Personal assistance for having sex only or making love
Pubblicato da: Associazione Vita Indipendente ETS della Toscana
Data: 04/09/2026
Categoria: Notizie e comunicati

Personal assistance for having sex only, or making love

by Raffaello Belli

Table of contents

Preliminary remarks
State provided sex
Do not discriminate
The disabled person
Being more ourselves in sex and love
It is difficult to have someone help and watch you during sex or love
Getting started
Explaining details to the personal assistance in advance
The disabled person has no experience
The type of help needed
A couple where both partners are disabled persons
A single personal assistant
Two personal assistants
The personal assistant
Privacy
An open-minded personal assistant
The personal assistant must not judge the disabled person or the couple
Deep mutual understanding between personal assistant and disabled person
Using one's own regular personal assistant for sex or love too
A personal assistant with a satisfying sex life of his/her own
Experience
Sexual orientation
The importance of this work
An extremely difficult job for the personal assistant
When the personal assistant can leave
Prostitution
Outside home
Violence Against the disabled person

Preliminary remarks

When it comes to sexuality, and the love that includes it, there are many aspects of the utmost importance for disabled people, as, among others, ENIL (European Network on Independent Living) is developing very well.

In this paper, I address only one of these aspects, namely personal assistance, and only for those who:

have exclusively physical difficulties,
have full capacity to understand and to will,
are normally, or on average, aware of the meaning of sexual activity, and of the love that includes it,
are not influenced by parents or other family members.

I am, however, well aware that, on this subject, many other aspects are of equal or greater importance.

It is likewise fully agreeable that sexuality and love are fundamental[1] and inviolable rights, and are essential for equality among people. That is, if the concrete possibility of fully, and therefore freely, living one's own sexuality or love is denied or restricted, the result is a very serious discrimination.

It is important to stress that personal assistance is a fundamental right, certainly for the needs of mere survival and reproduction, but also for the enjoyment of life. That is, disabled people too are in this world not merely in order not to die, still less in order to suffer. On the contrary, disabled people too have the fundamental, inviolable, and therefore equally unquestionable, right to enjoy all the pleasures of life, and to reproduce, just like everyone else.[2]

To better understand, in my view, the significance of the subject of this paper, the importance of having adequate personal assistance for this purpose needs to be kept clearly in mind. First of all, because if, thanks also to adequate personal assistance, one manages to fully express oneself, the sexual experience itself can be far more fulfilling, intense and rewarding — and that is not a minor detail. Furthermore, the greater this immensity, the more likely it is that a love story will arise that might not otherwise have existed. Or that immensity can strengthen an already existing loving relationship. Both of the possible consequences are far from insignificant.

To avoid any misunderstanding, it should be stated right away that, in this paper, whenever the word "sex" is used, it is meant in its single and varied sense covering casual sex, paid sex, sex within a couple, straight, gay, etc. Whenever the word "love" is used, it is meant in the sense of love between a couple, in which sex (hetero, gay, etc.) is included within genuine mutual affection.

It should also be noted that, for the sake of simplicity, this text almost always uses the phrase "personal assistant." This does not imply, however, that the couple must always rely on the same personal assistant.

Anyone already familiar with the subject of personal assistance for independent living will say: it's already extremely difficult to find personal assistants just to survive physically, let alone to find them for this activity, which, among other things and as we'll see further on, requires greater qualities on the part of the personal assistant. First of all, the real burden of living as a disabled person is not our incapacities, but having to constantly fight against a society where too many people are unable to respect others So, in order to keep going, in order to be able to win, it is essential to be able to dream. In this case, precisely, to dream of the availability of suitable personal assistants to help us be our true selves in our sexuality and our love.

State provided sex

Since, unfortunately and often, it can be harder for people with severe disabilities to have sexual encounters or a loving relationship, some Northern European countries had, at least in the past, sexual services. However, I don't know anything more about this, and I don't know whether these services still exist.

1. ENIL, Annual Report on the Independent Living Pillars: Sexual and Reproductive Health and Rights, 2026; ENIL webinar 7 May 2026 “ENIL’s Personal Assistance Watch webinar on disability, intimacy, sexuality and independent living”, in https://enil.eu/key-takeaways-from-enils-paw-webinar-on-disability-intimacy-sexuality-and-independent-living/

2. ENIL, Annual Report on the Independent Living Pillars, 2026; ENIL webinar 7 May 2026 “ENIL’s Personal Assistance.

As far as I know, the only initiative in Italy on this subject is bill No. 1432[3], put forward by the PD (Democratic Party) in the Chamber of Deputies in 2023 and still stuck in committee. In my opinion, this bill contains too many unacceptable elements, and I won't go into much detail.

