Whither a Welfare-Funded ’Sex Doula' Programme?

Abstract

The sexual citizenship of disabled persons is an ethically contentious issue with important and broad-reaching ramifications. Awareness of the issue has risen considerably due to the increasingly public responses from charitable organisations which have recently sought to respond to the needs of disabled persons—yet this important debate still struggles for traction in academia. In response, this paper continues the debate raised in this journal between Appel and Di Nucci, concurring with Appel’s proposals that sexual pleasure is a fundamental human right and that access to sexual citizenship for the severely disabled should be publicly funded. To that endeavour, this paper refutes Di Nucci’s criticism of Appel’s sex rights for the disabled and shows how Di Nucci’s alternative solution is iniquitous. To advance the debate, I argue that a welfare-funded ‘sex doula' programme would be uniquely positioned to respond to the sexual citizenship issues of disabled persons.

Anent the theoretical justification of a sex doula program

“…Some authors, such as Ezio Di Nucci, have argued that charitable responses to the problem are not only sufficient for the needs of disabled persons, but advantageous “as disabled people would probably enjoy it more” [ 14 , p. 160]. We find this position facile [ 12 , 15 , 16 ].…”

“…Sexual exclusion can obtain in ways that are importantly not mechanisms of exclusion for non-disabled persons; [ 7 ] that is, as a function of social attitudes around body-image and attractiveness which “may hinder the sexual expression of disabled people;” [ 6 , p. 66] as a function of physical or mental impairments; and perhaps most perniciously, because of the presumption of ‘sexlessness’ [ 10 , 11 ]. Together with the nature and severity of an individual’s impairments, this presumption has resulted in many disabled people being “denied sex or conversations about sex, sexual expression, and pleasure” [ 7 , 9 , 12 , p. 363]. Such dispositions exist in the ‘no sex’ policies of nursing homes and can even extend to the parents of disabled persons (who may have difficulty recognising their child as a sexual agent) [ 7 , 9 ].…”

“…A disabled person’s parents and caretakers are often their only interfaces with the world and constitute the only resources available to help them come to terms with puberty, development, and sexual awakening [ 7 ]. If such conversations are denied, then disabled persons are left with little-to-no ability to frame their sexual development; this may, in turn, result in improper attitudes towards sex and their becoming vulnerable and disadvantaged [ 7 , 12 ]. Mark O’Brian explains: No one...had ever discussed sex around me.…”

A Defence of Sexual Inclusion

“…This is analogous to the argument made byFirth (2019) about the distinction between a right to demand funding for sexual services versus a right to demand those services.…”

“…This article is not the first to defend or debate claims of this sort. There is, for example, a long-standing debate within the disability rights literature about the sexual exclusion of persons with disabilities and the possibility that they might have a right to sexual inclusion (Shakespeare 1999, de Boer 2014, Appel 2010, Di Nucci 2011, Thomsen 2015and Liberman 2018, Firth 2019. There is also a long-standing strand within feminist theory that is deeply sceptical of any suggestion of rights and entitlements to sex, largely on the grounds that patriarchal ideology already contains within it the belief that men have (or should have) a sexual claim right over the bodies of women and that this needs to be resisted (Pateman 1988, Jeffreys 2008, Manne 2018, ch 4, Srinivasan 2018.…”