Supported Loving toolkit
Sex workers
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People with learning disabilities can be supported to use a sex worker but a clear process must be followed to minimise the risk to both themselves and staff supporting them.
People with learning disabilities have sexual needs just like anyone else. People typically find sexual gratification through either masturbation or through sexual contact with a partner either as part of a relationship, a more casual arrangement or a one-night stand. A small section of people, for various reasons, choose to pay for a sex worker.
In the UK sex work is legal as long as both parties are over 18, have mental capacity, are not involved in each other’s care and have not been coerced. It is not an offence to earn money as a sex worker when you are 18, nor to pay for sex or arrange for an adult with capacity to enjoy the services of a sex worker, when that is what they have asked you to do. The main offences are soliciting, causing/inciting/controlling prostitution for gain, brothel keeping and paying for sex with someone who has been coerced or trafficked.
People with learning disabilities can be supported to use a sex worker but a clear process must be followed to minimise the risk to both themselves and staff supporting them. The important boundary in the law is between supporting a person with capacity who has decided to pay for sexual services, and causing or encouraging a person who either lacks capacity or is under your care to pay for sexual services. You do not ‘cause’ them to do anything which they freely choose to do.
Common areas where people may have difficulty and how best to support them
Capacity
It is illegal to support a person to purchase sex if they lack capacity. Those supporting must be confident that the person has the capacity to make this decision. If they lack capacity, a “best interest decision” cannot be made stating that they should use a sex worker. The person should also be able to manage the financial side of things. Staff getting involved in payment would not be appropriate. Some local authorities have stated that direct payment funding money cannot be spent on sex work. However, if a person has capacity then they would not necessarily need to be informed but for the individual’s protection this should be covered in the organisations sex and relationships policy.
Understanding the role of a sex worker
If a person has capacity and states that they want to use a sex worker, it must be clear that the person with learning disabilities understands what a sex worker is, that this is a business transaction. The worker will hopefully be nice to them, but it must be made clear to the person that they are not their partner that they will only see them if they are willing to pay and that they are unable to contact them unless they wish to purchase their services. This could be difficult for some people to understand.
Policy
Using a sex worker is often considered a taboo subject for anyone, especially people with a learning disability. If this is what a person chooses to do, staff need to ensure that the whole process and any decisions made are documented. This area should be covered in the organisations sexuality policy, so staff know where they stand legally. Some organisations will decide that this is not an appropriate way to support clients, staff can not then support clients to pay for sex workers but they could start a dialogue at work about the rights and sexual needs of people with learning disabilities. However, they should be aware that this may leave a person more vulnerable as they may seek a worker on their own.
Safety
To have capacity to have sex a person needs to understand that having sexual contact without a condom can lead to infections. Before accessing a sex worker the person needs to understand that sex should not take place without a condom (or another barrier method of contraception). It would not be safe to get a sex worker from the street so the person needs to consider where they would find a sex worker who has been vetted. The TLC trust can provide information in this area and all the workers on their site have experience of providing sexual services to people with disabilities. The Outsiders Trust also has a sex and disability helpline where they are happy to discuss sex work and how to do it safely. The number is 07770 884 985 and by email. It is open 11am to 7pm weekdays
Practicalities
People will need to think about the practicalities of using a sex worker such as where will they do this? Is it ok for the worker to come to their home? Would they like the support worker to remain close by in case of issues (but not in the same room- this is not appropriate), what support might they need before hand- do they need to be hoisted into / out of position? Can they get undressed/ dressed or will they need support. These are all decisions that need to be made in advance to ensure the person has a good experience.
Dos and don'ts
Do...
- respect the person’s need for sexual fulfilment
- help the person to be supported in this area if your organisation supports it even if it is not something you would do
- seek support/advice from others if you feel unsure in this area.
Don't...
- judge the person or the sex worker - this is their choice
- act outside your organisation's policy - ensure you follow the law to keep the person you work with and yourself safe.
- forget to document any decisions made regarding this.
Case study
Peter is a 47-year-old man with a mild learning disability who lives in his own flat in a block which has staff there 24-hours a day in the office/ staff flat. He can go out independently. He has never been in a sexual relationship. He has had relationships, but none involved the sexual contact he desperately wants to experience. He watches pornography but wants sex with a woman. He comes home from town one evening with a sex worker he found locally. The support staff find her in the communal area. This raises safeguarding concerns as there are vulnerable people in the shared space. Staff speak to Peter and he said he used a condom. Peter is clear he wants to do this again. The staff meet with Peter and a practice nurse and it is clear he has capacity as he understands about the potential consequences of sex without contraception (pregnancy and infections) and how to physically have sex. His staff document this in his records, stating who else was involved. They also speak to Peter to see if he understands about what a sex worker is and how this is different to a girlfriend- Peter is clear that he understands and this is documented. Staff support Peter to contact an organisation who have vetted sex workers (TLC trust) and he arranges to go to their flat while staff wait across the road in local café. Peter says it was a positive experience he would like to repeat.
Dr Claire Bates, Quality Analyst/ Researcher, Choice Support in consultation with Professor Claire De Than, Professor of Law at City University.
The views expressed in the Supported Loving toolkit are not necessarily those of Choice Support.
Useful websites
Supported Loving toolkit
The Supported Loving network has produced a series of guides to help support people with learning disabilities with issues around sex and relationships.
Read more
What is Supported Loving?
For people with learning disabilities finding love is often more than just chemistry – it can come down to getting the right support from your staff.
Read more
Supported Loving network
Supported Loving is not a formal membership organisation. Anyone can take part, it is free.
Read more