Sexual assistants appear to be sexual surrogates who are trained to provide services only to clients with disability, but the client does not go through parallel therapy sessions with a therapist while participating in appointments with a sexual assistant. EPSEAS, the European Platform Sexual Assistance, describes their role as:
Sexual assistance is supporting adults with disabilities in the whole spectrum of their sexuality. It could be to help them to learn or improve their skills when it comes to interpersonal relationships, intimacy and intimate and/or sexual relationships. Each person is unique, as is their sexuality. Each relationship between a Sexual Assistant and the beneficiary is unique and made of unique circumstances. Sexual assistance is determined as much by the particular needs imposed by disability as by the sexual experience itself. These two aspects are systematically present in each Sexual Assistance.
(EPSEAS European Platform Sexual Assistance, n.b)
Services offered are driven from what the clients feel they need and desire, although the sexual assistants also drive the direction of the appointments. Speaking with a number of sexual assistance organisations in 2017, it appears that different organisations have different structures. For example, in Austria, the sexual assistants only provided services up to and including masturbation, and, if the client was “ready and able” to experience other sexual experiences, then they would refer them to sex workers. Other organisations said that it was totally up to the sexual assistant as to what level of sexual contact they were willing to provide.
Sexual assistance services and organisations have emerged predominantly in Europe. The European Platform Sexual Assistance (EPSEAS) is a platform of non-profit organizations who are active in providing sexual assistance for people with disabilities and the elderly.Their partner organisations are located in France, Belgium, Switzerland, Spain, Italy and the Czech Republic.
The sexual assistant is paid a fixed amount each session, regardless of what activities occur. The rate is generally determined by the organisation, not the sexual assistant, unless the sexual assistant has decided to advertise and work independently.
Service aims and objectives and client motivation
Sexual assistance services are provided to those who need a level of specific assistance in learning about how to enjoy sexual expression, where their disability currently impedes their ability to move forward through the usual channels of dating and forming a relationship in society. This can include embarrassment of their bodies and their disability, lack of sexual and social experience, fear of rejection in dating forums, lack of confidence and the fear of approaching sex workers due to societal discrimination and stigma around who is involved in the sex industry (i.e., fear of being arrested, being abused or having money stolen from them).
Availability and eligibility of both the service provider and the client
The only clients that sexual assistants work with are those with disability or older adults. Clients are often interviewed/assessed for their eligibility by the organisation to determine what their needs are and then paired with the most appropriate sexual assistant. Some sexual assistants eventually have their own website and clients contact them directly for appointments. While this mirrors how sex workers operate, they are clear that they provide this type of therapy/support only to clients with disability.
Sexual assistants are also assessed for their eligibility. In one organisation, they need to be interviewed by a psychologist for an hour before being accepted to work with clients. Other organisations require sexual assistants to pay for and complete intense specialist training courses and graduate successfully before being allowed to work with clients. One of the trainers outlined the initial requirements used by several French-speaking organisations within France, Belgium and Switzerland (SEHP—Sexualité et Handicaps Pluriel, Corps Solidaires and CH (s) OSE),
We ask that candidates be over 25 years old, have physical and mental health compatible with the sexual assistance activity, have financial revenue equivalent to a parttimejob, a clean judicial slate and have spoken with their partner about their wish to become a sexual assistant.
While there are definitely a number of former or current sex workers who are also qualified as sexual assistants, the majority of them are not. Some sexual assistants go on to create and manage their own websites, while others may receive referrals directly from an organisation or from advertising on a specific website established to give direct information and contact details for sexual assistants (Freya 2019).
Specific organisations that facilitate training and referrals between service providers and the clients
The European Platform Sexual Assistants (EPSEAS) network has members operating in Belgium, France, Spain, Italy, Switzerland, the Netherlands and the Czech Republic. InSeBe, based in Zurich, Switzerland has been one of the training organisations partnering with others throughout Europe to provide concise but thorough sexual assistant courses. Some courses, like the one CH(s)OSE facilitates (Corps Solidaires; Credi 2017) requires over 120 contact hours for participants, spread out over a year.