Sexual Surrogacy

Yes, people who act as sex surrogates actually exist. The proper terminology for this line of work is surrogate partner therapy. Before the AIDs scare of the 1990s, there were many more surrogate partners than there are now. With the fear of a deadly sexual transmitted disease, many surrogates closed up shop and chose other professions. Yet some continue to thrive using safer sex practices.

William Masters and Virginia Johnson first introduced sex surrogacy as an effective therapeutic modality in 1970. In their book Human Sexual Inadequacy, Masters and Johnson explored the treatment of surrogate partner therapy for a person (mainly men) without an intimate partner that were experiencing sexual dysfunction. The modality was so successful, that they decided to classify it as a therapeutic intervention despite their foundation’s policy against it as a treatment for sexually dysfunctional people without a partner. They also went on to say that using partner surrogates had been one of the more effective clinical decisions they made over the 11 years of study.

The first study of surrogate partners focused entirely on male clients and female surrogates. Over the course of their work, Masters and Johnson mentioned three unmarried women who were interested in receiving similar services. All three of the women chose to bring in their own partners. The proper terminology for this is replacement partner; a partner of his or her choice brought by the client. Because women were not addressed in the original surrogate studies, some have concluded that Masters and Johnson meant for surrogate work to only be useful for men with inadequacies. Various studies validating the success of surrogate partners with women since have countered this idea.

There are many reasons why a therapist might want to introduce surrogate partner therapy into the therapy treatment. Some reasons for men are: erectile dysfunction, premature ejaculation, delayed ejaculation, or homosexual males interested in examining the possibility of a relationship with a woman. Some reasons for women might be: vaginismus, vestibulitis, anorgasmia, or lesbian females who are interested in examining the possibility of a relationship with a man. Both men and women might seek surrogacy to treat: lack of experience, general anxieties and anxiety of intimacy, low levels of sexual desire or lack of sexual arousal, difficulties in building relationships, lack of confidence in intimate relationships, uncertainty around sexual preferences, shame about sex, negative body image or physical disfigurements, the client’s partner is unwilling to be involved in the treatment, or sexual and emotional rehabilitation after separation, divorce, and/or disabilities. In addition, surrogate therapy has been found to be effective in cases of rehabilitation after sexual trauma and for clients who have complex problems such as extreme phobic reaction to intimacy.

A surrogate works in what is called the “three-person therapeutic team.” The team is the client, the supervising therapist, and the surrogate. To learn more about how surrogates work, check out the International Professional Surrogate Association (IPSA) website.

Some people wonder if this is prostitution? The most common misconception of surrogate work is the difference between a surrogate from a prostitute. Sex surrogate therapy has the potential for intimate sexual interaction and the surrogate is paid for their time, similar to a prostitute. The difference is in the intent in which they enter the arrangement. The surrogate’s intent being a long-term therapeutic re-education and re-orienting of inadequate capabilities of functioning or relating sexually; whereas the prostitute’s intent is immediate gratification localized in genital pleasure. Masters and Johnson commented on the difference: “So much more is needed and demanded from a substitute partner than effectiveness of purely physical sexual performance that to use a prostitute would have been at best clinically unsuccessful and at worst psychologically disastrous.”

Surrogate partner therapy was re-introduced into the public’s awareness in 2012 when the movie The Sessions was released. The movie is based on a true story of a handicapped man, Mark O’Brien, and his desire to lose his virginity. Mark was a virgin that was paralyzed from the neck down because of polio and he lived in an Iron Lung. He had been unable to lose his virginity until a sex therapist suggested a partner surrogate to him, Cheryl Cohen-Greene. The movie debuted at the 2012 Sundance Film Festival, where it won the Audience Award and the Dramatic Special Prize for Ensemble Acting. The movie also went on to win at the Independent Spirit Awards and San Sebastian International Film Festival. Unfortunately, the movie was written to draw an audience and some of the ways in which surrogate work was portrayed were not accurate. Cheryl, the surrogate portrayed by Helen Hunt in the movie, has since written her memoirs in a book titled, An Intimate Life. In her book, she describes the real relationship between her and Mark, which is somewhat different from the plot of the movie.

Although the real story is much less compelling to audiences because it does not include the romantic love required for mainstream audiences, the incredible learning experiences that a person can have with a surrogate is unmistakable. What is portrayed in the movie is how a man, who has few sexual options, can explore, learn about himself, his body, and how he performs sexually with someone who is caring, knowledgeable, and understands how to teach someone about sex in a way that is healthy and non shaming. A professional trained in the area of eroticism can help a person explore what sexual energy entails for themselves and how to be a potential viable partner for another person.

Eileen Chao is currently a Surrogate Partner Therapy Intern, as well as a sex and relationship coach. In addition to training with IPSA, Eileen is also a certified Sexological Bodyworker, graduate of the Somatica Method program of sex and relationship coaching, and is currently pursuing a Masters degree in Psychology. She had this to say about what she does and how she works with clients:

“Sessions with a surrogate mainly consists of exploring a series of touch exercises called sensate focus. We start with non-sexual parts of the body (hands, feet, face), then slowly moving on to more intimate areas. We take turns giving and receiving touch. The giver focuses on touching for their pleasure, using all parts of the hands and forearms to explore different kinds of touch. Both giver and receiver is consciously breathing and focusing on their feelings. Emotional feelings that arise are recognized then released, if there is any kind of fixation you are reminded to breathe and go back to focusing on the physical sensations. There is also a sex education piece concerning male and female genital anatomy, arousal process, STIs, and safe sex practices. Working with a surrogate basically gives you a step by step foundation of what it is to be physically and emotionally intimate with another person. There is lots of open and honest communication throughout the whole process.”

Eileen sees clients in San Francisco, and does travel for intensive sessions. Intensives typically last for 1-2 weeks, and consists of seeing the surrogate daily for around 2-3 hours, as well as time with the supporting therapist. If you’re interested in contacting her she can be reached at: somaticsexuality (at)  gmail (dot) com.

If you are curious to learn more about sex surrogacy, the documentary, Private Practices: The Story of a Sex Surrogate, which follows Maureen Sullivan (the surrogate) as she helps her clients overcome their sexual issues, is a great movie to start with.

– Keeley