Sex Surrogacy. Who knew?

When the folks promoting this DVD, a re-release, got in touch, I couldn’t resist taking a look at their film: Private Practices: The Story of a Sex Surrogate. It was originally released in 1985 and directed by Kirby Dick, the same guy who did This Film is Not Yet Rated.
It’s about what it sounds like–turns out that there is a field within sex therapy, in which trained practitioners try to help their clients get over sexual anxiety and disorders by literally having sex with them. The film follows one of these therapists, Maureen Sullivan, as she rehabs two very different men, 25-year-old Kipper, a virgin grad student, and 45-year-old John, a newly divorced fella with a lot of insecurity to battle.
I felt so torn while watching this highly provocative film. On the one hand, I can understand why this form of therapy exists. Americans are so hung up on sex, but rarely deal with it in a straight-forward open way. This approach feels very European–it’s sex, so what, get over it.
On the other hand, it all felt rather creepy too. Sullivan creates real relationships with her clients, as do all good therapists, but I wonder how much their experiences with her actually translate into the real world. She has to have sex with them, after all. She has to pretend that she enjoyed it and enjoys being around them. The real world is a far messier place, where your sexual partner has his or her own nexus of desires, anxieties, and moods to contend with. Sullivan is like a blank slate sexual partner. I hope these guys don’t go out after their experiences with her expecting other women to be as singularly focused or servile (I mean, she is being paid).
And apparently this practice is very much alive and well. I uncovered a 2003 article in New York Magazine on sex surrogacy and lots of websites offering it up. Anyone else know any good feminist analysis on this phenomena?
If you want a dose of super 80s fashion inspiration and a glimpse into a thought-provoking and bizarre subculture, check it out on Netflix.

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74 Comments

  1. AngeliKlaw
    Posted March 20, 2009 at 6:34 pm | Permalink

    I just want to make clear what sex therapy, in fact, is treating. Reading the description of the documentary, we’re talking about fears of sexual inadequacy and virginity. I haven’t seen the documentary either, but there is a lot to be said here about how sexism hurts men too.
    This idea of sexual inadequacy morphs into new kinds of diagnosable “sexual disorders” such as premature ejaculation, retarded ejaculation (wtf?), and a bunch of other things that make men look sexually inadequate. I don’t know about you, but I don’t think premature ejaculation is a sexual disorder: the creation of such a disorder shows society’s – and ultimately patriarchy’s – inability to recognize that sex is also extremely pleasurable for men, physically and emotionally, and it allows for them to be sensitive and vulnerable (which, unfortunately, has been deemed a more “womanly” characteristic).
    I can understand how the fear of being deemed sexually inadequate could literally take over a man’s life, given that a man’s sexual prowess is significant to a heterosexual man’s socially constructed identity, but the idea that virginity is a sexual disorder?! Firstly, this is a horrible double-standard. Women virgins are a-ok! But men virgins? Something can’t be right! In fact putting the words men and virgin is oxymoronic!
    What makes me reconsider how legitimate sex surrogacy is is that it can easily perpetuate gender and sexual double-standards, especially if the program is targeting the “sexual disorders” I spoke about above – which are the targets of the documentary. How exactly are these sexual disorders being treated? Are these programs offering women to be subservient, and reinforce the sexist masculine ideal by letting him know that he can in fact take control of a woman without having to pay for her services? I took a look at a sex surrogacy program based in NYC. It had profiles of sex surrogates, and it creeped me out a bit. The website was full of softcore pornographic pictures of white heterosexual “couples” experiencing intimate moments, and the profiles of the surrogates gave age, which is fairly reasonable, but weight? and ethnicity? She’ll at a little latina to your life? To me this says DANGER: REINFORCED WHITE MALE DOMINATION OF SEXUALITY!!!!
    Nothing in the websites I found worked towards helping sexual abuse survivors creating healthy sexual relationships. Also, none of these websites target women. I’m a woman and a survivor, and I never once thought I need to purchase a man’s attention to show me that healthy sex is in fact possible. But that’s just perhaps too many men were already propositioning me for sex – is it me or does sex seem a lot easier to find for anyone who looks feminine? I do enjoy the idea of creating a safe space for sexual abuse survivors to take control of their own sexuality and sexual experiences, but I’m not sure a sex surrogacy program can initiate or even imitate an experience similar to what a. spoke about.
    I’m not saying that I don’t disagree with the idea of sex surrogacy, and I’m not arguing that I’m an expert because I’ve done a little online research. I’m just extremely skeptical as there are a lot of problems that can arise. Sex surrogacy looks like a slippery slope of either extreme liberation or utter perpetuation of society’s sexual horrors.