As happens all too often, it starts out with some entirely sound statement of principle devoid of any useful concrete consequences.

Then, in the explanatory report, among much else, one reads: "Many people with disabilities are unable to engage in fully developed interpersonal relationships on their own, from a psycho-affective perspective, because they are prevented from doing so by reduced self-sufficiency in mobility and movement." Which is simply false, and therefore points in the opposite direction from the one that is needed.

And again: "the professional figure... [to] help people with physical-motor or psychological-cognitive disabilities to live an erotic, sensual or sexual experience and to best channel their inner energies, often discharged dysfunctionally as feelings of anger and aggression." Here too, in my view, among much else, physical-motor disability has absolutely nothing to do with the capacity to Love and to Enjoy sex.

If I've understood correctly, this bill would limit itself to providing for professionally qualified people — after completing a specific training course — to also masturbate people with disabilities. Staying with just that narrow scope for a moment, one of the bill's many limitations it would be other people (those who grant this professional qualification) who decide for those forced to live as disabled. In other words, it would be non-disabled people deciding whether, how much, and how to masturbate disabled people.

It has rightly been said[4] that today one should speak of "inclusive love," since the UN Convention on the Rights of Persons with Disabilities calls for the "inclusion" of disabled people. The bill mentioned above, does the opposite, riding on the separation of disabled people.

Do not discriminate

In general, being masturbated — all the more so by a professional — is in any case less fulfilling than a full sexual encounter, even a casual one. And it is even far less fulfilling than a genuine loving relationship.

It therefore becomes all the more important to note that, very often, the fewer opportunities that disabled people have to experience sex or the love that includes it, are not due to their physical, psychological, mental or sensory difficulties, but rather to how these people are treated in contemporary societies.

That is to say, very often the fewer sexual/romantic opportunities are due to the fact that disabled people have fewer opportunities for social relationships, and therefore have fewer chances to get to know others, to be known, to open up to others, to allow others to open up to them, and so on.

First of all, disabled people too often have fewer opportunities to leave the house — whether because of inadequate means of doing so, or because of too many barriers. Furthermore, when "disabling" difficulties are substantial, having only very limited personal assistance is another enormous obstacle to being able to leave the house and to have social relationships on an equal basis with other people. It should be stressed, however, that personal assistance is useful for establishing adequate social relationships only if it is truly suitable for this purpose.

3. https://www.camera.it/leg19/126?leg=19&idDocumento=1432

4. ENIL, Annual Report on the Independent Living Pillars, 2026; ENIL webinar 7 May 2026 “ENIL’s Personal Assistance.

What's more, the greater difficulties that disabled people face in finding adequate employment are another major problem that reduces the chance of social relationships on an equal basis with other people.

And it is also well documented that, compared with non-disabled people, disabled people on average have significantly lower incomes and therefore live in greater poverty. This is another obstacle to the full development of social relationships and to the possibility of starting a family. Among many other things, unless one is at least reasonably well-off, it is very difficult and costly to have a barrier-free home in order to start a family. And it is even more costly and difficult to have adequate personal assistance to manage one's own life without placing a disproportionate burden on one's partner. And all of this makes it much more complicated, or entirely undermines, the ability to develop one's sexual and emotional life to its fullest.

In other words, if, for example, a non-disabled child has the chance to attend all the primary school on truly equal terms with other children and reaches a noticeably lower level of knowledge than other children, then some psychological or learning support, etc., may be needed. Now take, again for example, a child who cannot walk unaided and who, because of gaps in services, is taken to school only a few days a week. If this child cannot give his best at school, it's clear that he doesn't necessarily need learning support, psychological help, etc., but rather need to be taken to school every day. It's the same as a truck driver who drives for very many hours without resting and then takes some substance to keep driving. It's obvious that what he needs is not chemistry, but rest. This means that I, as a person with a disability, must be completely free to choose who helps me, how and when they help me — for example, with getting dressed, going to bed, eating, leaving the house, etc.

It has rightly been observed that the help needed for one's own sexuality (and love, I would add) differs from person to person (disabled people included). These differences must be fully respected, and so, from this point of view too, personal assistance must be different for each disabled person.[5]

The disabled person

Being more ourselves in sex and love

In the first half of the 1980s, in one of the publications on independent living that I used to order from the United States, I also read about the need for personal assistance to be helped with sexual acts. At the time I still knew very little about independent living, but I immediately understood how fundamentally important the subject was.

The fact is that, in the case of severe disabilities, if one is helped by a personal assistant — obviously in an appropriate way — in sex and in love too, just as, and even more than, with other daily activities, one can be immensely freer and more fully oneself. If two partners want to have sex, or even more so to make love, and one of them, or both, have significant physical difficulties, they may find themselves facing a choice between having to give things up — sometimes significant things — or being helped by one or more personal assistants.

