Long Nights & Intimacy Rights Part 2: An Even More Detailed Look at Sex Rights for the Disabled

The following article is a follow-up to a previous article I published on Valentine’s Day 2016. You can find that article here.

Is Sex a Right?

“I need to be touched for pleasure, not just for function.”

partner kiss couple love sex therapy sex rightsIn 2013, Anne Marie Dickelé, a psychologist, and a member of the French National Ethics Committee argued that sex cannot be seen as a right that belongs to all citizens of France, for if it’s a right, then the government has a responsibility to protect and provide for its expression. This isn’t possible, she argues, since paying someone to engage in any kind of sexual contact is apparently unethical and degrading. You can find her statement in this video, which was part of a larger NY Times article about the situation in France. In the video, a paralyzed patient discusses the challenge of not even being able to masturbate. The girl in the video says, “I need to be touched for pleasure, not just for function.” Without a sexual partner, such individuals may otherwise never experience sexual pleasure throughout their entire lives. Is sexuality a fundamental human right? If so, what is the most appropriate way to provide people that right? These questions, however, tough and uncomfortable, must be presented to society and it’s policymakers. It is these questions that a bold and revolutionary new group of sex therapists, descendants of the ideas of Masters and Johnson, aimed to answer with Sex Partner Therapy (SPT).

It Takes Two to Tango

Addressing issues of sexual and/or intimacy dysfunction can be very difficult. Most sex therapy involves the dissatisfaction couples experience when attempting to be intimate (McCombs, 2016). However, not having a partner to explore these issues poses an exceptional challenge. Especially if the patient has a significant handicap, such as paralysis, that severely inhibits them from meeting partners and having intimate relationships. As such, a revolution exists that is attempting to evolve sexual psychotherapy into something that goes beyond a sympathetic ear, psychoanalyzes, and compassionate advice. This revolution has a name: Sex Partner Therapy (SPT), and its nothing like prostitution (McCombs, 2016).

What is a Sex Surrogate?

love sex disabled therapy surrogateA Sex Surrogate (more commonly referred to as a Surrogate Partner today) describes an individual who enters into a therapeutic relationship with a patient experiencing sexual and/or intimacy dysfunction in an attempt to help them through working with the treating therapist first to identify and then treat those sexuality/intimacy complaints via the context of such a relationship (McCombs, 2016). The titles “Relationship Tutor” and “Intimacy Coach” may, in fact, more accurately describe the role. While skeptics deem it so, this sort of therapy has nothing to do with the world’s oldest profession. In fact, SPT is recognized as a viable treatment modality by the American Association of Sex Educators, Counselors and Therapists (AASECT, www.aasect.org) and the Society for the Scientific Study of Sexuality (SSSS, www.sexscience.org), the premiere clinical sexology organizations in America.

“We all have the fundamental right to sexual pleasure” (Appel, 2009.

handicap wheelchair sex rights surrogateIt is the belief of such sex therapists that intimacy is a right for everyone, and the disabled and handicapped are no different. This further ignited controversy over these practices and therapy (McCombs, 2016). Michelle McCarthy, in her 1999 book Sexuality and Women with Learning Disabilities, discusses common sexual stereotypes held against persons with intellectual disabilities (ID), one of the most common being that of the “eternal child.” These patients have severely limited intellectual capacities and were considered never mature past the mind of a child. Thus, just as it was assumed that you should not talk to a young child about sex to protect their “innocence”, it was believed that one should not impart such information onto the “eternally” youthful and immature mind of a patient with ID. As a result, they are often kept in the dark about sex, intentionally left uneducated and “in a state of ignorance” (McCarthy, 2009). This lack of education about sexuality and the ignorance of the topic’s respective laws are fundamental problems that lead to the high rate of sexual abuse in this demographic of people (O’Callaghan & Murphy, 2007). The NY Times video above and the testimonials of countless disabled peoples today clearly show that patients with disabilities, regardless of the severity of their physical and/or mental incapacitation, still have sexual desires and yearn for intimacy and touch. To think otherwise is to blatantly ignore voices everywhere trying to stand up and speak out for their sexual rights liberties. The question for society now is simple: Are you listening?

