Surrogate sex therapy is a controversial topic, but in Israel it’s become a vital tool to help rehabilitate the likes of those injured in traffic accidents and serving in its military.
A ‘sex surrogate’ is a trained sex partner who helps clients practice intimate physical contact to work through problems that are preventing them from having normal, healthy sexual relationships.
Many patients – both men and women – have been through sexual or military trauma, or physical disability. A pioneering clinic in Tel Aviv, run by psychologist Dr Ronit Aloni, is helping them rehabilitate.
Patients are matched with a compatible surrogate with whom they work over five months, along with the therapist, Dr Aloni, learning every detail of interaction and relating; how to speak, touch, walk alongside someone of the opposite sex, and later, the physical aspects.
The process is spread over 21 weeks and costs around £11,000, and ends when the clinic is confident that the patient is functioning physically as well as emotionally.
In the wake of a year of brutal lockdowns, the pandemic has led to a surge in demand, and Dr Aloni has had to increase her team of less than 10 to over 15 since restrictions were lifted.
A ‘sex surrogate’ is a trained sex partner who helps clients practice intimate physical contact to work through problems that are preventing them from having normal, healthy sexual relationships. Pictured: a still from the film Surrogate, by Tali Shalom Ezer
‘You know when there is a trauma, many times it brings up historic trauma that you would usually try to ignore or avoid somehow and continue with your life,’ Dr Aloni tells FEMAIL.
‘This trauma of lockdown, nobody was ready for and it was like long lasting trauma. Conflict like we have now, we are in many ways used to, and it always passes, or a car accident that is over quickly and then you begin to do the work to repair… Covid wasn’t like any of these.’
Dr Aloni began the sex therapy work in 1985 and it went public in 1991. The clinic itself resembles a cosy apartment, with soft furnishings, bright colours, candles and erotic artwork on the walls, as well as biological imagery to aid the sexual therapy process.
Dr Aloni began the sex therapy work in 1985 and it went public in 1991
Some clients have fears and psychological issues which mean they carry a lot of trauma. Some even reach their 40s as virgins before reaching out for help.
The process itself is much the same as that of building a romantic relationship; meeting up for coffee, a movie, the beach, getting to know each other – though there are strict guidelines.
Sessions are 90-minutes long and the surrogate reports on all the observations and happenings of the session straight after, to send back to the therapist.
‘When they feel comfortable with each other they will move to a private room where they will start doing the exercises that we give them. Outside, it’s more the social and intimacy skills they learn, but inside, it’s the physical,’ explains Dr Aloni.
Most of the surrogates either study or have two jobs, like actress Seraphina Arden, who has been a surrogate for over 10 years, and in that time has helped over 40 patients. She sees her role as a ‘mission’.
‘The main thing is that people that go to prostitutes can function physically, and they come here for a completely different purpose. The clients that come to us cannot function, they cannot go to prostitutes. On the contrary, they come to us sometimes after they went to a prostitute and there was a whole disaster,’ she explains.
‘We communicate, we teach, we go step by step, and sometimes after as much as three months, we have a sexual relationship.’
The process is spread over 21 weeks and costs around £11,000, and ends when the clinic is confident that the patient is functioning physically as well as emotionally. Pictured: a still from the film Surrogate, by Tali Shalom Ezer
Virgin from a religious community who was taught masturbation was a sin and had never touched a woman
In her memoir, More Than a Sex Surrogate: A Unique Memoir about Intimacy, Secrets and the Way We Love, Seraphina Arden shares the story of one man she worked with early in her career as a sex surrogate.
The man, who is given the pseudonym Jack, was introduced to Seraphina at a friend’s party.
He had been raised in an extremely conservative religious community where he was taught masturbation was sinful and sex should only be between man and wife. When he met Seraphina, the only women he had spent time alone with had been his mother and sister. He had never seen a woman naked.
‘What is certain is that he is lonely, he just started working and meeting new people,’ Seraphina’s friend said, introducing Jack. ‘He craves meeting women but just the thought of an intimate relationship scares him, and he is incapable of initiating anything.’
Seraphnia arranged for her and Jack to spend a day-and-a-half at a secluded cabin in the woods, where they began by touching hands, before moving on to the arms and shoulders, then the head.
Eventually the session graduated to hugging, kissing then ‘disrobing’ and caressing.
‘Jack was embarrassed to look at my naked figure, lying by his naked figure – but he digested the new situation faster than he digested dinner,’ Seraphina recalled.
