Sex for a Cause - OZY | A Modern Media Company

Sex for a Cause

Sex for a Cause

By Meghan Walsh

Linda Wilson (aka Lulu), now based in Boulder, CO, has had severe rheumatoid arthritis since she was 3 years old. She is in her early 50's and was still a virgin until recently when she hired a sex surrogate in CA to help her experience this type of intimacy.
SourceCary Jobe for OZY


Because it’s time for women to find sexual satisfaction.

By Meghan Walsh

When Shai Rotem first met Katrina Marshall*, he asked if she’d like to take a seat on the futon in the corner of the room. Her initial response was no. The petite, blue-eyed blonde has severe rheumatoid arthritis, and she didn’t want the good-looking stranger to see the awkward choreography that lowering herself would require. Then she remembered how much her best friend was paying for her to be in that room with that good-looking stranger and decided to ask for help. “I knew if I didn’t open up then, it would never happen,” she says.

But when the bald, trim and olive-skinned Rotem asked if she wanted help taking off her suede knee-high boots, Marshall just couldn’t bring herself to say yes.  


Marshall, who’s had 42 surgeries in her 52 years of life, has struggled to perform everyday tasks like laundry for as long as she can remember. Bending over is impossible. Even sitting hurts. And taking off a shirt is hardly sexy. “When I was a teenager I didn’t want to leave the house,” she says. As an adult, Marshall couldn’t imagine how anyone could ever be attracted to her warped body, which is why at the time she met Rotem, Marshall was a midlife virgin.

Sex surrogacy — when a client hires a licensed partner to physically overcome his or her issues around sexuality — is a provocative idea that’s gained notoriety with movies like The Sessions, in which Helen Hunt helps a disabled man lose his virginity. But it’s rarely been seen as a legitimate avenue for women, who face a range of sexual dilemmas — from midlife virginity or being inorgasmic to more nuanced intimacy inhibitors, such as lack of a sexual identity. That perception may be changing, though. 

Almost one in two women face some sort of sexual dysfunction.

It’s difficult to know how many women have worked with surrogates since there are no official records, but if the rise in certified male surrogates is any indication, the number is on the way up. Ten years ago there were perhaps one or two in the country; now there are roughly a dozen. It’s still a small number, of course, especially when compared with the number of certified female surrogates in the U.S., which is upward of 60. While both sexes face erotic anxieties — a National Institutes of Health study estimates almost 1 in 2 women faces some sort of sexual dysfunction — men have used surrogate therapy far, far more often. Some have estimated the difference to be as broad as 97 percent to 3 percent. But as veteran sexologist and professor Dr. Marilyn Volker notes, more ladies are “learning if they’re not satisfied there are things they can do about it.” Which is why Marshall was in Venice Beach, 3,000 miles from her home in Florida, forcing herself to sit down on a futon next to Rotem.

Touch me

That first session, Rotem began with a sensate focus exercise, which is about learning to be present and to touch for your own pleasure, not someone else’s. To that end, Marshall closed her eyes and the good-looking stranger she’d just met placed a smooth stone in her hands. She spent a few minutes fingering the cold, hard surface before moving on to the channels of a silk scarf and then several more items. Finally, Rotem declared he was going to place one more object in her palm. “I was so nervous,” Marshall recalls to me. “I was just waiting for him to put his penis in my hand.” Instead, it was his fingers.

After their initial introduction, the two began meeting at the beach house Marshall was renting. Because there were no surrogates in her hometown, Marshall had signed up for a two-week intensive program, which her best friend had paid around $8,000 for as a birthday present. And since sex surrogates are only one prong in a therapeutic threesome, she spent two hours a day with Rotem and then one debriefing with a talk therapist. In other situations, a client might meet with a surrogate anywhere from eight to 50 times. (Surrogates certified by the International Professional Surrogates Association, the field’s only governing body, won’t work with anyone unless a licensed therapist is directly involved.)

After several days of stroking limbs and doing body image work in the mirror, it was time to get naked.

As the sessions progressed, so did the sensate focus exercises, going from the hand, up the arm, over to the chest, and down to the … “I didn’t touch him to make him feel good; I was touching for the sensation,” says Marshall. “Of course, what ends up happening is there is always someone receiving that touch.” 

Most people, says sex therapist Cynthia McReynolds, base their sexual identities on their partners — who they say yes to, who they say no to, how those partners judge them. She likens it to the way children construct their identities based on how their parents see them. This chain reaction, she says, has resulted in a “completely distorted view of sexuality,” where people are wrapped up in satisfying their partners rather than themselves. Or they get into a trading mentality. Working with a surrogate is meant to give women an opportunity to discover and define their sexual preferences in a safe environment. Sure enough, it’s been almost eight years since Marshall flew to Southern California to lose her virginity, but it turns out that was the easy part. Being able to ask for what she wants, or even identify what she wants, has been the real challenge.

Interestingly, Israel — which is Rotem’s native country and where he did his initial surrogate training after studying psychology — is a pioneer of partner surrogacy work. Rotem says it’s because women talk more openly with each other there. If a female isn’t sexually satisfied, she won’t hide it — she’ll look for help figuring out why. In the United States, on the other hand, he says, women bury their frustrations. “They start businesses and put all their energy into work or family rather than sexual relationships.”