The Roots of Sexual Surrogacy

The sexual surrogacy movement grew out of LA in the ’70s when sex therapists and sexologists created The International Professional Surrogates Association (IPSA), a nonprofit training, credential-developing, and advocacy organization to assist in the professionalization and growth of SPT and surrogate partners. Today, the IPSA is the primary authority in training, advocacy, and expertise within the field of SPT. They have developed a rigorous code of ethics, which can be found here: www.surrogatetherapy.org/code-of-ethics. The IPSA is the only independent Surrogate Partner credentialing program in existence today, as well. They have taken a resilient stand in advocating for sexual surrogacy and standing up for its therapeutic value and potential. They have taken a strong stance in differentiating sexual surrogacy from sex work/prostitution.

Differences Between Sex Surrogates & Sex Workers

sex worker sex surrogate prostitute sex therapy sex partner therapyIt is the IPSA that has laid out the following clear distinctions between sex workers and sex surrogates (McCombs, 2016). Here are the most common differences, in their words, as provided to me in regards to what prostitutes or sex workers lack: (a) no training, credentialing, education (either preparatory or continuing) nor any effort to receive training to function as a professional surrogate partner, (b) the absence of a professional clinically-trained supervisory sex therapist or mental health professional involved in overseeing the work or the referral in the service of providing professionally supervised couples work and recognized behavioral intervention techniques, (c) the lack of an agreed-upon ethical code of behavior that, among other priorities, establishes the supremacy of the client/patient’s needs and best interests, (d) a focus on premature / immediate sexual gratification exclusive of any therapeutic goals (if and when Surrogate Partners experience sexual interchange with a client, it is after many sessions and focused, incrementally-intimate sex therapy behavioral techniques), (e) a focus by the non-client partner upon monies, (f) a lack of mutual authenticity between parties, (g) a required closure date and moratorium of contact at the end of treatment in professional SPT, and (h) a prioritization of the alleged surrogate partner’s physical attractiveness as a function of effective treatment.

The difference should be clearer now that whereas a prostitute’s intention is generally to receive compensation, the sex surrogate’s desire is geared towards working with the supervising therapist to ensure the happiness and health of the patient. There is also a limited amount of sessions one experiences with a sex surrogate, after which communication is supposed to cease (McCombs, 2016).

Who Are Sex Surrogates?

sex surrogate love therapy people Who are these sexual surrogates? The IPSA states that they reflect the entire spectrum of physical and aesthetic attributes of sexual attraction, or lack of same, as well as variations in age, race, and abilities. IPSA, the US’s leading SPT organization, does not screen for potential surrogate partner trainees (or clients) based on attractiveness; potential surrogate partners are screened for emotional maturity, integrity, values consistent with SPT, and commitment to ethics and training (McCombs, 2016).

Is it Legal?

cops police legal sex rights arrestIf one were to be prosecuted for participating in sexual surrogacy, it would be under the laws prohibiting prostitution. Generally, prostitution in most states is defined as the exchange of sexual contact for a fee, as per legaldictionary.net. All states have enacted laws outlawing prostitution except for Nevada, where it is strictly regulated. Clearly, since sexual surrogacy is sexual in nature, this creates a potential problem in the eyes of the law. The IPSA states that none of its surrogates have ever been charged for practicing surrogacy. Estimates place the extremely small number of practicing sexual surrogates at no more than a couple dozen, as discussed in an article on about.com and FOX news. Thus it’s not surprising that this isn’t a major blip on law enforcement’s radar. The author of this about.com article claims to have spoken to several surrogates while writing the article and had been told by all of them that they are not afraid of being prosecuted, even though they all advertise their services online. Is arrest still a possibility? Indeed, an arrest is still possible in any state that does not clearly have a legal exemption (ref). With the amount of gray area surrounding this field, it doesn’t seem like this ambiguity will clear up in the near future.