  2. wax_ghost
    Posted March 20, 2009 at 7:12 pm | Permalink

    Yeah, that does make a lot of sense. Thank you.
    I definitely prefer the idea that it is ultimately the person who’s body parts they are who gets to decide whether it is “dysfunctional” or not. I just hate to see the kind of pressure that is put on people to try to be “normal”, to think of themselves as having something wrong with them, when “normal” is really such a wide range of different possibilities. And like any other question about these things, I wonder where society’s pressure ends and the individual’s own beliefs begin (if we can even know that).

  3. wax_ghost
    Posted March 20, 2009 at 7:21 pm | Permalink

    This might be a case of dealing with the sexist pressures for men, though. Men in our society are often expected to perform sexually on demand because, you know, “men are all horny beasts who only ever think about sex and can’t control themselves”. (*eye roll*) If they don’t live up to this expectation, their masculinity comes into question and that is, from what I can tell, the ultimate insult to a man.
    On the other side of the coin, women have to deal with this expectation too but the response is a little bit different since there is the old stereotype of the sexually frigid woman that doesn’t deny her her gender (or sex, depending on how you want to look at it) even if it is damaging in other ways.
    So in that way, it makes some sense that there would be more men seeking help in the sexual arena than women. I’m not saying this is the reason for sure, but I would consider it a strong possibility.

  4. mydishonestheart
    Posted March 20, 2009 at 7:23 pm | Permalink

    Its really true. As an LMP, I tend to adopt the attitude of “If they’re fine with it, I’m fine with it.” Its of course easier for me to do that because I’m far from being a doctor, but I mean… if I have a client with scoliosis who is happy with their spine and body’s adjustment to it, is pain free, or doesn’t want me to work on it, who am I to judge their condition dysfunctional because its “abnormal”? My job is to help make quality of life better, as is all therapist’s, really; but quality of life is determined by the human being in front of you, not a book.

  5. beth
    Posted March 20, 2009 at 7:48 pm | Permalink

    sorry–I meant to hit reply instead of “liked.”
    Not orgasming from PIV sex is not comparable to a real dysfuction. There are physiological reasons why most women do not orgasm from PIV sex. The real dysfunction comes from when she is unable to orgasm at all. Also, we only call it a dysfuntion if it has been going on for some period of time, and if it is causing the person some amount of distress. The people who go to therapist don’t go so they can be told they’re healthy–they go because there’s something that they feel is wrong. This has nothing to do with whether the therapist thinks not orgasming, for example, is normal or not, but with how much it is interfering with the client’s life. You have to have both personal distress and a time period of that distress/disorder/dysfuction to get any sort of disgnosis within the field of psychology or counseling. Dysfunction may not be the best term for it, granted, but a label really does help most people cope with their problem. How do you feel when you go to the doctor and s/he says they have no idea what’s wrong with you? You, and I, and most people, need that diagnosis so that we can make our problem more concrete and start to deal with it in a more construtive manner.

  6. The Law Fairy
    Posted March 20, 2009 at 9:07 pm | Permalink

    Fair enough, wax ghost, but there’s also the sexist pressure for men not to admit to anyone, least of all themselves, that they are having problems being sexually satisfied. In that cultural paradigm, prostitution is acceptable but sex therapy is most definitely not. So I would think the same kinds of pressures that make women reluctant to see a sex therapist would have a similar effect on men. It’s the fact that you only seem to see one side of that — the sexist pressure effect on women — that makes me wary.

  7. wax_ghost
    Posted March 21, 2009 at 12:42 am | Permalink

    That’s a really good point, beth. I hadn’t thought of it like that. Thanks.

  8. conductress
    Posted March 21, 2009 at 12:50 am | Permalink

    Not to be a hardass, but what ‘he’ are you referring to? This post was written by Courtney, a female. The NY Mag article Courtney links to was written by Amy Sohn, a female. To my knowledge, the commenter The Law Fairy was responding to, Frumious B (please correct me if I’m wrong), is a female. Maybe you should be more careful with and aware of your pronouns on a feminist site, rather than defaulting to a male one.