For the couple, this is an absolutely free and unquestionable choice, in terms of whether, how, when and how much. So the personal assistant helps the disabled person, or the couple, with their sexual and loving encounters only at the request of that person, or of the couple, and in the ways and at the times that they specify.

5. ENIL, Annual Report on the Independent Living Pillars, 2026; ENIL webinar 7 May 2026 “ENIL’s Personal Assistance.

All of this can actually happen in practice only if one has the right personal assistant. This, in turn, is only possible on condition that the personal assistant(s) are freely chosen by the disabled partner and by the couple.

It is difficult to have someone help and watch you during sex or love

At first glance, being helped by a personal assistant for sex, and for the love that includes, it may be a difficult decision for the disabled person and for the couple to make. In short — and this is entirely understandable — it may not be simple to make love, that is, to express and experience the deepest things about oneself, with the help of another person, and therefore also while that person is watching you.

The trigger that can make it possible to overcome this obstacle naturally is really listening deeply to oneself. Truly listening to how important it is, within ourselves, to have sex and to make love. Listening to the fact that sex and love are primary needs of life. And if one really listens to this, if one manages to free oneself from so many conditionings and to feel deeply the importance of living one's own life fully, then the presence of the personal assistant (who is working correctly) becomes insignificant.

That is to say, the presence of the personal assistant, in itself, is not a physical imprisonment, but can be a mental one, which can understandably exist in the disabled person, in the couple, and/or in the personal assistant. To overcome this imprisonment, it is, or can be, very important to talk about it within the couple, with the personal assistant, with people who have had positive experiences with this, with open-minded people: even simply talking about it very often helps one understand.

The fact is that this mental imprisonment disappears if the couple doesn't think about the assistant's presence at all. In other words, unfortunately and fortunately, the personal assistant is there in a very significant way, but at the same time the couple has to behave as if she/he werenn't there. In plain words: it is essential that the couple simply not care about the presence of the personal assistant, or about what they might think and/or feel. This is not a lack of respect for the personal assistant — quite the opposite, it is the utmost respect for the role he/she is performing. In short, the personal assistant's presence may need to be very substantial indeed, but at the same time all of this must happen, as much as possible, as if the assistant weren't there.

The fact is that the personal assistant, if he/she behaves correctly (and this is the central point, which we'll come back to), does not stop the couple from expressing and experiencing all their feelings and all their pleasure. On the contrary, it allows them to experience all of that much more fully.

Everything that can be experienced, and shared, in a genuine orgasm during a casual encounter, or in a moment of love, is immensely more important than the presence of the personal assistant. Put another way, the assistant may see or imagine, but cannot take away anything from what you share in those moments with the person you love, or with whom you simply want to have sex. And again: when you have a genuine casual orgasm, or one with the person you love, in those moments you experience the infinite, and the presence/help of a personal assistant (who is working correctly) becomes insignificant. In a way that is, admittedly, on a much smaller scale, one could say it's like when a disabled person needs help using the bidet and/or taking a shower.

Of course, the assistant sees you naked, touches your most sensitive parts. The fact is that, if they do it badly, or not the way you want, it can be very unpleasant or even hurt, and so it can humiliate you too. But if the personal assistant does the job correctly, it doesn't humiliate you at all, and then the fact that they see and touch you is immensely outweighed by the alternative of going unwashed.

More precisely, to be very exact about it: if the personal assistant does the job correctly, there is absolutely no situation of inferiority compared with someone who does these things by themselves. If anything, in some ways, there is even a kind of "superiority" compared with doing it alone. This is because, in those moments, if he/she works correctly, the personal assistant makes you feel that you are an important person, because he/she gives it his/her all to make you feel completely at ease even where you are most sensitive and vulnerable.

The same reasoning, though obviously on a much larger scale, applies to being helped to have sex or to make love. If the personal assistant does the job correctly (and, I repeat, this is the central point), he/she makes you experience the fact that you are just as important a person as anyone else, because he/she gives it his/her all so that you feel immensely good, just like everyone else. In other words, just as with all other life activities, even in sex and love, being helped by a personal assistant is a great moment of equality and non-discrimination.

A central issue is that there must be no a feeling of embarrassment, about one's own very personal peculiarities, one's own desires, one's own pleasures, or one's own limitations, which may become visible or perceptible during a purely sexual encounter or a couple's full loving relationship.

