Sexual Surrogacy (SS) and Body Work (BW)

1. Sexual Surrogacy (SS) and Body Work (BW) Dr Margaret Redelman Sydney Men’s Health Bondi Junction 5th Sexual Dysfunction Conference Queenstown, 4.2012

2. Sexual Surrogacy and Body Work Contentious topic Regularly comes up in media Relevant to our work Opportunity for collegiate discussion and ? “expert opinion” consensus position

3. Sexual Surrogacy and Body Work Session rules • No personal attacks • Differentiate personal religious / ethical position from the therapeutic utility • Separate therapeutic utility from governance/ lawfullness positions

4. Sexual Surrogacy and Body Work • Unregulated • Self proclaimed gurus • Self interested individuals • Various backgrounds • Various motivations • Varying levels sexual and psychological education • Varying levels of supervision

5. Definitions • Sexual surrogacy IPSA “ A surrogate is a member of a 3-way therapeutic team(therapist, client, surrogate) who acts as a partner for a dysfunctional patient in experiential exercises involving sensual and sexual touching as well as social and sexual skills training” • Body work “somatic sex educators, assisting individuals, couples and groups deepen their experience of embodiment” IPSA = International Professional Surrogates Association www.sexologicalbodyworkaustralia.com

6. Australian groups • SSEAA (Somatic Sex Educators Association of Australia) http://somaticsexeducators.org • ACSB (The Association of Certified Sexological Bodyworkers) www.sexologicalbodyworkersaustralia.com Courses $6000 genital touch but ? no intercourse

7. Sexual surrogacy is classified under sex work, under Australian law. • Sex + money= wrong - bad - evil

8. Dr Brian Hickman opened clinic in Melbourne 2004 Limited supporters: ? $600/session power imbalance patient ‘feelings’ for surrogate regulation and control

9. Sexual Surrogacy and Body Work Masters & Johnson in 60s Explosion in 70s AIDS, Viagra, explosion of sexual information, mainstreaming of sex therapy → ↓ surrogacy

10. Sexual Surrogacy and Body Work Surrogates problematic - respectability Issue of surrogacy “just about split AASECT board. Could not get a consensus. Worried about legal implications. AASECT never adopted a formal policy and debate relegated to the shadows.” Dr Howard Ruppel academic dean Institute for Advanced Study of Human Sexuality 2009 AASECT = American Association Sexuality Educators Counsellors and Therapists Dr Stephen Conley executive director AASECT 2009

11. Rationale for surrogates Single individuals who don’t have “study buddies” to do “homework” “can only teach how to ride a bike for so long before giving them a bike” Reality- we teach children most important things by: showing talking allowing to practice with correction On the spot ‘teacher’

12. Sexual Surrogacy and Body Work • No rigorous studies testing whether using a surrogate is any better than other forms of therapy

13. Efficacy for women • Ben Zion et al, Surrogate vs Couple Therapy in Vaginismus was accepted for publication in JSM 2007. • 100% of the women who were treated with surrogate succeeded vs 75% of the women who were treated in couple therapy

14. Sexual Surrogacy Sexual surrogacy is not a contract for sex. It is a contract to work on a problem that requires emotional and physical intimacy and practical sexual skills. Intent behind ss separates it from sex work Safe environment to practice

15. Difference between surrogate and prostitute • Surrogates are professionals • Surrogates receive supervision for every session. • Sessions focus on the therapeutic goals set by the therapist for the client/patient • Sessions focus on the SF exercises + a variety of intimate/social skills • The patient never pays the surrogate • Most time is spent on non sexual activities • It is a process of 12-20 sessions • Completed when therapeutic goals have been met

16. Special circumstances Disabled – learning difficulties Disabled – rehabilitation Experience in shared physical intimacy while working with client’s sexual self concept and body responses Modelling for sexual closeness and social skills Genital – genital contact may be minor part In vivo adaptation to patent’s abilities In vivo encouragement