  9. wax_ghost
    Posted March 21, 2009 at 12:53 am | Permalink

    That’s true. But I can see the need to be good in bed outweighing the taboo against admitting to any “weaknesses” for some men.
    I don’t think we’ll ever know without a serious study.
    And even if the need to be a stud is the reason, that doesn’t erase the potential for oppression/exploitation of women, of course.

  10. Fitz
    Posted March 21, 2009 at 12:54 am | Permalink

    I was referring to frumious, my apologies.

  11. Fitz
    Posted March 21, 2009 at 1:49 am | Permalink

    Actually, after further reflection, fuck it, apology retracted… I feel no remorse about using ‘he’ as the singular pronoun when the gender is unknown, as it happens to be the least awkward and shortest way, but that’s a discussion for another thread.

  12. conductress
    Posted March 21, 2009 at 2:07 am | Permalink

    Are you joking? You don’t see how using a gender-specific pronoun that happens to include only the dominant gender– male- is sexist? It really would have killed you to reword your sentence and use ‘they’? Or to type a measly two extra letters and write ‘s/he’? Hell, ‘ze’ is the same amount of letters as ‘he.’ Fuck it is right!

  13. timothy_nakayama
    Posted March 21, 2009 at 4:37 am | Permalink

    but there’s also the sexist pressure for men not to admit to anyone, least of all themselves, that they are having problems being sexually satisfied. In that cultural paradigm, prostitution is acceptable but sex therapy is most definitely not.
    There may be sexist pressure for men to not admit to anyone else, not even to their best friends, that they are having problembs being sexually satisfried, but the sexist pressure that waxghost mentioned, that men are judged as men by their sexual capabilities (being a good lover in bed) and their sexual appetites (ready to have sex any time, any place), tends to overrule the first. And unlike waxghost, who specifically mentions “from what I can tell”, I am a man and, though not being American, might give me more insight into the male mind.
    I mean afterall, if your whole life, society has told you that you want sex 24/7, men will be men, and that your sexual capabilities and libido is one aspect that makes you a “man”, do you not think that it would be reasonable to assume that sex(as in the act), makes up more of a man’s identity than it would be for a woman? And if it is reasonable to assume that sex makes up a significant portion of a man’s identity, would it not be reasonable to assume that if something threatens that portion of his identity (erectile dysfunction, not being easily satisfied, problems with intimacy during sex, etc), the one thing that makes him “a man” as sold to him by society, that he would one to get help with that? Is it f_ked up that a man would tie so much of his identity down to sex? Sure, just as it is bad that society make women tie so much of their identity down to how they look and connect with others.
    Also,one cannot make the assumption that because a man feels inadequate and not satisfied that he would prefer to go to a prostitute rather than a sex therapist/sex surrogate. Is our image of men so faulty, so laden with stereotypes, that we assume that men would rather go to prostitutes than a therapist/surrogate? There are men out there, YES they exist!, that would never think about going to a prostitute, and might actually care to visit a sex therapist/surrogate to try and improve his sex life.
    The above definitely ties in with what waxghost said that if men can’t perform/have sex problems/don’t like sex this goes AGAINST what Men are supposed to be like (masculine), while for women, not enjoying sex/having sex problems does not threaten her feminity in such a manner, because the stereotype is “Women don’t reallyy like sex….” (which is f’ed up as well).
    This then may provide a reason as to why women might not seek sex therapist/sex surrogates because if sex (the act) does not form as much of a woman’s identity as it does for a man, then wouldn’t it then be reasonable to assume that most women (who are brainwashed by society with the message that women just don’t enjoy sex as much as men) who can’t find happiness in sex just think “Meh, it’s only sex. The most important thing is the relationship” ? Afterall, I’m sure how we see in popular culture all the time that women are the ones who initiate couples therapy, because society tells that having relationships are what women enjoy and is important for the well-being of women. Could it be that this has caused them to place a lower emphasis on sexual problems as they have acknowledged the meme that “women don’t enjoy sex as much as men” ?
    Add to that most women are cautious of men. Would this not extend to a woman who might be thinking of a male sex therapist/surrogate? She might be thinking, Can I trust him to be professional, What if he loses control, etc. In a culture that glorifies rape and where we teach our children that “men will be men”, having such thoughts would only be prudent. This notion would certainly be less of a concern with men, who believe that they can overpower the female sex therapist/surrogate should anything happen.
    If men can get Viagra to solve problems with EDS, where erections are seen as VERY important for a sex culture that sees sex as PIV sex, would it not be reasonable to assume that men would do anything to improve their sexual performance, to be gods in their bedrooms, where their performances are often translated into being a good lover/or a bad lover. Afterall, this culture constantly laughs at the notion that men can’t satisfy women (ie. can’t find the clitoris, premature ejaculation, goes to bed after sex, etc…these are All humour points made in mainstream movies), so therefore, being a “good lover” in bed increases the desirability of a man in bed (“Finally! A man who actually knows what he’s doing!). Would it not be reasonable to assume that this might affect how men view their own performance (good, inadequate, bad, etc)?
    I think another reason why more men might go to a sex therapist/sex surrogate is due to problems of intimacy. It is no surprise that men have more problems with intimacy than women; afterall, Aspegers’ and autism strike more men than women. That and a culture where “Bro-mances” and close friendship among men are made fun of, and the widely-held selfbelief of quite a handful of men that displaying feelings of intimacy show weakness, show reliance on another human being. Even on this blog people sometimes make jokes about men that never meet a real woman (nerds, guys who live in the basement in their parent’s house playing WArcraft and computer games 24/7, etc)….it does seem that problems of connecting with other people, of being intimate with another human being, seem to strike men more than women.
    In my opinion, I think these are some plausible reasons as to why there might be more men seeing female sex therapists/sex surrogates than vice versa.

