A sexual surrogate helps patients to fix sexual problems by serving as a stand-in partner with whom to share physical and emotional intimacy. The therapy may or may not include sexual intercourse. Surrogates are frequently certified in fields such as counseling, psychology or sexuality and they often work in conjunction with psychologists and other therapists to help the patient. Relaxation techniques, building of social skills and sexual touching are often part of the therapy. Most surrogates are female and most clients are male, though there are exceptions. The human sexuality researchers William Masters and Virginia E. Johnson introduced the concept in 1970.
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Clients of sexual surrogates frequently come to therapy to address issues related to lack of experience, fear of intimacy, low levels of arousal or desire, and feelings of shame. More specifically, surrogates frequently help patients with premature ejaculation, impotence, adult virginity and delayed ejaculation. Clients may range, according to Tara Livingtson, a sexual surrogate in Los Angeles, "from 18 to 85, single, white or blue collar, students or CEOs, both able-bodied and physically challenged."
A surrogate serves as a guide and a teacher, according to Livingston, and is not intended to be an ideal woman in terms of appearance. Her role is to be compassionate, caring and gentle as she guides you toward a healthier self-concept and sex life. The key attributes she brings to therapy are her training, experience, insight and attitude--not her appearance. Surrogates are generally "everyday-looking" women.
Treatment time varies based on the client's needs, but often lasts four to six months. Some sexual problems stem from deep psychological issues and can be solved only when the underlying problem is addressed. A sexual surrogate will typically meet with the client once a week to keep progress moving steadily.
The top myth that sexual surrogates combat as they carry out their work is that they are prostitutes. Prostitution, according to Livingston, is about entertainment and focuses primarily on a release of sexual tension, with the client directing the scenario. In sexual surrogacy, on the other hand, "any sexual activity—if a therapist deems it necessary—is secondary to communication, education and healing."
Through experience and training, sexual surrogates bring a unique perspective to sex therapy. Livingston has developed a sense of the origins of many sexual issues and, as a result, how best to treat them. Sexual problems, she says, often "aren't sexual at all." The emotions of anger, resentment, frustration and rejection can manifest as problems in the genitals and "block functioning of the erotic pathway." Delayed ejaculation and other difficulties related to orgasm are often the result. On the other hand, according to Livingston, some problems are physiological in nature. Erectile dysfunction, lack of desire and premature ejaculation are examples.