‘Some patients have never kissed anyone’: Amid pandemic, sexual surrogacy sees rising demand

Shir, a single woman in her 30s, can’t reveal her real name. It’s essential in sexual surrogacy therapy for the patients not to know the identity of the person working with them. As part of Shir’s job, she acts as an alternate partner for people who are unable to forge intimate relationships in real life. She helps them to develop the intimacy necessary in couple relationships and to have sexual intercourse: Indeed, she herself has sex with them.

“I try as far as possible to see myself as the partner of the person I’m working with in therapy,” she says. “It makes no difference if he’s disabled or an older guy of 40 who’s never kissed anyone. I’m simply there, and I put my head on his shoulder. I get enjoyment from it, too, and my enjoyment is important, because for him it’s a whole world. During the moments where it’s uncomfortable for me – I share that with him, so he’ll learn mutuality.”

She adds, “It’s like being an actor who plays a role that’s not precisely him, but that also isn’t faking. Actors need to connect to their feelings and to do what the character does in order to play the part. When I am with a patient, those are my real feelings. For example, if something he does disgusts me I’ll say that it bothers me but I won’t make a scene, because I know what my role with him is.”

In some cases, she says, the encounter is also fun. “Sometimes it brings me back to my own youthful experiences. When we were terribly thrilled at holding hands. Sometimes for them it really is the first time. It’s magic that you don’t feel so much at my age.”

In the past few months, the sort of treatment offered by Shir and her colleagues has been increasingly in demand. The Tel Aviv clinic at which she works has have been inundated by requests. “Everyone is flooded,” says Ronit Aloni, the pioneer of the field in Israel and the eponymous clinic’s director. “My days go on until 11 at night. I am recruiting surrogates and therapists-in-training, everyone is trying to do their best, but I can’t handle everyone.”

The reason for the many applications is clear: Life during the coronavirus crisis is bringing people to the edge of despair: “People come who are in pain from the loneliness,” says Aloni, 68, in an interview in her Jaffa home overlooking the sea. “All the mental health clinics are packed. Couples are also at a breaking point. For people who suffer from mental instability and anxiety, it’s an absolute horror.”

The unusual method of treatment Aloni and others in her field use to help both male and female patients often stirs up controversy and criticism on ethical grounds. It’s work that doesn’t differ from prostitution, the fiercest detractors claim. Now, a number of sexual surrogacy therapists have agreed to speak with Haaretz frankly about their work. The interviews with them shed light on the patients, the experience of the treatment and also on the singular personalities of the therapists – whose very unconventional profession often has consequences that go beyond the therapy room.

High success rates

Surrogate partner therapy is based on a triangle – of therapist, patient and surrogate. The therapist, generally a psychologist by training, has sessions with the patient, as in typical treatment, and the surrogate provides the practical and experiential means to help develop intimacy, social skills, and sexual and sensual contact. The concept was developed in the 1970s by the U.S. sexuality researchers William Masters and Virginia Johnson, who believed that the only way to learn intimacy and sexuality was to experience them in practice.

In fact, studies have found that treating sexual dysfunction with the aid of a surrogate is more effective than classic psychological therapy or other methods. Some researchers report an 80-percent success rate for therapy of this for men, and even higher for women. Among physically disabled individuals, the success rates are a little lower.

I get enjoyment from it, too, and my enjoyment is important, because for him it’s a whole world. During the moments where it’s uncomfortable for me – I share that with him, so he’ll learn mutuality.

Shir, a surrogate

A 2007 study, published in the Journal of Sexual Medicine, examined 30 women who suffered from vaginismus (painful contraction of the vagina, which interferes with intercourse). Half of them participated in surrogate partner therapy, the other half were treated together with their regular partner. The researchers found that, while 75 percent of the latter group succeeded in overcoming the problem, the rate for those using surrogates was 100 percent.

Men constitute the majority of those who seek surrogate treatment. Some have physical or mental disabilities, are on the autistic spectrum or have suffered sexual abuse or trauma. But many are ostensibly healthy people who seek help due to lack of sexual experience, impotence, fear of intimacy, lack of libido, or various other problems relating to sexual performance or orientation. The women who seek treatment usually do so because of lack of sexual experience, vaginismus, lack of sexual desire or other difficulties with intimacy.

