, the client, reader or curious soul, get to join us in our solidarity. You get the chance to feel, to truly experience what it feels like to be touched. Even words can touch. They can stimulate and arouse.

However your need to be touched will be unique to you. I am humbled to have helped thousands of clients to find their own sexy buttons, erotic centres and emotional hugs. Here’s yours now – Hug! xXx

NB: Some details have been changed to protect confidentiality.

Matt-at-Lotus is based in England, where the sale and purchase of sexual services are legal. He can be found at:

Sexual Surrogacy
by Kendra Holliday

St Louis, MO, USA


I am a sexual surrogate working independently, as well as in conjunction with four local sex therapists. A sex surrogate, or surrogate partner, is a sex worker who provides hands on intimate therapy to people who wish to address issues surrounding their sexuality.

These issues may include lack of experience, a disability that interferes with activities of daily living, overcoming past trauma, life transitions, and sexual dysfunction and training.

Sex work is technically illegal in the United States, but there is a grey area when it comes to sex surrogacy. It is helpful to partner with a licensed therapist and ensure you are providing sex therapy, not entertainment. There should be a treatment plan and goal in place.

Some sex surrogates are trained or certified through programs such as IPSA, but I prefer to work independently and make my own decisions. I follow my own set of ethical guidelines, which include the following:

Treat each person as an individual.

Leave people better than I find them.

Review each situation on a case-by-case basis.

Be open and honest.

Operate on mutual respect.

Client examples:

60 year old virgin with a head injury – lack of experience

38 year old virgin with sickle cell anemia and kidney transplant – he was curious to know his stamina and capability

27 year old man with muscular dystrophy who was told by doctors he would die by age 21. When he did not, he decided to explore adult options

35 year old man with muscular dystrophy who wanted to gain sexual experience for future partners

40 year old man with schizophrenia who wanted to work on social interaction

65 year old diabetic amputee with Erectile Dysfunction who needed to practice penile injections

55 year old man who had spinal surgery and lost ability to orgasm

32 year old man with Asperger’s who wanted to learn dating skills

58 year old transgender man who wanted to practice using his neophallus

27 year old woman who has never had an orgasm

56 year old prostate cancer survivor who needed to learn a new approach to sex

38 year old man with essential tremor who wanted to gain confidence

For each of these cases, I regarded each person as an individual, on a case-by-case basis. I found beauty in every situation and practiced with patience and compassion. I helped eradicate shame and taught my mantra: Replace the fear with love.

Most of my teaching is verbal communication of ideas new to the client, but the physical component of our work together offers a quicker and more significant breakthrough, giving them the experience and confidence they are seeking.

In addition to client work, I am co-founder of Sex Positive St Louis (, a local organization that provides sex-positive education and events to our community. Topics include Dating with Autism, Sex-Positive Caregiving, Sex and Disabilities, Sacred Intimacy and Tantra, Cancer and Sex, and Living with HIV. We host clothing optional events that promote body acceptance.

I’m also Representative of Sex Workers Outreach Project USA, St Louis Chapter. SWOP-St. Louis (


Tantric Practice and Sexological Bodywork
by Sue Newsome

Hello, I am Sue Newsome and towards the end of my successful career in IT; I studied transpersonal psychotherapy, re-trained as a counsellor and explored Tantra for my own personal development. My quest for greater understanding of intimacy also inspired me to investigate traditional practices including Taoism, Native American Sacred Sexuality and Bio-energetics. I started Shakti Tantra with my colleague, Hilly Spenceley in 2001 and, as one of the leading UK Tantra schools, we offer self-development programmes that focus on all aspects of adult intimacy and relationships. In 2002, I fully stepped into my second career as a tantric practitioner and qualified as a sex therapist in 2012. My work is blend of the western theory of sexology with practices from traditions such as Tantra. More recently I have been involved in mentoring and teaching other professionals in the field of sex, relationships and bodywork.

I passionately believe that being sexual is part of being human. We all have the right to sexual satisfaction and pleasure with ourselves and potentially with others; irrespective of age, ability, appearance or sexual preference. Physical impairments we are born with or develop through injury or age do not have to affect this fundamental right.

