Treatment at the dressing site (sometimes)

Elaine Chao works with people who, for any number of reasons, are uncomfortable with sex.

Some of her clients are adult virgins with severe performance anxiety and vulnerability; Others have recently undergone a gender transition and are looking for help getting used to their new bodies. She also works with people whose religious upbringing has complicated their relationship with sex or taught them “that their bodies can’t be trusted.”

Ms. Zhao is a surrogate partner in San Francisco. Unlike more traditional forms of therapy, where practitioners are usually careful to keep clients at a distance, a surrogate partner “enters a temporary relationship” with a client on an intimate level, she says.

“It really is for clients to learn relationship skills and also develop a relationship with their sexuality,” she said.

Ms Zhao, 42, described her office as a “relationship laboratory” in which she initiates various experiences to help clients identify any barriers to emotional and physical intimacy.

One of the first things you do with people is help them engage their breath. What do they notice as they take a deep breath? What changes have they noticed in their bodies? They also experience touching, rotating, and focusing on the feeling of receiving and giving.

Ms. Zhao, who also works as a sexual intimacy coach — a similar job, though the clothes remain — believes the exercise helps clients get out of their heads thoughts like, “Is my partner bored?” or “Am I doing this right?” It can be hard to ignore. The goal is to return to their bodies.

Partner replacement therapy typically begins with a referral from a talking therapist, who first assesses whether someone is a good candidate for this type of treatment. Sessions usually take place weekly, in one- to two-hour meetings until all three agree that treatment is complete. It is not usually covered by insurance, and although fees vary, it can range from $75 to $350 an hour.

was an alternative partner treatment originally In St. Louis in the 1960s William H and Virginia Johnson, pioneers in the research and understanding of human sexuality.

According to Andrew Hartman, co-founder Alternative partner groupThe concept of replacement partner therapy was introduced to the public in 1970 with the release of Masters and Johnson’s book The Insufficiency of Humankind.

“They were all very oriented towards impotence,” he said of Masters and Johnson. Thus, they measured success by the couple’s ability to engage in heterosexual intercourse.

Today’s alternative partner therapy is trying to move beyond this approach by being more diverse and LGBTQ-affirming.

“Instead of looking at it as a treatment for ED with the goal of being sexual intercourse, the goal now is to help people form better relationships and better relationship skills,” said Mr. Hartmann.

“Gender can be included in that because sex may be part of relationships, but ultimately it’s a much larger umbrella than originally envisioned,” he added.

Mr. Hartmann, who has been in practice for 13 years, works predominantly with transgender and transgender women, non-binary individuals and people with disabilities. He does not work with male clients, gay or straight, as he is not attracted to men.

Because of the nature of the job, he said, it would be best for a male client to “be with someone who they’ll respond to, like someone they might respond to with actual attraction.”

In interviews, surrogate partners have clarified many misconceptions surrounding their profession. Surrogate partners aren’t whores, for starters. Many practitioners also object to being called sex surrogate, because they believe their form of treatment is about much more than sex.

For example, Ms. Zhao, who has been doing this for about 10 years and is also a member and coach of the Surrogate Partner Group, frequently works with clients to learn their unique relationship needs, but she personally does not engage in sexual relations. activities with clients.

She also has men who come to her looking for sex.

“A lot of them say things like, ‘Oh, I don’t want to do this job with someone who was forced to do it or someone who was trafficked,’” she said. “And there’s also a lot of stigma around being a sex work agent, so I do a lot of Education about that, too.”

For Nicole Ananda, a 48-year-old surrogate near Philadelphia and another co-founder of Surrogate Partner Collective, she said the biggest misconception about the job is the assumption that because it involves sex, it’s all about sex.

“Even though we focus on someone’s sexuality and their lack of sexual energy, it’s all about relationships and helping people connect with themselves,” she said in a phone interview.

In the past, I’ve encountered resistance when trying to find a place to train. In an interview, she said that once, when she was trying to buy an apartment, she was denied use and occupancy permits due to suspicions about her practice.

“I didn’t pursue it legally because it wasn’t worth it,” she said. “They told the condo board where we were trying to buy office space that we were doing something illegal and they shouldn’t sell it to us. And so they killed the deal.”

Ms. Ananda’s practice, Ananda Integration Therapeutic Group, has many alternative therapists and partners who often see clients who have experienced trauma or sexual abuse or who have certain types of disabilities.

“If any type of sexual intercourse is included in work, it is months after other types of work with a licensed therapist supervising,” she said. “So anyone who wants to get some kind of sexual experience, they can do it much faster and cheaper just by finding a regular prostitute, which I personally think should be legal and protected.”

According to Ms. Ananda’s research and conversations she’s had with other surrogate partners, only about 5 to 10 percent of surrogacy partner therapy cases involve sexual acts.

This work takes time. For example, if body image issues are an issue, after about three or four months of therapy, the surrogate partner might invite the client to do a mirror exercise: look at yourself naked in a full-length mirror, the surrogate will guide you, and be honest about how you feel about your body and its different parts.

“The possibility of actual sexual intercourse makes it real, so to speak,” Mr. Hartmann said. “It actually makes the environment so much more real that every part of the process becomes more efficient because the client knows this is leading somewhere.”

send your thoughts, Stories and tips to [email protected].