Sexual Assistance Research Articles

Preparing for a Sex-Positive Future Where Sexual Assistance Is a Possibility.

Preparing for a Sex-Positive Future Where Sexual Assistance Is a Possibility.

Sexual assistance as a form of support for the sexual needs of people with physical disabilities in Japan

The sexuality of people with disabilities has long been a taboo. The most controversial, mainly from an ethical point of view, is sexual assistance, which in many countries around the world is not only allowed, but also financed by the government. The aim of the article is to look at this form of supporting sexual needs and learn how sexual assistants function in Japan. Attention is drawn to the presentation of two non-governmental organisations: White Hands and Noir, which support and improve the quality of life of men with physical disabilities.

Putas y Discas: Sex Work Activism and Disability Justice in Argentina

This article examines how mutual aid efforts between sex work activists and disability activists straddled the tension between respectability politics and subversive work to invigorate feminist disability justice in Argentina. I specifically focus on a 2021 Instagram Live conversation titled "Putas y Discas" to elucidate how public debates during a pandemic and in the digital age contribute to the conceptualization of 'access intimacy,' a term introduced by disability activist Mia Mingus. I attended the event as a user taking notes and paying attention to how labor rights, disability justice, and online censorship converge in the Global South to strengthen the solidarity between sex work and disability activists, featuring digital platforms as a potential arena to uphold access intimacy. The juncture of sex work and disability activisms in Argentina informs notions of interdependency more broadly and reconfigures the relationships between vulnerability and resistance, especially in the pandemic context. "Putas y Discas" invites us to include sex as integral to health demands and recognize sexual assistance as part of a bundle of disability policies covered by healthcare. A more inclusive politics of desire can also identify the labor of sex workers as communal care and consider how the more revolutionary aspects of sex work can inform the broader politics of labor. In the form of access intimacy, sex work activism and disability activists contest the malfunctioning healthcare system that bypasses sexuality as integral health, displaying the vitality of collectives and the possibilities for digital activism.

Sexual Assistance for People with Intellectual Disabilities: Proposal for a Service Delivery Model

The figure of the sexual assistant is increasingly demanded as a right in the disabilities field. This figure requires debate, adaptation to the characteristics of countries and cultures, as well as to the characteristics of people with intellectual and developmental disabilities. This study presents the work carried out with representatives of Spanish organizations of people with intellectual disabilities to develop a proposal for the figure of support staff for sexual behavior. Together with a rights perspective, this proposal is aligned with the Supports paradigm to better meet the health and behavior needs of users. The figure is framed within the auto-erotic and therapeutic model of sexual assistance. This figure excludes characteristics of the erotic model that involves interaction or sexual exchange between the sexual assistant and the individual with a disability. Several advantages and disadvantages need to be carefully considered before implementing this support in a delivery service model. We argue that the proposed figure requires specific accreditation, training, and monitoring.

Efekat anksioznosti od Kovida 19 na seksualnu funkciju zdravstvenih radnika - anketa studije preseka

Objective. Coronavirus disease epidemic in 2019 (COVID-19) posed a big challenge to healthcare providers. The present study aimed to explore the relationship between coronavirus anxiety and the sexual function of healthcare providers. Methods. In this study, an online survey was used to explore the relationship between anxiety and sexual function in healthcare providers during COVID-19 pandemic. The questionnaire included Female Sexual Function Index (FSFI) and Corona Disease Anxiety Scale (CDAS). Results. A total of 300 healthcare providers were investigated in this study. The estimated self-reported rates of mild anxiety symptoms were 49%, moderate 29.2% and severe were 29.9%. The total mean score of FSFI of healthcare providers were 19.1 (SD=4.4). The results showed that on the total scale, 40.9% of healthcare providers had mild anxiety. The results also indicated that female sexual function is inversely correlated with anxiety during COVID-19 pandemic. Also, it was shown that anxiety during COVID-19 is inversely correlated with sexual functioning. Conclusion. This study presented the negative impact of the COVID-19 pandemic on anxiety and sexual function in healthcare providers. Therefore, psychological or sexual assistance may be beneficial.

