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.
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.
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.
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.
Generally, individuals considering sex surrogate therapy have been undergoing sex therapy or psychotherapy for months to several years to deal with concerns such as self-confidence, body image issues, fears, and sexual dysfunctions.
The range of concerns and conditions that may prompt the therapist or the client to consider a partner surrogate may include:
- body dysmorphic disorder, negative body image, or physical disfigurement
- medical conditions
- sexual, physical, or emotional abuse or trauma
- phobias, avoidance, or anxieties about touch, sex, and intimacy
- unresolved relational trauma
- confusion about sexual orientation
- lack of self-confidence or sexual confidence
- orgasmic inhibition
- pelvic pain or genital pain, including vulvodynia
- lack of experience
- sexual dysfunction, including erectile dysfunction, erection difficulties, and premature ejaculation
- vaginismus
- limited or no orgasms
- low arousal or sex drive
- shame about sex
Some researchers suggest that sex surrogate therapy may help treat sexual difficulties among transgender people who have recently undergone gender confirmation surgery. Some evidence also suggests that it may be beneficial for people with disabilities to help them learn about comfortable ways to experience sex.
While some individuals may benefit from this therapy, more research is necessary. Additionally, it may be advisable to establish clarity on the ethics and legality of this practice.
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.
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.
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.
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.
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.
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.
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.