Trick or Treatment?

Though she lives in the San Francisco suburb of Tiburon, 30-year-old Susan Greene is hardly the typical suburban housewife. A graduate of Cornell University, she has traveled extensively with her husband (a Ph.D. in Southeast Asian studies), taught school, backpacked in the California mountains and, as she freely admits, had sexual relations for a fee with two dozen different men during the past year. Despite her professional extramarital activity, Susan is not a prostitute. She is a "sex surrogate"--a paid partner for men who are being treated for sexual difficulties.

The idea of using surrogates to help alleviate such problems as premature ejaculation and impotency was developed by Dr. William Masters, co-author of the pioneering study Human Sexual Response. At his St. Louis sex clinic in the late 1950s, Masters enlisted women to work as sex partners with unmarried male patients under the guidance of therapists. The program proved success ful. Over an eleven-year period, Masters and his partner Virginia Johnson provided surrogates for about 50 men; the treatment overcame impotency problems for at least five years in 75% of the cases.

In 1970 the St. Louis clinic stopped using surrogates for a variety of reasons not the least of which was a lawsuit against Masters brought by the irate hus band of an alleged surrogate. Masters regrets having had to give up the surrogate therapy. "The success statistics with single impotent males have completely reversed," he says. "We now have a failure rate of 70% to 75%."

But other sex therapists have taken up where Masters and Johnson left off. Susan Greene, for instance, is one of three women at the Berkeley Sex Therapy Group, run by five psychologists near the University of California campus. In the Los Angeles area, at least 30 psychologists and psychiatrists refer patients to surrogates, including two men who work with women who have difficulty achieving orgasm. There are also a few surrogates in the New York area.

Sensate Focus. Early sessions usually involve touching and massaging, along with talk between patient and surrogate about sexual likes and dislikes. The objective: to overcome in males what Los Angeles Sex Therapist William Hartman calls "performance anxiety." Later sessions advance to genital contact, mutual stroking and eventually penetration. The emphasis is not so much on achieving orgasm as on reaching a state of bodily awareness that some surrogates call "sensate focus." In the $2,180 program offered by the Berkeley group, each often 2 1/2-hour sessions with the surrogate is followed by an hour's meeting of patient, surrogate and psychologist. The surrogate's share of the take is $110 per session; the psychologist gets $90, plus $180 for the initial consultation.

Surrogates tend to be serious, well-educated women in their late 30s or early 40s who approach their work with missionary-like zeal. "We are very professional. At all times I am giving so much information, it is very difficult for a man to think of me in any other way than as a therapist or teacher," says Los Angeles' Beverly Engel. Explains L.A.'s Sylvia Kars: "We work with dysfunctional clients in a slow, well-constructed program of therapy that may extend over many months."

Some sex experts have doubts about the practice. They point out an important similarity between surrogates and prostitutes besides the fact that they are paid for their time. Their services leave unresolved the emotional problems that are often at the heart of sexual difficulties. "A guy may be able to have sex with a surrogate," says Dr. John O'Connor, head of the sex therapy program at New York's Columbia Presbyterian Medical Center, "but what happens when he wants to have sex with his partner?" Adds Dr. Helen Kaplan, author of The New Sex Therapy, who directs a similar program at New York Hospital's Payne Whitney Clinic: "Lonely people can be helped by surrogates, but I would try to work in psychotherapy to figure out why the person is so lonely. We have to get humanity and eroticism back into sex. You can't do that if you pay someone $100 to go to bed with you."

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