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Writer's pictureRuth Ramsay

Inside The World Of 'Sex Surrogacy'

Sex surrogacy is a vital and transformative part of some individuals’ journeys to sexual empowerment and pleasure, but is often misunderstood. Here I interview a former surrogate to help give clarity on what the work is about, and who it may help.



A wheelchair is next to a bed. Tow pairs of naked feet can be seen sticking out from under a white bedsheet on a bed. They are intertwined.


As a sex coach, I work with clients who are ready to take positive steps towards improving their sexual life. This will begin with lots of work on themselves, before we even being to consider where another person fits in. Sessions with me are conversation-based, not practical, though I may set them homework which involves self-touch.


But what happens when practical education is needed, in being erotic with another person - if there isn’t another person accessible to them? What if this lack of accessibility means their development stalls?


This is where a sex surrogate may come in. In sex surrogacy, a practitioner - the surrogate - works with a client physically, around issues to do with sex and sexual intimacy. The work has a developmental goal - whether to overcome a problem, or to build experience and confidence. The idea is that when that goal is met, the client no longer needs the surrogate.


Because surrogacy is relatively unknown, when people hear about it, they automatically assume it is the same as sex work. From the perspective of being a transaction of providing sexual services for money, it is - but there are also big differences.


Meet a former surrogate


Sue Newsome is a sex and relationship therapist with previous experience of surrogacy. We first met at the Royal School of Medicine in 2009, when we were ‘performing’ at a conference on sex work and disability. At the time I was a striptease artist and demonstrated how I performed erotic dance for a deaf-blind client. Sue took to the stage with a tetraplegic client, showing how they had developed a multi-sensory experience so that he could experience sexual arousal through massage and touch techniques on his head, neck and shoulders.


“A surrogate offers a different service to sex worker, though there can be overlap - some sex workers are interested in supporting their clients to grow and build confidence.” Sue explains. “But with surrogacy, a pleasurable time, while it might happen, is not guaranteed. When someone books time with a sex worker, it doesn’t have to have a goal other than wanting to have a sexy time. Work with a surrogate always has a developmental goal.”


Clients of surrogates come to the experience from a variety of backgrounds. “The biggest is people with very little sexual experience,” says Sue. People with confidence issues, such as coming from toxic relationships, and people with disabilities are also part of the client base. More usually clients are men, but women do access surrogacy services too.


What surrogacy involves


Surrogacy is usually offered as a structured programme that empowers clients to manage themselves in intimate situations and includes communication, consent, being present, optimising pleasure for all involved. They learn about themselves so that they can be sensitive and attentive lovers; they learn about the opposite sex and unravel any misconceptions and unrealistic expectations.


Sue strongly recommends people accessing surrogacy services also work with a coach or therapist (though acknowledges this increases the costs involved). This ‘triangle’ model for surrogacy is widely recommended by surrogacy training schools and bodies, such as the The School Of Intimacy, Consciousness and Self Awareness (ICSA) in the UK and The International Professional Surrogates Association (IPSA) in the US. “Although a surrogate is a practitioner in the interaction, they are basically sexual partners with the client, helping them experience what sexual intimacy is,” Sue says. “It’s a big ask, to be doing that and holding on to the client’s process as well.” With a coach or therapist involved, the client has someone who they can talk to about their experience.


A therapist can also keep an eye on whether the client is becoming dependent on the surrogate and developing attachment, and discuss that with them. There is always the possibility of attachment in any therapeutic relationship and the nature of surrogacy means it can often happen. Talking about it is healthy and essential to reduce the risk of any shame and of it impacting the client’s development.


Clearing up misunderstandings


Surrogacy can be misunderstood as offering an easy route to a sexual experience or to increased confidence. “Some people simply just want to have a sexual experience, and they are carrying stigma about organising that with a sex worker. They think if they do it with a surrogate, that makes it ok. But that’s not what surrogacy is about,” says Sue.


