The Ins and Outs of Facilitated Sex

When it comes to typical volunteer activities, you probably think of walking shelter dogs or helping out at a soup kitchen. But in Taiwan, there’s an NGO called Hand Angel, which promotes the sexual rights of people with physical disabilities by providing free hand jobs to those who are unable to pleasure themselves.

Hand Angel screens recipients to make sure that they are recognized by the government as being physically — but not mentally — incapacitated. Once approved, each person is entitled to a maximum of three hand jobs. The volunteers (there are 10, from a range of backgrounds) can caress the applicants and kiss them on the face, but penetration (finger, oral, intercourse) is off-limits.

Unsurprisingly, the service has come under fire, according to Vice, with Internet users posting comments like, “Do they also offer Mouth Angels?” and a Taipei official stating, “I don’t think we need to bring up disabled people’s sexuality as an independent issue. There are more important and urgent problems we need to deal with.”

But there’s also a groundswell of support for the concept of facilitated sex. “Facilitated sex, otherwise known as sexual assistance, is supporting a person with a disability along the whole spectrum of sexual expression,” sexuality educator Mitchell Tepper, PhD, author of Regain That Feeling, tells Yahoo Health. “That may mean helping someone arrange a date, setting up for masturbation and cleaning up afterwards, helping to transfer somebody into bed to be with a partner, or — in the case where both partners have disabilities — positioning them so they can make contact.” As one Hand Angel participant explained to Vice, “The whole process was full of respect and equality. This might be deemed as controversial by society, but … what we desire is no different from others.” 

Satisfying a need 

For people who don’t have a physical disability, it’s easy to take for granted partner sexual activity and engaging in solo pleasure. “Any disability that results in severe muscle weakness or paralysis can make it difficult for a person to engage in sexual activity on their own,” Tepper says. He points to examples like complete cervical spinal cord injury, cerebral palsy (which may result in paralysis and severe spasticity), and traumatic brain injury that affects planning, movement, and coordination. 

Sexual rights advocates argue that sex is an essential need, the same as eating and bathing. And as such, people with disabilities deserve to have a means to access their sexuality. “Caregiving is intended to assist people with the activities of daily living that they would normally engage in themselves if they didn’t have a limitation,” says Linda Mona, PhD, founder and president of Inclusivity Clinical Consulting Services, and a clinical psychologist specializing in health psychology, sexual health, diversity, and inclusion. “Everyone has a right to have their basic needs met, and that includes sexual activity.”

So if an individual wants to engage in masturbation or intercourse, the question becomes whether he or she has the physical ability to do so. For some people, that may translate to help with transportation and access to social venues where they might mingle and eventually form a relationship. Others need assistance with setup (think: being given a vibrator, or positioning their hands to facilitate masturbation). Or they may require more direct aid, such as having another person’s hands on top of theirs to manually guide them to orgasm.

But many physically limited people don’t know where to turn for help with their private desires. Needless to say, it would be awkward to request sexual facilitation from their regular caregiver. Even more uncomfortable, 80 percent of people who are disabled are cared for by relatives, according to Mona.

(That said, family members stepping up to the plate is not unheard of, as evidenced in this Reddit AMA from a physically incapacitated man who received sexual assistance from his mother. Mona encountered a similar situation in her practice, where a mother helped her son with a disability prepare for masturbation.)

“As a result of the difficulties involved, the vast majority of people in this predicament simply go without expressing their sexuality altogether,” says Mona. “The emergence of Hand Angel is a reflection of the fact that we haven’t adequately addressed the sexual rights of people with disabilities