“Almost half the patients are totally normal people who function in society,” Aloni, whose credentials include a doctorate in sexual rehabilitation, tells Haaretz. “People who work, go out with friends, but aren’t able even to start a romantic relationship. Some, of both sexes, are virgins in their 30s and 40s. Sometimes, their difficult is connected to sexual abuse in childhood that they are unable to remember. In some cases, that comes up in the treatment, and in some cases it doesn’t. But you see from their behavior that they underwent some sort of trauma.”

What behavioral elements attest to a sexual trauma?

Aloni: “Dissociation. Pervasive anxiety the moment that closeness or any sort of physical contact starts, or when the contact involves the genitals. As soon as something erotic begins to emerge they disconnect. That’s the situation with almost half the patients in our clinic. Some become addicted to porn, because they have no other option.”

One method used in surrogate partner therapy is the controlled reenactment of those traumas. “I had a patient who was a victim of rape in childhood,” Aloni relates. “He lost his partner, because in every sexual act he experienced dissociation and then disconnected from it. In the final stages of treatment, when deep trust had been forged between him and his surrogate partner, we reenacted the trauma under controlled conditions. After he went through that, the automatic disconnect ceased. It’s riveting and moving work, sometimes bringing me to tears, even after 35 years.”

Some of the disabled patients Aloni treats are in serious condition. “I treat people who are on ventilators, who lack the capacity to talk, but you can still develop capabilities,” she explains. “I had one patient who was in nursing care, almost in a vegetative state. But there was a soul there. When he arrived for treatment he only wanted to die. Afterward he discovered that he had a will to live and creativity, and endless areas of interest opened up for him. Many times I’m told, ‘Fine, he had surrogacy therapy, but a partner won’t come from all that.’ The goal is not to find a partner, it’s to find oneself, one’s sexuality. Who said everyone has to be in a relationship? What are we, Noah’s Ark?”

Disabled patients were Aloni’s original trigger for entering the profession. “I grew up in a family in which disability was a presence,” she says. “My grandfather was missing a hand, my father was traumatically brain damaged after having been in a plane crash, and my sister has cystic fibrosis. When I started to learn about sexuality [professionally], I went very quickly in the direction of disability.”

Early on in her studies Aloni, who is Israeli-born but has degrees from New York University and from Union Institute, in Cincinnati, grasped that treatment of the disabled community entailed many limitations. Many disabled people experience only functional touch, not intimate touch. It’s a whole different concept of contact,” she explains.

And then she heard about surrogate-partner therapy. “I looked for a surrogate who worked with the disabled, and I found a Jewish woman practitioner in New Jersey. She taught me everything. I heard from her patients what the treatment did for them, and it was clear to me that it was like magic.”

Ronit Aloni.Credit: David Bachar

Aloni presented the idea at a conference in Israel in the 1980s. A representative of the kibbutz movement who was in the audience was taken by the possibility. In 1989 Aloni opened the first clinic in Israel, launched a course for therapists and started to treat patients in accordance with the ethical guidelines of the International Professional Surrogates Association.

Afterward, she worked under the aegis of the Defense Ministry, which offers surrogacy treatment for disabled veterans, and managed the Sexual Therapy Clinic at the Lowenstein Hospital Rehabilitation Center, in Ra’anana. She opened her own clinic in 1996.

Over time and as she gained experience, Aloni realized that not only the disabled could benefit from surrogacy therapy. For example, she recalls a patient she had 20 years ago, a woman in her 30s who had immigrated from the former Soviet Union. She suffered from depression, and after several suicide attempts was committed to a psychiatric hospital.

Aloni: “She had a very dedicated caregiver there who understood that part of the woman’s mental condition was related to her being a virgin. She referred her to me, initially without informing the hospital staff, because she thought they wouldn’t authorize it. The patient underwent surrogate partner therapy, and little by little a metamorphosis occurred. Halfway into the treatment she basically forgot that she had been depressed, she didn’t want to die, she lost weight and revived her social ties. Of course, she also resumed full-time work. She had her life energies restored to her.”

‘It’s very gradual’

It’s very difficult to know how many people are actually engaged in providing sexual surrogacy therapy in Israel. The Israel Society for Sex Therapy has about 150 registered members, but they only provide consultation and psychological therapy. The sexual surrogacy practitioners don’t meet the organization’s criteria and are therefore not members. Surrogate partner therapy is not officially organized, there is no government supervision, and so it’s not clear how many clinics engage in it or how many of them operate without their staff having proper training.

