Editors Note: Those interviewed prefer the term "surrogate partner" to "sex surrogate". They state less than 15% of time spent with clients involves activities that could be considered "sexual."
Back in 1970, famed research duo William Masters and Virginia Johnson released their book, Human Sexual Inadequacy. The text documents the sexual struggles experienced by hundreds of individuals and introduced a new means of rectifying them. Sex therapy was about to set off in an entirely new direction.
Masters and Johnson found surrogate partner therapy (SPT) to be an effective solution to sexual dysfunction in single individuals. The course of treatment follows a triadic model including a client, a therapist and a surrogate partner. The client’s relationship with the surrogate partner largely revolves around strengthening his or her capacity for emotional and physical intimacy through a series of structured experiences. And yes, sex is (sometimes) one of them.
Andrew Heartman serves as secretary and training coordinator for the International Professional Surrogates Association. He is one of just seven men certified through IPSA to work as a surrogate partner in the United States. He tells me, “Women have been socialized to not place importance on their sexuality and intimate life. And so now I think there are more and more people who are making it a priority to see that there’s some way this can be improved and there are things that can be done about it if necessary.”
A Streaky Timeline
According to Heartman, more women are seeking out surrogate partner therapy than ever before. That seems logical enough. As time progresses, so do our attitudes toward sex. But the timeline attached to SPT isn’t quite as linear as most would assume.
Another IPSA-certified surrogate named Dave* explained, “Back in the ‘80s we had hundreds of female surrogate partners practicing, but in the ‘90s and 2000s it just kind of went by the wayside. We have less than 50 certified surrogate partners in the country now, with about 20 or 30 therapists who are actually members of IPSA.”
IPSA was founded around 40 years ago, in the early '70s, but experienced a huge boom in popularity during the mid-'80s. When I asked why, Dave explained that the sexual revolution had been marinating for around 20 years, and the need for this form of therapy was starting to show. But when the AIDS epidemic hit, many surrogates decided to stop working. This is also when conservative organizations like the Moral Majority, the Christian Coalition, Focus on the Family began to emerge and gain in social and political relevance.
In the years since, surrogate partner therapy has started to resurface and reenter the conversations about sexual health. And the demand for male surrogates is growing. Heartman explains,“[Women] can engage in sexual activity, but not really be present, and not really enjoy it, and they can perform sufficiently to have their partner be satisfied. But for them, it’s more about having themselves be satisfied.”
He added, “As you do the work, you learn about what really is the problem, address those things first… If a woman doesn’t have the sorts of relationships that she wants, that’s the symptom, that’s not the problem.”
Going Slow and Getting Hard
The relationship between male surrogates and female clients is invariably different from the one female surrogates will form with male clients. Andrew Heartman says one of the most important parts of his job is helping the client establish her boundaries and making her comfortable communicating them, a point he learned to address early on in his career.
When describing his initial meeting with a former client he told me, “I asked her if she would like to share a hug, she said yes, and so we hugged, and we had the remainder of the session. And things appeared to me to be going okay. But then a week later she sent me an email saying she didn’t feel safe with me and she didn’t want to continue working with me. And whenever I had asked if she wanted to hug, she knows that she said yes, but she wasn’t comfortable saying no."
He continued, “So many women, so many people, but women in particular, are socialized to have their attention on other people’s needs, and sometimes they neglect their own. What we want to do, is have the client put her attention on what she needs, and when she feels safe, and when she doesn’t. What does work for her, and what doesn’t work for her, and be able to communicate that to a partner. Even if she thinks they want something different. And so, until we are both confident that that has been established I won’t do any kind of physical intimacy with a client. There are certain things that are foundational. And I think that’s the most important part of the foundation.”
It’s an eyeopening experience, and one that speaks to just how sensitive male surrogates must be to the needs of female clients. It also got me wondering, how do men working in the field avoid feeling creepy? And what measures should they take if someone accuses them of being so?
Heartman says there are a few reasons he feels comfortable doing this work. The first revolves around the involvement of the therapist. He said, “The therapist is an important part of the therapy, not just for the protection of the client, but also for the protection of the surrogate. The therapist generally gets to know the client before the surrogate is involved, and is able to assess whether SPT would be appropriate for this client.”
He added, “Clients are making a significant investment, both in time and money, in the therapy. They would not be doing so unless they really wanted to heal their difficulties with physical and emotional intimacy. It's not a decision that is taken lightly. Every client I've ever had is genuinely appreciative of the help.”
Then there’s the other question on everyone’s mind. Women are anatomically able to have sex whether or not they are aroused. It’s not preferable, but it’s possible. But men require erections. So what does Heartman do when he can’t get one?
Heartman tells me, “With every female client there comes a time where I have what I call the erection talk. I want her to know that if there is ever an erection in the room, it’s not her responsibility, and she doesn’t have to do anything.” He added, “I invite her to take responsibility of her arousal and I will take responsibility of my own arousal. People have asked me, Are there any times where you can’t perform? They mean when I can’t get an erection. And I say, Well yeah, of course. I believe that happens for every man, that there’s a time they want to get an erection and aren’t able to, or when they don't want an erection and it happens.
"If I’m in that situation, where I’m with a client, and I’m not getting an erection, the way I handle it is part of the education. If I’m ashamed, and really upset… then that sends one message. But if I’m comfortable with that, and I say, It’s not about you, and we can still engage in ways that are pleasurable for both of us, then that sends a message also. If I handle the situation with grace and comfort, the client will be able to also, both with me and with her future partners. And for every sexually active person, it’s guaranteed to happen sometime."
Why They Do the Work They Do
Becoming a surrogate partner isn’t an easy endeavor to take on. All surrogates must find a way to synchronize their professional responsibilities with their personal lives. They also have to be prepared should the two ever be at odds. Luckily, both Heartman and Dave are based in California, a hub of sex positivity. Heartman has been in a committed relationship for the past nine years, and explained his intention to become a surrogate partner the night of their first date.
Dave explained, “It’s not like we do this for money. It’s very rare that you’ll have more than two or three clients at any one time. Personally, for me, I usually have like one at a time. And I have a regular 9-5 job. Most everybody else does… [You do it] because you feel like you have a calling to do it....You want to help other people become fulfilled in their sex lives and in their relationships. What’s more important than sex? You want to help people who have had issues with sex.”
SPT and the Future
The fact that society is placing more of an emphasis on female sexual health and functionality is worth celebrating. But as my conversations progressed, something became clear. History has largely excluded women from conversations pertaining to the pursuit of sexual pleasure. And while that experience can be depressing, it’s not exactly unique.
Dave explained to me, “One of the untapped markets that could benefit from SPT are the LGBTQ community. They need a lot of help regarding their sexuality, especially trans people who have different body parts than they used to. And surrogate partner work would be a great help to them. Unfortunately, it’s not a cheap thing. You’re going to therapy, you’re going to sex therapy, which is sometimes, sometimes not, covered by insurance. And then at the same time you’re going to see a surrogate partner, which is not covered by insurance. It's not a cheap thing to undertake.”
The laws surrounding SPT are vague. There is no one particular law that says it’s legal, and no one particular law to state it’s illegal. But the fact that sex is an element of the therapy leaves a lot of people asking the question, is it prostitution? Those working in the field insist it’s not. Their reasoning? Clients are not paying for sex. They’re paying for therapy.
* Names have been changed.