You know what sex is, and you’ve likely heard of the term “surrogate,” at least in reference to babies and bellies. But if slamming those two words together has you like “???” you aren’t alone.
Most folks don’t know what sex surrogates are.
And most who think they do have it way wrong, according to Jenni Skyler, PhD, LMFT, and AASECT certified sex therapist, sexologist, and licensed marriage and family therapist for AdamEve.com.
“It’s really not the sexy thing most people think it is.”
That’s why there’s been a push to start calling sex surrogacy “surrogate partner therapy” instead, says Mark Shattuck, a certified partner surrogate and media chair with the International Professional Surrogate Association (IPSA).
For context, the IPSA has been recognized as the leading authority in sex surrogacy and surrogate partner therapy since 1973.
Surrogate partner therapy, as defined by the IPSA, is a three-way therapeutic relationship between a licensed therapist, a client, and a partner surrogate.
It’s designed to help the client become more comfortable with intimacy, sensuality, sex and sexuality, and their body.
While this relationship can develop with any kind of licensed therapist, Shattuck says it’s usually with a sex therapist.
He adds that sex therapists tend to be more open to surrogacy work than more traditional therapists are.
So, what is a partner surrogate, exactly?
“A professional who uses touch, breathwork, mindfulness, relaxation exercises, and social skill training to help a client meet their specific therapy goals,” explains Shattuck.
Sometimes — he says in his experience it’s about 15 to 20 percent of the time — partner surrogacy includes intercourse. “But that all depends on the issue the client is working through,” he says.
The purpose of all this? To give the client a safe space to explore and practice intimacy and sex in a structured environment.
Important note: At no point is the therapist watching or directly involved with what’s happening between the partner surrogate and the client.
“A client meets with their partner surrogate separately,” explains Shattuck. But a client gives their therapist and partner surrogate the green light to talk to one another about their progress.
“The therapist, client, and partner surrogate communicating well and often is an important component to successful surrogate partner therapy,” he says.
You actually can’t access a partner surrogate without already having a licensed therapist, according to Shattuck.
So generally, he says, “someone who begins working with a partner surrogate has already been in sex therapy for a few months or few years and still has a lot of work to do around feeling comfortable with sex, intimacy, dating, and their body.”
The problems that may motivate a client to suggest they incorporate a partner surrogate into their healing process — or for a sex therapist to suggest the same to a client — range from generalized social anxiety to specific sexual dysfunctions or fears.
Some folks who may benefit from the healing powers of partner surrogacy include:
- trauma and abuse survivors
- folks with little or no sexual experience
- penis-owners with erectile dysfunction or early ejaculation
- vulva-owners with vaginismus, or other pelvic floor dysfunction that may make penetrative intercourse painful
- people who struggle with body acceptance or body dysmorphia
- people who have anxiety or fear specifically around sex, intimacy, and touch
- folks with disabilities that make it more challenging to have sex
Unfortunately, because most insurance policies don’t cover surrogacy partner therapy (or sex therapy, for that matter), many of the folks who could benefit from this healing modality can’t afford it.
One session typically costs anywhere from $200 to $400 out of pocket.
Once you and your therapist have decided surrogate partner therapy could benefit you, your sex therapist may reach out to their network of partner surrogates to help you find a potential match.
They may also contact the IPSA Referrals Coordinator for assistance in finding a compassionate, well-trained, certified professional surrogate partner who best fits your needs.
Shattuck calls out that nowadays many partner surrogates have online and social media platforms, so if you stumble on a partner surrogate you think might be a good fit for you, bring it up with your sex therapist.
But to actually work with that particular partner surrogate, both your sex therapist and that partner surrogate will have to sign off.
From there, “the client and partner surrogate will meet to determine whether or not it’s a good fit,” says Shattuck.
The first meeting happens in the sex therapist’s office, but all subsequent meetings happen elsewhere — usually in the surrogate’s office, or the client’s home.
A “good fit” isn’t determined by things like how attracted you are to the surrogate, but rather by feeling like you can (or eventually can) trust them.
