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This article originally appeared on VICE US.

A few years back, Ernesto Morales, a University of Laval design specialist was working on plans for a new type of shower that would be easier for young adults with cerebral palsy to use. Morales, who researches ways to improve the physical accessibility of home items and urban environments, then thought about masturbation. The muscle control issues many of these people have prevents them from being able to fully wash themselves, he mused, but it also means that some can’t reach their genitals in general. “So I asked myself,” he says, “how on earth do they masturbate?”

Like any good academic, Morales turned this casual curiosity into a full-fledged research question. In recent years, he's released several articles exploring how individual disabled communities view and approach masturbation. In the process, he learned about the importance of sex toys for many, but also the paucity of toys on the market that work perfectly with many populations’ needs or limitations.

Morales is not the first person to learn about or describe this dilemma, not by a long shot. Disabled folk have long noted that society and culture tend to de-sexualize them. As a result, Erika Lynae, a sex toy reviewer with an eye toward functionality for disabled users, says that “most toy companies genuinely do not consider that disabled folks might use or want to use their products.”

That means that as most companies design their products they aren’t considering, say, someone with low muscle control who might not be able to keep hold of a vibrator with a certain grip when its motor gets going. Or that they might not be able to get a dildo into position using some handles. They also aren’t considering that altered sensation in their genitals (or a total lack of sensation) might mean some people need differing types or levels of stimulation out of any given kind of toy. The list of potential hitches is almost infinite, given the wide variety of disabilities and experiences that come with them.

Disabled people have long dealt with this by figuring out which products on the market are incidentally accessible. Folks write entire guides on which devices work with certain conditions, or how they can be used to achieve certain sensations for those with limitations. People also figure out how to hack toys so they work with idiosyncratic needs or desires.

This process is getting easier as sex toys become more visible, commonplace, and diverse. Nick Mahler, the owner of Dallas Novelty, a sex toy store focused on helping disabled people find toys that work for their needs, notes that there are more hands-free and digitally controlled devices than ever before, which is great for people with mobility issues. There are also more flexible toys that can be bent into the desired shape, harnesses and straps that can be used to mount toys or hold one in place during sex, and even silicone dildos that can be molded into new shapes.

Folks like Mahler are making it easier than ever to learn about these toys and how people with varied disabilities can use them. He says that even some major toy distributors are “releasing free training online to help make their sales people better informed on…sex and disability.”

Advancements like these often lead to the belief, among those in the sex toy industry who do think about disability, that there’s already enough toy diversity to work for all bodies. Ariana Rodriguez, pleasure products editor for the adult industry trade publication xBiz, argues that the only real issue is lack of awareness of all the options out there and how they could work for diverse bodies. In truth, Lynae tells me, “there will be lots of sex toys that are almost perfect, but then there will be one aspect—hard-to-press buttons, un-ergonomic handles, etc.—that ruin them.” Hacks can only go so far in patching these shortcomings. And disability awareness advocate Andrew Gurza says that many disabled people are still underserved, at times still not well catered to by anything already on the market—especially those who have fine motor skill issues or sensory impairment.

These are, Lynae says, “usually things that would have only taken a small amount of effort for the manufacturer to make accessible if they’d been designing with disabled people in mind.” The end result could still be a mass audience product, just accommodated for more bodies. To Gurza, not consulting disabled people while designing toys is basically just forsaking extra revenue.

Recognizing some of these gaps and the importance of community input in designing accessible devices, Morales and a team of associates decided to try to build their own toy using the kind of direct feedback many feel is missing in the industry. They published a paper outlining how they consulted disabled people and created a product—a long handle for sex toys that made it easier for women with limited motor skills to navigate them into position—in the journal Sexuality and Disability late last year. The reception to their effort was, sadly, mixed. Morales credits this to the fact that they are not proper manufacturers; they had to use a certain kind of plastic compatible with the 3-D printer at his university, which led to brittle handles with a tendency to break during use.

Fortunately, a few actual sex toy manufacturers have tried to keep disabled communities in mind in recent years. IntimateRider makes a sex chair specialized for people with mobility issues that makes having sex easier. Hot Octopuss draws on medical technology used for spinal cord injury patients that allows them to ejaculate without erections or penile sensation (to inseminate their partners) to create hands-free masturbators for men with motor issues or erectile dysfunction. Tantus makes lightweight and ergonomic products specifically so that people who fatigue easily or have poor muscle control can use them. And the bondage-focused company Sportsheets has created straps and harnesses for disabled users, sometimes customized and with direct input from disabled people their team meets at conventions.

But these disability-aware devices are limited in scope. There does not appear to be any common protocol among these companies for how to consult disabled communities; if there’s no set initiative for regularly hearing disabled voices, it limits how much they can contribute. And Tom Stewart, founder of Sportsheets, tells me that he doesn’t think the wider industry has taken much note of the success these companies have found by keeping disability in mind. Neither he nor most of the other people I spoke to for this piece believe the industry at large will wake up to the potential these companies have discovered, or take their work further.

So what can be done to increase the consideration of disabilities in the sex toy industry to improve accessibility? Morales believes in hammering away at more research; he’s currently applying for a grant to develop sex education systems for people on the autism spectrum. Relentless plugging about how important acknowledging and accommodating sexual pleasure for disabled individuals is crucial. And modeling how to get their input in design processes may eventually have an effect. He also speculates that time may help, as a generation more comfortable with sex toys ages and starts to develop mobility issues and demand more of producers en masse.