Consent Is Not Enough

Consent Is Not Enough

Sexuality in Kidney Transplant Recipients: A Qualitative Study.

End-stage kidney disease has a negative impact on patients’ quality of life. People who receive a kidney transplant experience an improvement in many areas of their daily life. Sexuality is a general component of health, which can be affected by end-stage kidney disease and kidney transplant. The aim of this study was to explore and understand the experiences and perspectives of kidney transplant recipients regarding their sexuality. A qualitative study based on Gadamer’s hermeneutic philosophy was carried out. Two focus groups and nine interviews were conducted with 18 kidney transplant recipients. Data were audio-recorded, transcribed, and analyzed with the help of qualitative analysis software. Two main themes emerged from the data: (1) “The impact of a kidney transplant on sexuality”, with the subthemes “sexuality is relegated to the background”, “physical decline acts as a sexual inhibitor”, and “changes in sexual activity following a kidney transplant”; (2) “Sexual education in kidney transplant recipients” with the subthemes “sexuality: a hidden concern amongst kidney transplant recipients” and “talking about sexuality with healthcare professionals”. Sexuality is a frequent concern among kidney transplant recipients. The physiological and emotional changes experienced after kidney transplant exert a great influence on their sexuality. Healthcare professionals rarely discuss sexuality concerns with kidney transplant recipients. Professional sexual education and assistance are necessary to improve sexual health satisfaction of kidney transplant recipients.

Experience of women with multiple sclerosis about their sexuality

Purpose To understand how women with multiple sclerosis (MS) experience their sexuality. Material and methods This was a qualitative study in which eight women belonging to MS associations in Elche or Alicante (Spain) completed semi-structured interviews. We subsequently carried out a thematic analysis of this data. Results Four main themes and multiple sub-themes were identified. The first theme was the ‘influence of stereotypes on sexual expression’, which included social and gender perspectives; the second theme was ‘physical and emotional causes of sexual dysfunction’, which were classified as primary, secondary, and tertiary; the third theme was ‘experiencing sexuality in a personalised way’, which included relationships with a partner, the concept of sexuality, and resources for improving sexual function; and the final theme was ‘external support’, which included sexual assistance, professional care, and peer support. Conclusions Sexual needs change in women with MS after diagnosis of the disease. However, this is not addressed routinely by health professionals. In their search for resources, women with MS highlighted that support from partners and from associations, could constitute a support network for the expression of their sexuality. IMPLICATIONS FOR REHABILITATION Women with MS refer changes in their sexual function, and these changes are not addressed routinely by healthcare providers. Inclusion of the sexual partners of women with MS in consultations regarding the treatment of sexual dysfunctions should be considered with previous consent. The positive experience of a woman with MS who used sexual assistant services may justify further research. MS associations can also play an important role in the sexual field as a meeting place for peers with shared experiences.

Public Discourse of Sexual Assistance in the Czech Republic

Public Discourse of Sexual Assistance in the Czech Republic

Ethics and pre-exposure prophylaxis (PrEP) in adolescents: an integrative review

Introduction: Worldwide estimates suggest an increase in the number of deaths by AIDS among adolescents. The Pre-Exposure Prophylaxis (PrEP) has been considered a potential intervention of major impact on new HIV infections. However, the discussion on PrEP in the adolescent population needs to expand mainly regarding ethical issues that emerge with its implementation. Objective: The objective of this research was to identify ethical issues related to PrEP in adolescents in the current scientific literature and discuss their impact in the implementation of this preventive strategy. Methods: An integrative review of the literature was performed on Medline, Scopus, and Web of Science databases using descriptors Ethic and PrEP. Results: The search retrieved 284 articles, of which 16 was related to adolescents and were kept in the sample after analysis. The issues detected were classified into two categories: 1) Ethics in research and 2) Ethical problems regarding access to PrEP. Conclusion: It seems that the issues discussed could diminish the potential impact of PrEP on new HIV infections among adolescents. Discussions on the theme must be deepened, as gaps regarding Ethics and HIV prevention in adolescents are evident, especially when it comes to sexual minorities, both in research and assistance.