Usually, the partner surrogate and sex therapist work together to come up with a treatment plan based on your goals. After that, you and your partner surrogate will work together toward that goal.
Things a treatment plan may incorporate:
- making eye contact
- sensate focus
- breathing exercises
- body mapping
- one-way or mutual nudity
- one- or two-way touch (above or below clothing)
- intercourse (guided by safer-sex practices)
“There isn’t always, or even usually, intercourse between a partner surrogate and the client, but when there is, we focus on building an intimate foundation first,” says Shattuck.
Surrogate partner therapy isn’t a one-and-done thing.
“We work together once a week or so until the client reaches their goals. Sometimes that takes months, sometimes that takes years,” he says.
“Once a client has reached their goals, we have a few closing sessions and then send them off into the real world!”
There may be some overlap, but surrogate partner therapy isn’t sex therapy.
“They are radically different fields,” says Skyler.
“Sex therapy is a type of therapy that helps an individual or couple deconstruct negative messages and experiences in order to help them build toward optimum sexual and relationship health,” she says.
While clients may occasionally have hands-on homework — for example, masturbating, watching porn, or making a Yes, No, Maybe list — sex therapy is talk therapy.
“There are no hands-on interactions between a sex therapist and the client,” says Skyler.
Surrogate partner therapy is when a sex therapist calls on another expert —a certified surrogate partner therapist — to be physically, sexually, or romantically intimate with their client outside of the sex therapy sessions.
“While we support sex workers, we don’t consider ourselves sex workers,” says Shattuck. “We consider ourselves adjunct therapists and healers.”
Sometimes there are sensual and sexual things involved in sex surrogacy, but the goal is healing — not necessarily sexual release or pleasure.
This metaphor, courtesy of partner surrogate Cheryl Cohen Greene, may help:
Going to a sex worker is like going to a fancy restaurant. You choose what you want to eat from a menu, and if you like what you ate, you’ll come back again.
Working with a surrogate partner is like taking a cooking class. You go, you learn, and then you take what you learned and you go home and cook a meal for someone else…
Usually, your sex therapist will make the introduction. But you can use this IPSA Surrogate Locator to find a partner surrogate in your area.
Good question. In the vast majority of the United States, paying for sex is illegal. But partner surrogacy isn’t synonymous — or at least not always synonymous — with paying for sex.
“There is no law against doing this,” says Shattuck. “But there’s also no law that stipulates that this is OK.”
In other words, partner surrogacy falls in a legal gray area.
But, according to Shattuck, the IPSA has been around for over 45 years and has never been sued.
“A sex surrogate has a very important role for the client who needs them, but they don’t need academic or clinical training in psychology,” says Skylar.
Does that mean anyone becomes a partner surrogate? Nope.
“Those who work in surrogacy need to go through an ethical program and certifying body, like IPSA,” she says.
According to Shattuck (who, to reiterate, is IPSA certified), becoming a partner surrogate is a fairly involved process.
“There’s a multi-week training process, then there’s an internship process where you work under a certified surrogate partner, and then if/when you’re deemed ready to go off on your own as a certified partner surrogate yourself, you do.”
The IPSA calls out that comfort with one’s own body and sexuality, warmth, compassion, empathy, intelligence, and nonjudgmental attitudes toward others’ choice of lifestyle, consensual sexual activities, and sexual orientation are all prerequisites for becoming a surrogate partner.
For folks for whom intimacy, sexuality, their body, and touch are a source of anxiety, fear, stress, or worry, working on a team with a (sex) therapist and a partner surrogate can be incredibly healing.
Gabrielle Kassel (she/her) is a queer sex educator and wellness journalist who is committed to helping people feel the best they can in their bodies. In addition to Healthline, her work has appeared in publications such as Shape, Cosmopolitan, Well+Good, Health, Self, Women’s Health, Greatist, and more! In her free time, Gabrielle can be found coaching CrossFit, reviewing pleasure products, hiking with her border collie, or recording episodes of the podcast she co-hosts called Bad In Bed. Follow her on Instagram @Gabriellekassel.