First of all, if the assistant already does this job in other respects, they already know a considerable part of the disabled person's peculiarities and limitations. But the central fact is that we all have peculiarities, deepths and limitations, and it is quite wrong to feel ashamed of them. First, because without peculiarities, without infinities, without limitations and without incapacities, we would not be people, and life could not go on. And so, being helped by a personal assistant — indispensable in order to be able to fully and completely live out one's own desires, pleasures, infinities, limitations and incapacities — is, in the end, to affirm to the fullest, right up to the peak of orgasm, our being a person just like everyone else. And our capacity to love is, among other things, far greater than that of the few people who, unfortunately, are more or less in charge of this planet and are pushing it to rid itself of us.

Despite everything written so far, it is nonetheless understandable that a feeling of embarrassment may remain at revealing certain, or many, parts of oneself to a personal assistant. In reality, once the first moments have passed, this embarrassment no longer exists if the personal assistant behaves so correctly that, even though she/he is very much present, it is, in reality, almost as if she/he weren't there at all.

Ultimately, then, the proper selection and training of the personal assistant is essential. So, for sex alone, and for that included within love, too, independent living becomes essential — one of whose fundamental pillars is precisely the quality of personal assistance.

Getting started

For a couple in which there are physical, psychological, cognitive or sensory difficulties, it may be necessary for the two partners to talk to each other, even in some depth, about one or more practical aspects of the upcoming intimate encounter. This is an extra difficulty, one that doesn't exist for some non-disabled people. But that's how it is.

Explaining details to the personal assistance in advance

It is essential, first of all, to talk about it in depth within the couple, not least in order to get to know each other better. However, before being helped with sexual activity and/or love, it is advisable and necessary for the disabled person to explain a number of things to the chosen personal assistant — while stressing, as is essential, that in practice things could actually turn out differently, even though that might complicate matters.

It's advisable for the disabled person to explain clearly beforehand to the personal assistant the positions he/she might take, and to discuss how to get into those positions. It may also be advisable to explain whether these positions need to be reached with great precision or not. And so it should be agreed in advance with the assistant how the disabled person can communicate to the assistant, as concisely as possible, when and how he/she wants to get into that position — and when they want to change it.

Likewise, it can be important to explain clearly beforehand to the assistant which movements one needs help with, and how.

It can also happen that a certain position and/or movement, that the disabled person wants and/or believes to be possible and/or has already experienced, turns out to be impossible at that particular moment. This too should be agreed in advance: how the personal assistant should behave so that any such failure comes across as insignificant as possible. It must be the disabled person who decides whether, how and when to accept the failure and move on. That said, it is always fully the disabled person's own responsibility not to expect impossible feats from the personal assistant.

During sexual activity and/or lovemaking, the desire or need may also arise, quite legitimately, to make movements and/or take up positions that were not foreseen, and that the disabled person had not discussed beforehand with whoever is helping him/her. In these situations, it is essential that the personal assistant show not even the slightest hint of refusal or annoyance at not having been told anything in advance. And personal assistance must do everything possible so that the disabled person can make the movement and/or reach and maintain the desired position to their full satisfaction. It might also happen that these unforeseen movements and/or positions are impossible to reach and/or maintain. In that case, obviously, what was just written above applies.

The disabled person has no experience

If he/she has no experience in this area, or is with a new partner, there may be fewer movements to make and positions to reach that the disabled person is able to explain to the personal assistant beforehand. The success of these situations depends on the personal assistant's intelligence and intuition, and on however much the disabled person manages to communicate to the assistant.

The type of help needed

The help that may be needed depends on the couple's own unquestionable choices. So what I am about to write may not apply at all in specific situations.

First of all, it can be essential that the personal assistant have no time limit whatsoever when helping the couple with this activity — though this point must be made very clear to the personal assistant beforehand.

Furthermore, depending on the partners' physical difficulties and their own unquestionable choices, it may be advisable for the assistant to stay in another room and come in only when called. Or, for her/him to stay in the same room and face the couple only when assistance is requested. Or, again, it may be necessary for the assistant to follow everything closely.

When both partners have physical difficulties, again entirely at their own unquestionable choice, a single personal assistant may be enough, or two may be needed. Here, for now, I'll use the singular.

The key point is that the couple may need a great deal of physical help from the personal assistant, and perhaps with extreme precision, because one small mistake in a detail can ruin the moment.

At the same time, it is essential that the couple be able to use, each time, as few words as possible — perhaps even with just a quiet signal, or with a tiny gesture — to ask the assistant for the necessary help. This is because every word spoken in this context is a little less intimacy for the couple. So, from this point of view, there is more intimacy for the couple if the personal assistant comes to know them so well as to be able to step in at the right moment and in the right way without any request from the couple at all. And when this happens, it is almost as if the disability disappeared, which is no small achievement. But to reach this point, the personal assistant must already have followed other encounters of the couple very closely — and that takes away some intimacy from the couple in another sense.