That training involves a 40-hour course over two weekends. Applicants are first screened, including interviews and psychological tests. The course provides knowledge about sexuality, sexual dysfunctionality and sexual damage, with workshops that include exposure to erotic material and guided physical contact. It’s a basic course whose primary intention is to provide a common language for therapists and surrogates.

When a patient arrives in the clinic, Aloni first assesses whether the possibility exists of his being able to forge an intimate connection without a surrogate: “Sometimes emotional therapy or medicative treatment are enough, if the person possesses sufficient social skills. But if I see that he’s stuck, I find an appropriate surrogate. With people who are extremely disabled, who are seriously brain-damaged or severely mentally challenged, for example, I examine whether they have the ability to forge a connection. If the damage is too great, surrogacy therapy is sometimes not possible.”

After their first meeting, the surrogate and the patient decide whether they wish to continue the treatment. Both have the option to decline. If there’s mutual consent, they launch the process.

The average protocol calls for about 20 meetings, once a week for an hour and a half. The cost of each appointment is 1,500 shekels (about $470). Both sides also sign a confidentiality agreement. The surrogate uses a fictitious name, and they and the patients commit to not being in contact between meetings.

The goal is not to find a partner, it’s to find oneself, one’s sexuality. Who said everyone has to be in a relationship? What are we, Noah’s Ark?

Ronit Aloni

After each appointment, the surrogate submits a detailed report to the therapist about what transpired and about her own feelings. In a meeting with the patient, therapist then reads out the report, which constitutes part of the platform on which the treatment takes place.

Most of the meetings do not involve a sexual act, Aloni explains. “Penetration only occurs at the conclusion of the treatment,” she says. “It’s a sign that we achieved everything and the process is over. If we have gotten there, it means that there is intimacy, confidence, acceptance, enjoyment and an ability to express oneself and say what is pleasant for me and what isn’t. There is a definite relationship. ‘I am connected to my body and his, I acknowledge my genitals and I am not afraid.’”

The encounters never take place in the home of either the surrogate or the patient. The first meetings are held in public places, like a real date, and focus on dissipating tension, drawing closer and addressing social problems. Afterward, according to each patient’s pace, the meetings take place in a room at the clinic.

“It’s a small room that has a sofa that opens, with sheets, music, lighting,” Omer, a male surrogate, relates. “And there a process of intimacy is slowly entered into. It’s very gradual. At first contact is via the hand, which is called ‘sensual focus.’ You touch and see what works best, what makes her uptight and what’s pleasant. Often, you ask her to touch you, and you can understand from the way she does that what’s pleasant for her, and that’s it. The next meeting – legs. In the third meeting maybe the stomach, and then the face. Only at the end do we take off our shirts. Many times the patient will remain with her bra and there will be no contact in the area of her chest. It’s all very gradual.

“Often,” he continues, “the patient will want to progress faster, but you have to stop, because if it’s too fast, it’s like a false note in the therapeutic process. In some cases the stage of the kiss can be more stressful than being naked next to me, because many of these women have never kissed, or if they have, it wasn’t a good experience. To kiss is the symbol of intimacy, so a meeting is set aside for that, too, and if it goes well, you proceed from there. After each stage, the therapist checks with the patient to see how it was for her.”

I meet with Omer (not his actual name) in his modest apartment in the center of the country. He’s a good-looking, affable artist in his 40s who has been a surrogate for 10 years. He got into it by chance, after a few women he knew said they thought it would be an appropriate occupation for him.

“I was in a period of my life when I was working at miserable jobs,” he says. “Just then I heard about sexual surrogacy. When I did the course, I understood straightaway that I had come to the right place. It’s like falling in love.”

Omer expected to meet many women who had undergone sexual abuse, but that hasn’t been the case. “Mostly there was something in their upbringing or in their parents’ approach that made them dismiss themselves, and they took the feeling of being unworthy to the place of relationships and intimacy,” he says. “Many of them have had no romantic experience. It’s rare that they have sexual experience. In certain cases, the sexual experience was bad and they come in for a corrective experience.”

Working as a surrogate also affects one’s personal life, he says, such as in his own personal relationships with women. “I’m on a different frequency,” he says. “You become more sensitive, the senses become more acute. Women tell me they feel very comfortable in my company.”

