Note: Licensed therapists should not and do not partake in sexual or romantic intimacy with clients. Surrogate partner therapy involves support from an outside third-party surrogate worker who is not a therapist. The therapist does not participate in or watch the activities between a surrogate and a client.
Surrogate partner therapy is a therapeutic approach developed by Masters and Johnson led by a licensed sex or relationship therapist. In this therapeutic modality, a client, an assigned surrogate partner, and a therapist meet to discuss the client's goals around sexual intimacy, emotional intimacy, boundaries, body image, and relationships.
There is some controversy about the ethics and legality of this method, so learning more about how it functions can help you make an informed decision on your care, as well as methods for finding support.
What Is Surrogate Partner Therapy?
Surrogate partner therapy is a type of therapy involving a partner surrogate for a client. It is a three-way partnership between a client, a licensed therapist, and a surrogate partner. Surrogate partners are professionally trained in surrogate therapy and offer sex surrogate services to those seeking support with relationships, intimacy, safety, and sexual concerns. The goals of this type of therapy may include the following:
Increased confidence in sexual ability
Healing from emotional or physical trauma or adverse sexual experiences
Connection with another person
Coping with physical challenges or sexual dysfunction
Learning what one likes with a partner
Learning about consent and healthy relationships
Studies show that healthy relationships can be essential for physical and mental health, and many individuals may struggle to find these satisfying relationships and connections in their lives. For this reason, a sexual or romantic surrogate can offer company, guidance, and a safe space to explore healthy interactions. Anyone of any gender and sexuality can partake in surrogate therapy with sex surrogates.
Who Benefits From Surrogate Therapy?
Often, those who seek surrogate therapy may have difficulties with effective communication and struggle to maintain relationships or find physical and emotional intimacy in their lives, which can occur for various reasons. For example, they may live with an anxiety disorder like social anxiety or have a physical disability that causes difficulties in dating. They also might struggle with being comfortable in their own body. Individuals might benefit from surrogate therapy if they have the following:
A physical disability
A lack of romantic or sexual history
A lack of relationship skills
Confusion about their sexual orientation (lack of clarity of sexual identity)
Painful emotions, memories, or symptoms from trauma or abuse*
A terminal illness
Specific sexual dysfunction, such as erectile dysfunction or erection difficulties
Difficulty achieving orgasm or orgasming too quickly
Genital or pelvic pain (including vaginismus, contraction of the vaginal muscles)
Mental health conditions, such as anxiety or depression
Concerns with libido
Avoidance of relationships
Shame or guilt
Body image issues or negative body image
Anyone can seek surrogate therapy with a certified professional surrogate partner for any reason. However, it may be most beneficial if you go into the treatment seeking a healthy learning experience. Surrogates are not sex workers or real partners for clients. They are temporary professional support workers who may or may not engage in sexual intimacy with individuals.
How Can You Choose A Surrogate?
A surrogate partner may be referred to you during sex therapy with the goal of surrogacy. However, you may have a choice in the gender and age of your surrogate. You might also find a surrogate via their online social media platforms. The International Professional Surrogates Association (IPSA) suggests not choosing a provider you feel immense attraction toward to ensure the therapeutic purpose of the treatment. Clients can also choose between an intern or a certified surrogate partner. These professional partner surrogates work with organizations like the International Professional Surrogates Association.
You may also want to consider your surrogate partner's sexual orientation, character traits, and specialty. If they have experience working with others with your condition, concerns, or goals, they may be more of a benefit to you. IPSA offers a list of registered surrogate partners throughout the US and worldwide. Once you have chosen a surrogate partner, you can choose a therapist and get connected for your first session.
Is Therapy For Surrogate Partner Legal?
According to the Surrogate Partner Collective, surrogate partner therapy is legal and ethical. Before a client is paired with a surrogate partner outside of a therapeutic session, therapists ensure they would be a healthy candidate. If the client does not understand consent, the purpose of the therapy, or is looking only for sex work with a sex worker, they could be disqualified for the treatment.
The therapist works with the client to discuss their concerns through standard talk therapy. This process might involve a modality like cognitive-behavioral therapy (CBT) to discuss concerns surrounding sex, intimacy, and emotional closeness with others. They may then create a treatment plan, including the surrogate partner, with strict consent and limits set before any sensual and sexual touching is involved.
In addition, activities between the client and the surrogate partner happen at an assigned time outside of the therapy session, and the therapist is not involved. For an activity to occur, it must be necessary for the client to achieve their therapeutic goals, and a foundation must be developed with respect, boundaries, and professionalism.
Although many individuals may refer to this process as "sex surrogacy," it does not always involve sexual intercourse or touching. It is, instead, a type of therapy unique to each client. Some clients may come to treatment seeking cuddling, practicing communication skills, and education about their bodies.
Finally, while it may seem like a legal gray area, partner surrogacy is not illegal as long as it occurs with a licensed therapist, a registered and experienced surrogate, and a consenting adult client.
