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"  So this is it, I think as I&amp;#039;m led into what looks like a guest room. Three windows, shutters partially closed, face the backyard; a queen-size bed sits center stage. It&amp;#039;s pretty unremarkable as beds go, with white-and-beige plaid sheets, a pair of pale blankets, and a dream catcher hanging overhead. It isn&amp;#039;t exactly what I&amp;#039;d expected, but then, I really didn&amp;#039;t know what to expect. This is the bedroom that Cheryl Cohen Greene shares with her husband\u2014and hundreds of other men. Call it her home office. Cohen Greene isn&amp;#039;t a prostitute. She&amp;#039;s a sexual surrogate, someone paid to teach men\u2014late-in-life virgins, the disabled, abuse or trauma victims, and those with erectile dysfunction, Asperger&amp;#039;s syndrome, self-esteem issues, phobias, or crippling performance anxiety\u2014to get it up and get it on, first with her and then, in theory, in relationships with real partners. Cohen Greene is a certified sexologist with a doctorate in human sexuality (DHS) from the Institute for Advanced Study of Human Sexuality in San Francisco; for 19 years, she was a member of the San Francisco Sex Information training staff, which provides sex info free of charge through its website and hotline. As a surrogate, her technique is more show than tell: Part lov\u00ADer, part wife, part shrink, part confidante, she guides men through relaxation techniques and eventually through their and her erogenous zones, teaching them how to communicate, how to touch, how to be touched. &amp;quot;I like to call myself a surrogate partner therapist,&amp;quot; Cohen Greene says, in a thick Boston accent that flattens her a&amp;#039;s and eliminates her r&amp;#039;s. &amp;quot;Because that&amp;#039;s what I am, a temporary partner.&amp;quot; It&amp;#039;s an accent that Helen Hunt nailed in last fall&amp;#039;s The Sessions\u2014the Oscar-bait film that has put Cohen Greene at the forefront of her little-known field. The movie was based on a 1990 article by poet Mark O&amp;#039;Brien (played by the excellent John Hawkes), a polio survivor mostly confined to an iron lung since childhood, who, in his late thirties, became valiantly determined to lose his virginity\u2014with Cohen Greene&amp;#039;s help. The film takes artistic license with some aspects of surrogacy; it downplays, for instance, the role usually performed by sex therapists, who form a sort of trinity with surrogate and client. But it accurately depicts Cohen Greene&amp;#039;s unpretentious warmth, her sometimes hilarious matter-of-factness, and her unusual career skills: utter open-mindedness, intuition, and a deep well of tenderness. In one scene, when we watch Cohen Greene kneel over a bed and gently kiss O&amp;#039;Brien on his bare chest, the gesture tells us more than any speech could. &amp;quot;The only other times he&amp;#039;d been touched were when he was handled by an aide or given a medical procedure,&amp;quot; recalls the real Cohen Greene, tears welling in her eyes. &amp;quot;I don&amp;#039;t know where that kiss came from. He was so frail, and I was so afraid to hurt him. I had no idea it would be so profound.&amp;quot; Cohen Greene and I meet at her Monday morning Pilates class in Berkeley, California. While 40 years of nonstop sex with some 900 partners (by her estimate) appears to be an excellent anti-ager\u2014at 68, she has glowing skin, and there&amp;#039;s a slink to her step, a certain sparkle in her eye that reads as sensual\u2014Cohen Greene&amp;#039;s body is square shouldered, maternal looking. &amp;quot;I&amp;#039;m no porn star,&amp;quot; she says right off the bat. &amp;quot;I&amp;#039;ve had my breast removed. I&amp;#039;ve had reconstruction. I had my nipple removed. It looks like somebody came at me with a saber here [she lifts her shirt to reveal a scar], and I&amp;#039;ve had my hip replaced.&amp;quot; She&amp;#039;s also a survivor of lymphoma, which nearly killed her. &amp;quot;I never did get a fake nipple put on. I don&amp;#039;t make a big deal about it to clients,&amp;quot; she says. &amp;quot;I mention it as we&amp;#039;re getting undressed the first time. Then we move on and explore our bodies.&amp;quot; There&amp;#039;s a reason many of us had never heard of sex surrogacy until The Sessions came along: In the world of mainstream therapy, it&amp;#039;s widely considered to be an experiment better left behind in the freewheeling &amp;#039;70s\u2014at best unorthodox and at worst irresponsible or even unethical. &amp;quot;People discount so much of what I do: Oh, she has sex for money,&amp;quot; says Cohen Greene. &amp;quot;But really, there is so little sex in the end.