What is sex therapy in the NDIS context?

In paragraph 34 of his reasons, for instance, the QC discusses the therapeutic benefits of sex therapy as it relates to the applicant.

'… as a result of the services of a specialised sex therapist [,] were described by the applicant in evidence which I accept as good for her mental wellbeing, her emotional wellbeing and her physical wellbeing … she also said that her mood is less dull, it releases tension and anxiety, and improves her outlook on life.'

An additional advantage to categorising this service as a therapy is that it aligns with the NDIA's conservative interpretation of the National Disability Insurance Scheme Act, which is to treat people with disabilities as broken and in need of repair.

The disability sector has been lobbying governments around the world since the 1960s to move from the medical or rehabilitation model of disability to the preferred social model. The social model locates the need for repair within the built and socially constructed environments rather than with the individual.

The social model would say, for instance, that the applicant's inability to achieve sexual release is a social environment problem: with her lack of the ability to engage appropriate help, rather than her lack of the physical ability to masturbate. It is the same in the built environment: it is the building's lack of a ramp that is the problem rather than a person's inability to walk. Nevertheless, categorising 'sex therapy' as a medical problem should enable the NDIA to save face by not being seen to be using taxpayers' funds to pay for sex workers.

Training

The second key element in what is meant by 'sex therapy' is appropriate training for the therapist.

Presumably, the QC meant that a sex therapist's training would be focused on how to work with people with significant disabilities. This training might include communications, advance consent issues, and bodily contact protocols.

Already these training sessions are run by organisations such as Touching Base Inc. (This Sydney‑based charity developed out of the need to assist people with disability and sex workers to connect with each other, focusing on access, discrimination, human rights and legal issues and the attitudinal barriers that these two marginalised communities can face.)

The QC's distinction between 'sex therapist' and 'sex worker' seems sensible because it recognises the safety needs of both the worker and the client with disability. This is achieved through ensuring the sex therapist is appropriately trained and regulated. Most importantly, this service should also ensure that the client is not left without the benefits from sexual release, nor vulnerable because of their need to seek sexual release by using other, 'backyard', measures.