Good quality education about intimacy and sexual pleasure is almost non-existent in our mainstream education system which means that increasingly people are believing what they see in the media and pornography is what they need to aspire to. Consequently, many people have very unrealistic expectations about sexual function and performance and are left feeling inadequate or inept. The popularity of Tantra has increased in recent years as we seek useful teachings and practices that can help us navigate the complexities of intimacy and sexual satisfaction. Tantra brings us fundamental knowledge relating to how we can firstly connect to our own sexual pleasure and then choose how we wish to express and enjoy this in our life.

Tantra originates in the east, pre-dates most western religions and its teachings have been translated and adapted to suit modern lifestyles. A fundamental concept from Tantra is being totally present in each moment which means letting go of performance goals and this acts as a powerful antidote to our goal-oriented view of sexual activity. The digital age considers the mind as superior which can create a disconnect from the body. Tantric practices encourage us to celebrate our physical body and connect to our physical response so that we can expand our arousal. This allows us to stay in our pleasure for longer and experience altered states of consciousness which opens up the possibility of sex becoming a spiritual experience.

There are some aspects of Tantra that have specific benefit for people with disability and can help men, women and couples who are struggling to explore the possibilities of sexual pleasure and intimacy. By letting go of the goals of erection, orgasm and intercourse; we can be creative in our exploration of pleasure including the vast realm of sensual eroticism. We replace the ‘P’ of performance with the ‘P’ of pleasure. For example, Tantric practice includes a structured sensual massage which is designed to encourage relaxation and to awaken the sensual response throughout the whole body. This allows for an expanded experience of pleasure which is not dependant on the genitals or breasts, includes primary, secondary and tertiary erogenous zones and can lead to the sensation of a full-body orgasm.

In the UK a number of students of Tantra are now working as tantric practitioners and this provides opportunities to people with disability where they can explore the possibilities of their pleasure in a conscious and responsible manner. At the moment, Tantra is unregulated which means that it is important to find a reputable practitioner or Tantra school.

Further professional trainings that are available in the UK in the field of sexuality include Sexological Bodywork and Psychosexual Somatic Practitioner Training (PSST) – both of these are focused on helping people overcome any blocks or trauma to their sexual expression and enjoyment. In both Sexological Bodywork and PSST, the practitioners engage in one-way touch and remain clothed. An exciting development is that there is now a governing body for all professionals offering bodywork (i.e. touch) as part of their service. Practitioners can join ASIS which means that they can get full insurance cover for their work and there is a code of ethics which aims to support both clients and professionals.

Some practitioners include sexual surrogacy in their practice which gives a developmental or educational intent to the sessions and as part of this, the practitioner and client may engage in sexual activity. Surrogacy usually extends over a number of sessions and generally induces education, skills practice and pleasure! One of the potential risks of intimate work is dependence and attachment and it is important that this is discussed openly in the sessions rather than being ignored. There are different models for surrogacy; one involves a coach/therapist managing the session with the client and surrogate, and another model is where the client works with a surrogate partnerand periodically reviews this work with a sex therapist or coach.

My experience of working with people with disability has required me to draw on all my skills and resources, and it has been and continues to be immensely rewarding. I have learnt that it is necessary to ensure that the client has full capacity to consent and that it is necessary to adapt to the client’s practical environment and, as part of this, it may be necessary to build a relationship with the care team. My experience includes working with clients with spinal cord injury, cerebral palsy, amputees and Parkinson’s, and I feel that communication is an essential aspect to this work. My policy is to establish an agreement to include the following:

  • The agreed intent for the session
  • What each person is happy to do and what is outside of what they are happy to do
  • How communication will happen during the session
  • That all parties will take responsibility and communicate (yes, no, pause)
  • Practical considerations regarding mobility, special equipment etc
  • Hygiene and safe sexual practices.