Case in point: Marshall. She is energetic, charming and has no problem making friends; and while her disability makes working full time difficult, she holds certificates in holistic health and integrative nutrition. Because she focused all her energy on friends, family and her physical health, it wasn’t until she began seeing a psychologist at the age of 44 that she began to grudgingly acknowledge the hole in her life. “I was so filled in my heart with other things, I didn’t miss anything in my vagina,” she says.

The real thing

With a lifetime of doctor’s appointments and hospital rendezvous behind her, Marshall knew her experience with Rotem couldn’t feel prescribed. And it didn’t.

After several days of stroking limbs and doing body image work in the mirror, it was time to get naked. Rotem showed her his penis, then talked about his first memories of feeling aroused, what he likes, what he doesn’t like.  When it was Marshall’s turn, she at first felt timid and didn’t know what to say in her own introduction; but by the end of the two-hour session, when Rotem asked if he could take a picture “down there,” she didn’t hesitate. “The person who came in was not someone who would have said, ‘Hell yes, take a picture of my awesome vagina,’” says Marshall, who uses lots of words like “delicious,” “exquisite” and “sacred” when describing her experience. She keeps that snapshot in a hot-pink sex journal. 

Psychologists William Masters and Virginia Johnson introduced the concept of surrogacy in 1970. The duo pioneered research on sexual disorders and were the first to suggest a treatment regimen that prescribed partner work, rather than just psychotherapy. The purpose is to build self-confidence, communication skills and a better understanding of sensuality and intimacy.

Marshall didn’t only lose her virginity; she fell in love.

Marshall recalls about halfway through the two weeks when they did a sensate exercise giving each other footbaths. After being on the receiving end, it was Marshall’s turn to wash Rotem’s toes. The woman, who had always been self-conscious about her bony feet and who had been embarrassed to lower herself onto a futon, rolled on her side and slithered off the couch onto the floor, where the washtub was, without a tinge of shame. “I realized I had constructed all these cement walls,” Marshall says, “and one by one they just started crumbling.” Then one day Marshall began to cry. And then to heave. During a lull in the tears, Rotem asked where they were coming from. “I’m crying because I can’t believe I’ve allowed myself to miss out on this experience for so many years,” she recalls saying. “At the same time, I’m crying because this is so beautiful.”

Still, when the day came that Rotem asked Marshall if she was ready for penetration, she froze. First, there was the word “penetration,” which felt far too clinical. But then there was the thought she’d tried to push down from the start: She shouldn’t be doing it this way. The first time should be special — not paid for. 

For certain, Marshall isn’t the only one who is apprehensive about surrogacy work. Professional groups like the American Psychological Association have pretty much avoided the topic. (The group “does not approve or endorse specific therapy techniques,” a representative told OZY via email.)  Law enforcement, too. Even though paying for sex is technically illegal most places, police usually let sex surrogacy go as long as a licensed therapist is overseeing the relationship, according to sex therapists and police alike. Advocates estimate that only about 13 percent of surrogacy work involves any sort of sexual interaction. Mostly the goal is to give individuals the tools to construct their own fulfilling sex lives.

Marshall and Rotem didn’t have sex that day. Instead, they just embraced one another, breathing in rhythm and spooning for an entire hour. Then the unimaginable happened: Marshall got her period two weeks early. “There I am with these sexy panties on and a big fat pad,” says Marshall. But it didn’t matter. Being in a real relationship means that sometimes things get messy. So several sessions after the initial penetration scare, with only a couple of days remaining, Marshall on her period and Rotem on the payroll, they had sex. And although it looked like there had been a massacre on the bed, the experience was “spiritual and sexual and emotional and crazy awesome.” When Rotem left, Marshall called her sister in New Hampshire to tell her the news. Together they screamed and cried with joy.

But it wasn’t all good times. 

Marshall didn’t only lose her virginity; she fell in love. The day she left California was one of the saddest of her life. The grief was part of it, though. “This part of the journey was just as important as every other part,” she says. After returning to Florida, Marshall asked out the guy painting her garage, had a few hookups, and began a complicated relationship with a man-friend. But she still didn’t have the confidence or capacity to be totally intimate. So Marshall, who now lives in Boulder, Colorado, continues psychotherapy. “Those were giant steps for me,” she says, “but I still need a few more tools in my toolbox.”

Sex surrogacy, of course, carries with it the potential for the patient to develop feelings for the surrogate, which in clinical circles is called transference. Ann Rosen Spector, a psychologist working in Philadelphia, says women are more likely than men to become emotionally attached because of sex. “If that’s not reciprocated,” she warns, “there may be costs that are greater than when she went into it.” Some proponents of surrogacy contend transference is a good thing, because it shows the client is able to form an attachment. They point out that the licensed therapist is there to guide them through those feelings. “We create a mini relationship with a beginning, middle and end,” Rotem says, which also allows a lesson in how to end a relationship with grace, despite heartache.

For Marshall’s last day with Rotem, the pair took a stroll on the boardwalk and got something to eat. Marshall, wearing the same colorful dress and suede boots as the first day she met Rotem but now propelled by sexual jet fuel rather than fear, flagrantly flirted with the waiter, something she never would have done before. “I could have held my hand to my face and not seen any of the arthritis in it,” she says.

When the two went back to the room for one last tryst, Rotem once again asked if Marshall would like help taking off her boots. While she had no qualms about letting him, Marshall said no. “I wanted to fuck him with my boots on.”

*Name changed at subject’s request. 

Photography by Cary Jobe for OZY.

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