In many countries surrogate
sex therapy - in which a person is hired to act as a patient's sexual partner -
is controversial, and not widely practised. In Israel, however, it is available
at government expense for soldiers who have been badly injured and need sexual
rehabilitation.
The Tel Aviv consultation
room of Israeli sex therapist Ronit Aloni looks much as you would expect. There
is a small comfy couch for her clients and biological diagrams of male and
female genitalia, which she uses for explanation.
But what happens in the
neighbouring room, which has a sofabed and candles, is more surprising.
This is where paid surrogate
partners help teach some of Aloni's clients how to have intimate relationships
and ultimately, how to have sex.
"It doesn't look like a
hotel - it looks more like a house, like an apartment," says Aloni.
There's a bed, a CD player, an adjoining shower - and erotic artwork adorns the
walls.
"Sex therapy is, in
many ways, couple therapy and if somebody doesn't have a partner then you
cannot complete the process," she goes on. "The surrogate - she or he
- they're there to model the partner role in a couple."
Although critics liken this
to prostitution, in Israel it has become accepted to the extent that the state
covers the cost for soldiers with injuries that affect their ability to have
sex.
"People need to feel
they can pleasure somebody else and that they can get pleasure from somebody
else," says Aloni, who has a doctorate in sexual rehabilitation.
"People are coming for
therapy. They're not coming for pleasure. There is nothing similar to prostitution,"
she adds firmly.
"Also, 85% of the
sessions are [about] intimacy, touching, giving and receiving, communicating -
it's about learning to be a person and how you relate to other people. By the
time you have a sexual relationship, that's the end of the process."
Mr A, as he wants to be
known, was one of the first soldiers who got Israel's Ministry of Defence to
pay for sex surrogate therapy after a life-changing accident nearly 30 years
ago, when he was an army reservist.
A fall from a height left
him paralysed from the waist down and unable to have sex in the ways that he
had previously.
"When I was injured I
made a list 'To Do,'" he says. "I have to [be able to] do a shower by
myself, I have to eat, dress by myself, to drive by myself and have sex
independently."
Mr A was already married
with children, but his wife did not feel comfortable talking about sex to
doctors and therapists, so she encouraged him to seek help from Aloni.
He explains how Aloni gave
directions and feedback to him and his surrogate partner before and after each
session.
"You start from the
beginning: you're touching this, you're touching there and then it's building
step-by-step until the last stage of getting an orgasm," he says.
Mr A argues it was right for
the state to pay for his weekly sessions, just as it did other parts of his
rehabilitation. Today the cost of a three-month treatment programme is $5,400.
"It wasn't the goal of
my life to go to a surrogate, OK, I was injured and I want[ed] to rehabilitate
in every aspect of my life," he says, sitting in his wheelchair, in a
tracksuit, on his way to play table tennis.
"I didn't fall in love
with my surrogate. I was married. It was just to study the technique of how to
get to the goal. I took it as a very logical thing that I have to do."
He blames Western hang-ups
about sex for any misconceptions.
"Sex is part of life,
it's the satisfaction of life," he says. "It's not that I'm being
Casanova, this is not the issue."
A steady stream of people of
different ages and backgrounds visits Aloni discreetly at her clinic.
Many are struggling to have
a romantic relationship because of intimacy issues or anxiety, or have suffered
sexual abuse. Others have physical and mental health conditions.
Aloni has focused
particularly on disabled clients since the start of her career. Several of her
close relatives had disabilities including her father, a pilot, who suffered a
brain injury after a plane crash.
"All my life I was next
to people having to deal with and overcome different disabilities," she
says. "All these people were very well rehabilitated and so I had this
very optimistic approach."
Aloni became close to
a surrogate who worked with disabled people while studying in New York.
When she came back to
Israel in the late 1980s, she gained the approval of leading rabbis for the use
of sexual surrogates and started providing therapy at a rehabilitation centre
on a religious kibbutz - a rural community.
The rabbis had one
rule - no married men or married women could be surrogates - and Aloni has
followed it ever since.
Over time, she has
won backing from the Israeli authorities. Out of about 1,000 people who have
had surrogate sex therapy at her clinic, dozens have been injured army veterans
- many with brain trauma or spinal cord injuries, whose treatment has been
funded by the state.
Aloni
believes that Israel's family-oriented culture and its attitude towards its
armed forces has worked in her favour. At 18, most Israelis are called up for
military service and they can continue as reserve soldiers into middle age.
"We
are in a war situation all the time since the country was established,"
she says.
"Everybody
in Israel knows people who were injured, or died and everybody has a positive
approach to compensating these people. We feel obliged to them."
