By msnbc.com contributor
updated 3/26/2009 8:38:09 AM ET 2009-03-26T12:38:09

“Jane” looks to be somewhere shy of 40 years old, though she’s squirrelly about telling me her age. She is, as she likes to say, “unaltered,” not a supermodel type. She’s slightly soft, ample in a pleasing way, with brown hair and an open face. I suppose you might say she’s average, but she earns part of her living in a very unaverage fashion.

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Jane is a sex surrogate. Los Angeles-area therapists and counselors send male patients to Jane and then she takes off her clothes and engages in that time-proven pedagogical method of teaching by doing. In the three years she’s been a surrogate, she has taught about 20 men the pleasures of the flesh.

You can be forgiven if you’ve never heard of sex surrogates, or thought they were more urban myth than reality. But if you can recall when backyard “spas” were called hot tubs, Peter Frampton ruled and you were traumatized by the discovery of your mom’s copy of “The Joy of Sex,” you may also recall that surrogates were once the rage.

The boom started when famed sex therapy pioneers Masters and Johnson revealed they had prescribed surrogates for some of their clients. Then a lot of people decided they needed therapy, too. Having a naked surrogate touch your privates or gently encourage you to have intercourse made therapy seem far more pleasant than sitting across from a shrink talking about how your oedipal complex caused your premature ejaculation.

In the 10 years between 1970 and 1980, surrogacy went from being practically unknown to pop culture fascination. In 1980, one California therapist estimated there were between 400 and 500 surrogates working in the United States.

Shrinking into the shadows
Then, like the passenger pigeon, sex surrogates seemed to disappear. Nobody knows how many are left in the U.S. today, but estimates from therapists who use them say there might be 40.

The reason for the disappearance was largely, though not entirely, political. Sex therapy had a sketchy reputation when it began. Throw in the notion of using a substitute sexual partner, with its heavy payload of sniggering and the foggy legality of paying for sex, and the fledging field was at risk of being regarded as more whoopee than therapy.

Sexual healingBesides, after AIDS, Viagra, the explosion of sexual information, the mainstreaming of sex therapy, surrogacy came to seem an anachronistic and somewhat embarrassing holdover from the ‘70s, like orange shag carpeting, maxi-skirts and men with goldfish in their platform shoes.

In an effort to provide a patina of legitimacy, one surrogate named Vena Blanchard created the International Professional Surrogates Association to train and certify sex surrogates. That helped, but not much.

“A couple of things made (surrogates) problematic for some therapists,” Howard Ruppel, Ph.D., academic dean at the Institute for Advanced Study of Human Sexuality in San Francisco, explained. “One is the matter of respectability. If you want to get an interesting discussion going on the bulletin boards of professional groups that certify sex therapists, just put surrogate partners out there and the thing goes berserk.”

According to Stephen Conley, Ph.D., executive director of the American Association of Sexuality Educators, Counselors and Therapists, the issue of surrogacy “just about split the AASECT board years ago. They could not get consensus. Some people were strongly in favor and some worried about legal implications.” AASECT never adopted a formal policy one way or the other, but the debate itself relegated surrogacy to the shadows.

“There are people out there who do work with surrogates but they are a little below the horizon and that is unfortunate,” Ruppel said.

Susan Kaye, a therapist working in Philadelphia and Austin, Texas, works with surrogates “below the horizon” for a practical reason — she can’t even find certified surrogates in her areas. “I have gotten around it by working with people who are ‘body workers,’ people I have trained on what I want them to do with clients.” “Body work,” as Kaye defines it, excludes intercourse, but can include genital touching and genital massage. 

“There are too few therapists trained to work with surrogates,” said Marilyn Lawrence, Ph.D., a Beverly Hills counselor who has used surrogates for 35 years, “and too few surrogates trained to work with therapists.”

Struggling with legality
The rationale for surrogates is simple, according to Lawrence. While patients with a regular sex partner can do therapy “homework,” single men and women, who, after all, might be single because they need sex therapy, don’t have study buddies. Even a partnered man or woman trying to work out a fetish, or someone who has been raped or assaulted and can’t stand being touched could use a surrogate.   

As Kaye explained, “You can only sit across the desk for so long and tell them how to ride a bicycle until you have to give them the bicycle.”

Still, there have been no rigorous studies testing whether using a surrogate is any better than other forms of therapy. That, and the dubious legality of the practice, keeps surrogacy on the fringe.

Lawrence regards the legal issue as a red herring. In 35 years, neither she nor any of the surrogates she’s used have faced legal trouble, probably because most legitimate surrogates do not advertise and work only with men sent to them by mental health professionals.

Indeed, if Jane’s experience is any indication, men who try to use surrogates for easy, zipless sex in exchange for cash are seriously overpaying.

“I would say, of all the clients I’ve worked with, I have had intercourse with two,” she said.

Sometimes surrogates and patients may do nothing more than hold hands and caress. “It is misunderstood,” Lawrence said. “It is not a contract for sex. It is a contract to work on a problem that requires intimacy skills.”

For example, Jane, who charges $150 per hour or $225 for 90 minutes, worked with a man whose Asperger’s syndrome caused him to misinterpret facial expressions. “He wanted to date and he was having difficulty making connections.” She has helped victims of sexual trauma, men with depression, erectile dysfunction and fetishes that limited sexual menus.

“My favorite clients are the 40-year-old virgins,” she said. “Everybody is shocked, but there are a number of men out there who, for whatever reason, have not had many successful sexual experiences or none at all.”

Exactly what Jane does varies depending on the man’s needs. “I reintroduce people to their own bodies,” she explained. “It is close and intimate but not necessarily sexual. For example, for people with sexual trauma, it is important for them to know they can touch and be touched and not be in jeopardy.”

After every session, Jane reports back to the assigning therapist who uses the information in treating the patient. For some patients, Lawrence said, surrogacy may be the only method that works.

That’s why she is campaigning for the return of sexual surrogacy. “Look,” she said, “sometimes all somebody needs is literature. Sometimes they need basic sex ed, sometimes talk therapy. But sometimes people need a surrogate.”

Brian Alexander is the author of the book “America Unzipped: In Search of Sex and Satisfaction," now in paperback.

© 2013 msnbc.com

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