The Effectiveness Of This Form Of Counseling
Although there are limited studies on the effectiveness of surrogate partner therapy, a few studies have found favorable results. One 2007 study found that the form of treatment was effective for treating vaginal pain during penile-vaginal intercourse for 100% of clients enrolled in partner surrogacy therapy, compared to 75% of clients who participated in the activities with a current partner.
How Does A Surrogate Therapy Session Work?
During these therapeutic experiences, clients will meet with their sex therapists when they first come in for surrogate therapy. The therapist is a licensed professional in counseling, social work, or psychology, and they may have further education or training in sex therapy. The client and therapist can first devise a treatment plan comprising the client's treatment goals. Sometimes the treatment involves homework, like watching porn or masturbation.
Afterward, the therapist may invite the client's surrogate to sessions, and the three can discuss their goals and potential activities for the client and surrogate. Afterward, the client and surrogate can schedule sessions to partake in the activities or treatment goals outlined. These activities might include the following:
Discussions about types of touching, such as friendly, sexual, romantic, or comforting touches
Discussions about consent, boundaries, and areas the client doesn't want to be touched
Discussions about the surrogate's boundaries and needs during the session
Sexual touching, such as genital contact
Sensual touching, such as cuddling
Emotional connection activities
Discussing interests and desires
Roleplaying a relationship dynamic
Depending on the client's goals, the professional surrogate-partner relationship may last a few weeks, months, or years. The therapy process varies depending on the client’s needs.
When Is Surrogate Therapy Considered Successful?
The time it takes for surrogacy therapy to be successful and conclude depends on each client. For some, successful surrogate partner therapy might occur when they can reduce pain during sex or improve their sexual functioning. For others, it might occur when they feel closure from sexual traumas from their past. After the sessions are concluded with the surrogate, the individual and the surrogate can meet for a closure session to discuss their experiences. The client may continue to visit with the sex therapist near me or them for talk therapy after the surrogacy has ended. Clients feeling residual emotional attachment with their surrogates can discuss these feelings in a safe environment with their family therapist.
How Do Sessions Stay Professional?
Although clients may develop emotional connections or sexual attraction for their surrogate partner, the surrogate is trained to handle these concerns and follows a code of ethics. One of the ethical rules outlined by IPSA is that the surrogate's relationship with the client is temporary and professional and is strictly a therapeutic relationship. Consistent communication is also important. It also involves boundaries, therapeutic methods, and contraception. They must also test for sexually transmitted infections (STIs) and stay healthy. Clients may also be required to test for STIs and ensure protection is used. If a client violates a surrogate's boundaries, they may be banned from further sessions.
If you're considering surrogate partner therapy, you're not alone. You can reach out to IPSA to find a surrogate partner in your area or seek a sex therapist in your area who is linked with surrogate partner programs. Note that your insurance plan may not cover these services, and surrogate partner therapy can cost around $75 to $200 per hour. Many sessions last from one to two hours.
If you cannot afford this type of therapy, or it is unavailable in your area, you can also consider online sex or relationship therapy. However, online services are not connected with surrogates, a sex therapist can address many similar concerns through talk therapy, including social skills training and more. Note that online therapy does not involve a sexual or romantic relationship between the therapist and the client.
Studies show that online therapy can be as effective as in-person therapy for those experiencing loneliness, isolation, and depression, which can motivate someone to seek a relationship or sexual advice from a therapist. Through an online platform, you can match with a therapist specializing in the unique symptoms you're experiencing through phone, video, or live chat sessions.
If you're interested in meeting a licensed sex or relationship therapist through an internet-based option, consider a platform like BetterHelp for individuals or Regain for couples. Both platforms do not offer surrogate partner therapy but can offer a match-based system for clients looking to speak to a professional about abuse, sex, love, and relationships.
Partner surrogacy is an ethics-based therapeutic practice for those experiencing distress, pain, or other symptoms surrounding sex, intimacy, and relationships. You can find a surrogate partner through ISPA's search tool or seek a therapist in your area that offers this type of therapy. Consider reaching out to learn more and gain further guidance.
Frequently Asked Questions (FAQs)
Below are some of the most frequently asked questions about surrogate partner therapy.
Yes, surrogate partner therapy is a real and professional form of therapy. Therapists offering this form of sex therapy do not partake in a sexual relationship or any form of emotional intimacy with their clients. Instead, they counsel the client on the process of surrogate intimacy. After this process, professional surrogates of physical and emotional intimacy can be contacted by the client and therapist. The International Professional Surrogates Association certifies trained international professional surrogates for this work.
Outside of therapy sessions, without the therapist present, the surrogate can work with the client on goals that were discussed in therapy regarding intimacy and sex. This process may involve physical intimacy but can also involve talking about sex, exploring one’s body, or learning more about physical and emotional intimacy. This process is separate from the therapy sessions and is not a form of therapy. It is a professional service used alongside therapy on the client’s own time. To learn more about what a surrogate does and doesn’t do, consider contacting the International Professional Surrogates Association for support.
What is surrogate partner therapy?
How does surrogate partner therapy work?
Who can benefit from surrogate partner therapy?
Is surrogate partner therapy a legitimate form of therapy?
What is the difference between surrogate partner therapy and sex work?
How can I find a qualified surrogate partner therapist?
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