  14. Fitz
    Posted March 21, 2009 at 5:26 am | Permalink

    “It really would have killed you to reword your sentence and use ‘they’?”
    That’s the main thing that prompted me to change my mind… I know the shift has been going for ‘they’ to be the more acceptable word to use in the situation, but it just feels too wrong for me to use it at the time being… and that would be awesome if ‘ze’ were a word with that meaning.

  15. mobius
    Posted March 22, 2009 at 2:09 am | Permalink

    I googled around and the “training” these people receive to become certified consists of approximately a week or two of mostly exploring their own sexual make-up and activities with others in the classes combined with some book study. From having explored this before it does seem that the “coursework” is lovely sexual exploration. How it is supposed to qualify anyone to call themselves a “therapist” is beyond me.
    These women are then “certified” to go out and basically…get paid to have sex. Almost all “therapists” are female and almost all “patients” are men. The sexual surrogate websites that I found on google had scantily clad “therapists” in seductive positions. Basically, they looked like escort sites that take themselves a bit too seriously. Inherently there is something skewed with that system and it reeks of male dominated society where male sexual desires/issues take forefront to anything that women might actually feel/need/desire. Just
    I’ve never in 15 years of work in the field of psychology seen or heard of any licensed therapy practitioner of any actual degree program recommending that their clients with sexual dysfunction seek a sex surrogate. Ever.
    I have no problem at all with prostitution, and firmly believe in and support sex workers. I do however take issue when prostitutes try to convince the masses they are therapists. It’s not fair to the consumer in the least to set up expectations that there will be “treatment” or “cure” for sexual and intimacy dysfunctions by using sex surrogates and there is NO data to suggest such a thing.

  16. rhowan
    Posted March 22, 2009 at 11:27 am | Permalink

    It sounds like sex therapists vary in quality and professionalism in the same way that “nutritionists” do.
    This site seems closer to what people would hope for from a professional sex therapist: certified sex surrogate & sex educator, working in conjunction with a regular therapist (and no lounging pin up photos to be found). She mentions that one of her certifications comes from the International Professional Surrogates Association. It looks like the initial course work is 60 hours of classes, followed by an internship supervised by a therapist combined with mentoring from an already certified sex surrogate. She also mentions the Institute for Advanced Study of Human Sexuality. (both organizations have websites if you want to look them up)
    For contrast here’s the website of another woman who’s a sex surrogate who takes a very spiritual attitude to her work. I find the different approaches interesting.

