How sex workers can bring much-needed “human happiness” to the disabled | Pillow Talk with Jessie Sage | Pittsburgh | Pittsburgh City Paper

How sex workers can bring much-needed “human happiness” to the disabled

click to enlarge How sex workers can bring much-needed “human happiness” to the disabled
Photo: By demaerre

When Ethan* (names have been changed to protect privacy) was growing up, he remembers his older brother asking him repeatedly when he could have a girlfriend. Over a Zoom call, Ethan tells me that he always understood this question to be shorthand for, “When can I have a sensual experience?’” His brother, who is now in his 60s, is autistic and didn’t have the skills or support necessary to be able to make the kinds of erotic connections that would have met his very normal, very human desire for touch and intimacy.

This is not uncommon for autistic adolescents and adults (though clearly, autism is a spectrum and this isn’t true for everyone with Autism Spectrum Disorder). Emily’s* sibling is also autistic and has expressed similar desires to her. “My sibling has always struggled to connect with people on an emotional level and it's incredibly lonely,” she tells me over Zoom. “They will go to bars, they’ll try to make those connections, but they face rejection over and over.”

Yet not having an outlet for their desire for intimacy does not make those needs go away. It certainly didn’t for Emily’s sibling. “I think because of the lack of intimacy in their life, my siblings overcompensate with people who they are close with like family and friends,” she says. For example, they are often touchy in a way that makes some uncomfortable.

Allison* is a New York City-based Licensed Clinical Social Worker who works with disabled adults. Specifically, she works for a case management agency that supports disabled adults and their families in navigating benefits and entitlements. In her words, “We’re helping fill in the nooks and crannies of adulting for adults with disabilities.” This often includes assisting with housing and employment, pairing their clients with volunteers who will help meet some of their social needs, etc. While these “nooks and crannies” fill basic needs, sexual intimacy is rarely considered to be a basic need; and yet, Allison says her clients express this desire to her and the other professionals in their lives.

It makes sense that disabled adults would look to the professionals they work with when trying to express their need for intimacy because, often, their therapists and aid workers are the people they are closest to. “For an adult with a disability, their most intimate moments are still professional moments.” But Allison points out the problem here by asking, “So where do they have access to truly intimate moments?” In the absence of other options, she often sees clients “holding their one-on-one community habilitation worker’s hand when they’re out to dinner, or wanting to touch their speech pathologist’s face, or wanting to hug their case manager for a long time and getting aroused.”

While it is certainly not the therapist and support staff’s job to meet the intimate and sexual needs of their clients, Allison is intentional about calling these attempts at intimacy unexpected and not inappropriate, as to not shame the clients she works with. After all, what they are expressing is a natural human desire. “All of these things communicate to me that they do not have roles and relationships in their lives where they have an expected outlet for intimacy.”

In her work, these unexpected moments have forced her to confront the gaps in available social services. “There are moments where I’ve been touched in a way that was harmful or in a way that was unexpected to me,” she says. And yet, stepping outside of her own experience has allowed her to see why that happens. She reflects, “More than one thing can be true in the same moment: It’s true that I feel physically uncomfortable or like a boundary has been crossed. It can also be true that the person is trying to express a need that’s not being fulfilled.” This got her thinking about the fact that while it is not her job to meet those needs, there is an entire profession of people who do just that: sex workers.

Jet Setting Jasmine is both a sex worker and a licensed psychotherapist who knows that it is not just disabled adults who look to therapists, social workers, and other professionals to meet some of their needs for intimate connection. She says, “I think that if therapists are able to see the way that their clients can inappropriately utilize therapeutic services, then they could redirect them toward a professional companion [a common euphemism for sex workers].”

As someone who has worked in both capacities, she understands that there are boundaries that therapists cannot and should not cross, but is quick to point out there is an alternative to “tossing our clients out into the general public.” If therapists could “get past their own biases,” she says, they would see that sex workers provide “a guided learning space to explore and experience sexuality.”

Indeed, Ethan points out that in Denmark, one of the most progressive countries in the world in regards to the disabled, “there is part of the monthly disability check that includes money devoted to hiring sexual services.” That Denmark would consider sexual services to be a basic need makes sense to Ethan who was asked for decades by his brother when he could have a girlfriend. “Every creature alive, just about, is capable of being soothed by touch,” he says. “It’s just a tragedy that it’s not addressed.”

This tragedy has very real consequences in the lives of many disabled adults. “I think that [lack of intimacy and erotic touch] absolutely contributed to my brother's difficulties in life,” Ethan says. “To have no sensual outlet, to never be held, to never be cradled, to never feel safe within his own skin in the way that one does when they’re in an intimate connection with somebody else.” This belief was confirmed when Ethan finally decided, after his parent’s death, to hire a sex worker for his brother — to get his brother the girlfriend he’d been asking for. Indeed, after his first meeting with the sex worker his brother calls Julie (not her real name, and also not her sex worker name), Ethan’s brother said to him, “Julie makes my life easier.”

Emily and her sibling’s case manager Allison ultimately realized that it was worth hiring a sex worker for Emily’s sibling too, who was struggling in some of the same ways Ethan’s brother was. After his first session, Emily’s sibling called Allison and told her over the phone, “That was the best date I’ve ever had!” Allison tells me that as she talked to them on the phone she cried. “This is a person who is wildly misunderstood,” she said. Yet in turning to a sex worker, they could have the kind of experiences they wanted and needed.

Emily feels strongly that access to these services can be life changing for adults with disabilities who don’t otherwise have access to touch and truly intimate experiences. “I think working to lower the stigma and seeing how [working with a sex worker] can lead to beautiful intimacy and joy for so many people is very important,” she says. “The work that sex workers are doing is really important and should be celebrated.”

Celeste Pietrusza, PhD, a clinical psychologist who works with the Manhattan Alternative, a collective of unaffiliated sex positive therapists, tells me that it is sad that there are not more places where we can talk about the importance of collaboration between sex workers and other professionals, like therapists. She says, “I realize that the project of talking about sex saving us all is a fantasy, but the optimistic psychoanalytic part of me believes that some problems could be averted if we had more collaborative, collective places to explore sexuality.”

Allison shares this vision. “Just as clinics exist with a bunch of therapists, I foresee a space for sex workers who specialize in different things or work with a specific type of client, just as therapists do,” she says. Having something like this, she says, would allow her to make thoughtful referrals based on who the sex worker and the client are.

Though this remains a fantasy so long as sex work is criminalized, Ethan feels strongly that this is to the detriment of those who would benefit from sexual services. “Sex workers show demonstrable, concrete results. Their currency is the currency of human happiness,” he says. This can be a hard sell in a culture where sex workers are marginalized, stigmatized, and criminalized. Yet in Ethan’s words, “Every parent wants their child to be happy. Below all of their prejudices and biases, they still want their child to be happy.”

In conclusion, he says, “Any sex worker who is even minimally talented will leave their client happier than they were when they came in. That is especially true for those who are crying out for sensual attention.”


Jessie Sage (she/her) is a Pittsburgh-based sex worker and writer. Her freelance writing has appeared in a variety of publications including The Washington Post, Men’s Health, VICE, The Daily Beast, BuzzFeed, Hustler Magazine, and more. At the beginning of 2024 she launched a new podcast: When We’re Not Hustling: Sex Workers Talking About Everything But.

You can find Jessie on Twitter @sapiotextual & Instagram @curvaceous_sage. You can follow her new podcast on Twitter & Instagram @NotHustlingPod. You can also visit her website jessiesage.com.

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