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Introduction <p>Since the early 2000s, France has witnessed growing debates around the necessity of legislating support mechanisms for individuals with disabilities to engage in sexual relationships. This study examines how sexual assistance emerged as a legitimate public policy issue through strategic advocacy efforts.</p> Methods <p>This research employed documentary analysis of 778 texts (1975–2011) and 23 semi-structured interviews with key stakeholders collected between 2015–2017. Data were analyzed using thematic analysis following Braun and Clarke's framework, examining how different actors constructed and contested meanings around sexual assistance.</p> Results <p>The analysis reveals three key phases: medicalization of disability sexuality (1975–1995), emergence of rights-based discourse (1995–2005), and strategic institutionalization (2005–2011). Marcel Nuss and other activists successfully reframed sexual assistance from a medical issue to a fundamental rights concern through strategic coalition building, international comparisons, and media mobilization.</p> Conclusions <p>The French case demonstrates how marginalized groups can successfully challenge cultural taboos and construct new policy categories through sustained advocacy efforts. Sexual assistance advocacy succeeded in legitimating previously unthinkable concepts while highlighting persistent tensions between professional expertise and disabled people's autonomy.</p> Policy Implications <p>The partial success of sexual assistance advocacy reveals the need for sustained policy efforts that address both cultural acceptance and institutional barriers. The French experience offers valuable lessons for advocacy groups working on controversial issues, emphasizing the importance of strategic framing, international examples, and long-term coalition building.</p>

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The Birth of a Social Problem: Sexual Assistance Advocacy in France (1975–2011)

  • 期刊论文

  • 发表日期：

    2025年9月2日

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  • Pierre Brasseur

摘要

Introduction

Since the early 2000s, France has witnessed growing debates around the necessity of legislating support mechanisms for individuals with disabilities to engage in sexual relationships. This study examines how sexual assistance emerged as a legitimate public policy issue through strategic advocacy efforts.

Methods

This research employed documentary analysis of 778 texts (1975–2011) and 23 semi-structured interviews with key stakeholders collected between 2015–2017. Data were analyzed using thematic analysis following Braun and Clarke's framework, examining how different actors constructed and contested meanings around sexual assistance.

Results

The analysis reveals three key phases: medicalization of disability sexuality (1975–1995), emergence of rights-based discourse (1995–2005), and strategic institutionalization (2005–2011). Marcel Nuss and other activists successfully reframed sexual assistance from a medical issue to a fundamental rights concern through strategic coalition building, international comparisons, and media mobilization.

Conclusions

The French case demonstrates how marginalized groups can successfully challenge cultural taboos and construct new policy categories through sustained advocacy efforts. Sexual assistance advocacy succeeded in legitimating previously unthinkable concepts while highlighting persistent tensions between professional expertise and disabled people's autonomy.

Policy Implications

The partial success of sexual assistance advocacy reveals the need for sustained policy efforts that address both cultural acceptance and institutional barriers. The French experience offers valuable lessons for advocacy groups working on controversial issues, emphasizing the importance of strategic framing, international examples, and long-term coalition building.