What is a sexual surrogate therapist

Deborah C. Escalante

Sexual surrogacy is a type of therapy that aims to help individuals feel more at ease with sex, their bodies, and the emotional and physical skills required for intimacy. In this therapy, the client works with a licensed sex therapist and a surrogate partner. Unlike other forms of sex therapy, sexual surrogacy involves physical touch and intimacy.

Sexual surrogacy is a controversial and frequently misunderstood form of therapy. There is a lack of published research on the subject due to its potential ethical and legal complications. However, some people have reported positive experiences with it as part of their sex therapy, although this evidence is anecdotal.

Other Names for Sexual Surrogacy

Another term for sexual surrogacy is surrogate partner therapy (SPT). Sex surrogates also go by the title “surrogate partner.”

Myths and Misconceptions about Sexual Surrogacy

The biggest myth surrounding sexual surrogacy is that it is a form of prostitution. But there are important differences. Sex workers focus only on giving sexual gratification to a client. But a surrogate partner’s goal isn’t around sexual satisfaction or stimulation — they aim to help a person overcome troubles they have around sex and intimacy, whether they are physical, social, or emotional. They may focus on areas like relaxation, communication, and social skills training. In some cases, surrogate partners never have physical contact with their client.

Still, the legality of surrogate partner therapy is complicated. There are no specific laws against it. But major professional organizations in the fields of psychology and social work have also refrained from making any official statement about the ethics of surrogate partner referral. Many people agree that the key is to work with a licensed sex therapist who can guide the process.

The International Professional Surrogates Association, a professional organization for those in the field of surrogate partner therapy,  ensures that its members receive training, achieve competency, and maintain a specific code of ethics.

Some people believe that surrogate partners should only be part of therapy for people with physical limitations that affect their sex lives. However, SPT can treat a variety of issues.

Therapeutic practitioners trained in addressing issues of physical intimacy

Sex surrogates, sometimes referred to as surrogate partners, are practitioners trained in addressing issues of intimacy and sexuality. A surrogate partner works in collaboration with a sex therapist to meet the goals of their client. This triadic model is used to dually support the client: the client engages in experiential exercises and builds a relationship with their surrogate partner while processing and integrating their experiences with their therapist or clinician.

The modality in which surrogate partners work is called Surrogate Partner Therapy. This modality is used to address obstacles to physical and emotional intimacy that a client is unable to resolve through traditional therapy and requires the involvement of a partner. Clients’ presenting issues have commonly included sexual dysfunctions, lack of healthy intimate experiences, or traumatic history.

Masters and Johnson introduced the practice in their book Human Sexual Inadequacy, published in 1970. They believed that people could learn about sexual intimacy only by experiencing it. In their research, subjects that were partnered used these partners to aid in a series of exercises designed to help overcome sexual dysfunction. Unpartnered subjects were paired with “surrogates” who would take the place of a partner, work under the direction of a trained therapist, and act as a form of mentor for the client. In their research, all of the surrogates were women who were assigned to work with single men. Today, most surrogates are women, but a few are men.[1]The practice of Surrogate Partner Therapy reached its peak in the early 1980s with a few hundred surrogate partners practicing in the U.S. Since then, Surrogate Partner Therapy’s popularity declined but reentered social consciousness after the 2012 film The Sessions, which depicts one surrogate partner’s work with a disabled man. As of 2014, those practicing Surrogate Partner Therapy were still very few in number.[2]

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There are people who have experienced a change in sexual lifestyle due to an acquired disability (accident, paralysis, disease, trauma), and a surrogate can help them explore and develop sexual potential.[5] The causes of sexual concerns are numerous and the methods a surrogate might use to help improve a client’s sexual life are varied.

The course of this therapy involves continued communication with both the therapist and the Surrogate Partner. The therapist is responsible for addressing the client’s concerns and helping them explore ways to overcome their sexual problems through talk therapy. If the therapist and client deem it necessary that they need additional assistance, they can explore the option of working with a Sexual Surrogate Partner. Therapists are limited only to talk therapy, which is why a Surrogate Partner can be beneficial in helping address the client’s concerns through exposure therapy, with no limitations of touch. The therapist is responsible for relaying critical information and treatment goals to the Surrogate Partner for the meeting with the client, so that they may fully address their concerns during the interaction. The therapist, surrogate partner, and client work together to create their course of a treatment plan, the interaction between the client and the Surrogate Partner is essentially for the client to practice what they’ve learned with their therapist through talk therapy.