Asistencia sexual y diversidad funcional. Representaciones a través del discurso de profesionales de la sexología

En este trabajo exploramos los puntos de vista, las opiniones y las representaciones sociales que realizan profesionales de la sexología sobre la Asistencia Sexual. A través de una metodología cualitativa, utilizamos como técnicas de investigación los grupos de discusión y la entrevista semiestructurada a informantes clave. Entre los principales hallazgos encontramos que los profesionales estudiados tienen una visión liberal de la sexualidad de las personas con discapacidad, pero la desarrollan desde una perspectiva individual, asistencialista y terapéutica. Los profesionales configuran la Asistencia Sexual como una forma de terapia sexológica que favorece la rehabilitación de las personas con discapacidad. Se trata de un modelo alineado con una perspectiva patológica de la sexualidad en las personas con diversidad funcional y que, a su vez, encuentra en ese argumento una justificación para diferenciar la Asistencia Sexual de la prostitución o del estigma del trabajo únicamente sexual.

What Sexual Assistants Want and Need: Creating a Toolkit and New Solutions to Help Them Better Perform Their Work with Individuals with Disabilities

Sexual assistance services that people with disabilities use for help with sexual activity must be specialized and adapted to the users’ different conditions. Some aspects of sexual assistance have been mentioned in the literature, but the subject is still relatively unexplored, particularly regarding adapted services for people with disabilities. The objective was to create a toolbox with items that might be required in encounters with individuals with disabilities and to think of innovative ideas to improve sexual assistants’ work. This multi-method qualitative study involved two meetings: one workshop and one co-design session. The sample included six future sexual assistants studying at the Italian Institute of Sexology in Rome. The workshop presented two different scenarios so the students could think of what is needed to improve their work. At the end of the workshop, a list of items was developed. The co-design session explored possible design solutions to improve and facilitate their work as sexual assistants. The idea that interested everyone due to its practicality, usability and feasibility was an inflatable sofa/mattress that includes internal divisions so different sections of the mattress can be inflated and/or deflated. The development of projects such as this one provides different perspectives on what still needs to be done within the sexual assistance domain.

Prostitutes, Sex Surrogates and Sugar Babies

Prostitution is a categorically moral activity, sexual surrogacy and sexual assistance are hypothetically moral, while sugaring is hypothetically immoral. First, some moral objections to prostitution will be refuted and it will be argued that prostitution is moral in principle. Second, it will be argued that sexual surrogacy and sexual assistance can be morally justified under certain assumptions. In that sense, they are hypothetically moral activities. Third, sugaring is immoral, unless its reason and conditions are known to both parties in the transaction. As this is mostly not the case, sugaring is hypothetically immoral. If sugaring is however not based on cheating, it is consensual and hence morally justified. In terms of moral adequacy, the taxonomy is as follows, in decreasing order of morality: prostitution, sexual surrogacy/assistance, sugaring. It will be shown that the moral adequacy of these activities is very similar from the perspectives of utilitarianism, deontology and virtue ethics. Finally, it will be contended that prostitution, sexual surrogacy/assistance, as well as morally appropriate forms of sugaring (mostly via sugaring agencies) ought to be encouraged by the state.

Una aproximación a la bioética de la diversidad funcional desde el deseo

This work exposes some of the issues that directly affect the way of understanding and approaching the reality of people whose global functioning differs from the standards generally accepted as “normal.” In the first part, the issues that affect the use of language and its influence on the cultural and symbolic representation of disability are reviewed; The following are the considerations on personal and sexual assistance as the basis of an effectively independent life. Third, two classic bioethical questions are debated, abortion and euthanasia, their relationship with the politics of tolerance and their implications in the lives of people with functional diversity. Finally, alternatives are explored, to move from the politics of tolerance to the “politics of desire.

