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Sexual Health Blogs

Seeking S-xual Skills: What is S-xual Surrogate Therapy?

Sexual surrogacy—officially called surrogate partner therapy (SPT)—is a topic that you may not understand well, if you’ve heard of it at all. This can make realizing that you might benefit from SPT, as well as finding a skilled surrogate partner, challenging. Many people have found this type of therapy to be beneficial, however, and you’ll soon understand why.

Surrogate partner therapy was first suggested by sex researchers William Masters and Virginia Johnson (the team behind the four-stage sexual response cycle model), so it is still relatively new but isn’t a brand-new idea. The duo focused on men’s sexual dysfunction, including erection problems. Initially, male clients were paired with female surrogate partners, but SPT has come a long way since its advent.

Some surrogate partners might see themselves as sex workers, while others don’t. The law doesn’t differentiate between sexual surrogacy and sex work. However, the International Professional Surrogates Association (IPSA) describes how surrogacy differs from other sex work in one significant way: surrogate partners work closely with clients and their therapists to coordinate care and meet goals related to sexual competency and confidence. 

Often, and depending on legality in their location, therapists might refer clients who are struggling in this area to surrogate partners. Surrogates may require their clients to seek therapy before agreeing to work with them, and some might also recommend specific therapists with whom they are familiar. Either way, this team involves a licensed therapy professional, and working with a therapist may calm the nerves of clients who are anxious about seeing a sexual surrogate.

The International Professional Surrogates Association states that sexual surrogacy has an undefined legal status in most places. Because sexual surrogacy can involve sexual touch, it may be legally considered sex work and thus illegal wherever prostitution is illegal. Although sexual surrogacy might involve intercourse, somatic sex educator Betty Martin explains how this happens less frequently than one might think. The emotional and physical intimacy skills that a client can learn from a surrogate partner can cover far more ground than the general public might realize, including

  • Being comfortable with (parts of) your body

  • Communicating effectively and respectfully

  • Flirting

  • Physical skills such as hugging, holding hands, or kissing

  • Recognizing the body’s response to different types of stimulation or sensation

  • Unlearning shame or guilty about sexuality

  • Gaining control over erections and ejaculation

  • Mastering sex-related fears

  • Confidence

  • Understanding your sexual orientation or desires

  • Facing intimacy avoidance

  • Having (more) orgasms or more satisfying orgasms

  • Increasing desire or arousal

  • Establishing and respecting boundaries

Many of these could be described as somatic skills because they involve the body. The somatic component of SPT can be especially helpful for trauma survivors and those who struggle with pain, low desire, premature ejaculation, or shame around sex. However, surrogate partners see a variety of clients, ranging from those with disabilities to couples who are sexually struggling. Many, many sexual dysfunctions could potentially be improved or even resolved with a surrogate partner.

Some surrogate partners may be certified somatic providers or even offer other somatic services—such as sexological bodywork, massage therapy, or somatic sex education—in addition to sexual surrogacy. Others might be sex or intimacy coaches who also provide sexual surrogate therapy. To ensure that a sexual surrogate partner is ethical and has the right training, look for a provider who is certified by IPSA. This certification includes 100 hours of training, supervised internships, case consultations, and continuing education. The IPSA website doesn’t list SPT providers. Instead, the organization arranges for potential clients to work with therapists who then refer them to a sexual surrogate. Many therapists may be unfamiliar with, have misconceptions, or lack connections to providers of sexual surrogate therapy, so referral coordination makes finding a surrogate partner much easier.

The ultimate goal of sexual partner therapy is to “graduate” from SPT when it is no longer needed, which will be determined by the therapist, sexual surrogate, and client. As such, these therapeutic relationships have a limited timeline. IPSA describes two types of therapy, with differing timelines: local and intensive therapy. Local therapy works for clients who have access to a surrogate partner for weekly appointments between one and two hours long. On average, clients meet with their providers for at least 30 hours. For those who do not have local access to a surrogate partner, a 10 to 14-day intensive with daily appointments may make SPT feasible. Hopeful clients must apply for intensive sexual surrogacy on the IPSA website, however. 

Other practical concerns include cost. While some of the cost of sexual surrogacy may be covered by insurance, this is not guaranteed. Many clients pay their surrogate partners directly out of pocket. Surrogate partners typically charge hourly, and the fees are generally comparable to or higher than those of therapists. Providers might require all payments up front ,based on the agreed-upon treatment plan.

Because of these constraints and laws that prohibit sexual partner therapy in many areas, not everyone who could benefit from a surrogate partner will be able to access one. But if you think you might benefit from this therapy–or could be a good provider–you now understand where to start your search!

Written by Nicole Martinez.