One of my first experiences of working with a person with disability was a man who was paralysed from the neck down and needed a ventilator to breathe. We spent a number of sessions getting to know each other and establishing our communication practice before we developed the multi-sensory experience which allowed him to experience touch that had the intent of pleasure and gave him the opportunity to really explore what delighted him. Ultimately he was able to experience an orgasmic response as a result of having his ear lobe touched in a specific way. He emailed everyone to tell them the wonderful news! It was a happy ending to his life, as, soon after that, he passed away. Another of my clients with profound disability said that, as a result of our work, he felt normal. I also worked with a female client who was paraplegic and, since the insertion of a supra-pubic catheter, she no longer liked her genitals. With my support, a mirror, use of photographs of females’ genitals and discussion, she came to accept the appearance of her genitals.

More recent work has included supporting couples with cerebral palsy find ways that they can enjoy intimacy that minimise their physical discomfort.

by Peiyu Kuo

COSWAS (The Collective of Sex Workers and Supporters) was formed by sex workers and supporters in Taiwan on 1st May 1998. The majority are core members of the Taipei Alliance of Licensed Prostitutes (TALPS), which was established in 1997 when the city mayor suddenly abolished Licensed Prostitution.

In Taiwan, up to 85% of people with disabilities live with their families, 10% stay in institutions and only 5% live on their own. The state tends to push the responsibility of care into parents and family, and all the services and resource are subsidiary – only designed to supplement the primary caregivers, and certainly not encouraging, or allowing disabled people to become independent and self-sufficient.

The sexuality of disabled people is highly suppressed in this situation. Caregivers and professions don’t tend to see them as valid sexual beings but as either children or patients, which makes it hard for them to express sexuality freely. Disabled people also have little hope of getting a decent job with the income to enjoy a romance. However, even paying for sex services is not allowed morally and legally because sex trade remains illegal in Taiwan. Multiple constraints have aggravated their plight. This is the reason why COSWAS not only fights for sex workers’ rights but works with the disabled community by connecting disabled clients to sex workers and facilitating the dialogue between the marginalized – sex workers and disabled people- and the broader society.
COSWAS started working with the disabled community in 2006, beginning with an experiment of ‘translating’ pornography for blind people. Since then, COSWAS have held forums, film festivals and workshops for/with disabled community, and worked with social workers as well. COSWAS began connecting disabled clients with sex workers in 2010.
A the only form of sex work activism in Taiwan, COSWAS has been campaigning for changes to laws and policies that persecute sex workers because of social stigma and political repression. COSWAS also works directly with and organises sex workers on a daily basis to fight for the rights of sex workers and the recognition of their work as work in order to improve their working conditions.
COSWAS fights on behalf of not only sex workers but also those who have experienced repression around sexuality, such as disabled, gay and lesbian people.
For more information about COSWAS, visit our website:

Sensual and Sexual Assistants in Europe
Sheila Warembourg, France

My involvement in sexual assistance has come out of my work during the last 18 years supporting disabled people, their families and care workers to pay better attention to disabled person’s intimacy, relationships and sex lives. I was aware that some adults with disabilities are not able to enjoy the sexual pleasures they desire. At the same time, I was meeting many generous people who would like to offer themselves, heart and body, to those with disabilities.

I describe here the principals used in several associations in French speaking Europe, that is France, Belgium and Switzerland. They are:

SEHP – Sexualité et Handicaps Pluriel, a Swiss association that trained a group of 10 men and women that were certified in 2009. In 2015, 6 women sex-workers were certified in a shorter version of this training programme. See

Corps Solidaires, a Swiss association composed mostly of certified sexual assistants. Based in Switzerland, CS trained and certified 2 men and 7 women (from different European countries) in 2015.

Corps Solidaires in partnership with a French association, CH(s)OSE, will offer a certification training in 2016-2017. The selection process for candidates has begun. See or

These associations guide the selection, training, sexual assistance ethic stance, post-training support of sexual assistants and consultation and information to people with disabilities or potential clients. These principals are adhered to despite the differences in legal framework that each country may have.

1. Selection of Sexual Assistants :

The selection process starts with the candidate applying. Only once the motivations and understanding of the activity are clear will an application form be sent.

We ask that candidates
– Be over 25 years old,
– Have physical and mental health compatible with the sexual assistance activity,
– Have financial revenue equivalent to a part-time job,
– A clean judicial slate,
– And have spoken with their partner about their wish to become a sexual assistant.