Omer, who leads a polyamorous way of life, acknowledges that it’s very difficult to engage in his work while being in a monogamous relationship at the same time. “When I have a partner, I tell her about my occupation at quite an early stage.” Not all women are ready to accept his line of work, and when he’s been forced to make a choice between them and his job, he has chosen surrogacy. But according to him, “There are girls who accept it, who understand that it’s a very special therapeutic framework. You don’t go there for the sex or for the money.”

Credit: anemad / Shutterstock.com

He still hasn’t told everyone in his family about what he does, however. “I only told my mother for the first time about a year ago,” he says. “She reacted with no little shock, even though she tried to hide it. She hasn’t mentioned it since.”

There’s a reason it’s difficult for people involved in surrogacy therapy to share what they do, says Omer: “As a surrogate, you do something that’s so contrary to our culture. If society were different, many people wouldn’t need surrogacy. Think of a very sensitive, hurt young woman. If she were to meet, in a natural way, a man who’s sufficiently gentle and sensitive, she wouldn’t need a surrogate at all, but it’s rare for that to happen. In surrogacy, everything is very controlled. It won’t happen that we’ll be walking in the park and I’ll suddenly plant a kiss on her. Everything is known in advance, and predictable. That affords a great deal of confidence.”

Has a patient ever fallen in love with you?

Omer: “Yes, it’s happened three or four times. There was also a case when I fell in love with a patient – one time for sure, and another time when I became very attached.”

How did you cope?

“In our training course we were constantly told that falling in love – whether it’s the patient with the surrogate or vice versa – is par for the course and can also contribute a lot to the process. When you’re into a scene of falling in love, you trust the person who’s with you, you want to be with them along the way. As far as I’m concerned, it should happen each time. A process in which a patient falls in love with a surrogate is one that will be imprinted on her as something positive. It’s an amazing experience.”

What if he feels no sexual attraction toward vis-a-vis a woman he’s working with? Omer describes himself as a person who’s relatively open to a broad range of women; but in his view, that ability has been enhanced over the years.

“You need to be something of a juggler when it comes to the ability to be attracted to different types,” he explains. “I have worked with patients who didn’t attract me immediately, so I tried to find the place in them to which I connected from the heart. Add to that good conversation, familiarity and intimacy, and there can be a breakthrough. If I don’t feel attraction, I remind myself why I’m here. I don’t choose women from a catalog. I come to women in distress, often it’s the last stop for them.”

The attraction issue doesn’t matter much to Dr. Aloni, either. “I don’t care at all about that,” she says. “I see the pickiest people in the world, and in the end I attach a surrogate to them and it works. And it’s not like I have 200 surrogates to choose from. I have about 10, of whom seven or eight are women and two or three are men. In the end it works wonderfully, and most of the patients feel good with the surrogate and most of the surrogates feel good with the patients.”

So does that mean that everyone can be attracted to everyone else?

I had a cute patient, and we were able to reach the stage of taking off pants, and then I told him, “Listen, I haven’t spoken to the therapist. I don’t make a move without her authorization.” So we called her in the middle of the meeting. She split a gut laughing.

Naama, a surrogate

“Exactly. Most people can be attracted to most people, feel good with them, certainly to reach the stage of orgasm, to give them pleasure and be pleasured. I have had experience with about 1,500 patients. It does happen that I replace surrogates, but it doesn’t happen often, and usually it has nothing to do with attraction but with difficulty [of the patient] to enter into the whole process.”

No married women

Most of those who work as surrogates are women. A study conducted in 2009 by Liat Yakobov-Ivri, a social worker from Tel Aviv University, found that the ages of the female surrogates ranged from 25 to 52 and that most of them had studied at the college level, were living without a partner but did have children.

One characteristic they all shared was that none of them was married. Because the occupation arose in Israel through the kibbutz movement, which also included the religious kibbutzim, the condition for its establishment was the exclusion of married women, to avoid the possibility of adultery.

Another important rule for Aloni is that the surrogates are not totally dependent on their work at the clinic to make a living. And in fact, they all have other professions. When she first opened her clinic, most were engaged in therapeutic professions (nurses, social workers, special-education teachers), but over time, she says, she realized that this wasn’t right. “A surrogate needs to be sensitive and to have experience, but we want the patient to learn how to be in a relationship with a regular woman, not with a therapist,” she says.

Aloni studied surrogacy in the United States in the course of obtaining her master’s degree in human sexuality. She found that successful surrogates harbored a positive body image, positive self-esteem and an understanding of the meaning of their role, but besides that had almost nothing in common. “The most notable element was the chronological age,” she says. “Not the seniority, but the age. The more mature and maternal a woman is, the better she will be.”

