Sex surrogate therapy: What is it and how does it work?

Sex surrogate therapy is a three-way therapeutic relationship to help a person feel more comfortable with sex, sensuality, and sexuality. It involves working with a licensed therapist and a surrogate partner.

Exploring the Realm of Sexual Surrogate Therapy:
A Path to Intimacy and Well-being

In the realm of human connection, sexual intimacy stands as a profound expression of love, affection, and self-discovery. However, for many individuals, sexual dysfunction, trauma, or anxieties can hinder their ability to experience the joys of intimacy. This is where sex surrogate therapy emerges as a beacon of hope, a therapeutic approach that empowers individuals to navigate the complexities of their sexuality and cultivate meaningful connections.

Often referred to as surrogate-assisted therapy or surrogate partner therapy, this transformative treatment aims to foster self-awareness and equip individuals with the skills necessary to navigate physical and emotional intimacy. Under the guidance of a skilled sex therapist and a compassionate surrogate partner, clients embark on a journey of self-discovery, developing a healthy self-image and improving their sexual functioning. While intercourse may be a component of this therapy, it is not always the case.

The decision to seek sex surrogate therapy often stems from a desire to address sexual dysfunctions, overcome past traumas, or alleviate fears and anxieties related to intimacy. Sexual health and satisfaction play a vital role in overall well-being, and the ability to form fulfilling sexual relationships directly impacts happiness and fulfillment.

In this comprehensive article, we delve into the intricacies of sex surrogate therapy, exploring its methodology, potential benefits, and the diverse range of individuals it can empower. We also shed light on the distinctions between this unique approach and other therapeutic practices. Embark on this journey with us as we uncover the transformative power of sex surrogate therapy and its ability to unlock the doors to intimacy and personal fulfillment.

Surrogate partner therapy

is a three-way therapeutic relationship among a licensed therapist, a client, and a surrogate partner.

The treatment typically involves a variety of therapeutic experiences, sometimes including sexual intercourse, to explore and resolve barriers preventing a person from having physical, sexual, and emotional intimacy.

Dr. William Masters, a gynecologist, and Dr. Virginia Johnson, a sexologist, introduced the concept in their book, Human Sexual Inadequacy, which they originally published in the 1970s.

Who can benefit?

Generally, individuals considering sex surrogate therapy have been undergoing sex therapy or psychotherapy for months to several years to deal with concerns such as self-confidence, body image issues, fears, and sexual dysfunctions.

The range of concerns and conditions that may prompt the therapist or the client to consider a partner surrogate may include:

  • body dysmorphic disorder, negative body image, or physical disfigurement
  • medical conditions
  • sexual, physical, or emotional abuse or trauma
  • phobias, avoidance, or anxieties about touch, sex, and intimacy
  • unresolved relational trauma
  • confusion about sexual orientation
  • lack of self-confidence or sexual confidence
  • orgasmic inhibition
  • pelvic pain or genital pain, including vulvodynia
  • lack of experience
  • sexual dysfunction, including erectile dysfunction, erection difficulties, and premature ejaculation
  • vaginismus
  • limited or no orgasms
  • low arousal or sex drive
  • shame about sex

Some researchers suggest that sex surrogate therapy may help treat sexual difficulties among transgender people who have recently undergone gender confirmation surgery. Some evidence also suggests that it may be beneficial for people with disabilities to help them learn about comfortable ways to experience sex.

While some individuals may benefit from this therapy, more research is necessary. Additionally, it may be advisable to establish clarity on the ethics and legality of this practice.

How it works

The course of therapy usually begins with the therapist and the client determining goals and creating a treatment plan to address the issues behind the client’s difficulties.

The therapist may recommend surrogate partner therapy if they deem it helpful. Partner surrogates work in collaboration with the therapist and the client. They receive training to mentor, coach, and help clients meet their treatment goals.

Similarly to the way exposure therapy enables a person to face their fear, this treatment provides access to a safe partner to allow a person to practice techniques, among other skills.

The goals of this treatment may include building self-awareness and self-confidence, developing effective communication, training social skills, and developing physical and emotional intimacy skills.

Surrogates guide clients through the program and gradually progress through varied therapeutic experiences that aim to explore, build the client’s skills, and promote their healing. The plan may incorporate:

  • relaxation and meditation
  • eye contact
  • effective communication
  • sensate focusing
  • sex education
  • body mapping
  • one-way or mutual nudity
  • one-way or mutual touching
  • genital-genital contact

A person may opt for local therapy, which is when the therapist and the surrogate are both available in the local community. It usually involves meeting with the therapist for 1 hour per week and meeting with the surrogate partner for 1–2 hours per week.