17. What is “well trained”? International Professional Surrogate Association (www.surrogatetherapy.org) Mare Simone – calls herself a “sex surrogate” has had penetrative sex with 1,500 men 10,000 clients took a 4 day course in sex therapy sex with husband in front of wife to show them www.thesun.co.uk/sol/homepage/woman/2637533/Sexual-healer-has-slept-with-1500-men.html

18. Interesting ? • Young couple who wanted to learn more about themselves and each other

19. Training surrogates in Israel • Ads in newspapers or professional journals. Each candidate interviewed. Comprehensive information about proposed role. Biographical information. • Battery of psychological tests. • Interview by sex therapist with full sex history. • 50 hour training program for surrogates 3 workshops: • SAR • Touching workshop • Nudity workshop

20. Lectures on: • Anatomy, physiology of sexual organs, human sexual response, sexually transmitted diseases, sexual dysfunction in men and women, treatment of sexual dysfunctions, role of the surrogate in sex therapy, code of ethics for surrogate partners, case studies. • Rules of conduct agreed on for duration of surrogate therapy Dr Ronit Aloni http://www.dr-aloni.co.il/english

21. Aloni R. Katz S.;2003; Sexual Difficulties After Traumatic Brain Injury and Ways to Deal with it, Charles C. Thomas, Pub. Springfield USA, chapter 9, pp,153-190. • (Aloni R., Dangur N., Ulman Y., Lior N., Chieger M.; A model for surrogate therapy in a rehabilitation center, International Journal of Adolescent Medicine and Health, vol. 7, no. 2 1994.) • Apfelbaum B; The myth of the surrogate, Journal of Sex Research, vol. 13, no. 4 pp.234-249, Nov. 1977. • Ben Zion I, Rothschild S. Chudakov B. Aloni R. "Surrogate versus Couple Therapy in Vaginismus" JSM Vol. 4, issue 3, start page 728-33 may 2007 • Blackerby, W.F. (1988,1994). Head injury rehabilitation: sexuality after TBI. The HDI Professional Series on Traumatic Brain Injury.10, Houston, Texas. HDI Pub. • Blackerby, W.F. 1990; A treatment model for sexuality disturbance following brain injury, Journalof Head Trauma Rehab. 5(2) pp. 73-82. • Brown P.T. Jan. 1986; Comment, Surrogate Therapy, British Journal of Sexual Medicine, pp. 5. • Cole M, March 1982; The use of surrogate sex partner in the treatment of sex dysfunction and allied condition, British Journal of Sexual Medicine, pp. 13-20.

22. Dauw D. Nov.19, 1983 ; Re evaluating the surrogate assisted sex therapy: Myth, experiences and research findings, Society for the Scientific study of sex, 26th annual meeting, • Davis D. Schnieder L.K. 1990; Ramifications of traumatic brain injury for sexuality, Journalof Head Trauma Rehab. 5(2)pp. 31-37 • Dunlap D. Roberts M.B. June1984; Surrogate partner therapy, clinical, ethical and legal concerns: A 1984 update, AASECT/SSSS National conference, Boston MA • Johnson W. and Kempton W., Sex education and counseling of special groups, Charles C. Thomas Pub., pp. 224-231, Springfield, 1981. • Joseph Robert; A case Analysis in Human Sexuality: Counseling to a man with severe cerebral palsy, Sexuality and Disability, vol.9,No.2, Summer 1991 • Kilman P.R. Mills K.H. 1983; All about sex therapy, Plenum Press pp.67-69 • Herbert d'H. Lee; Surrogate wife; Dell NFpub. • Len M. Fischer J. Feb.1978; Clinicians' Attitudes toward and use of four body contact or sexual techniques with clients, The Journal of sex research Vol. 14.No. 1 pp. 40-49. • Lief H.T. 1981; Sexual problems in medical practice, American

23. Sexual Surrogacy and Body Work Thank you DISCUSSION Dr Margaret Redelman