Contrary to social misconceptions, unexpressed sexuality is often a source of great conflict and frustration for many people living with disabilities, according to Sydney University sexual health researcher Russell Shuttleworth.
"It is totally one of their major concerns," said Dr Shuttleworth, from the university's faculty of health sciences, one of the few places in the world studying the issue.
"For younger, disabled people - their hormones are raging. They are adolescents and young adults too."
But he said there was a widely held assumption, reinforced by society, that people with intellectual or physical disabilities were asexual.
By treating disabled members differently, families often denied permission for sexuality to be expressed and the lack of specific sexual education and portrayals in the media of sexy disabled people, all added further barriers.
In his research involving men with cerebral palsy, Dr Shuttleworth said they reported being treated in social situations as asexual. People viewed them only as friends, a perception that they too took on after continued reinforcement.
"When you are growing up in a cultural context that is highly sexualised and you don't see any models for yourself in terms of being seen as sexy, it can build barriers inside yourself," he said.
A viable option for some was found through sex workers, while others wanted real relationships, he said. And even though many disabled people were in relationships and some were married, most had experienced considerable sexual discrimination and being treated as asexual.
"Some people have had a lifetime of rejection, trying to get into relationships and socially withdrawing at some point, thinking, 'What's the use'," he said.
Communication issues and mobility problems could be barriers as was a self-perception based on traditional macho ideals.
A change of mindset and greater flexibility that allowed a woman to take the lead physically was often needed to overcome these society- perpetuated and self-imposed barriers.
"If they showed their sensitivity a bit more and let women take more of the initiative, they were much more likely to get into relationships," Dr Shuttleworth said.
"If they also did not feed into the societal obsession with functionality . . . once they could get past those expectations and just be themselves, then they were more apt to get into relationships."
Further research was required into the needs for facilitated sex for people with various disabilities, including options for sexual aids which were available in the US, but difficulties abounded in what was still widely considered a taboo subject.
"Facilitated sex is where somebody assists you if you need positioning during sex or need to be taken to a sex worker," he said.
"It is assistance in getting your sexual needs met, not necessarily in having sex with you.
"We are trying to get research that looks at these issues but they are not simple issues. They have complex ethical and moral components and so generally that kind of research is hard to get funded."
He said the NSW organisation Touching Base, which was started 10 years ago by sex workers to advocate for easier access to their services for people with disabilities, now ran workshops educating disability service providers in ways to help clients find sympathetic sex workers, if requested.
However, because of legislative differences in most States, the issue remained mired in legal complications and ethical debate.
Curtin University head of sexology Gareth Merriman said while there was a range of education-based services available in WA to help re-educate people with acquired disabilities such as spinal cord injury about their bodies or to help those with long-term disabilities understand their sexuality, there were many barriers to those who wanted to take the next step and chose to access sex services to do so.
In WA, it remained technically illegal to assist someone to seek the services of a sex worker, he said. "The legal status of the sex industry in WA is currently unclear," Dr Merriman said.
"When it gets around to this sort of level, no one is clear where to go. People are not sure what to do because we are so stubborn at the moment moving on the Prostitution Act, we are holding up a whole lot of things.
"In WA, access to sex workers for people with disabilities is available but current laws place carers and government workers in a difficult situation because they are unsure about the legal connotations.
"Therefore, people are being restricted and are not learning about their bodies and they are suffering."
There was an urgent need, to address the sexual rights of people with disabilities, including facilitating access to sex services through changes to prostitution laws.
"It is not about prostitution but about access to sexual pleasure which we can all do every day if we choose to," he said.
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