For Disabled People Seeking Intimacy, It’s a Fine Line Between Health Care and Sex Work

By Jen Muranetz

March 6, 2015

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"It's unusual to be in a room with three naked people lathered up with oil and having a massage with candles and soft music."

Seated in his wheelchair, Dave recounts a time he had a sensual threesome with two sex workers.

"I basically went to everyone, from escort to massage to body work," he lists off some of the services he's visited over the last decade to meet his intimacy needs. "I had some really, really good experiences, I had some really negative experiences."

Dave, who asked us not to publish his last name, hasn't always turned to the sex trade. He tells stories of long-lasting girlfriends and spontaneous relationships, but when you have a spinal cord injury, the options are limited.

"My injury is considered complete," says Dave, who has only minor mobility below his shoulders. It was a diving accident that put him into this state 40 years ago, depriving him of his independence, sensory functions, and, in turn, his sex life.

Trish St. John has heard countless stories similar to Dave's. She worked as a receptionist for a Vancouver escort agency for seven years, answering many phone calls from disabled men, women, and couples. With every call came the voice of someone admitting to loneliness, pleading for affection, and craving companionship.

"Most of the ladies this company represented didn't feel comfortable going out and seeing someone with a disability," she says. "Plus, it could be a whole different body type that you're dealing with."

Yet the calls kept coming and the thought lingered in St. John's mind that these people deserved to be treated like whole sexual beings. So in 2010, she started Sensual Solutions, a Vancouver business that hires intimacy "coaches" to help people with physical disabilities looking to explore their sexuality.

"What kind of services do you offer?" I asked.

She pauses before saying, in her most diplomatic voice, "educational services." A laugh follows, hinting to the hands-on approach that is practiced.

Priced at $225 an hour, their website lists three different "educational" practices: massage and body work, coaching and healing, and tantra. This essentially means anything from caressing, massaging, or kissing to unclothed body play.

One of Sensual Solutions' intimacy coaches is 22-year-old Taryn, who chooses to use a pseudonym to protect her day job. She admits the difference between her work and the work of a prostitute is "blurry," with the defining factor being that an intimacy coach doesn't necessarily partake in intercourse or perform oral sex. Instead, Taryn describes the most common work she does as cuddling and body mapping, which means using physical touch to help people find erogenous zones on their body.

"Often these are places I think most people would find pleasurable if they weren't so hyper-focused to achieve orgasm through genital stimulation," she says.

For Dave, it's his ears.

He tilts his head to the side, his hand instinctively cupping his right earlobe as he talks about the biting, nibbling, and scratching sensations he considers erotic. "Which is not why I'm touching my ear right now," he clarifies, before playfully adding, "but maybe it is. Would you just tug on that a little bit?"

Dave's had a total of eight coaching sessions with Sensual Solutions, but he refers to the most recent meetings as "training sessions" for an advocacy group he co-founded several years ago. Dave's goal is to use his time with the intimacy coaches to develop informed orientation sessions for anyone looking to get intimate with a person who has limitations.

"So we'll talk about things like how to assist with a transfer, what a urinary bag is like, or things to be aware of: spasticity, sensation, pain, communication, how to use certain types of equipment, general functional traits."

The subject matter of sex for the disabled community is viewed differently around the globe. In the United States, for example, surrogacy partner therapy has been legal since 2003, whereas in Canada, surrogacy is only recognized if you're trying to get pregnant. (Surrogacy in the US was explored in the 2012 film The Sessions, based on the life of Mark O'Brien, a Berkeley, CA poet who was paralyzed from polio and wrote about sex for people with disabilities, eventually detailing his own experience losing his virginity in his 30s to a sex surrogate.) In Israel, the topic of sex for the disabled is looked at from a medical perspective, using established sex therapy clinics to offer "experiential learning." In some European countries, such as the Netherlands, people with a disability are eligible for government funding to have a visit from a sex worker 12 times a year.

"So it would be great if there was something in the middle here," St. John says, although she considers it wishful thinking at this stage because of the newly implemented Protection of Communities and Exploited Persons Act. Made law in November 2014, this legislation is based on the Swedish prostitution laws, making it illegal to buy sexual services but not to sell them.

"I know the law," St. John says, with one of the new clauses making it illegal to advertise the sale of sexual services for other people. "I don't feel that we fit into that category per say, and that's because we do get a lot of referrals from relationship therapists, from doctors."

One doctor working in the field of sexual medicine is Dr. Stacy Elliott. She's quick to express compassion for her patient's sexual needs, yet mindful of the legalities around the topic.

"Hiring a sex trade worker is still an illegal act," she says, before adding almost regrettably, "We are not allowed to suggest off-site sexual services, but we certainly encourage [patients] to reach out to potential resources they find themselves. But we have to, by the law, be hands-off on that."

Instead, Dr. Elliott emphasizes the efforts being done at Vancouver's GF Strong Sexual Health Rehabilitation Service, the only sex therapy centre of its kind in Canada where a team of doctors and nurses work together around sexual health. "I think our best work is done within the medical system, the patients have access to it without cost."

Even though Sensual Solutions comes at a heftier price, St. John believes the experience of physical touch comes with great reward. She says that, for the clients, it's a confidence booster—especially for people who've had little to no sexual experience.

That wasn't the case for Dave.

He was 19 when he acquired a disability, in the "prime of his sex life," as he describes it. Still, he takes a moment to pause and glance out the window before giving me an ironic look. "I've had more satisfying experiences post-injury, sexually, than I had before."