So it is the couple's own unquestionable choice: whether to let themselves be known more deeply and receive the right help almost without having to ask, or to be known less but have to ask for the necessary personal assistance in more detail each time. In any case, the first option is only possible when one always has the same personal assistant, and the disabled person or the couple have multiple intimate encounters.

This holds true, though with less intrusiveness, for personal assistance in general.

A couple where both partners are disabled persons

Up to this point, we have written of the personal assistant in the singular. If both partners have significant physical difficulties, the help of a single personal assistant might be enough. But the help of two personal assistants might be needed. In that case, matters could be more complicated. In any case, whether it is one assistant or two is an unquestionable decision that belongs exclusively to the couple.

A SINGLE PERSONAL ASSISTANT

In any case, whether there is one or two personal assistants, the two partners first need to know each other to some extent. Furthermore, in both situations, before the sexual encounter — whether or not part of a loving relationship — it is more essential than ever to talk properly and in depth with the personal assistant.

If the two partners do not know each other very well, it may be advisable for each partner to meet the personal assistant separately. If, on the other hand, the two partners have a deep understanding of each other, it may be better for them to meet the personal assistant together.

TWO PERSONAL ASSISTANTS

If both partners in the couple have disabilities, the highly personal assistance of two assistants may be necessary. In some respects this is a situation that can be more complex than with a single personal assistant. In others it can be simpler.

To make use of the help of two assistants, in my view, a deep understanding between the two partners is more necessary than ever. Obviously, without having previously been able to rely on personal assistance for this activity, it's likely that two disabled partners cannot have deep, intimate understanding with each other from the outset. But, within the couple, by talking a great deal and in real depth, a considerable degree of mutual understanding can be reached.

If there isn't a very deep understanding between the two partners, or if one wants to leave some surprise for the other partner, it may be essential for each disabled partner to have, beforehand and separately, a very in-depth conversation with his/her own personal assistant. This in order to explain in advance all his/her needs, requirements and pleasures. Obviously, as already noted, it must be kept firmly in mind that it isn't possible to explain absolutely everything to the assistant in advance, because new and unforeseen desires, needs and experiences can arise during the encounter. So the personal assistant needs to have an open approach.

If, on the other hand, the two partners already know each other deeply, it may be advisable for them to meet the two personal assistants together. This can obviously be a much longer, and perhaps less simple, meeting than meeting them separately. But it makes it possible to address how the two assistants need to coordinate at certain moments. This might not be simple at the planning stage, but which then becomes very important during the sexual encounter.

The personal assistant

When interviewing a personal assistant to help with other personal activities of daily life, one can and should ask him/her, or try to understand, whether and how they are used to doing those things for themselves. For example, if the candidate personal assistant shows up to the job interview looking unwashed, while the disabled person cares about their own personal hygiene, that candidate is unlikely to be a good fit. Likewise, if you notice that the candidate is in the habit of eating in a sloppy way, while the disabled person cares about eating decently, that candidate may not be a good fit. This needs to be looked into carefully.

When, instead, one is looking for a personal assistant to be helped with sex and/or love, one cannot ask him/her about his/her own sex life. It may therefore be more necessary than ever to try to sense what is essential from that person's general attitude on this subject.

Privacy

Obviously, and more than ever for this kind of work, the personal assistant is bound to total privacy. In fact, to be precise, it isn't correct to say "more than ever," because the personal assistant is bound to total privacy regarding their work in any case.

An open-minded personal assistant

First of all, whoever is chosen as the personal assistant must have a strong ability to put the disabled person and the couple completely at ease — certainly never showing attitudes or behaviours that are in any way discouraging. More precisely, it is essential that the personal assistant show enthusiasm and act accordingly. Facial expressions, tone of voice, breathing, the assistant's movements, and the way they touch the disabled person are also decisive in this respect.

The personal assistant

must have an absolutely and totally open mind. There must be no limit on the type of help requested by the disabled person or the couple, unless in were illegal, other than the two limits of the assistant's own physical capacity and hygiene. In other words, this work can only be carried out properly if the personal assistant is deeply convinced, in their soul, that in sex — and even more so in the love that includes it — nothing that the couple enjoys is forbidden or unacceptable.

The personal assistant must not judge the disabled person or the couple

Still in the spirit of openness, the assistant must obviously refrain from any judgment about what they see and what they are asked to do.

To keep things realistic: it may well inevitably happen that, inside her/himself, the assistant forms opinions. But he/she must bear firmly in mind that this is very burdensome and destructive for the couple. That is why the personal assistant must take the utmost care to forget all of this as soon as possible, and in any case must never let their judgment or their thoughts show through in any way, either during or afterward.