A tall
man of about 40 is sitting in his garden in central Israel with a blanket
across his lap. He is a former reserve soldier whose life was shattered in the
2006 Lebanon War.
David -
as we will call him - was left unable to talk or move.
He can only communicate with the
help of his occupational therapist - if she supports his arm and holds a pen in
his hand, he can write on a whiteboard.
"I was just an ordinary
person. I'd just got back from a trip to the Far East. I was studying in
university and worked as a barman. I used to love sports and being with
friends," David says.
When his military unit came under
attack, he suffered serious leg and head injuries and went on to spend three
years in hospital.
During that time, he says he lost
the will to live.
Things only began to turn around
after his occupational therapists suggested surrogate sex therapy.
"When I started the
surrogate therapy, I felt like a loser, like nothing. In therapy. I started
feeling like a man, young and handsome," David says.
"It was the first time that
I felt that since my injury. It gave me strength and it gave me hope."
This was an intimate relationship
that David started, knowing that it would have to end. So was there a risk that
he would be emotionally hurt?
"Initially, it was difficult
for me because I wanted the surrogate all to myself," he says. "But I
realised that even if we're not partners, we're still good friends. And it's
worth it. It's worth everything. It just helps you rebuild yourself all over
again."
While the usual rules are that
surrogates and clients cannot be in contact outside of the therapy, David and
his surrogate - a woman who uses the alias Seraphina - were given special
permission by Dr Aloni's clinic to stay in touch when their sessions ended.
Since the treatment, those close
to David say they have seen a transformation in him. He has been focusing on
plans for the future.
While having a sex life remains
very difficult, before Covid-19 struck he had begun socialising more, going out
with the help of his careers.
Seraphina has worked as a
surrogate with Ronit Aloni for over a decade. She is slim with bobbed hair and
is warm and articulate.
Recently she published a book
about her experiences. Titled More than a Sex Surrogate, the publishers
describe it as "a unique memoir about intimacy, secrets and the way we
love".
Like all of the surrogate
partners at the Tel Aviv clinic, Seraphina has another job. Hers is in the
arts. She says she took on her role for altruistic reasons.
"All those people that
suffer under the [surface] and have all those hidden secrets that they walk
around with, I really wanted to help because I knew I had the ability,"
she explains.
"I had no problem with the
idea of using sexuality or my body or touch in the therapy process. And the
subject was fascinating to me, sexuality was fascinating to me."
Seraphina describes herself as
"like a tour guide", saying she takes clients on a journey in which
she knows the way.
She has worked with about 40
clients, including another soldier, but says that the severity of David's
injuries posed a unique challenge. She learned how to help him to write so that
they could chat privately.
"David is the most extreme
case ever known. It was like walking in a desert - you had no idea of the
direction [in which] to go," she says.
"I had to be very, very
creative because he doesn't move at all. I moved his body as I imagined he
would have moved if he could. He felt his body but he could not move it.
"He always said: 'She knows
exactly what I want, even if I don't say anything.' So, it was really
flattering."
While being a surrogate,
Seraphina has had boyfriends who, she says, accept what she does. But she knows
other women and men who have stopped acting as surrogates for the sake of their
personal partners or to get married.
She explains that saying goodbye
to clients after they have been intimate is necessary but can be difficult.
"I say, it's like going to a
vacation. We have an opportunity to have a wonderful relationship for a certain
short time and do we take it or give it up?
"And it's the happiest
break-up anybody can have. It's for good reasons. I can cry sometimes, but at
the same time, I'm so happy.
"When I hear that anybody is
in a relationship or had a baby or got married, it's unimaginable how happy and
thrilled and thankful I am for what I do."
Late in the evening, Ronit Aloni
is still working, giving an online lecture to a group of sexologists from
Europe and as far afield as South America.
She recounts cases and quotes
studies suggesting surrogacy is more effective than classic psychological
therapy at treating sexual problems.
"This is most interesting,
those therapists who did already work with surrogates all of them said that
they will do it again," she tells them.
With modern surgery helping more
severely wounded soldiers to survive she believes surrogate treatment could be used
more widely.
"You cannot rehabilitate a
person without rehabilitating their self-esteem, their perception of being a
man or a woman," she says.
"You cannot ignore this part
in our life. It's very important, powerful. It's the centre of our personality.
And you cannot just talk about it. Sexuality is something dynamic, is something
that has to be between us and other people."
In Aloni's view, modern society
has developed unhealthy attitudes towards sex.
"We know how to joke about
sexuality. We know how to humiliate people, we know to be very conservative or
too extreme about sexuality," she says.
"It's never really balanced.
It's never weaved into our life in the way it's supposed to be, and sexuality -
it's life. This is how we bring life. It's nature!"
culled from bbc.com
