PARIS – Steven Coppens had already spent most of his lifetime battling illness before his autoimmune disease took yet another toll seven years ago, leaving him in a wheelchair.
But, the 31-year-old Belgian says in a gravelly voice, he's still the man he once was, and he has the same desires as anyone in the prime of life.
"In the beginning I had to adapt to life in a wheelchair. And over the first years, sex came second. But after a while, it does come back," said Coppens, who lives about 30 kilometers (20 miles) outside Brussels.
That was when he went looking for escorts on the Internet.
"Those girls show up and you realize they have a problem with this and are scared off. And at this point, I'm not even talking about the prices they ask for," he said. "Just imagine that for some reason you cannot have a girl. You keep on looking. A man in a wheelchair still has the same sexual drive."
Coppens now volunteers with Aditi, a Belgian organization dedicated to helping the disabled in their search for sexual fulfillment. And he supports the use of "sex surrogates" — people who are paid specifically to help disabled people explore their sexuality.
Belgian law often leaves the sale of sex in a legal gray area, allowing for some sexual services for people with severe disabilities. In neighboring France, however, a tense debate on the topic is just beginning.
The question came up after an official near Paris called for allowing sex assistants as part of the publicly funded social services offered to those, he said, who were least able to "discover their sexuality and their bodies."
The Socialist politician, Jerome Guedj, pulled the most contentious proposal Monday, just ahead of the vote in the local council, removing the term "sex surrogates" after coming under criticism for opening the door to legalized prostitution. Instead, the council agreed for now to open a "reflection on the sexual life of the disabled."
It wasn't what activists for France's disabled community were hoping for.
"Sexuality doesn't take disability into consideration. It's in human nature," said Pascale Ribes, vice president of the French Association for the Paralyzed, which has pressed for state approval for sexual assistance. "There are people who are deprived of access to their bodies, of their sexuality. Some can handle abstinence, but to be abstinent without choosing it is terrible."
The national ethics council, however, has recommended against sex assistants and says such a move risks "merchandising the human body."
Guedj, head of the Essonne department south of Paris, noted that sex surrogates for the disabled are permitted in other European countries as well as in the U.S., as seen in the recent film "The Sessions," which was inspired by an essay by Mark O'Brien, an American writer who contracted polio as a child and used an iron lung and a reclined wheelchair for rest of his life.
"Why do rehabilitation hospitals teach disabled people how to sew wallets and cook from a wheelchair but not deal with a person's damaged self-image? Why don't these hospitals teach disabled people how to love and be loved through sex, or how to love our unusual bodies," O'Brian wrote in his 1990 essay, "On Seeing a Sex Surrogate."
Guedj had hoped to send a working group of associations for the disabled to Belgium and Switzerland to see how the process works in places where sexual assistance is legal.
In Belgium, however, people involved say the reality is more complicated than the law indicates, because the provision of sexual services is part of a murky legal netherworld initially created to counter the criminal aspects of prostitution.
"This kind of care has no legal framework," said Miek Scheepers, chairwoman of Aditi. "When it comes to legal protection, labor law and finances, we still have a lot to do."
The organization hopes to impose requirements like coursework on the needs of the disabled, medical certificates and a system of client feedback. But money is hard to come by.
"Every year we get more queries. There is need for a proper debate and especially a need for subsidies so that this operation can continue to exist," Scheepers said.
In the Netherlands, where prostitution is legal, disabled people are given a certain amount of money per month that can be used for sexual assistance if they choose. But for those who depend on the state funds, even a single visit would wipe out a solid chunk of their spending money. The visits are not considered part of basic health insurance, although some cities provide municipal funds.
France's Minister for the Handicapped, Marie-Arlette Carlotti, said Guedj's initiative is premature, but she welcomed a French debate on the issue.
"We're lagging a bit in France," Carlotti told Europe 1 radio in an interview Friday. "Reflecting on the emotional and sexual life should be a legitimate question."
In 2011, a conservative French lawmaker released a report recommending sexual assistance for the disabled but it went nowhere.
"We want a public debate. We have to ask real questions, about ethics but also about fundamental rights for the handicapped," said Ribes, the French activist. In France, she said, "we consider people who are handicapped not people in and of themselves, but as objects of care."
Casert reported from Brussels. Toby Sterling in Amsterdam contributed to this story.