It is essential to stress that having seen the couple at their most intimate must not change, even slightly, the way the personal assistant continues to carry out any other ordinary daily work he/she may do with that disabled person or couple. This is also because the personal assistant must be able to avoid showing anything — not through a facial expression, a sigh, a smile, and certainly not through any kind of remark — about what they have seen or experienced, whether things went perfectly or not. This is a fundamental point in allowing the "disabled" person to become, thanks to personal assistance, not disabled. In other words, if a disabled person is helped with full correctness during his/her sexual experience, and afterward the personal assistant shows complete indifference, that person is, in effect, almost as if they weren't disabled at all. Conversely, if the disabled person, who had to be helped with the sexual activity, subsequently has to witness one or more comments (expressed in whatever form) from the personal assistant, then that disabled person really is disabled.

Especially in the work of helping a disabled person in their own intimate life, the personal assistant must never form an opinion, because how a person, disabled or not, wants to live their life — all the more so their intimate life — is beyond question.

It is understandable, however, that this is different, more emotionally involving work than that of a healthcare worker who, in the course of their profession, sees the nakedness of many people every day. So, if, despite every effort, the personal assistant forms an opinion about the intimacy he/she has seen and/or perceived, he/she must try their very best to forget everything as soon as possible. And in any case they must never show it in any way to the disabled person.

And, on the other hand, the disabled person must absolutely not care what the assistant might think. This is an absolutely fundamental point, and it is not a lack of respect toward the assistant — quite the opposite, it means valuing their work to the fullest. To put the matter in legal terms, one could also say that Article 2 of the Italian Constitution implies that the exercise of fundamental freedoms is beyond question, because otherwise it wouldn't be free. This must apply, first and foremost, to sex and love, which are the ultimate moments of freedom.

And again, Article 48 of the Italian Constitution states that voting is free and secret, because it can only be free if it is secret, and it can only be secret if it is free. The same holds for sex and love. Unfortunately, with certain disabilities, one needs help both at the ballot box and in sex and love. On one hand, this requires greater inner strength and awareness from the disabled person. On the other hand, it is very telling of just how important and elevated the work of a personal assistant is for independent living — and therefore also for the sexuality and love of those with severe disabilities.

Deep mutual understanding between personal assistant and disabled person

In order to have suitable — and therefore optimal — personal assistance in these situations, a great deal of affinity and/or empathy on the part of the assistant toward the disabled person and the couple is essential. This requires great intelligence and great sensitivity on the part of the personal assistant. It is essential to stress, however, that sensitivity is part of intelligence — that is, it is indispensable for fully understanding many things. In other words, without sensitivity, intelligence is only partial. But it is equally true that sensitivity is not truly sensitivity unless it is part of intelligence. In other words, when it comes to a personal assistant's suitability, it is misleading to focus on sensitivity alone. In order to develop the personal assistant's empathy — and therefore also his/her sensitivity — toward the disabled person and toward the couple, the disabled person needs to build a relationship with the personal assistant that goes deeper than for other life activities. On one hand, in short, the disabled person needs to understand whether the chosen personal assistant has the abilities and qualities suited to his/her intimate needs. On the other hand, it is necessary that these intimate needs, at least as far as can be foreseen or anticipated, be known in advance by the chosen personal assistant:

to establish whether the personal assistant might not be suited to the role;
because, as examined above, this means that, during the encounter — whether purely sexual or a loving one — the disabled person and the couple can receive greater help from the personal assistant while having to ask as little as possible;
to allow the personal assistant to prepare themselves mentally and emotionally for the task ahead.

Establishing this preliminary relationship of mutual understanding therefore also allows both the disabled person and the personal assistant to approach that sexual and/or loving encounter with greater calm.

Using one's own regular personal assistant for sex or love too

Following on from what was said above, when possible and appropriate, it might be better for this activity if the disabled person is helped by someone who is already, in the normal course of things, one of his/her regular personal assistants. This is because there is already a certain degree of understanding — sometimes even deep understanding — meaning it may be easier to reach the even greater level of understanding that this kind of personal assistance requires. And this can be even easier if it is a personal assistant who already helps that disabled person with intimate hygiene.

It is by no means a given, however, that a personal assistant who is perfect for other daily-life activities will automatically also be right for being helped with sex alone, or with the love that includes it. Both sides need to think it through carefully beforehand. It would, moreover, be a serious mistake to think that already knowing each other well through ordinary day-to-day personal assistance means there's no need for further, deeper dialogue before being helped with sex or love.

If, for this activity too, one can be helped by a personal assistant who is already one's regular assistant, one has the advantages just mentioned. The "downside" might be that the personal assistant then comes to know absolutely everything about the disabled person, which could feel like a kind of imprisonment for them. However, this “disadvantage” does not exist if the personal assistant truly deserves all the trust one could possibly imagine. In the concrete reality of life, though, that can be a significant unknown.

