Ian Kerner, a sexuality counselor and New York Times best-selling author, blogs about sex weekly on The Chart. Read more from him on his website, GoodInBed.

A provocative movie premiered recently at the Sundance Film Festival that caught the attention of audiences and critics as well as sexuality professionals such as myself.

“The Surrogate” chronicles the true story of a relationship between a surrogate partner (played by Helen Hunt) and her client (John Hawkes), a poet who is stricken with polio and seeks to lose his virginity before he dies.

When we hear the term “surrogate,” most of us probably think of a surrogate mother, who carries and delivers a baby for another couple or person who cannot. Yet surrogate partners (sometimes called sexual surrogates) have been around for years, providing a potentially valuable, though oft-debated, service to clients who wish to increase their sexual, physical and emotional experiences.



Surrogate partners gained attention in the 1960s when William Masters and Virginia Johnson (also known as Masters and Johnson) began training surrogates at their research institute.

These days, surrogate partners are typically trained by the International Professional Surrogates Association in Los Angeles, the main surrogacy organization. Clients are referred to surrogate partners by their therapists or other mental health professionals.

So just who sees a surrogate partner? The short answer is: anyone who wants to improve his or her sexual intimacy skills or, more likely, overcome a daunting sexual problem.

Surrogates, who can be male or female, see a wide variety of clients. Some people may use a surrogate partner because they are sexually inexperienced and want to gain skills before sleeping with a romantic partner.

A man may seek a female surrogate to help him deal with issues such as erectile dysfunction or premature ejaculation. Likewise, a woman might seek a male surrogate for assistance working through issues such as painful sex or difficulty reaching orgasm with a partner.

Surrogates also work with people coping with the infirmities of multiple sclerosis, cerebral palsy, quadriplegia and other physically challenging conditions - as was the case with the real-life woman upon whom “The Surrogate” is based.

Watch: A look into the work of a sex surrogate

But surrogate partners don’t just have sex with their clients. In fact, some never engage in intercourse at all, instead focusing on other intimate activities including kissing, touching, cuddling and answering the client’s questions about sex.

The goal is to provide a safe, comfortable atmosphere for clients to explore sexual issues without judgment or fear, and with a professional who is able to go beyond talk therapy and into the hands-on realm of intimacy-interaction.

And like a therapist/patient relationship, the question of whether a surrogate partner is sexually attractive to the client is not part of the equation.

Many sex therapists would prefer that their clients work through their sexual issues themselves - using their romantic partners as they would a surrogate partner, if you will.

“I always tell my patients that I cannot really know how a person works to say whether they are physically healthy or psychologically appropriate and sensitive to a person's needs," says sex therapist Madeleine Castellanos, author of the "Good in Bed Guide to Male Sexual Issues."

"Because of this (and the legalities of surrogacy in New York and other states) I do not recommend or encourage my patients to do this. I always prefer that individuals work out their issues with their partner.”

One of the main issues with sexual surrogacy is that it remains highly unregulated. The International Professional Surrogates Association does have its own code of ethics, but that only matters if a surrogate partner is trained by and aligns him or herself with this organization. Better regulation could add more legitimacy to what is already an important, but often misunderstood, profession.

You're probably asking - how is this different from prostitution? A professional, empathetic surrogate partner is light-years away from a prostitute (the services of which, in addition to being illegal outside of Nevada, often amplify rather than mitigate a sexual issue). But while sexual surrogacy is not prostitution, the legality is somewhat fuzzy, and therefore polarizing in clinical and medical circles.

Sexual surrogacy is not a contract for sex. On its website, the International Professional Surrogates Association addresses the issue of legality thus: “The legal status of surrogate partners is undefined in most of the United States and most countries around the world. This means that there are generally no laws regulating the profession.”

Even if a person is interested in retaining the services of a surrogate partner, finding a surrogate may not be easy. While the profession hit the ground running during the sexual revolution of the 1970s, today locating a surrogate partner is nothing like locating, say, a dentist, or even a sex therapist. At its peak, the association had 200 to 300 members in the United States but now has about 50.

Even if you do reside in a community with access to a surrogate (or can travel to meet one), you may face challenges: Many traditional therapists aren’t comfortable discussing sexual issues with their clients in the first place, and may be further reluctant to recommend a surrogate.

Perhaps with the release of the movie, more people will become aware of the value these partners provide and the potential role they can play as sexual healers.