The methodology of this therapy is described to have four phases to achieve a successful treatment:

  1. Emotional connection
  2. Sensuality
  3. Sexuality
  4. Closure

The first step in Surrogate Partner Therapy is for the surrogate to verbally create an emotional connection and bond with the client, to create a safe environment and address any boundaries and expectations. During this step, the surrogate and client can get to know each other as individuals and create a meaningful relationship. This first step is essential in making the client feel comfortable in pursuing this new type of therapy and laying a good foundation for practicing emotional intimacy.

The next step involves exploring the client’s sexuality. This step can involve physical touch and nudity to help the client overcome their sexual concerns, but would not involve sexual arousal or interaction between one another. In this step, the surrogate can work on exercises with the client to feel comfortable in their own body and next to someone else’s body, this can involve hugging, or cuddling.

In the third step, the surrogate and client focus on sexuality, this can involve:

  • Physical touch
  • Sexual arousal
  • Sexual contact
  • Oral-Genital Stimulation
  • Sexual intercourse

The fourth step is closure, to close out the therapy once all parties are satisfied with the results.

Since sexual problems are often psychological rather than physical, communication plays a key role in the therapeutic process between a patient and the surrogate partner, as well as between the surrogate partner and the therapist.Surrogate partners offer therapeutic exercises to help the patient. These may include, but are not limited to relaxation techniques, sensate focusing, communication, establishing healthy body image, teaching social skills, sex education, as well as sensual and some sexual touching. Surrogate partner therapy begins with a meeting between the client, therapist, and surrogate partner in which the goals of the client are discussed and the scope/duration of the therapy are established. Throughout the process, communication between surrogate partner-client, client-therapist, and surrogate partner-therapist is maintained.[6]

Some couples attend surrogate partner therapy sessions together, while some people (either single or in a couple) attend them alone.[7] The surrogate engages in education and often intimate physical contact and/or sexual activity with clients to achieve a therapeutic goal.[7] Some surrogates work at counseling centers, while others have their own offices.[8]

The 2003 Salon.com article “I was a middle-aged virgin”, by Michael Castleman, discusses a middle-aged American virgin (Roger Andrews) and his therapy with the sex surrogate Vena Blanchard.[9]

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Sex surrogate therapy is a three-way therapeutic relationship to help a person feel more comfortable with sex, sensuality, and sexuality. It involves working with a licensed therapist and a surrogate partner to manage potential issues with intimacy.

Also known as surrogate-assisted therapy or surrogate partner therapy, this treatment aims to help build self-awareness and skills in physical and emotional intimacy. A person sees both a sex therapist and a surrogate partner to help develop a healthy self-concept and improve sexual functioning. While this treatment can involve intercourse with the surrogate partner, it does not always.

A person may seek this type of therapy because of sexual dysfunctions or any trauma, fears, or anxieties they experience related to sex. Sexual health and satisfaction can play a crucial role in a person’s health and well-being, and forming sexual relationships may impact happiness and fulfillment.

In this article, we discuss what sex surrogate therapy is, how it works, who can benefit from it, and how it differs from other practices.

 

Definition

A person in a sex surrogate therapy session.

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Surrogate partner therapy is a three-way therapeutic relationship among a licensed therapist, a client, and a surrogate partner.

The treatment typically involves a variety of therapeutic experiences, sometimes including sexual intercourse, to explore and resolve barriers preventing a person from having physical, sexual, and emotional intimacy.

Dr. William Masters, a gynecologist, and Dr. Virginia Johnson, a sexologist, introduced the concept in their book, Human Sexual Inadequacy, which they originally published in the 1970s.

 

How it works

The course of therapy usually begins with the therapist and the client determining goals and creating a treatment plan to address the issues behind the client’s difficulties.

The therapist may recommend surrogate partner therapy if they deem it helpful. Partner surrogates work in collaboration with the therapist and the client. They receive training to mentor, coach, and help clients meet their treatment goals.

Similarly to the way exposure therapy enables a person to face their fear, this treatment provides access to a safe partner to allow a person to practice techniques, among other skills.

The goals of this treatment may include building self-awareness and self-confidence, developing effective communication, training social skills, and developing physical and emotional intimacy skills.

Surrogates guide clients through the program and gradually progress through varied therapeutic experiences that aim to explore, build the client’s skills, and promote their healing. The plan may incorporate:

  • relaxation and meditation
  • eye contact
  • effective communication
  • sensate focusing
  • sex education
  • body mapping
  • one-way or mutual nudity
  • one-way or mutual touching
  • genital-genital contact

A person may opt for local therapy, which is when the therapist and the surrogate are both available in the local community. It usually involves meeting with the therapist for 1 hour per week and meeting with the surrogate partner for 1–2 hours per week.