Jack had been taught that masturbation was sinful and had been encouraged by the leader of his community to ‘injure his genitals’ when he felt the urge to pleasure himself, in order to make the feeling ‘dissipate’.
Over their time together Jack had sex for the first time and reached orgasm.
Seraphina added: ‘By the farewell the next day, he went from an anxious virgin to a man who had known a woman.’
As a surrogate, Ms Arden explains that she always has half her character in role as a therapist, while the other must be a teacher. It is a complex role to play, and one her acting career could not have prepared her for.
‘Half of me is his guide and half is his partner. I cannot be either,’ she says.
Her patients are learning to fall in love. ‘They need to because what’s important is the experience of falling in love, having a relationship. It’s okay, we all broke our heart at one time in our lives,’ she says.
Dr Aloni shared insights into her work for a new film called Surrogate, by Tali Shalom Ezer
Some patients will even say they want a ‘better looking’ surrogate, but Dr Aloni does not always allow this option, putting the patient needs and surrogate compatibility first. Those who do display aversions usually show similar aversions in real life relationships, picking the wrong partners, so this becomes a part of the therapy.
In her latest memoir, More Than a Sex Surrogate: A Unique Memoir about Intimacy, Secrets and the Way We Love, Ms Arden admits that in the beginning things were hard, and even now, she must draw a line when she works with a patient she knows could feasibly be a partner ‘in the real world’.
‘I fell in love with someone – I was really not prepared to be so attached,’ she says. ‘I really needed to understand and to learn how to manage my feelings.’
In her memoir Ms Arden explains how she picks her underwear according to her clients’ progress; a thong if they are ‘advanced’ so that he can ‘enjoy the suggestion of nudity and let him start experiencing sex atmosphere’, as opposed to dark coloured pants that ‘resemble a swimsuit, grandma fashion’ for a patient in the ‘beginning stages’. A virgin will get ‘yellow cotton underwear with a flower or hearts’.
She describes herself as a woman who ‘accompanies men of all shapes and shades, all difficulties and anguish, in journeys from sexual dysfunction to complete functionality, from sitting in a cafe to lying in bed, from coffee to sex’, and says she’s driven by ‘motherly compassion’.
She recalls one of her first patients, called Jack, who had left a conservative religious community where he’d never come into contact with women.
Dr Aloni (pictured) says sometimes patients who know they are getting to the end of the therapy process sometimes try to hold back because they don’t want to leave the surrogate
Ms Arden began by touching his hands before moving onto arms, then shoulders, then head, graduating from timid to curious caressing. Eventually they moved onto hugging, kissing, disrobing and touching genitals. By the farewell the next day, he went from ‘an anxious virgin to a man who had known a woman’.
‘If there is a prominent advantage to surrogacy, it’s getting compliments like being a wonder, special, amazing… it reminded me to say it to others,’ she writes.
Over the 10 years as a surrogate it has been hard for her to date. Her first partner supported her career path but since then, many have not been as understanding.
‘It’s not like I’m going on a sexual adventure with someone, it’s so far from that. It’s completely different,’ she explains.
In her latest memoir, More Than a Sex Surrogate: A Unique Memoir about Intimacy, Secrets and the Way We Love, Ms Arden admits that in the beginning things were hard, and even now, she must draw a line when she works with a patient she knows could feasibly be a partner ‘in the real world’
She feels her role helping others has simply been too important to sacrifice for someone who will not allow her to follow her path. ‘It’s like giving up a part of myself,’ she explains.
In the early days, and even now, distinguishing how sex surrogacy differs from prostitution was and remains, a challenge.
‘As a tutor, you teach someone how to do something, it doesn’t matter what, whether it’s to repair a shoe, or to do a brain surgery, but there is an expert to teach them step by step how to do what you need to do,’ Dr Aloni explains.
‘It’s a teaching process in many, many ways.’
Male surrogate ‘Alex’ has been in the role for almost 10 years. He admits there is much less stigma and judgement for a man to do the role than a woman.
However, he has been no less prone to the same challenges as a female surrogate in matters of the heart.
‘In some cases it is easier for a male than for a woman surrogate though I must admit that both genders are naturally very likely exposed to the risk of getting attached emotionally and that is just part of this occupation,’ he says.
‘During the years I’ve been in the field of surrogate treatment I have been emotionally attached to most of the women and even fell in love more than once.’
Dr Aloni adds that sometimes patients who know they are getting to the end of the therapy process sometimes try to hold back because they don’t want to leave the surrogate.
‘They have such a very emotional relationship with her or with him, so we have to watch it and, and they must let go so that they can finish the therapy process,’ she explains.