Sex workers’ narratives about clients with disabilities: can training improve sexual health in Portugal?

Abstract People with disabilities face barriers that limit their sexual lives. In Portugal, some individuals with physical impairments have shown interest in resorting to sexual assistance provided by trained professionals, according to the client’s preferences and needs. However, in Portugal, sex workers lacking any formal training represent the only way to access commercial sex services. Thus, this study analyzes the experiences of sex workers that provide services for disabled clients. The interviews of thirteen sex workers were analyzed using the thematic analysis method proposed by Braun and Clarke. The key findings show that men seek out sexual and emotional satisfaction from sex work. Additionally, specificities inherent to the lack of training and the relationships established tend to embarrass professionals. Finally, we conclude that training coupled with sexual education and popular awareness about gender differences in the pursuit of sex is fundamental to improve the sexual health of those who choose sex services as a way of sexual expression.

IS SEXUAL ASSISTANCE A RIGHT?

In this paper I will reflect on sexual assistance, and I will discuss the possibility of shaping sexual assistance as a right. The question of whether sexual assistance is a right can have different answers depending on the framework we are in. We could fall within a purely legal framework, an ethical framework, or a combined framework such as the human rights context. From this point onwards, the question of whether sexual assistance is a right shall depend on the answer to the question regarding the nature of sexual assistance. Sexual assistance for persons that cannot perform sexual activities on their own body can be ethically justified by the theory of needs or by the notion of Instrumental Activities of Daily Living. It can also fall within sexual rights or within the right to choose a way of life.

Disability Rights Meet Sex Workers’ Rights: the Making of Sexual Assistance in Europe

The last decade has seen an expansion in initiatives promoting the development of special sex services oriented to people with disabilities, which in Europe are increasingly labelled ‘sexual assistance’. These have become the object of political and media attention, and arguably call for a critical analysis incorporating both disability and sex workers’ rights perspectives. Based on an 18-month embedded participant observation, I explore the case of a grassroots organisation which brings together sexual assistants, disabled activists and (potential) clients, and their allies in Switzerland. Opposing ‘therapy’, ‘charity’, and ‘care’ approaches to sexual assistance, members of this organisation work within their own model of ‘ethical’ services. While they place sexual pleasure at the centre of this approach, in practice, they promote forms of self-regulation aimed at limiting the risks of sex services, connected in particular to intimate violence, stigmatisation, sex normativity, and the role of intermediaries. Clearly rooted in a disability rights perspective, this grassroots initiative does not only concern sexual assistance but more largely sex services. In this sense, this study invites us to look at sexual assistance as an interesting space for alliance between sex workers’ rights and the rights of people with disabilities, as a uniquely politicised group of (potential) clients.

Mapping French People’s Views Regarding Sexual Assistance to People with Physical Disabilities

The study mapped French lay people’s positions regarding sexual assistance to people with physical disability. A sample of 238 adults living in the south of France, aged 18–67 years, was presented with a set of 30 vignettes that depicted a situation in which a minor who, as a result of an accident was quadriplegic, expressed his/her sexual needs to a nurse who arranged an encounter with an assistant at the hospital. The scenarios in the vignettes were created by orthogonally combining the levels of three factors: Patient’ gender × Assistant’s identity (same gender nurse, opposite gender nurse, opposite gender nurse who has been trained in sexual assistance, prostitute, or former boyfriend/girlfriend) × Parent’s attitude (agree with the procedure, agree with the procedure and financially compensate the assistant, disagree with the procedure). Through cluster analysis, five qualitatively different positions were found: (a) never very acceptable (21% of the sample), (b) depends on the assistant’s identity (13%), (c) non-remunerated assistance (14%), (d) parents’ agreement (8%), and (e) always quite acceptable (28%). Seventeen percent of the participants were undetermined. Religious involvement had a strong effect. The quite always acceptable position was above found among male atheists, and the never acceptable position was above all found among participants who were either regular attendees to religious celebrations or members of the less educated segment of society. Regular attendees with tertiary education tended to be undetermined.

