Should disability insurance pay for sex workers?

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Matthew YauJames Cook University

An Australian court, the Administrative Appeals Tribunal, recently granted a woman with multiple sclerosis the right to have a sex therapist paid for under the country’s National Disability Insurance Scheme (NDIS). The NDIS is a social welfare scheme of the Australian Government that funds costs associated with disability. When it is fully rolled out in 2020, it will provide about 460,000 Australians aged under 65, who have a permanent and significant disability, with funding for supports and services.

After her initial application for sex therapy to be covered under her NDIS package was rejected, she appealed the decision. The tribunal ruled in the applicant’s favor, arguing sex therapy is a “reasonable and necessary support” for this woman and for other people with disability.

This is a significant milestone in the advancement of sexual rights of people with disability. It represents a recognition that people with disability have sexual needs, and that they experience sexual challenges that require attention and assistance.

To further recognise this, people with disability should also be able to access sex workers under the NDIS.

The difference between a sex therapist and a sex worker is in the provision of physical contact. While a sex therapist will offer verbal coaching, a sex worker has a specified role in providing a paid sexual service.

Like everyone else, people with disability have sexual needs

Sexual expression is a fundamental part of being human, and disability does not dampen a person’s sexual desire, nor their need for intimacy.

Decades of research have shown the many benefits of sex, which include improved physical healthquality of life, and psychological well-being.

People with disability – whether physical or intellectual – may face challenges in achieving sexual pleasure. Professional sex therapy can provide sex education, guidance, and counseling to couples and individuals with a disability.



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Sex therapists generally come from a professional background of health care, psychology or counseling, with specialized training in sex therapy. Treatment for clients with disability may focus on how to enjoy or resume sexual and intimate activities after an injury, or how to adapt sexual activities as the client’s disability progresses.

Should disability insurance pay for sex workers?

While we can choose our sexual partners and the ways we express and satisfy our own sexual needs, these things can be more challenging for people with disability. This is due in a large part to social prejudices and discrimination.

In this sense, the Australian government’s tribunal decision did not go far enough. It should have recognized not only sex therapy, but also that the service of sex workers may be required by some people with disability.

Sex workers may engage in sexual intercourse with a person with disability, or physically assist a couple with disability to have sex.

For those who don’t have potential partners or the physical and/or intellectual capacity for sexual expression, access to sex worker services to satisfy their sexual needs should be seen as a legitimate option.

Opposition to the decision

Australia’s National Disability Insurance Agency (NDIA), the agency charged with implementing the NDIS, has previously stressed it doesn’t cover sexual services.

Following the tribunal hearing, NDIS minister Stuart Robert reiterated this position, and noted the NDIA would appeal the ruling to the federal court.

Many people question why we should use taxpayers’ money to subsidise a person with disability pursuing sexual pleasure, when this may also be a challenge for couples and individuals not affected by disability.

Looking to the future: should disability insurance pay for sex workers?

If we believe our Australian welfare system is equitable and respectful of individual rights, whether the NDIS service user is using the money for a hobby class on entomology (the study of insects), a sex worker’s intimate service, or something else, this is an individual choice which we need to support for his/her quality of life and independence.

With the tribunal decision, people with disability can now legitimately request sex therapy in their care plan and access professional assistance to address their sexual challenges.

Sexual expression and intimacy are basic human needs, and should be equally recognized among people with and without disability as facilitating improved quality of life.


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Sexual expression and intimacy are basic human needs, and should be equally recognized among people with and without disability as facilitating improved quality of life.