WHAT IS A SEX SURROGATE?
Sexual surrogacy is a therapeutic practice designed to help a person become more comfortable with sex, their body, and/or the emotional and physical skills they need for intimacy.
The client works together with a licensed sex therapist and a sex surrogate, or surrogate partner. While other forms of sex therapy do not include the possibility of physical touch or intimacy, sexual surrogacy does.
Sexual surrogacy is a controversial and commonly misunderstood form of therapy. Due to its potential ethical and legal complications, there is a lack of published research on sexual surrogacy. But there is anecdotal evidence that it can be an effective part of sex therapy for some people.
Another term for sexual surrogacy is surrogate partner therapy (SPT). Sex surrogates also go by the title ‘surrogate partner’.
During Covid, surrogates were each only allowed one patient to work with, not only slashing their income – some experienced surrogates are used to working with as many as four or five if they have the time – but it severely restricted the clinic’s ability to help those in need.
Israel’s Ministry of Defence now supports its staff to have the rehabilitation therapy, some of whom have lost limbs in conflict, or have severe PTSD meaning relating becomes a huge barrier. Now, those severely injured in road traffic accidents can also get insurance coverage for the therapy.
‘At the beginning, the clinic was more oriented to sexual dysfunction but it’s developed into relationship intimacy problems for both men and women,’ explains Dr Aloni.
It takes a certain person to take on the role, and a recent round of trainees has just joined the ranks, trained by the likes of Ms Arden and Dr Aloni, who are vetting them for characteristics which seem well suited to the challenging work.
‘At the beginning I was looking for people coming from the helping fields but not any more because it’s not always needed, sometimes it’s about people who understand introverts, or who display certain traits, but mostly it’s about finding the right person for the patient,’ says Dr Aloni.
Though the issues men and women face are often very similar, Dr Aloni says there are always less women in therapy.
‘Sexuality per se is less of a problem for women… and they can function and imitate easier than men, while men are more expected in our society to function to perform than women,’ she says.
Surrogate Alex explains it more simply as women struggling to receive the intimacy they need or desire, while for men, it tends to be that they are struggling with other more mental issues such as PTSD or physical disabilities.
‘From my experience, most women reaching out for therapy come with very low self-esteem which prevents them from intimacy,’ he says – the main work for him being to explore ways to achieve that and build trust.
Woman with no ‘wants or desires’ who believed sex was ‘repulsive’
‘A’ has been going to the clinic for six months in what has been an emotional process for her. ‘In this time, a whole life has passed,’ she says.
‘A girl came in and I left a woman, and somehow I did not realise that so much can change in so little time.’
It has been many years that sex was not present in her life, perceived in her mind as something ‘repulsive’.
‘I had such a hard time looking at myself as a woman, as a sexual creature who wants and desires,’ she explains, having convinced herself that she can live without sex.
‘I did not really have a chance for a real relationship because the fear of sex coming sooner or later closed everything off,’ she admits. She imagined her therapy would be a tough process, ‘a long and stubborn struggle’ after years of pain and discomfort around the topic.
‘From this journey I got so much more than the ability to sleep with a man. I felt that the clinic wanted to help me, from a respectful place and not condescending even for one second.
‘I got warmth, I felt heard, sensitivity, patience, a feeling that I had someone to rely on and that I could let go a little and nothing bad would happen,’ she says, explaining it has been like lifting a heavy stone from above.
‘I have found inside areas of joy, of desire and lust, things I buried so deep that there were times I no longer believed they were there,’ she now smiles. ‘This is the first time in so many years that I feel that life is something worth living, for so long I have not really lived.”
She calls it one of the most meaningful and amazing experiences of her life. ‘And with that I go out into the world knowing that everything is open to me and possible, permissible and desirable. I touch that there will still be bumps in the road, but I leave a very heavy load behind me wholeheartedly.’
Dr Aloni, who shared insights into her work for a new film called Surrogate, by Tali Shalom Ezer, says more men come due to simply earning more money. In an OECD survey in 2017, it found that Israel has one of the biggest gender pay gaps in the West, women in the country earning on average just 78 per cent of what their male peers earned.
‘I think it’s more legitimised by society that men will go for [sex] therapy too,’ she adds.
However, for men and women alike, the treatment, however stigmatic, is a ‘life changer’ as far as surrogate Alex is concerned.
‘Intimacy and affection are basic human needs and research shows the major effect of loneliness on the human spirit,’ he says. ‘Not being able to be part of giving and receiving such a basic need leaves many people in a daily struggle and shame and it is much wider than just the idea of intimacy.’