Alternatively, they may use an intensive setup, which is when the therapist-client and surrogate-client sessions overlap to facilitate rapid growth and change for the client. This involves meeting with the surrogate partner for 2–3 hours per day and with the therapist for 1 hour per day. Intensive therapy typically lasts for 2 weeks.

It is important to note that the therapist is not involved in the sessions between the surrogate and the client. However, open, proper, and consistent communication among all three team members is fundamental for the approach’s success. All team members make a mutual decision to terminate therapy, typically when the client achieves their goals.

 

Sex surrogate therapy vs. sex therapy

There is some overlap between sex therapy and sex surrogate therapy, as both treatments aim to help resolve sexual issues.

While sex therapists may provide sex-based exercises to perform at home in between sessions, such as watching porn or masturbating, they do not participate or offer hands-on exercises to help their clients practice and develop these skills. Sex therapy is essentially a form of talk therapy.

Sex surrogate therapy may often involve a sex therapist as a licensed professional in addition to a certified surrogate partner. With consent, a person may be able to practice physical or sexual intimacy or techniques that a sex therapist advices with the surrogate partner.

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Becoming a sex therapist typically requires a person to earn a master’s degree in a related field such as mental health, therapy, counseling, or psychology. In contrast, a person does not need any specific degree or course to qualify as a surrogate partner.

Sex surrogate therapy vs. sex workers

Many people may see sex surrogate therapy as a form of sex work. However, the two have different goals.

Sex workers receive payment in exchange for consensual sexual services. Sex surrogate therapy aims to provide a safe, structured environment where the client can explore intimacy and resolve barriers that prevent them from developing physical and emotional intimacy with a partner.

Sex surrogate therapy may also include sensual and sexual contact, but the focus is on developing skills and healing. In some cases, surrogate partners never have physical contact with their clients.

The International Professional Surrogates Association (IPSA) Code of Ethics states that the term “surrogate partner” applies only when the therapeutic relationship includes the involvement and participation of a licensed therapist. The surrogate may act as a substitute partner or a co-therapist.

 

Legality

There are currently no laws regulating or prohibiting sex surrogacy therapy. While paying for sex is illegal in most of the United States, this type of therapy does not always involve the exchange of money for sexual services, so it may fall into a legal gray area.

Sexual gratification is not necessarily the sole aim of the treatment. The treatment is also a therapeutic tool to help people overcome sexual challenges and improve their sexual health. Although the rationale for using a surrogate partner may be for sexual engagement, sexual contact is not mandatory and occurs only if necessary for the client to reach their goals.

Like any decision in a traditional therapeutic relationship between a client and a therapist, the decision to engage in intercourse as part of treatment is the choice of both parties and requires informed consent.

Since its establishment in 1973, IPSA has not experienced any legal issues.

How to find a surrogate

A person may be able to access a partner surrogate through a licensed therapist, who can tap into their network of partner surrogates.

A person may also refer to IPSA’s list of surrogate partners. However, because not all surrogate partners want to post their personal information publicly, a person may also connect with IPSA’s referrals coordinator to be connected with a trained and certified professional surrogate partner.

Moreover, because some surrogate partners have profiles on social media platforms, a person may encounter people who claim to be IPSA certified or IPSA members. Individuals or therapists may contact the IPSA referrals coordinator to confirm.

 

Training

While a specific degree or course is not a prerequisite for applying to IPSA’s Professional Surrogate Partner Training Program, the training committee does look for certain qualities, such as:

  • emotional maturity
  • evolution through personal therapy or other growth-oriented life experience
  • comfort with one’s body and sexuality
  • readiness to be involved in a close, caring relationship with others who are having difficulties with emotional, physical, and sexual intimacy

Interested applicants may begin their training application process with IPSA. They will need to fill out forms that require them to share very personal information.

Applicants need to go to Southern California for training, which has two phases. The first involves a 100-hour didactic and experiential course. Upon completing this, a person can enter a multiyear, multiclient supervised internship for phase 2.

Summary

Sex surrogate therapy is a therapeutic relationship involving a client, a therapist, and a surrogate partner. It can offer a place of healing and growth for people who are having difficulty with fears and anxieties about sex, their sexuality, or intimacy.

However, the therapy may not be suitable for everyone, and it does not necessarily involve intercourse with the surrogate partner. Individuals who are working with a sex therapist and interested in trying sex surrogate therapy may discuss it with their therapist. It is up to a licensed therapist to determine whether a person may benefit from a surrogate partner.

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