  17. rhowan
    Posted March 22, 2009 at 11:31 am | Permalink

    In at least some cases the therapy is for people who don’t currently have a partner, and part of the goal is to help them gain the confidence to go out and find someone.

  18. baudknight
    Posted March 22, 2009 at 3:59 pm | Permalink

    I think the fact that there is a noticeable imbalance in the utilization of these services by men and women is a cause for concern; at the same time, I’m not convinced this isn’t a result of general sexist social norms (i.e. that men expect more pleasure/less dysfunction from sex) rather than inherent sexism of the profession.
    I think it’s important to note that there are a very large number of late-life male virgins with varying pathologies. This isn’t particularly surprising to me, given the “man pursues woman” template for relationships in our society–it seems that if a man were sufficiently passive it would be entirely possible to never have relationships with the opposite sex, where I’d imagine that a similarly predisposed woman would at least be occasionally approached. I suspect this is the main group of people treated by sex therapists.
    Now, is that the proper use for “sex therapy”? I think probably not–the situation I’m describing here, while it has “sexual dysfunction” (being a virgin at age 45, say) as a symptom, that’s not ultimately the cause of the problem (which is probably more self-confidence/social skills). But like most psychological issues, I think it’s difficult at some point for the sufferer to separate cause and effect–so it’s not surprising that one would try to treat the symptom rather than the cause of the disease. And it’s entirely possible that, psychological issues being interconnected, it may help.

  19. techno_cat
    Posted March 22, 2009 at 4:42 pm | Permalink

    Courtney: I find your analysis of this video interesting and agree on a few points. Given the situation, and reasons why this sex therapist does what she does; are there heterosexual male sex therapists and homosexual female and male sex therapists out there? Someone else might have already asked this question, but I’m also curious.
    Otherwise, it’s only to serve heterosexual men and I think those men (and maybe others too), should begin regular therapy if need be and then develop a real relationship with someone and go to couple’s (sex) therapy. I think this would result in less of this sex therapist as being “used” and possibly move away from any lines beng crossed in terms of her mental and emotional well-being, and maybe even those of the man.

  20. rhowan
    Posted March 22, 2009 at 10:04 pm | Permalink

    There do appear to be male sex surrogates.
    Regarding your second paragraph, I gather it’s common (usual?) for a patient to see a regular therapist who works in conjunction with the sex surrogate on the patient’s treatment plan.

  21. Unree
    Posted March 23, 2009 at 12:49 am | Permalink

    @rhowan: In his (pretty good) book “The New Male Sexuality,” a bestseller several years back, the Bay Area psychologist Bernie Zilbergeld wrote that he offers sex-surrogate therapy. He teams up with a female worker to serve each client. The clientele–mainly rich men from Middle Eastern countries, he implied–pay a double fee, part to Bernie and part to the worker. Zilbergeld said that his surrogates admit that “bodywork” can be emotionally complicated and so it’s better to keep it separate from the clothes-on office therapy that he does.
    Sounds a bit patriarchal to me, and I suspect the male doctor’s hourly rate is higher than the surrogate’s!

  22. rhowan
    Posted March 23, 2009 at 1:23 am | Permalink

    It would be interesting to know the male/female ratio of therapists who choose to work with sex surrogates.
    I’m not clear, was Zilbergeld implying that he was pimping out the sex surrogates he worked with for non-therapeutic purposes? Or was he just reflecting on the sorts of clients who are comfortable with and able to afford the services of a sex surrogate?
    The issue of remuneration is definitely an interesting one, since as a society we tend to devalue physical work, and place a higher value on intellectual labour especially if higher education is required. A therapist would probably have at least a Bachelors degree, whereas becoming a sex surrogate requires much less formal education. My knee jerk reaction is to think “Well of course the person with a doctorate degree is paid more!”, but that’s not necessarily right given the potential physical risks and emotional rigors of sex surrogacy.

