The Value of Hands-On Therapy

The Beautiful Kind (TBK, for short) is a St. Louis, Missouri-based sexual surrogate … among other things. A bisexual, atheist, vegetarian, self-identified “sex goddess,” TBK works as a sex writer and consultant, as well as a sex worker specializing in fetishes and surrogacy. Her definition of a sexual surrogate is “someone who helps others overcome social and sexual issues through hands-on intimacy.”

That “intimacy” may or may not involve having sex with her clients.

In researching “Personal Touch” for Best Sex Writing 2010, Brian Alexander polled a number of experts in the field: therapists, researchers, and even a surrogate he dubbed “Jane.” Exactly what Jane does varies depending on the man’s needs. “I reintroduce people to their own bodies,” she explains. “It is close and intimate but not necessarily sexual. For example, for people with sexual trauma, it is important for them to know they can touch and be touched and not be in jeopardy.”

Beth Krakower, a psychotherapist in Florida who specializes in counseling patients with sexual issues, says it makes good therapeutic sense to use sexual surrogates. “So much of sex therapy involves homework,” she notes. “I give my patients homework for different reasons. What if someone has a sexual difficulty like rapid ejaculation or an erection problem? If you don’t have a partner, surrogates may work.”

After investigating the legality of sexual surrogacy in her area, Krakower joined the ranks of those therapists who refer clients to sex surrogates—experts who stand in for sexual partners to help with specific problems. (Florida, like many other states, has no specific laws specifically banning sexual surrogacy, but none endorsing or protecting it.) Since sexual surrogates have no certification or licensing requirements, they cannot bill insurance companies for their services and must operate in a legal gray area.

Legitimizing Sex Work

Sexual surrogacy is nothing new. Masters & Johnson introduced the concept in the ’50s. There was a surge the popularity and prevalence of surrogates in the ’70s, but then it seemed to go underground with disco and bell-bottom jeans.

“A couple of things made (surrogates) problematic for some therapists,” Howard Ruppel, Ph.D., academic dean at the Institute for Advanced Study of Human Sexuality in San Francisco, explains. “One is the matter of respectability. If you want to get an interesting discussion going on the bulletin boards of professional groups that certify sex therapists, just put surrogate partners out there and the thing goes berserk.”

Stephen Conley, Ph.D., executive director of the American Association of Sexuality Educators, Counselors and Therapists, the issue of surrogacy “just about split the AASECT board years ago. They could not get consensus. Some people were strongly in favor and some worried about legal implications.” No formal policy was ever adopted and the issue of sexual surrogacy was buried.

Some try to resurrect surrogacy and breathe life and legitimacy into it. Leading that revival is surrogate Vena Blanchard, who created the International Professional Surrogates Association to train and certify sex surrogates. IPSA qualified surrogates must be knowledgeable and ethical. To be a licensed, officially recognized surrogate, one must adhere to the IPSA standards of conduct, which puts high priority on surrogates ensuring a client’s interests, safety and confidentiality.

Surrogacy by the Book

Surrogates are experts that work alongside a therapist with the goal to help clients’ progress and restore a healthy sex life. The therapist, client and surrogate communicate with each other and the client sees the therapist on a regular basis. Sometimes a therapist will refer the client to a sex surrogate with instructions on what the client needs, and the surrogate will demonstrate these methods. A surrogate must be qualified, experienced, and extremely knowledgeable about sexual dysfunctions and resolution. Surrogates consult therapists following client encounters to provide information to guide the therapist in which direction treatment should take.

Sex in this context isn’t entertainment, release, or a cure for loneliness. It is a tool in the therapist’s tool belt to help people who suffer from sexual dysfunction. No responsible credited therapist will (or legally can) have sex with his or her clients. Seeking “counseling” directly from a sex worker is a different matter entirely.

Therapy can take as many forms as there are sexual dysfunctions. Sexual dysfunctions can be physical (disabilities or diseases) or psychological problems that relate to sex, including phobias or relationship concerns. The encounter with the surrogate may be about building self-esteem, or teaching basic social and dating skills. Physical intimacy between a surrogate and a client might not be explicitly sexual, but merely talking or touching. While some diseases or disorders are not curable, the reported success outcome of treating sexual problems with sexual counseling and surrogacy is near 90 percent (according to IPSA).

“There are too few therapists trained to work with surrogates,” notes Marilyn Lawrence, Ph.D., a Beverly Hills counselor who has used surrogates for 35 years, “and too few surrogates trained to work with therapists.”

Susan Kaye, a therapist working in Philadelphia and Austin, Texas, can’t even find certified surrogates in her areas. “I have gotten around it by working with people who are ‘body workers,’ people I have trained on what I want them to do with clients.” As Kaye explains, “You can only sit across the desk for so long and tell them how to ride a bicycle until you have to give them the bicycle.”

To purchase the Naked Reader Book Club selections, visit the Naked Reader Book Club Store.

The Naked Reader Book Club	Selections for April 2010
Best Sex Writing 2010 Edited by Rachel Kramer Bussel	Best Fetish Erotica Edited by Cara Bruce