The Netherlands – Four years ago, 20-year-old Peter discovered that he could no longer masturbate. Since the age of five, he had been diagnosed with Duchenne muscular dystrophy, a disease that causes all muscles to slowly degenerate until the body is completely paralyzed.

The disease had finally taken his hands and arms. The only chance at happy time for him in his condition had just been taken away. Frustrated, he demanded a hand job from his female caretaker but was refused.

In anger, he called his counselor, adamantly reasoning, “They do everything for me. Clean my shit, wipe my ass, but they won’t touch my penis.”

Peter’s true story is an extreme example that forces the question, where should the line between sex and health care be drawn? A year ago, Dutch society had to ask that question when a 42-year-old man fired a nurse for not having sex with him as part of his health care at home. Nurses and caretakers say sex is not part of the job description. The patient says sex is a necessary aspect of health.

Complicating (or resolving?) the issue is a relatively new breed of women for hire: sex care workers.

Organizations like FleksZorg, Sar, and Interact Service train their girls on how to pleasure handicapped clients. Most of these groups are non-commercial establishments whose clients are referred to them by disabled people’s homes or other medical institutions.

But a few, such as Interact Service, have decided to make a pretty buck out of the affair. Very much a commercial establishment, Interact Service is a specialized branch of Society Service, a high-class escort service that started out in 2006.

Competitive Rates

I meet Marike van der Velden, founder and owner of Society Service, in the resto-bar of a five-star hotel. She tells me over her six-euro cup of coffee that most “companions” are from 21 to 30 years old and are all Dutch.

They earn twice the salary of regular sex workers at 300 euros an hour, meaning that a boy like Peter could never afford them. On average, most companions can wrap up an evening with at least 1,000 euros, after taxes, in their pocket.

This is mainly because a night with an Interact Service companion lasts three hours at a minimum. Van der Velden says that, especially for disabled patients, an hour or two is simply not enough to get to know the client, be intimate with him, discover his fantasies and desires, and then discover “what is possible and what is not.”

Companions are required to be “beautiful, elegant and sophisticated.” They also all have college degrees.

Companions receive training in several courses given by physical therapists, sexologists and psychologists, and get first-hand tips from a resource person: a gentleman in a wheelchair.

Van der Velden says, “The psychologists that we work with train the girls how to deal with people who have not been intimate with women and how to communicate with a person who’s feeling nervous, how to put them at ease.”

Putting them at ease is a vital part of the experience. According to Annelies Kuyper of Rutgers WPF, an NGO that helps disabled children, people with disabilities are also crippled by their low self-esteem, insecurities about their appearance, and ability to perform sexually.

Even their chances of just meeting somebody, much less having sex or falling in love, are severely hampered by their dependence on their parents and caretakers to move them around. They can’t simply roll their wheelchair to the nearest train to catch a date wherever.

The reality of their situation makes it doubly difficult for them to have intimate relations with people who aren’t in their immediate surroundings.

Making a Connection

Having a disability that hampers movement isn’t just bad for moving around. Clients who have lost the use of their limbs and are confined to the wheelchair have a difficult time enjoying the ’ol in-and-out.

When asked how companions handle such situations, van der Velden says, “When you have no feeling below your chest then there isn’t going to be intercourse because there isn’t going to be an erection. But there are many ways to have sex with someone. For many people, what makes it memorable and special is the connection you make and the intimacy you share. For example, the visual part of watching a woman undress can be just as fulfilling as actual intercourse.”

It’s a “different group of girls” who work for Interact Service. One of the companions knows sign language, another is a med student. “They have a genuine interest in people who are disabled because most of them have handicapped friends or family members, or are sexologists or psychologists.”

Though the girls earn a lot from this, van der Velden says they do it for the fulfillment as well. “They know they are going to be remembered forever. They are able to provide someone with a very special experience and it’s very meaningful.”

Satisfied clients often send long emails expressing deep gratitude to their companions for giving them the most fantastic night of their lives.

But for a large number of young disabled persons, sex is not even in the cards. Parents and nurses hardly ever give them “the talk.” The lack of proper sex education among the disabled is simply because parents and caretakers don’t see sex in their future. Getting pregnant could cause more health complications and besides, how would a disabled son or daughter be able to take care of a baby, perhaps even a disabled one?

Sex and health, though different from each other in many ways, do share common ground. But what are the implications of mixing the two?

According to Kuyper, blurring the line between sex and health can create problems. “Especially for someone who has been handicapped from birth, there is no clear distinction between what is wanted touch and what is unwanted touch because they are always being touched by lots of people for care. It would be so easy for caretakers to take advantage of their patients.”

Parents and caretakers, Kuyper says, should be more open about discussing sex with their disabled wards. Rutgers WPF, for example, holds parties for handicapped kids and events where they can discuss sexual issues. It’s not something you can hide under a rug and forget about.

But when asked about Peter, the disabled 20-year-old who called her up four years ago, and whether or not she would tell him to go to a sex care provider, Kuyper smiles and says with a laugh, “If he’s willing, then why not?” Sex care might just be what disabled people like Peter need to have their “happy ending.” – Rappler.com