Dear Josey,

I bet you get a lot of letters starting with “I have a friend,” but I really do have a friend who was recently (14 months ago) diagnosed with ALS., or Lou Gehrig’s disease. He’s now 31, sexual desire and ability unaffected, and had just yesterday lamented to me that he misses contact with a woman. I suggested that if he’s comfortable, why not get a call girl. He was receptive to the idea, and asked me to help him with the research, as the ALS is advancing, limiting his speech and ability to surf the net.

He’s my best bud, and it’s been really tough to watch him deteriorate. He’s still the same guy, and if I could help him with this it would be awesome. How do I find a girl that would be sensitive to his emotional state, and accommodating of his limitations? He has said he may not even require sexual contact, but possibly just someone to lay or talk with him. He wants to preserve his dignity as much as possible, so he doesn’t want me there, but given his fragile state, should a girl want to, he could easily be robbed, or otherwise taken advantage of. What questions should I ask of anyone I contact, or could you suggest a direction for me to take?

— Helping A Friend in Sexual Need

Dear Helping,

My uncle had Lou Gehrig’s disease. It was heartbreaking to watch his body deteriorate while his mind stayed completely sharp. So I feel for you. And I think it’s very compassionate and kind of you to want to look into this for him.

Cory Silverberg, one of the owners of Toronto-based sex shop co-operative Come As You Are, is also one of the authors of The Ultimate Guide to Sex and Disability. I presented your question to him and he told me that in the survey they did for the book, many of the respondents wrote in about their experiences with sex workers. He also pointed out that “sex workers and people living with disabilities have something in common when it comes to sex, as both groups are wrongfully seen as sexual outcasts.” His advice? Avoid the yellow page ads. He recommends the website www.eros-guide.com as a good place to start.

“It’s a good idea to e-mail [the woman you’re considering hiring] and ask how comfortable she’ll be talking about disability,” adds Silverberg. He adds that some women advertise that they have accessible workplaces. If you’re worried about personal safety, come up with a safety plan, a way of checking in, or being in the next room, says Silverberg. Beyond that, it's important to be a good client if you want a good experience with a sex worker. This includes being respectful, polite and as upfront as you can about what you’d like and any specific concerns you have. Silverberg also recommends a site called The Outsiders (www.outsiders.co.uk), a great disability organization with lots of free information about sex and disability.

If you or your friend want more information, certainly check out Silverberg’s book, which was recently re-released as part of Cleis Press’s Ultimate Guide series. The book, written by Silverberg, Dr. Miriam Kaufmen and disability activist Fran Odette, includes an updated resource guide and covers things like what to do if your doctor has told you you’ll never have another orgasm, where you can find a vibrator that won’t aggravate your carpal tunnel syndrome and how you can feel sexy when your lover is also your caregiver. You can order copies through comeasyouare.com.

Dear Josey,

One recent alcohol-fuelled night, my fiancée and I experimented with anal sex for the first time. We ended up combining anal and vaginal sex. Is this an unhealthy practice that would put my fiancée at risk for infection? Do you have any suggestions for a more hygienic way of combining these practices together?

— Suffering Mixed Feelings

Dear Suffering,

Just as women are always told it’s better to wipe front to back to avoid carrying bacteria from the back door to the front door, it’s also a good idea not to use the front door after you’ve used the back door without wiping your feet first. Bums contain poop, which carries more bacteria than the virtual self-cleaning oven that is the vagina, so by dipping into the back door and then knocking on the front door you could be carrying bacteria from bum to vagina. If she hasn’t noticed any wonky smells or unusual discharge from her vagina, you’re probably OK. However, next time, if you want to use both doors in one session, use a condom, and put on a fresh one for each entry. Or wash up in between.