&amp;quot; In her work with clients\u2014&amp;quot;not patients,&amp;quot; she&amp;#039;s quick to correct, &amp;quot;because they&amp;#039;re not sick&amp;quot;\u2014it usually takes more than a month of sessions before the individual is ready to advance to any kind of sexual touching. &amp;quot;Think of a prostitute as a restaurant. I&amp;#039;m more like culinary school. I teach them the tools, so they can move on. I don&amp;#039;t want repeat business.&amp;quot; Intercourse is not necessarily the endgame, and sometimes it&amp;#039;s not even on the menu. Proponents of sexual surrogacy believe it picks up where conventional sex therapy leaves off. &amp;quot;No therapist is going down to that root level,&amp;quot; says Cohen Greene, &amp;quot;to see them, their bodies, to talk to them while they&amp;#039;re naked.&amp;quot; The practice was in part pioneered by renegade researchers William Masters and Virginia Johnson in the late &amp;#039;50s, as an in-clinic experiment to treat problems of erectile dysfunction, premature ejaculation, and anorgasmia (in women, the inability to orgasm). The initial work showed promise\u2014primarily, that the men were able to achieve erections and sustain them through intercourse\u2014and they expanded their research in the &amp;#039;60s to include surrogate partners for single subjects. Though Masters and Johnson had what they considered fantastic success with the approach\u2014the clients who worked with surrogates showed about as much progress as those who worked with their spouses or partners\u2014the duo stopped referring patients to surrogates after the husband of one threatened to embroil them in a divorce-related complaint. Masters may have regretted the decision. &amp;quot;Without surrogates,&amp;quot; he told Time in 1974, &amp;quot;we now have a failure rate of 70 to 75 percent&amp;quot; for single men suffering from impotence. AIDS also took its toll on the practice; then Viagra and Cialis came along, promising a quick fix without the expense or embarrassment of interaction with a therapist. (&amp;quot;Look at those commercials. It looks like fun,&amp;quot; says Cohen Greene. &amp;quot;What I&amp;#039;m doing is work. This is therapy, intimacy, education.&amp;quot;) According to Vena Blanchard, DHS, president of the 30-year-old International Professional Surrogates Association (IPSA), the only organization in the U.S. that trains and certifies surrogate partners, there are a scant 50 of them working in America today (down from 300 two decades ago), operating mostly in California. The clientele has changed too. &amp;quot;The original model was men were the clients, women were the surrogates,&amp;quot; says Blanchard. &amp;quot;But now women have independent incomes and with that, a greater sense of entitlement about their sexuality.&amp;quot; Today, some 30 percent of those seeking treatment are women suffering from conditions such as anorgasmia, vaginismus (a spastic contraction of vaginal muscles that can be related to a fear of penetration), body dysmorphia, self-esteem issues, and what Blanchard calls, somewhat inelegantly, &amp;quot;the 100-pounder club&amp;quot;: &amp;quot;women who&amp;#039;ve lost 100 pounds but still feel as if they&amp;#039;re unqualified for relationships and have been so deeply wounded they have trust issues.&amp;quot; Up-to-date statistics about sex surrogacy are relatively scarce. According to IPSA, the practice has a success rate of 90 percent or greater in treating issues such as rapid ejaculation, compared with the 40 percent to 60 percent success rate of traditional sex ed and sex therapy reported by the American Association of Sexuality Educators, Counselors, and Therapists. In a surrogate, clients find someone willing not just to accept, but literally to embrace the parts of themselves they find most shameful\u2014and the issues that come up in that process are rarely limited to the bedroom. Blanchard recalls a 50-year-old germaphobe who was finally able to overcome a lifelong fear of kissing; a pro athlete who realized the anxiety he felt in the bedroom was left over from childhood feelings of being unloved by his mother. In her new memoir, An Intimate Life: Sex, Love, and My Journey as a Surrogate Partner, Cohen Greene writes about a man whose marriage was on the rocks because he&amp;#039;d developed a bondage fetish and a predilection for wearing constricting clothing. When Cohen Greene indulged the fantasy, the man was able to unlock a long-buried memory of childhood abuse by a babysitter. IPSA puts prospective surrogates through an in-depth screening process, followed by 100 hours of classes and an internship lasting up to a few years; surrogates-in-training learn, among other things, relaxation techniques, body-image therapies, and mindfulness