Japanese conversations about sexuality and disability in the context of sexual services are possible because of the openness in which prostitution is advertised and available. Because able-bodied Japanese men are able to easily access sexual services, the question of accessibility for men with disabilities becomes a conversation about social equality rather than of morality.

To reiterate the distinctions used by sakatsume shingo, the founder of white Hands, there is affectionate love, sexual intercourse, and physiological release. Surveying the list of books on “disability and sex” available in english, i found the overwhelming focus was on sexual intercourse within the context of affectionate love. With the exception of noonan (1984), very little of the conversation in the United states has been on paid sexual intercourse for physiological release, given the legal constraints on prostitution.

There is also the added dimension of gender. With the exception of takeda and asaka, most of the discussion on sexual needs in Japan has been on men with physical disabilities rather than those with intellectual or psychiatric disabilities. The emergence of some dating services for people with intellectual disabilities, as well as the focus of organizations such as Bethel House on safer sex for people with psychiatric disabilities, does indicate some movement in these directions, although nowhere as explicitly as the service provisions for menwithphysicaldisabilities. If we think back to the first part of this chapter, where i discussed the fictional deaf teenage girl in the film Babel and the very real deaf woman takeda Mayumi, who became a soapland worker, the issue of women with disabilities has largely been overlooked by the conversation over men's physiological needs. In many ways, the framing has prevented conversation about women's having any physiological needs. In many ways, Kawai Kaori's discussion of the woman with a congenital hip displacement emphasizes the romantic nature of her weekly “prince's” visit.


The author wishes to thank satsuki Kawano, susan Long, and Glenda roberts for their critical feedback in shaping this chapter. Research on this topic was conducted with the support of the waseda University/yale University 125th anniversary asakawa Kanichi Fellowship (2011–2012), yale senior Faculty Fellowship (2011–2012), yale Junior Faculty Fellowship (2007), and Center for Global Partnership abe Fellowship (2004–2005).

1. Yoshiawara was the name of the red-light district in edo, the old name for tokyo.

2. There also exist onabe and okama (male and female transgender) bars but these fall outside the scope of this chapter.

3. Because of the illegal nature of prostitution in the United states (except in some areas of nevada), there appears to be little or no advertising of brothel or escort services that are barrier-free or handicap accessible. Instead, sexual service providers in the United states generally specialize as “sexual surrogates” or “surrogate partners,” who operate in legal gray zones. These terms were first introduced in Masters and Johnson's 1970 seminal work, Human Sexual Inadequacy. In 1984, raymond noonan distinguished between prostitution and sexual surrogacy as follows: “the distinctions commonly noted between the two usually rely on the intent of the sexual interaction: the prostitute's intent being immediate gratification localized on genital pleasure; the surrogate's intent being long-term therapeutic re-education and re-orientation of inadequate capabilities of functioning or relating sexually.” This concept is explored in Ben Lewin's (2012) film The Sessions, which is based on an essay by Mark O'Brien (1990).

4. La Mer (2012). For the curious, “holy water” is also known in the United states as golden showers.

5. It should be noted that the Japanese loan word borantia (volunteer) in general encompasses both paid and unpaid volunteers, so this is not unusual.

6. “suzuki” is a pseudonym.

7. Cushing and Lewis (2002) explore the issue of agency in an american home for people with intellectual disabilities.

8. The web site for noir is References Cited

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