sex partner, sexual dysfunction, impotence, sexual replacement, partner surrogate

Thirteen women have accompanied unmarried men to the Foundation, agreeing to serve as replacement partners to support these men during treatment for sexual dysfunction. In all instances, both individuals were accepted in therapy with full knowledge of the referring authority.

Since the women were selected by the men involved, they were accepted as if they were wives. They were interrogated in-depth and attended all therapy sessions. They lived with the unmarried males as marital partners, in contrast to the partner surrogate, who spent only specific hours during each day with the sexually dysfunctional male.

Details of treatment for the various forms of male sexual dysfunction need not be repeated; clinical situations with replacement partners are managed in the same way as with wives.

Of the 13 men, 4 were premature ejaculators who with the aid of their replacement partners had this particular symptom brought under control. Of the 2 men who were primarily impotent, 1 achieved success in coital function and the other finished the course of therapy without resolving his sexual dysfunction.

Of the 7 secondarily impotent men who brought replacement partners to therapy, 5 experienced a successful reversal of their symptoms during the two-week clinical program.

Three unmarried women referred to the Foundation brought with them replacement partners of their choice. In each instance, the current relationship was one of significant duration. The shortest span of mutual commitment was reported as six months. Two of the three women had previously been married.

Replacement Partners

Were treated as husbands of sexually inadequate wives. They attended all sessions and went through in-depth history taking to provide information sufficient to define their roles in providing relief for their distressed women companions.

Two women provided histories of situational orgasmic dysfunction with occasional orgasmic return with manipulative or mouth genital approaches, but they had never been orgasmic during coition. In one instance coital orgasmic return was accomplished.

In the second it was not. In both circumstances, the male replacement partners were totally cooperative with therapists and patients. In the third instance, a woman reporting that she had never been orgasmic was indeed fully orgasmic both with manipulative and coital opportunities during the acute phase of the therapeutic program. Again, full cooperation from the replacement partner was both expected and received.

No unmarried woman has been referred for therapy without being accompanied by a replacement partner of her choice, nor has there been any professional concept that a male partner surrogate would be provided if an unmarried woman had been unable to establish a meaningful relationship with a cooperative man before referral to the program.

Refusing to make a male partner surrogate available to a sexually inadequate woman, yet providing a female partner surrogate for a dysfunctional man seems to imply application of a double standard for clinical treatment; such is not the case.

As repeatedly described, psychosocial factors encouraged in this method of psychotherapy are developed from the individual’s existing value system.

Sexual Heritage

A man places a primary valuation on his capacity for effective sexual function. This is both valid and realistic. His sexual effectiveness fulfills the requirement of procreation and is honored with society’s approval, thereby providing support for the cultural idiosyncrasy of equating sexual function with masculinity.

Even prior exposure to a “sex is sin” environment does not preempt this primary valuation. As a result, a man usually regards the contribution made by a partner surrogate as he would a prescription for other physical incapacities. Further, he is able to value a woman who makes such a contribution.

For him, the restoration of sexual function justifies putting aside temporarily any other value requirements which might exist.

For her, on the other hand does not have a similar sexual heritage. As far as is known, her effectiveness of sexual function is not necessary to procreation.

In addition, prevailing attitudes through much of history have not encouraged valuation of female sexuality as a means of human expression.

Therefore, partner surrogate selection for the sexually incompetent woman would require quite different psychosocial considerations than would a similar selection for a sexually inadequate man.

Socio culturally induced requirements are usually reflected by woman’s need for a relatively meaningful relationship which can provide her with “permission” to value her own sexual function. It is the extreme difficulty of meeting this requirement in a brief, two-week period which influenced Foundation policy to deny the incorporation of the male partner surrogate into treatment concepts, yet to accept male replacement partners selected by the unmarried women themselves to join them in the program.

In all cases, the length and security of the relationship had been firmly established before the patient was referred. This key area of therapeutic concern was, of course, carefully checked with referring authority before accepting the unmarried woman for treatment.

For the sexually dysfunctional woman, security of an established man-woman relationship, real identification with the male partner, and warmth and expression of mutual emotional responsivity are all of vital concern first, in securing a positively oriented sexual value system and, second, in promoting effective sexual functioning.

These social and sexual securities cannot be established in the brief period of time available during the acute phase of the therapeutic program. For these reasons, the use of a male partner surrogate in the treatment of sexually dysfunctional unmarried women was felt contraindicated.