Sex surrogates helping patients treat anxiety, PTSD and erectile dysfunction through sexual intimacy

The prospect of paying for sex, in the minds of most people, conjures up the idea of prostitution. However, there is another very different scenario where this occurs.

It’s called sex surrogacy, which is a controversial form of sex therapy.

It entails pairing up patients with trained sexual partners and is used to help people with problems including physical disabilities, anxiety, autism, schizophrenia, PTSD, vaginal spasms and erectile dysfunction. Practically all of them are nervous about intimacy.

The Defence Ministry even pays for severely wounded soldiers to have sex surrogacy.

One of the therapists who provides the treatment is Dr. Ronit Aloni, whose clinic is in Tel Aviv.

“Sex therapy is by definition couples therapy, and those people who don’t have a partner can’t have the therapy,” Aloni, 64, told the Jerusalem Post. “Surrogacy allows us to do the ethical thing and provide therapy to the people who need it.”

Aloni is a sex therapist with a distance-learning doctorate in sexual rehabilitation, and although sex surrogacy has many critics in what is a relatively conservative society, many people - including sex therapists, Israel’s Defence Ministry and civil courts - praise her for her work.

She employs sex therapists, physiotherapists, social workers and doctors as well as sex surrogates, and about a third of her patients undergo sex surrogacy.

This takes place in either the ‘green room’ or the ‘red room’ - private rooms furnished with a futon, private shower, erotic artwork, candles and a CD player.

“It’s not really about sex,” Aloni says. “I sometimes tell my staff that we’re really an anxiety clinic.”

Of course, the idea might sound appealing to some people who just want casual sex, but the high price-tag of the treatment deters them - the cost goes up to $2,000 (£1,540) a month, which is over half the average Israeli salary.

“I believe some people come in wanting to get laid,” says Idan Milchan, a co-director of the sex therapy clinic at Ichilov Hospital in Tel Aviv who used to work for Aloni and refers patients to her.

“But the therapists are professional enough to understand if a guy or woman has a sexual problem or not, and it’s so expensive that people can find cheaper sex.”

The sex surrogates are regular people who are trained at the clinic. Patients usually see their surrogate for months, but treatment can go on for years.

The surrogate and patient usually meet in public, at a coffee house, for example. Once they’ve established some initial contact and intimacy - such as light touching - they move on to the green or red room, where sessions last 90 minutes.

Before getting started, however, both parties are tested for STIs and must use contraception.

“Maybe it sounds like a cliché, but I have an ability to love and not be afraid of being compassionate,” sex surrogate Talia* explains. “I cuddle the patients in a very, very secure place and let them grow. I don’t like humanity to suffer.”

Although Aloni is against sexual conversion therapy, some of her patients are young Orthodox and haredi men who’ve expressed attraction to other men - they tend to be sent by rabbis to learn to have sex with women.

These men are treated by Orthodox therapists and ‘kosher’ sex surrogates who are willing to use the mikvah, or ritual bath, before the session begins.

“It’s not about conversion. We don’t do that,” Aloni said. “If you’re homosexual, you’re homosexual. But we know sexuality is on a spectrum.

“Some people can function both ways. We go through the process with them and talk about what they’ll win and what they’ll lose. It’s not for me to judge.”

Aloni says sex surrogacy is more mainstream in Israel than other countries. She is well-respected in sex therapist circles, many of whom refer their patients to Aloni.

And apparently it does work.

“Like every profession, it’s not 100 percent effective,” said Milchan, a former chair of the Israel Society for Sexual Therapy Training. “But if it didn’t work period, it would have extinguished already. It’s still here. It does work.”

But not everyone is on-board: “I do not refer patients to surrogacy ever. I’ve been in this business more than 40 years, and I’ve never encountered a situation where surrogacy would be the only way out,” David Ribner, a Jerusalem-based Orthodox sex therapist, says.

“And as an Orthodox Jew, I believe sex only takes place in the context of marriage, and this is not marriage.

“The relationship between the surrogate and the patient is complex,” he said. “I think the ending can be highly problematic, especially with patients for whom this might be their first meaningful sexual experience.”

And testimonies on the website suggest this problem can be very real: “My treatment is over and I don’t know what will happen in the future. At the moment, my heart is broken and I am quite unhappy,” one female patient wrote.

“All that remains is for me to hold on to the belief that I will continue to enjoy [my surrogate’s] positive and constructive influence on my future interpersonal behaviour and sexuality.”

*Name has been changed