“Or they think working with a surrogate is going to solve all the problems in their relationship; or they have a struggle around their sexual response - around erections or rapid ejaculation. They get the idea that being with a professional and paying, is going to be enough to sort it out. They don’t understand it’s going to take some effort from them - they may need to be vulnerable, self-reflect, be prepared to make behavioural and cognitive changes and commit to practice between sessions.”


Here are some questions for anyone who is curious about working with a surrogate to consider:

  • Am I willing to commit? – financially, to the agreed sessions, and to allocate time for practice between sessions?

  • Am I willing to be vulnerable? – to say what I am nervous about, to ask questions when I don’t understand, to speak my fears, to speak my hopes, to say No, to challenge?

  • What are my goals and what would be a successful outcome for me?

  • Am I willing to stick with the process even when it feels scary or challenging?

  • How will I apply my learning and experience to my everyday life in order to make a difference?


Surrogacy has been around for decades, but has become more know-about in recent years. The 2012 film ‘The Sessions’, telling the true story of disabled poet Mark O’Brien working with a surrogate to lose his virginity, is considered by Sue as a pretty accurate representation of what surrogacy is about. It raised the profile of the work, and people with sexual issues are more aware than ever before that there is help available.


“There are more different types of help - for example, 20 years ago sex coaches such as you, Ruth, didn’t exist in the UK,” Sue tells me. “There were sex therapists, but they all worked within the NHS. Now we have independent therapists, sex coaches, sexological body workers, Tantric practitioners... There are lots of different ways to get help.”


Looking to the future


What’s needed for the future of surrogacy, Sue says, is for the stigma around sex work to lift. “That’s what puts people off from offering the work, or being public about it. As soon as you mention surrogacy, within seconds people go ‘oh that’s the same as prostitution’. Not everybody is robust enough to handle that conversation.”


Surrogacy would ideally be a recognized treatment option – a viable way forward for particular client groups. “It’s particularly powerful and works really, really well for people with disabilities, or who have no sexual experience, or very limited experience,” says Sue. “Or something has knocked their confidence – they’ve come out of a long relationship, or are recovering from serious illness.”


It’s hard to estimate the number of surrogates in the UK at present as the work is so underground. For people with disabilities, the first place to search for a surrogate is via the TLC Trust website, which lists surrogates and sex workers who are open to working with people with disabilities. Sue says she’d love to see more directories, of surrogates and sex workers. She’d also like to see UK-based training for surrogates, and accreditation so that other professionals feel confident to refer to them.


As a sex coach I know the positive transformation that can be seen in a person’s life overall when their confidence in the bedroom increases, and recognise the crucial role surrogates can play in this. Like Sue, I hope the work soon becomes more recognised and respected.


It feels right to give the final words of this piece to people who have experienced surrogacy themselves*:


“Working with a surrogate, I gained knowledge and experience of my sexuality, sensuality and tenderness as well as learning about a woman's pleasure in a safe and supportive environment from both therapist and surrogate. Both gave me confidence in myself to know that I can enjoy and give pleasure and I can take the lead.”.


“I was an adult virgin. I was crippled by anxiety and in particular had a strong fear response to physical and emotional intimacy. I can now recognise and take control of my anxieties instead of being held back by them. Sometimes sessions are great fun and easy, sometimes it can be overwhelming and difficult - but in the end it is so worth it."


"I was born with no legs and a deformed right arm. I accessed surrogacy ten years ago and after regular visits, I feel complete and fulfilled. I now feel human."



Find out more at:


Sue Newsome, sex and relationship therapist: www.suenewsome.com


Ruth Ramsay, sex and intimacy coach and author of this article: www.ruthramsay.com


The TLC Trust: tlc-trust.org.uk


The School Of Intimacy, Consciousness And Self Awareness (based in UK):


The International Professional Surrogates Association (based in the US): internationalprofessionalsurrogatesassociation.wordpress.com


*All testimonials from Sue’s former clients



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