  23. figleaf
    Posted March 25, 2009 at 12:01 am | Permalink

    Yeah, it’s really nice hearing so many people just being dead sure that sex surrogacy is prostitution. Really nice. It’s like all those small-town types who are just as dead sure that massage therapists are prostitutes (the customer undresses; the therapist touches them; prostitution Q.E.D.)
    And hey, it’s not even a *totally* bogus conclusion to draw: during the 1970s “massage parlour” was basically a legal euphemism for “brothel.” That this mistake drives actual non-sex-worker massage practitioners absolutely insane (from the community accusation, stigma, and avoidance standpoint) and puts them at risk of physical danger and professional embarrassment (from confused customers hoping for “happy endings) should *not* be “just a cost of doing business.”
    But please, by all means, go ahead and assume based on very little knowledge and a 1985 movie that sexual surrogates, like massage therapists, are glorified whores.

    Let’s think for a minute about the premise of this post. Hmm. Let’s see. A movie maker decides to make a movie. His backers hint that they’d like to see a return on their investment. Society is a big knee-squeezing, voyeuristic, patriarchal mess. So the movie maker makes his decision to… surprise!… choose scenarios that he hopes are informative but that, necessarily, have maximum salacious value. Which would be, what? Women taking money to have sex with men with cliche dysfunctions like 40-year-old virginity and bad divorces.
    Riiigght! Why don’t we base *all* our assumptions on Hollywood contingencies. Did you know Vulcans can interbreed with humans? That CSI labs are all glass, chrome, and edgy lighting with multi-million dollar machines that work every time? Did you know innocent bystanders always dive out of the way in the nick of time during high-speed car chases?
    Yeah, and sex surrogates are really just prostitutes with no training, really mostly women, really working mostly with men, really working with problems they should just suck up and get over, yada yada yada.
    Hey, sometimes it’s true. More often not.
    I don’t know what the state of the art in surrogacy is, but I used to know someone who did. She wasn’t a sex therapist, she was (if I recall correctly) a psychiatric nurse who moonlighted on a largely volunteer basis and took what she did *very* seriously. She didn’t work to “cure” erectile dysfunction, she worked with mostly men who for various reasons wanted to be able to have sex but had (mostly) psychological problems that weren’t always related to sex itself but to, say, body boundary issues, PTSD. Other times the point was to overcome conditioned aversions to sexual contact, to overcome childhood sexual trauma, or to overcome issues of emotional trust. Also I’m not sure where people got the idea that surrogates only work with single men. Many patients are, or at least were, in partnerships.
    And finally, it’s just not the case that sexual surrogates have *actual sex* with their clients. Because unless you’ve *totally* drunk the coolade of “sex” meaning only PIV intercourse there are generally *quite* a few steps… and roadblocks… before you get to intercourse. Or even get *close* to intercourse.
    But no, please, let’s all squeeze our knees together and insist it’s illegitimate, insist it violates ethics, insist therapists “pimp out” surrogates to their clients, insist it’s all about patriarchy, insist that all clients are men and all surrogates are women, insist they’re all heterosexual, insist clients are all unkempt shlubs who should get over it, insist (dear sweet mother of pearl!) that it’s some kind of “sacred temple” revival thing, and insist it’s all about Teh Intercourse because what else could something related to sex therapy *possibly* be about? Because we all feel *so* much better when we do that we don’t have to actually, you know, *think* about whether it a) serves a purpose, b) meets a need, or c) might be undertaken competently, professionally, and, believe it or not, sometimes surprisingly non-salaciously.
    Clue? Eight seconds with Google (try it some time) turns up lewd, suggestive code words like “These therapeutic experiences include partnerwork in relaxation, effective communication, sensual and sexual touching, and social skills training.”
    “Effective communication?” Nudge, nudge, eh? “Social skills training?” A wink’s as good as a nod to a bloind man, say no more!
    Another clue? (21 seconds with Google): “Often female clients will ask their therapists, or seek out therapists who are open to the possibility, to find a male surrogate with whom they might work. Largely because of the sexual double standard that continues to operate in many, if not most, therapists, however, most clients of surrogates continue to be male.” (Admittedly that was from a 1984 paper.)
    Final clue? From a 2007 post about sex therapy: “a study published earlier this year in the Journal of Sexual Medicine found surrogate therapy was significantly more effective than couples therapy alone in treating vaginismus.”
    Sheesh!
    figleaf

  24. figleaf
    Posted March 25, 2009 at 12:49 am | Permalink

    Just to be clear, Courtney, I thought your post itself was a perfectly ordinary and sensibly inquiring. Sorry about totally foghorning in your comments about something I could have just posted about elsewhere.
    figleaf

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