Supporting Sexuality in Adults with Intellectual Disability—A Short Review

Sexuality in persons with intellectual disability (ID) is one of the frequently discussed topics of many scientific disciplines. Sexuality in persons with ID is determined by the specific features of ID, but also by the attitudes of the society and possibilities of persons with ID to establish intimate relationships, have sexual experience, and be able to express their own sexuality as an autonomous human need. The objective of the review was to present an analysis of published knowledge about supporting (and expression) of adults with ID in the area of sexuality (i.e. support provided to persons with ID as well as carers, professionals and family members providing support to persons with ID in the area of sexuality). Relevant studies (N = 47) identify the following as the most significant areas of supporting sexuality in adults with ID: sexual relationships, contraception, pregnancy and parenthood, sexually transmitted diseases, gay or lesbian relations/relationship, unacceptable and criminal sexual conduct, taking responsibility for sexual behavior, defining sexuality, values, body image, etc. Another important aspect is cooperation with close persons, carers and parents of individuals with ID. There is a possibility to use specific instruments for elementary assessment (SSKAT, SexKen-ID, ASK), the technique of social stories, and the content of educational program aimed at sexuality in persons with ID. Another option is sexual assistance and self-advocacy. Existing research focuses mainly on prevention of sexual abuse of persons with ID, but attention should also be paid to other aspects of their sexuality. Available evidence suggests that providing support to persons with ID in relation to their own sexuality is a difficult task. There is a need for further training and education of professionals, close persons and carers in order to provide qualified support to these clients.

Estado actual de la salud afectivo-sexual de las personas con diversidad funcional en españa.

El objetivo de este estudio es aportar conocimiento sobre el estado actual de la Salud Afectivo Sexual de las personas con Diversidad Funcional (PDF) en el territorio español a partir de las consultas a la Asesoria de ANSSYD. Para ello se realiza un diseño cuantitativo descriptivo transversal, donde los sujetos de estudio sonPDF, familiares y profesionales que contactan con la asesoría. Los datos se obtienena partir de las consultas realizadas via online, telefónica durante 6 años. (Octubre de 2012 a Octubre de 2017).Para el registro de los datos se ha utilizado el paquete Microsofot Office 2010. Resultados: Se atienden 1856 consultas de familiares, cuidadores y PDF, centrando sus dudas en las siguientes variables: Embarazo, desconocimiento sobre sexualidad, disfunciones sexuales, coito, orientación sexual, juguetes eróticos, asistencia sexual (AS), desconocimiento de las funciones del AS equiparándolo a terapia. En referencia a las consultas planteadas por profesionales se recogen 1758 consultas centrando sus dudas en las siguientes variables: anticoncepción, desconocimiento y dudas sobre sexualidad en PDF, Masturbación, coito, orientación sexual, juguetes eróticos, asistencia sexual (AS), fantasías y Derechos sexuales y Reproductivos de las PDF Conclusiones: Es patente el aumento de consultas recibidas en la Asesoría que se centran en intereses informativos sobre sexualidad que no han sido cubiertos por los profesionales a su servicio. La falta de desarrollo de la Ley Orgánica 2/2010 de 3 de Marzo de Salud Sexual y Reproductiva e interrupción voluntaria del embarazo tiene como consecuencia el incumplimiento de la misma con las consecuencias de falta de formación e información . La escasez de formación en sexualidad y más concretamente de sexualidad y diversidad funcional en los profesionales para afrontar las necesidades de las PDF y la carencia de programas y materiales educativos adaptados a las necesidades especiales de las PDF, dificulta el aprendizaje a este colectivo, a sus familias y a los profesionales en relación a la sexualidad, impidiendo a estas personas el empoderamiento a través de ella. Han de tomarse medidas urgentes por parte de las Administraciones, de los Ministerios de Educación y Sanidad y de los profesionales que ostentan cargos de gestión, para que en el siglo XXI los problemas de visualización y de reconocimiento de la afectividad y sexualidad en las PDF dejen de producirse.