Katie's Diary

Sex Therapy in Care Homes

11th April 2013

The press recently revealed that some Care Homes had let sex workers 'provide services' to their residents. These were "trained" individuals who were apparently experienced in working with disabled people and so were simply addressing the patients' needs in the same way that the regular staff would support them with medication, finances or food.

One headline in particular read: Red Socks at Night...Care Home Delight, which references the fact that the sex workers would hang a red sock on their customers' door when they were working so that they weren't disturbed.

The patients paid for the service themselves and the staff were always aware of who they allowed to enter the premises, so the questions the media was asking were, is it right for this to happen? When does providing a service become crossing the line? How could they really be sure the patients weren't being exploited?


One element that was made very clear in the Metro article was that residents paid for the services themselves. Presumably the inference is that the community would not wish to see such things being paid for with public money. But public money is often spent on supporting people to access their human rights. Why is sex so different? We would support people to have relationships. Might that sometimes involve sex?

This topic was recently tackled in a high profile film called The Sessions starring John Hawkes, in which a polio sufferer who has spent much of his life in an iron lung decides to employ a sex worker as a means to experience a sexual relationship, no matter how professional.

The movie received great critical praise for its handling of human relationships and also the inherent difficulties, insecurities and feelings of any sexual relationship, irrespective of it involving someone with a disability. It also received a Best Supporting Actress Oscar nomination for Helen Hunt which again propelled the subject into the public eye. The film's trailer can be seen here. and will be released on DVD in the UK in May this year.

Often when dealing with disability services the onus is put on cost and necessity. But when dealing with this kind of subject matter it quickly becomes apparent that a personal longing may be reason enough to allow such practices to happen. Although it may be better for anyone facing such a situation to be encouraged to form relationships first and not just pay for something that many of us would hope to find organically through the sharing of interests, lives and love. Where do you stand? Is it a simple matter of enabling people to address their basic human needs? Is it a disability service that should be offered like any other? Or is it wholly inappropriate and wrong because of the negative messages it conveys and potentially harmful emotional impact it could have on those participating?

The care home from the Metro's story continues to facilitate 'special visits', the council are checking their protocols and the media remains non-committal. Do disabled people have the right to live a full life even if that means having sex? Clearly they do. The question is whether this is the right way to do it and for the right reasons. Is this in fact just exploitation and, if so, exploitation of who and by whom, and why is no mention made of whether this is good or bad for the sex worker?


It is very difficult to talk about the most intimate moments in our lives and specifically the subject of sex. Some see it as embarrassing whilst others see it as inappropriate. Because of this one of the aspects of disability that is often ignored is also one of the most simple and natural of human urges; sexual intercourse.

The care home mentioned by the Metro newspaper made the case that residents had primeval needs that should be met within a holistic care environment. How could they refuse? The care home supported residents to make arrangements through the internet or on the phone using a 'consultant' who was able to arrange a sex worker "trained to deal with the situation."

The interesting element was the apparent difficulty that editors were having in coming up with a suggestion as to whether this was a good thing, or a bad thing. They appeared to be sitting rather uncomfortably on top of the fence. They reported that surely this was a "basic human right" so presumably this was a good thing. They also reported that East Sussex County Council "did not welcome the idea" and were reviewing their safeguarding policy amid concerns about "exploitation and abuse'" - inferring that is a bad thing.

Perhaps this editorial indecision is indicative of a question for the community as a whole. Do we think this is a good thing or a bad thing? The care home makes the case that it is only trying to stop residents getting frustrated, and that if they don't people will "resort to groping staff". So they think it is a good thing, but are they doing it because the residents want it, or because it is better for staff? Why do people need a 'special room' and a sock on the door? Does one presume that the right to privacy in the care home only applies to sex? And how private is sex with a red sock on the door?

Sex Therapy in Care Homes

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