Alternatively, they may use an intensive setup, which is when the therapist-client and surrogate-client sessions overlap to facilitate rapid growth and change for the client. This involves meeting with the surrogate partner for 2–3 hours per day and with the therapist for 1 hour per day. Intensive therapy typically lasts for 2 weeks.

It is important to note that the therapist is not involved in the sessions between the surrogate and the client. However, open, proper, and consistent communication among all three team members is fundamental for the approach’s success. All team members make a mutual decision to terminate therapy, typically when the client achieves their goals.

Sex surrogate therapy vs. sex therapy

There is some overlap between sex therapy and sex surrogate therapy, as both treatments aim to help resolve sexual issues.

While sex therapists may provide sex-based exercises to perform at home in between sessions, such as watching porn or masturbating, they do not participate or offer hands-on exercises to help their clients practice and develop these skills. Sex therapy is essentially a form of talk therapy.

Sex surrogate therapy may often involve a sex therapist as a licensed professional in addition to a certified surrogate partner. With consent, a person may be able to practice physical or sexual intimacy or techniques that a sex therapist advices with the surrogate partner.

Becoming a sex therapist typically requires a person to earn a master’s degree in a related field such as mental health, therapy, counseling, or psychology. In contrast, a person does not need any specific degree or course to qualify as a surrogate partner.

Sex surrogate therapy vs. sex workers

Many people may see sex surrogate therapy as a form of sex work. However, the two have different goals.

Sex workers receive payment in exchange for consensual sexual services. Sex surrogate therapy aims to provide a safe, structured environment where the client can explore intimacy and resolve barriers that prevent them from developing physical and emotional intimacy with a partner.

Sex surrogate therapy may also include sensual and sexual contact, but the focus is on developing skills and healing. In some cases, surrogate partners never have physical contact with their clients.

The International Professional Surrogates Association (IPSA) Code of Ethics states that the term “surrogate partner” applies only when the therapeutic relationship includes the involvement and participation of a licensed therapist. The surrogate may act as a substitute partner or a co-therapist.


There are currently no laws regulating or prohibiting sex surrogacy therapy. While paying for sex is illegal in most of the United States, this type of therapy does not always involve the exchange of money for sexual services, so it may fall into a legal gray area.

Sexual gratification is not necessarily the sole aim of the treatment. The treatment is also a therapeutic tool to help people overcome sexual challenges and improve their sexual health. Although the rationale for using a surrogate partner may be for sexual engagement, sexual contact is not mandatory and occurs only if necessary for the client to reach their goals.

Like any decision in a traditional therapeutic relationship between a client and a therapist, the decision to engage in intercourse as part of treatment is the choice of both parties and requires informed consent.

Since its establishment in 1973, IPSA has not experienced any legal issues.

How to find a surrogate

A person may be able to access a partner surrogate through a licensed therapist, who can tap into their network of partner surrogates.

A person may also refer to IPSA’s list of surrogate partners. However, because not all surrogate partners want to post their personal information publicly, a person may also connect with IPSA’s referrals coordinator to be connected with a trained and certified professional surrogate partner.

Moreover, because some surrogate partners have profiles on social media platforms, a person may encounter people who claim to be IPSA certified or IPSA members. Individuals or therapists may contact the IPSA referrals coordinator to confirm.


While a specific degree or course is not a prerequisite for applying to IPSA’s Professional Surrogate Partner Training Program, the training committee does look for certain qualities, such as:

  • emotional maturity
  • evolution through personal therapy or other growth-oriented life experience
  • comfort with one’s body and sexuality
  • readiness to be involved in a close, caring relationship with others who are having difficulties with emotional, physical, and sexual intimacy

Interested applicants may begin their training application process with IPSA. They will need to fill out forms that require them to share very personal information.

Applicants need to go to Southern California for training, which has two phases. The first involves a 100-hour didactic and experiential course. Upon completing this, a person can enter a multiyear, multiclient supervised internship for phase 2.


Sex surrogate therapy is a therapeutic relationship involving a client, a therapist, and a surrogate partner. It can offer a place of healing and growth for people who are having difficulty with fears and anxieties about sex, their sexuality, or intimacy.

However, the therapy may not be suitable for everyone, and it does not necessarily involve intercourse with the surrogate partner. Individuals who are working with a sex therapist and interested in trying sex surrogate therapy may discuss it with their therapist. It is up to a licensed therapist to determine whether a person may benefit from a surrogate partner.


National Clinical Society for Sex Therapy and Research

Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional.

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