The candidate must fill out the application form asking general personal information.

Once the application is accepted, a first telephone contact is made with one of the training team. The next step will be a face-to-face personal interview. If the training team has any doubts, a second telephone contact or face-to face interview can be requested. Only after all of these procedures have been met will the candidate be accepted for the first weekend of training. The first weekend is called “preliminary” and will give the training team and the candidate the chance to express our desire whether to continue together or not.

The training is organised in two phases, the first being more theoretical and the second more practical.

The cost of these long training programs has been approximately €1700,00 per person.

2. Training

The whole training process lasts 12 to 15 months, with 5 or 6 workshop weekends (detailed later), reading or film reviews, 4 or 5 half group telephone or Skype conferences and a final oral or creative presentation – approximately 200 hours of professional training.

Yes, we can all agree that the selection and the training process is long and requires a very important amount of personal investment. This is our “guarantee” that we have motivated and competent sexual assistants who we can count on as they go on to work independently.

The selection and training process assures the security of the sexual assistants and the security of the adults with disabilities who will call on their services.

Training weekend content. The three associations adhere to our standards.

Each association has its own combination of professionals who intervene during the training, but all use combination of the following professionals : experimented sexual assistants (peer to peer training), sexologists, psychologists, professionals specializing in in different types of disabilities, and the medical-social environment that they live in, lawyers and professionals able to share their knowledge – the lawyer makes sure that everyone is very clear with what French and Swiss law say about prostitution, vulnerable populations, parents rights (or not) over their adult children, etc. and experts in massage – erotic massage – intimacy and sexuality techniques.

Theoretical training times are mixed with more hands-on physical and technical practice.

We have seen that the long training process allows for the future sexual assistance to question their motivation, evolve with their partner/family/friends, so that their work is understood by those who’s close support is important, and better understand the needs (sexual and other) of their disabled clients.

It is my personal conviction that a training based on anything less in time and content cannot assure competence and security for all concerned.
3. Ethics :

All certified sexual assistants agree to a certain number of ethical standards.

– Mutual respect for the autonomy, liberty, confidentiality and fundamental rights, and one that respects the special needs of those with disabilities.
– Not to work alone. To be connected to an association or group of associations.
– Not to work with an aim of making money, and to respect the time and financial compensation encouraged by the affiliated association(s).
– Have your own financial resources so as not to be obliged to live off of sexual assistance practice.
– Know the judicial framework of the country you practice in.
– Have knowledge of different impairments.

Sexual assistants are paid compensation for their service. The service is based on a fixed time together – usually 1.5 hours for €100,00 to €130,00. What will happen or not during this time is based on the agreement between the sexual assistant and the client. There is no obligation to perform by more money being added.
4. Post-training support

At different times of the year, all our successful candidates are given the opportunity to discuss specific situations they have experienced, how improve their services , and expand their knowledge of massage and erotic massage techniques, sex-toys, and how to help people transfer from their chair to bed, bed to wheelchair, toilette, floor, etc.

All of our associations also offer e-mail or telephone support of sexual assistants at any time they need it.

5. Consultation or potential client support

We actually call clients ‘beneficiaries’ but I use the term client so that I am more easily understood. We actively match the best sexual assistant with the client. First, we meet with the client to discuss the possibilities and limits of sexual assistance and then puts the client in contact with the sexual assistant who seems best suited to respond to the particular request.

We are often contacted by parents, social workers, and special education professionals who think that a disabled person they know could benefit from the services of a sexual assistant. In most cases, we quickly contact the potential client, to ensure that it is, indeed, the disabled person who wants sexual assistance and not someone else deciding for them.

We are also available for the client after the sexual assistance experience, if they feel the need to discuss. For all concerned, this is not an obligation, and the support is done in the most confidential and respectful manner possible.


Thanks to the engagement of competent professional trainers (very often who’s time was given on a volunteer basis to reduce costs), well thought-out programmes and the perseverance of those being trained, I am very proud to witness very high quality, respectful sexual assistance… and very satisfied clients !

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