Sex surrogacy, is the term for the controversial practice of using 'hands on' tutoring as part of psychotherapy for sexual disorders or 'sex therapy.' Use of a Sex Surrogate is legal in the state of California, when working in tandem with a licensed mental health professional, however, check with your locality before embarking on this journey, as many states and/or countries do not recognize a Sex Surrogate as a legitimate profession.
'Sex therapy' is an umbrella term for a number of established psychological and behavioral treatments for sexual difficulties for either couples or individuals, and is done by licensed mental health professional.
Most commonly,'Sex therapy' involves a mental health professional working with a couple or individual to discuss the problem, work out what might be going wrong, and then by asking the couple or individual to try a number of approaches to improve their relationship, communication and intimacy. It is done in an office setting, CLOTHING IS A MUST AND NOT OPTIONAL. As a psychotherapist who focuses on sexual issues, I recognize that many sexual problems are often a manifestation of bigger issue/s either within the relationship or individually, (examples are body image, financial stress, anxiety, depression, etc..) and focus of treatment is often on working towards alleviating the core symptoms in tandem with addressing the sexual concerns.
I believe that this approach key as, despite what all the latest drug research and implementation might imply, (although I do believe there can be advantageous uses of combining psychotherapy with medical treatment if done appropriately), as many sexual problems arise from anxiety, mismatched expectations in relationships, and unhelpful learned responses carried over from previous relationships, rather than simply physical or physiological problems with the sexual organs which can be fixed with a pill.
A common approach is to initially ask the couple not to have sex and simply focus on touching and intimacy (an approach designed initially by Masters and Johnson, known as Sensate Focus). This takes the pressure off (such things as erection, orgasm, female arousal) and reduces stress and anxiety, and attempts to bring back the sensuousness of sex. Once the couple starts to feel more connected, therapy focuses on introducing sexual activities or exercises for the couple to try at home to help deal with the remaining difficulties.
Similarly, the therapist might ask the couple to explore new ways of communication, and consider how they understand their partner, both sexually and in everyday life. Some 'sex therapy' is very couples focused, but other forms of sexual psychotherapy, can help broaden the options for someone whose sexual problems are preventing them from getting a partner, or other longer standing issues like intimacy, or attachment issues or sexual abuse and/or trauma.
Another controversial option is to use a 'sex surrogate', someone who is employed by the sex therapist to practice sexual exercises with the patient.
Sex surrogacy was pioneered in the UK by the now retired therapist Dr Martin Cole, who became a controversial figure in the 60s and 70s media for advocating, even at the time, quiet radical views on sexual freedom and treatment.His clinic provided, amongst a range of other treatment and advice services, sex therapy using surrogates and even managed to get public money for his clinical work.
Surrogate therapy is minimally used in mainstream clinics these days, largely because of the difficulty of getting competent and responsible surrogates, getting suitable referrals, and dealing with the ethical dilemmas and media interest. Surrogate therapy is still being used in many private settings with psychologists, therapists, and other mental health professionals who focus on the issues of sex and sexuality. And, surrogate therapy is still being researched and has been found to be effective in limited trials. One example is a study published earlier this year in the Journal of Sexual Medicine which found surrogate therapy was significantly more effective than couples therapy alone in treating vaginismus.
Nevertheless, the use of surrogates in sex therapy has received very little attention from researchers, and many are concerned about it's being limited in terms of being regulated, and the actual effectiveness of surrogate therapy.
Dr. Petra Boynton who happens to be in the UK, discusses the state of modern surrogate therapy, what's involved, and gives some advice for you if you are considering it as an option.
It's probably worth mentioning that many sexual problems can be successfully treated from qualified and experienced psychologists and psychotherapists who don't use surrogates, so it's always worth enquiring with your providers.
And remember, when receiving therapy, it's always worth checking that the person is fully qualified and accredited by recognized state boards and associations. If you are interested in working with a sex surrogate, work with a sex therapist first. The therapist can refer you and will work together with you and the surrogate.