People who are drawn to the profession, she notes, have an affinity for giving that they don’t have the opportunity to realize in everyday life. “People lose their sense of humanity in society, because they don’t do enough for other people in their lives, which is a need we have. It’s like volunteering.”

But why in this way?

“There are people for whom this is the way. Their sexuality is accessible to them. They love sex, they feel good with sex, they connect well to themselves and to others through sex, and they are looking to be human.”

Liat Yakobov-Ivri.Credit: Hadas Parush

‘Rough fantasies’

Naama (not her real name), an artist in her late 40s, worked in sexual surrogacy for about 10 years, and left a year ago. She heard about the work from a friend. “I went online and was amazed that such a thing existed,” she relates. “The whole subject of repressed sexuality intrigued me from an early age. I wanted to understand why there was such a thing. Why all the shame?”

She talks about a patient who had never had an erection. “He didn’t know why, and he had never dealt with it. For 25 years, he lived in isolation, by choice, didn’t leave the house, ruined his own life. A smart man, sweet, good-looking. He didn’t form connections with people, and he felt like a failure. During the treatment with me, we discovered that he had a medical problem, which was solved with a a medicinal treatment. These are things I say to myself: What’s screwed up in the world? Because it’s sexual, there’s guilt, fear and shame, and people get conflicted with their body.”

You apparently feel very comfortable with your body.

Naama: “The great plus of surrogacy is age. The older I got, the less of a deal I made about my body. I’m not someone who will go to the beach in a bathing suit. It’s not ‘feeling comfortable’ in that sense. With the first patient, I almost died when the therapist instructed me, ‘You have reached the stage of taking off your blouse.’ But there’s something in this treatment, in which the neediness of the other person seems to help in overcoming the obstacle. If I want him to feel comfortable, I become his model, and that also serves me.”

The three-way connection between therapist, patient and surrogate is of particular importance. In this context, Naama recalls an incident that amused her. “I had a cute patient, everything was good and we were able to reach the stage of taking off pants, and then I told him, ‘Listen, I haven’t spoken to the therapist. I don’t make a move without her authorization.’ So we called her in the middle of the meeting and asked for her go-ahead. She split a gut laughing.”

From Naama’s perspective, the core of her work had nothing to do with sex; it was more related to parenthood. “The concept that it’s mainly about sex is mistaken,” she says. “The most significant thing is the compassion. With the patients, especially those who are really hurting, I felt that I wanted to put them back into the womb for a few months. It’s totally maternal energy, it’s absolutely not sexual. On the contrary: If the surrogate is demonstratively sexual, it’s a disaster for the patient. I needed to break the connection between sex and closeness and intimacy, and gradually bring them to sex from a place of security. Most patients will die of fear if they see something sexy. The best exercise is to lie naked together under the sheet and do nothing, just laugh.”

Like Omer, Naama also acknowledges that she didn’t always feel comfortable about sharing what she did with other people. “I would come out of a session and say to myself, ‘God help me, if anyone knew,’” she recalls. “I would ask myself why I couldn’t go into the street and say that this is what I do. Most people are still appalled by it, I’m still sort of controversial.”

And like Omer, she too attests that her work trickled into her private life. “It made me take more responsibility for my role as a woman,” she says. “We have the amazing power to crush a man. One casual comment – you’re a man, you’re not a man – and the guy is done for. That’s something I very much took to heart. I also learned to be a person who doesn’t take things so personally. To see that there’s someone there who is a whole world and that I am not always the subject. I learned how to touch. I learned what it is to be connected.”

Did you ever refuse to work with a patient?

“There were patients who rejected me. Sometimes it was their anxieties and sometimes they didn’t connect. The therapist will always allow them to switch. If someone says about me that I’m not attractive, I don’t let it get to me at all, because it’s someone who gets uptight just from thinking about attraction. I never refused a patient, but I’m one of the stubborn ones.”

What’s the most extreme thing you experienced?

“It could be a very elderly person who no longer looks good, or someone with a tough psychiatric background, or there are wild and rough fantasies that you have to cope with. You come out of these things drained.”

What do you do when you encounter wild fantasies?

“Give them legitimacy and define them as fantasies, and not as something that is necessarily supposed to be acted on. I will tell him, ‘Look, as long as there’s agreement between the two sides, it’s perfectly fine, but I am not the place for that. If you find a partner who will go with it – terrific.’ I am not meant to realize their fantasies.”