A personal assistant with a satisfying sex life of his/her own

When a disabled person chooses a personal assistant to be helped by in his/her own sexual and/or love life, it is very important that the person identified have a satisfying sex life of his/her own. Great care must be taken over this. Otherwise, situations can arise that are difficult to manage, or even dangerous. To give one of the simplest examples: a personal assistant who has never seen a person of the other sex naked could only be chosen for this kind of assistance if there is certainty that they would experience this with complete ease.

Experience

Being helped in this area by a personal assistant who still lacks any full sexual experience can be more difficult both for the disabled person and for the assistant. This is because it might be harder for the personal assistant to sense, in the moment, the movements and positions the disabled person needs. But this isn't necessarily the case, because, in any event, the personal assistant's intelligence — obviously including his/her sensitivity — matters enormously. That is to say, even someone "experienced" may have no empathy or sensitivity at all. In which case, "experience" is of no use whatsoever, while great intelligence and empathy can make up for "inexperience."

That said, if a couple quite legitimately just wants to have sex, the "experience" of someone who has it in this area can be enough on its own. If, instead, the couple wants to make love, sex included, then, if the personal assistant has already done so before, things may be easier. Though again, even in these cases, it isn't necessarily so.

Sexual orientation

To be helped adequately with sex or with love, it is not necessary for the personal assistant to have the same sexual orientation as the disabled person. In any case, though, it is necessary for the assistant to experience his/her own sexuality with a sense of ease. If she/her shares the same sexual orientation, the assistant might be better able to sense the movements and positions the disabled person needs, meaning the disabled person might need to give fewer explanations to his/her assistant. But this isn't necessarily the case: a great deal can depend on the personal assistant's intelligence, empathy and sensitivity.

The importance of this work

On the part of the personal assistant, there must be absolutely no sense of inhibitions or hesitation of that kind. On the contrary, the assistant should feel deeply happy and fulfilled to have been chosen for this. They should feel a bit as if they had been invited to lunch by God (if He existed, and were a just being).

Article 527 of the Italian Criminal Code used to establish that making love in a public place constituted the crime of "obscene acts in a public place." This has since been decriminalised and is now subject to an administrative penalty.

It should be noted, though, that without sex and without love, all animal life on this planet would become extinct. In my view it would be a very important, positive thing if human life were to become extinct, and we will certainly come very close to that. But it really strikes me as unacceptable that whatever generates animal — and therefore also human — life should be considered obscene. Note carefully: if Italian law provided that sex and love were penalised as extremely private acts performed in public, that would, in part, be reasonable. The fact is that, under the law still in force, sex is penalised as an "obscene" act, and it is this penalisation, to me, that is obscene.

An extremely difficult job for the personal assistant

It certainly is, or can be, extremely difficult for the personal assistant to know when and how to step in to help the disabled person during sexual activity — all the more so at the moment the couple reaches orgasm.

The fact is that the full accomplishment of the assistant's work is when the disabled person is completely happy and fulfilled. Sex and love are certainly fundamental for disabled people too. So, any need for greater effort on the personal assistant's part should be experienced not as a burden, but as the crowning achievement of his/her work. A key point is that, while having sex, or including it within a couple's full loving relationship, one is much more vulnerable, and so a personal assistant who happens to be unsuitable can ruin everything, or a great deal, and can cause a great deal of suffering, tremendous pain, discomfort and embarrassment for the couple.

In particular, among other things, a personal assistant can hurt someone by rushing through, or completely neglecting, things that instead require the utmost attention. Or by not being gentle in helping the disabled person with activities that require the greatest deal of tact. In particular, during an encounter — whether purely sexual or a couple's full loving relationship — it can be especially important, among other things, that the personal assistant respect 100% the timing and manner desired by the couple, and not treat as less important any position, movement or detail that the couple "simply" wants. And if the personal assistant neglects or skips something, his/her ruins everything.

If his/her ruins something, or everything, in that couple's encounter, it may be that this personal assistant is the wrong person and should be moved away from that couple, or at least from this particular activity. But it may also be that this personal assistant simply didn't have a sufficient chance to get to know that disabled person's or that couple's needs beforehand.

For the personal assistant, contributing to and witnessing certain peaks of happiness between two partners can be a very powerful experience. And it can be all the more powerful when witnessed in the person his/her provides daily personal assistance to, and toward whom his/her may feel real regard and/or a degree of affection. But this activity, too, is part of the personal assistant's job, which his/her should normally be ready to carry out.

