What’s a Sexual Surrogate, and Who Needs One?

Many of us feel insecurity, self-consciousness, or even shame around sex — we can feel this way whether we’re having sex for the first time or have been sexually active for 50 years, especially if we’ve recently come out. There’s still a lot of stigma around sex and sexuality, and unfortunately, also a stigma around one of the resources that can be most helpful in addressing it: therapy.

For those of us who have worked past any internalized shame about seeking support around our mental health, we know that therapy can move mountains when it comes to challenging issues that we may feel we can never overcome. Even when it comes to sex, one of the hot-button issues we often find hardest to talk about, therapy offers a range of options. One that many people have questions about is sexual surrogacy or surrogate partners. What is sexual surrogacy, and is it right for you?

What’s a sexual surrogate?


A sexual surrogate, also called a surrogate partner, is a trained professional who helps people improve their sexual functioning and intimacy through hands-on techniques. Essentially, they work with individuals or couples who may be experiencing sexual difficulties or challenges, such as erectile dysfunction, premature ejaculation, or difficulty with intimacy. The sexual surrogate works in tandem with a separate trained therapist to focus on the client’s needs surrounding partnership and sex, and to set goals and assess the client’s progress toward them.

Sexual surrogates use a variety of methods to help clients overcome these difficulties. For example, they may teach clients about their bodies and how to communicate their needs and desires with a partner. They may also engage in activities such as touching, kissing, and even sexual acts to help clients work on specific issues.

What’s the difference between hiring a sexual surrogate and a sex worker?


A sexual surrogate is a trained professional who works within a therapeutic context to help individuals or couples overcome sexual challenges and improve their overall sexual health and well-being. They typically work in collaboration with therapists, medical professionals, or other healthcare providers and may use hands-on techniques to help clients improve their sexual functioning and intimacy. Sexual surrogacy is generally legal, regulated, and considered a legitimate form of therapy in some countries.

While the interactions that a sexual surrogate has with their client might seem intimate or sexual in nature, and it is a livelihood they’re paid money for, there are key differences between sexual surrogacy and sex work. Sexual surrogacy and sex work are two different professions with distinct differences in their goals, methods, and legal status. 

Put simply, sexual surrogacy is a clinical and therapeutic profession, while sex work is a customer service profession: the former is about working to reach clinical goals agreed upon with the client; the latter is primarily for pleasure and recreation. While people interested in working with a sexual surrogate may find that some of their needs, like a desire to practice sexual interactions or skills in a judgment-free, sex-positive environment, can also be met by sex work, the professions involved ultimately have different goals. A sexual surrogate is aiming to leave you with skills, strategies, resources, and experiences that will support you in what you need in your life outside your sessions; a sex worker is performing a customer service job, focused on making sure you have fun and your wants are provided for within a session.

Is sexual surrogacy legal? Will my insurance cover it?


It’s important to note that sexual surrogacy is not the same as sex work or escort services. Surrogates work within a therapeutic context, and their goal is to help clients improve their overall sexual health and well-being. That said, it’s uncommon for insurance to cover the cost of sexual surrogacy, as it is not typically considered a medically necessary service. In fact, in some places, sexual surrogacy may not even be legal or regulated. If sexual surrogacy is legal in your area, the cost of sexual surrogacy can vary widely depending on the provider and the specific services that are being offered.

How do I find a sexual surrogate, and what happens when I see them?


Some organizations, like the International Professional Surrogates Association, can offer resources and registries for getting in touch with a surrogate to work with. It’s not necessarily recommended to start working with a surrogate on your own as a first step toward addressing a sexual issue; a surrogate will likely recommend that you start working with some kind of sex or relationship therapist first, and that therapist can help refer you to a surrogate if you both feel it would be a useful step. 

Although sexual surrogates are therapeutic professionals, you’ll likely also want to be seeing a separate therapist to process the sessions you have with your surrogate. Surrogate partner and queer sex and relationship coach Katherine Yeagel describes the process like this:

  1. The client and surrogate partner meet
  2. The surrogate partner and therapist discuss the session on the phone and plan for the next session
  3. Client and therapist meet to process the session and discuss other areas of the client’s life

Sessions with the surrogate themselves may include touch (with both people giving and receiving touch, or just one), practicing structured activities around touch or communication, one-way or mutual nudity, mindfulness and body mapping, sensate focus, and other somatic practices.

How do I know if I need a sexual surrogate?


To be clear, no one “needs” a sexual surrogate — not because it isn’t important and meaningful work that can offer a lot to the right person, but because no matter what your relationship to sex is, you aren’t broken or have something wrong with you. That said, there are a lot of people who may find working with a sexual surrogate useful, constructive, and even healing. It’s not necessarily common for people to try working with a sexual surrogate as a first step; more likely, you may first try something like sex therapy, and a sex therapist with whom you have a well-established relationship may recommend a surrogate if they think it would be useful for you.

If you’re considering working with a sexual surrogate, it’s important to do your research and find a qualified professional who is experienced in this field. It can be a sensitive topic to discuss, but with the right support, it can be an effective way to address sexual challenges and improve intimacy in your relationships.

A sexual surrogate may be helpful for individuals or couples who are experiencing sexual challenges or difficulties. This can include a wide range of concerns, such as:

  • Erectile dysfunction
  • Difficulty with arousal or reaching orgasm
  • Lack of sexual confidence or experience
  • Sexual shame or sex-based religious trauma
  • Learning about a new sexuality or identity after coming out
  • Practicing healthy consent 
  • Body image issues impacting your relationships and sex life
  • Physical barriers to pleasure, including vulvodynia
  • Low arousal or low sex drive
  • Exploring how your sex life relates to your queerness or gender identity
  • Trauma or past abuse affecting sexual functioning
  • Challenges with intimacy or communication with a partner

Sexual surrogacy is often used as a part of a broader therapeutic approach to address these concerns. It may be recommended by a therapist or medical professional who is working with the client to improve their overall sexual health and well-being.

It’s important to note that sexual surrogacy is not a solution for everyone, and it may not be appropriate for certain individuals. Ultimately, the decision to see a sexual surrogate should be made in consultation with a qualified professional who can help assess the client’s needs and recommend the best course of action.

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