In March, the French National Ethics Committee decided that sexual surrogacy was an "unethical use of the human body for commercial purposes." Committee member Anne-Marie Dickelé justified it to Rousselle: "The sexuality of the disabled cannot be considered a right."

But some French people like Laetitia Rebord, who is confined to a wheelchair due to spinal muscular atrophy, are campaigning passionately against the committee's decision. She's 31, a virgin, and wants to have sex -- "In her sexual fantasies, she is a fit and impetuous blonde who dominates her male partners." As she told Rousselle, "Eventually, one has to address the issue and understand why we are demanding this. I can't move. I can't masturbate."

The International Professional Surrogates Association notes that in most countries, including the United States, sexual surrogacy is simply undefined by law. It remains unregulated -- unless someone wants to allege prostitution, which could potentially become slippery, though it has not yet been successfully legally challenged as such in the U.S.

North Carolina-based sex therapist Dona Caine Francis says the distinction is that prostitution is about instant gratification, where surrogate therapy involves "months or many sessions in coming as you get to know each other and develop both this deeply personal and deeply therapeutic relationship first."

That's the way surrogacy is portrayed in the 1986 documentary (on Netflix) Private Practices. Director Kirby Dick follows surrogate Maureen Sullivan through encounters with real clients -- men with issues like anxiety and premature ejaculation -- throughout the course of their work together. Sullivan meets with them regularly, at first only to talk, and then gradually escalating physical contact. Their relationships are clearly limited, finite, and tailored to address specific issues.

Sexual surrogacy for people with physically debilitating conditions invites a different discussion, probably because social anxiety is less outwardly appreciable as a barrier to a healthy sex life than, say, quadriplegia. The ends are also different: Sometime surrogates are working temporarily with clients to pepare them real-life sexual relationships; in these cases, they're standing in for them indefinitely.

As the world increasingly sees health care to be a human right -- Kathleen Sebelius and Barack Obama understand health care to be "not some earned privilege, it is a right'' -- it might seem a leap to not only fail to address sexuality in caring for people with conditions like Rousselle's, but to go the additional step of precluding them from procuring it for themselves. Holland, Switzerland, Denmark, and Germany agree.

Marie-Francelyn Delyon, a retired French advocate for the disabled, does not. She told Rousselle, "It seems that people are saying we are incapable of inspiring love." Delyon worries about stigma, that the practice would only drive disabled people further into shadows.