What is sex therapy in the NDIS context?

People with profound disabilities have been considered asexual, and protected by criminal laws as being highly vulnerable, for well over a century. When taken with Australia's general prudishness and the stigma associated with the commercial sex industry, it is little wonder that law‑makers and senior public officials classify our sexual needs as private and beyond the scope of the National Disability Insurance Scheme (NDIS).

A July 2019 Administrative Appeal Tribunal (AAT) review has challenged both these assumptions. It found that the National Disability Insurance Agency (NDIA) is to consider whether sex therapy is reasonable and necessary for those NDIS participants who have no other way of achieving physical sexual release.

In WRMF and National Disability Insurance Agency [2019] AATA 1771, the applicant was single, in her forties, and unable to masturbate due to her profound multiple sclerosis. It was accepted that physical sexual simulation reduces her pain and spasms and improves mental health, mood and overall wellbeing.

Coining the term 'sex therapy' to distinguish it from the service provided by sex workers, the Deputy President of the AAT, Mr B W Rayment OAM QC (the QC) gave a few cues on how the two terms differ.

'The applicant does not seek the services of a sex worker. Rather she seeks the services of a specially trained sex therapist, a term which I have used to draw attention to an important difference.'

A conservative interpretation of the term 'sex therapy' might entail the establishment of a speciality from within the fields of psychology, sexology, social work, counselling or even occupational therapy, or some combination of these classical therapies. The objectives of such a speciality would be to assist a client to develop new skills to improve independence and/or to live a happier life as asexual.

Had the QC intended for the applicant to receive counselling and/or occupational therapy, he could have said as much. Instead, he coined the term 'sex therapy' to mean sexual physical touching and felt it was necessary to distinguish this from sex work.

Classical therapists' professional and ethical codes would need to be redrafted to permit the sexual touching of their clients. It is also unlikely that these classical therapists' licencing bodies would agree to the creation of such a speciality, as it would negatively alter the status of their professions. For instance, dictionaries and some criminal laws have inclusive definitions of 'sex work', and these would apply to, regulate and stigmatise all of the licencing bodies' members.

The extended coined term, 'a specially trained sex therapist', involves two key elements: a need for the service to be therapeutic; and the need for the therapists to be appropriately trained.

Therapeutic benefit

The QC coined the term 'sex therapy' rather than referring to a definition in the relevant legislation or a finding in a common law case. In the absence of case law or a statutory definition of 'therapy', it is good practice to adopt a dictionary's definition. Topick an online dictionary at random, the Cambridge Dictionary defines 'therapy' as:

'a treatment that helps someone feel better, grow stronger, etc., especially after an illness.'