It’s Time to Listen Up

It seems that for the longest time, in trying to determine what’s best for our handicapped population, we haven’t really given them a chance to speak up. Now that we are listening, we hear that their needs and desires are no different than
the rest of ours. As a society, we need to become better acquainted with the idea that the need for sex is normal and healthy in all human beings, regardless of their physical capabilities. Limiting or prohibiting access to sexual

sex rights disabled handicap surrogates STP sexual health

surrogates means a life completely devoid of sexual pleasure for a large amount of the disabled population. Is that truly ethical? It is through comprehensive education and understanding that we see sexual surrogacy and sex work as two very different things. To label them similarly is a disservice to the field, as well as to the countless individuals around the world who can benefit from such a therapy. It’s time to ask ourselves the tough questions: Is sexual pleasure a right?


It’s More Than Pleasure

love sex therapy sex surrogate partner therapyThe issue at hand may be of even greater importance than the emotional and psychological needs of men/women. A growing body of literature identifies sexual activity as promoting various health benefits, both sexually as well as in regards to general/overall health, in men and women (Brecher, 1977). Very recent studies even show that sexual behavior is a critical factor in the adolescent development and contributes to factors of well-being (Lefkowitz et al., 2014). We need to stop considering sex an out-of-reach commodity for the disabled. With the health benefits of sex becoming clearer and more defined, it is pressing that we reevaluate our position on sexual surrogacy and STP. Given the importance of sexual health as stated by the studies above, it begs the question, “are we denying people opportunities to live not just a happier life, but a healthier one, too?” We have reached a point in society where we have begun to hear the cries of those groups of people we had, for so long, unfairly labeled and dismissed. With that awareness comes the responsibility to spark dialogues and encourage change. If we are truly meant to freely pursue life, liberty, and happiness, should we not afford every individual the chance to do so? How we approach this issue going forward still remains to be seen. In the meantime, the biggest agent for positive change is education. By understanding that people with disabilities have the same desires and feelings as anyone else, we can realize their need to be afforded the same opportunity for health and happiness as everyone else.

Author: Gaurav Dubey, Biolitics Founder & Host
Editor: Dean Sangalis, Biolitics Editor in Chief



Aloni, R., Dangur, N., Ulman, Y., Lior, N., & Chigier, E. (2011). A model for surrogate therapy in a rehabilitation center. International Journal of Adolescent Medicine and Health, 7(2), 141-152. doi:10.1515/IJAMH.1994.7.2.141 [doi]

Appel, J. M. (2010). Sex rights for the disabled? Journal of Medical Ethics, 36(3), 152-154. doi:10.1136/jme.2009.033183

BAUME, M. (2013, 4 July 2013). Disabled people say they, too, want a sex life and seek help in attaining it. New York Times

Brecher, J. (1977). Sex, stress, and health. International Journal of Health Services : Planning, Administration, Evaluation, 7(1), 89-101.

Lefkowitz, E. S., & Vasilenko, S. A. (2014). Healthy sex and sexual health: New directions for studying outcomes of sexual health. New Directions for Child and Adolescent Development, 2014(144), 87-98. doi:10.1002/cad.20062 [doi]

McCarthy, M. (1999). Sexuality and women with learning disabilities., 52-53.

Silverberg, C.Is it legal to see a sexual surrogate in the united states? Retrieved from http://sexuality.about.com/od/sexualhealthqanda/a/Are-Sex-Surrogates-Legal-In-The-United-States.htm

Use of surrogate sex partners rising among women. (2011, 6 September 2011). Fox News Health

Featured Image Credit: Anne Canright/Moment/Getty Images

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