When the personal assistant can leave

During the preliminary meeting, or meetings, with the personal assistant, in order to be helped with sex or love, it may be necessary to clarify very clearly the moment when his/her can leave — that is, when his/her work is done. First of all, because it can really be inappropriate for this kind of personal assistance to have to end at a preset time. Furthermore, it may not be easy, or obvious, to understand when the couple no longer needs this kind of personal assistance. It might, for example, be agreed that the personal assistant leaves when explicitly told to do so by the couple, or at a certain signal, or when the assistant determines that a certain situation has arisen.

Prostitution

In any case, sexuality is also essential to the psychophysical well-being of every animal, and therefore of humans too. The issue is even more pressing if the disabled person is unable to masturbate on his/her own. For these reasons too, disabled people must have the same concrete possibility as non-disabled people of having paid sexual encounters. So there is nothing wrong — and it deserves the utmost respect — if a disabled person, by his/her own unquestionable decision, wants a paid sexual encounter.

Consequently, if a disabled person asks to be accompanied and helped in order to have a paid encounter, the personal assistant must do so with the utmost respect.

Outside home

If this encounter takes place outside one's own home, it is the disabled person's responsibility to ask to be accompanied to as safe a place as possible. Unfortunately, in today's world, absolute safety is hard to come by. So the assistant should not object if a place's safety is not absolute. If, on the other hand, his/her believes there is significant risk, the assistant must point this out to the disabled person, who nonetheless remains responsible for his/her own choices. If the lack of safety of a place is significant, the personal assistant may in any case refuse to go there.

At first glance, one may wonder how to proceed if, in the opinion of the person with a disability, the place is not dangerous, while in the opinion of the personal assistant, it is. It matters that the answer lies in the fact that the personal assistance relationship can work well only if there is a certain understanding between the two parties, and so the decision about how dangerous a place is should be reached through dialogue between the disabled person and the assistant. In any case, since there is always at least some degree of danger in today's world, it is in any case the assistant's job to pay attention to the surrounding situation during the sexual encounter, and to warn and help the disabled person if any immediate danger arises.

Violence Against the disabled person

But there is another fundamental issue.

Whether the sexual encounter takes place outside, in a safe setting, or in the home of either the disabled person or the other party, it can happen — immediately before, during or immediately after sexual encounter, the other person may commit acts of violence against or steal from the person with a disability. Obviously, if the disability is such that the disabled person can be entirely self-sufficient in this regard, then there are no further specific problems.

There can be situations, far from rare, in which the disability (of any kind) is such that the disabled person may not be self-sufficient in the event of attempted theft or violence. When the disabled person is not able to defend themselves unaided during a sexual encounter with a stranger, it is good practice for the personal assistant to be present and carefully observe what happens before, during and after the sexual encounter. Here too, the consideration made above regarding non-casual relationships applies first and foremost: having sex while the personal assistant is watching you may be somewhat more complicated, to say the least. But here too, the only solution is for the disabled person not to think about it and simply not care about the personal assistant's presence. And that the latter person should be fully aware that they are witnessing an activity of life so normal that it is primordial.

What should be stressed is that, especially with certain disabilities, it can be dangerous to be alone during a sexual encounter with a stranger. This possible danger, however, in no way justifies "State-provided sex," however disguised.

On the other hand, it may be more difficult for the personal assistant to help a disabled person with a paid sexual encounter than with a non-paid one. Nonetheless, the disabled person has the fullest right to want to experience his/her own sexuality as best his/her can and to derive all the good possible from it. And so the personal assistant must come to terms with this, showing themselves to be extremely calm, open and kind toward the disabled person.

Obviously, all the more so in situations involving a paid encounter, the personal assistant must help the disabled person before, during and after the sexual encounter only if, and in the manner in which, this is requested by the disabled person themselves.

It may be enough that the disabled person explains him/herself to the paid partner whether, how and when to help them, and/or whether, how and when to allow the personal assistant to step in. And this is the best solution, because it makes it clearer to the paid partner that his/her his dealing with a client who is capable of asserting him/herself. And so, if the disabled person has speech difficulties, it is essential that everything his/her says be repeated exactly by the personal assistant to the paid partner.

At other times it may be preferable for the personal assistant to know the disabled person so well that his/her themselves explain to the paid partner whether, how and when his/her has to help the disabled client. This is unfortunately because it often happens that non-disabled people listen more to the assistant than to the disabled person. In any case, in a paid sexual encounter, it is more essential than ever that any communication difficulty be resolved, because any misunderstandings on the part of the paid partner can have proportionally greater negative consequences.

One very important thing may be having to explain clearly to the paid partner that the disabled person has the right to the utmost respect, just like everyone else. It's better if the disabled person can do this her/himself.