Not always euphoria

Surrogate partner therapy is a controversial field that begs multiple ethical and legal questions. In many countries it’s illegal. The biggest criticism is that it combines physical and sexual contact with payment. The fiercest opponents maintain that the surrogates are exploited, because many of them also underwent sexual abuse and there is no real difference between what they are doing and prostitution.

Very few studies exist on the subject, and the evidence they present is inconclusive. Yakobov’s research is one of the few studies executed in Israel and encompassed only 10 interviewees. In a phone conversation, Yakobov reinforces her conclusions, which also surprised her, she notes. “I entered the field as a militant feminist, with the assumption that the surrogate populations are hurt and that they carry with them earlier traumas and wounds,” she says. “I was surprised to discover how wrong I was. The experience was very powerful from the women’s standpoint. I felt that there was a choice there and feelings of empowerment. I didn’t discern any previous traumas. They described the experience as one that electrified them, as though they were entering a place where no one had been before and succeeding in effecting a change that leaves an imprint in the world.”

Yakobov also examined a claim that women who have previously worked in surrogacy are likely to feel negatively about the experience with the passage of time. Among the women she interviewed, at least, one expressed ambivalent feelings later on, while four others who left the field spoke of it in very positive terms.

Naama, who is able to speak from a remove of one year from the work, explains it like this: “To be a surrogate partner, you have to have your finger on the pulse in terms of what you feel. Never did anyone in the clinic force anyone to do something they didn’t want to. Never. Some left a patient in advanced stages of the process, because they couldn’t cope with it, and there was never even an unpleasant feeling about it. Every surrogate has to know her own limits.”

Shir, who is still engaged in sexual surrogacy practice, doesn’t understand why people claim that she is being exploited in her work. On the contrary, she says that she feels very empowered in what she does. “Love is a basic right,” she says. “Sex is a basic right if you want it. Society perceives people who are on the autistic spectrum, or the disabled, as not needing sex, but that’s not true. Many want it.”

She continues, “I think that we are all battered by the patriarchy and some have had a worse experience. I am there to help people get rid of fixations about how a man is supposed to look and how relations should look. It’s treatment that allows you to feel.”

It’s difficult, Shir adds, for her to live in a world “in which everything that’s good undergoes a type of suppression. And there is a great deal of suppression in the realm of love, relations and sexuality. All that needs to be experienced in concealment and all according to rules about how and what there should be. Well, I have a gift to give people, but in the closed world we live in, it’s forbidden. And suddenly there is a place in which I can make use of that and people can be helped by it to change their life. If only the whole world were a place in which people could deal with these things openly.”

According to Ronit Aloni, “To be a surrogate is a process of empowerment. You get a person who’s in a bad way and within half a year you part from a person with self-confidence and a feeling of self-esteem, who’s grateful to you and feels he’s been given life.”

Aloni notes that surrogacy treatment “is very often attacked from the ethical perspective.” Yet it was “precisely because of the moral aspect of it that Masters and Johnson started it. From their point of view, what was immoral was not accepting every patient for treatment. In the end, you function sexually with another person – meaningful sexual treatment can’t be done without a partner.

“What’s not ethical is that it’s not part of our health-care system. If it’s available to for disabled army people, if there are accident victims whose insurance pays for surrogacy treatment, there’s no reason that other people shouldn’t receive it too.

“It’s clear that there are also difficulties [in the work} and that it’s not only euphoria all the time,” she continues. It’s something like giving birth, which is also a powerful experience that involves difficulty. That’s what I was told by my first supervisor in sexual treatment, in the United States, who was a gynecological obstetrician. He was already quite elderly [when he became a therapist]. I asked him why he had suddenly switched to sexual-surrogacy therapy. He said that ‘to be an obstetrician is to be me and God bringing babies into the world. It’s a wild feeling. The only thing that could replace it was sexual therapy. It’s like delivering people anew.’ So, it doesn’t surprise me at all that people choose to be surrogates. What surprises me is why more people aren’t going into it. And the main reason is stigma.”

Sexuality, Aloni explains just before we part, is such a central axis within all of us, that without functioning sexually, without connecting to your own sexuality, a person feels like the walking dead: “Without sexuality there is no vitality, there is no joie de vivre. It’s like being a shrunken person, a person in a shell. And when the sexuality starts to emerge, the snail comes out of its house and begins to move.”


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