of all sensations, not just sexual ones. But there is much that can&amp;#039;t be taught. Clich\u00E9d as it might sound, Cohen Greene has an innate ability to find something attractive in every human being\u2014and something enjoyable in every experience. Of one client who was obese and prone to road rage: &amp;quot;He was very ashamed of his body and didn&amp;#039;t think anybody would touch him. After our first session, we became more intimate, with him touching me. I was stroking his back, and his skin was so soft and so smooth. Of course I felt the weight, but that wasn&amp;#039;t the focus. It was more about how clean he smelled, how wonderful his skin felt against mine, and, eventually, what a wonderful kisser he was.&amp;quot;  In her prime, Cohen Greene juggled two clients a day, a long-term lover, and a husband (she was in an open marriage for more than 20 years). It&amp;#039;s hard to imagine any sexual appetite could be that voracious\u2014isn&amp;#039;t there a point at which she becomes tired of being touched at all? &amp;quot;What happens with me is I get energized,&amp;quot; she says, her crystal blue eyes flickering. &amp;quot;I don&amp;#039;t think I was made to be monogamous.&amp;quot; And, for the record: &amp;quot;Do I get off?&amp;quot; she asks. &amp;quot;You bet! Part of what I&amp;#039;m teaching them is what pleases a woman and how to communicate with a partner.&amp;quot; When orgasms result, they&amp;#039;re &amp;quot;like frosting on a cake.&amp;quot; This is the first grandmother I&amp;#039;ve met who has a plaster cast of her vulva greeting guests at her front door, along with a selection of erotic artifacts including one giant phallus. Not that it keeps the grandkids away: Her son, a therapist wed to another therapist, has two children; her daughter, who works in IT, is single. Both live close to Mom. Cohen Greene&amp;#039;s path to surrogacy reflects the culture of her time as much as her DNA. In her book, she writes about growing up in Salem, Massachusetts, a mile or so from the historic landmark now known as the Witch House, the home of the judge who, in the 1690s, sentenced 19 &amp;quot;innocent women [to be] hanged after being caught in the crosshairs of hysteria and religious fundamentalism\u2026when I was growing up, witches were no Halloween marketing ploy. To my child mind, they were very real. They served as warnings to stay on the right side of God\u2014or at least the church.&amp;quot; As a preteen, she was so ashamed to have discovered her clitoris\u2014and, with it, a passion for masturbation\u2014she went to great lengths to find different priests to confess to, so that she didn&amp;#039;t have to face the same one all the time. One told her, &amp;quot;Girls like you ruin young boys&amp;#039; lives.&amp;quot; She also had dyslexia, which went undiagnosed until adulthood. But she was cute and charming; dating came easily. Petrified about getting pregnant when she lost her virginity at 14, she enjoyed &amp;quot;everything about the act except for penetration.&amp;quot; One year of secretarial school led to a job where she met her ticket out of town: Michael Cohen, a few years her senior, Jewish, with none of the sexual hang-ups she&amp;#039;d inherited. She married him at 19 and had their daughter by the time she was 20 and their son three years later. Michael floundered through various jobs and colleges in Boston, then decided it was time to move West. They found their way to Berkeley, where they quickly embraced the late-&amp;#039;60s lifestyle\u2014especially Michael, who wanted to experiment with an open marriage. &amp;quot;I thought I&amp;#039;d lose him if I didn&amp;#039;t,&amp;quot; she says. At their first swingers&amp;#039; party, he scored on the living-room floor while she stood sadly on the balcony. But Cohen Greene found that she too wanted a lover of her own. First, though, she had to overcome her self-esteem issues. &amp;quot;I didn&amp;#039;t love myself for a long time,&amp;quot; she says. She&amp;#039;d had two kids, fractured her back in a car accident. &amp;quot;The kind of body I wanted was Jane Fonda&amp;#039;s. Little did I know she was throwing up all the time.&amp;quot; She found out that a local woman who was built &amp;quot;like a fertility idol\u2014big ass, big boobs, big legs&amp;quot;\u2014was posing as a nude model at a local art school. &amp;quot;I thought, If she can do it, so can I.&amp;quot; The job upped her confidence, and when the San Francisco Sex Information hotline opened\u2014the 55-hour training involved watching explicit educational films\u2014Cohen Greene didn&amp;#039;t hesitate. A friend bought her 1971&amp;#039;s Surrogate Wife: The Story of a Masters &amp;amp;amp; Johnson Sexual Therapist and the Nine Cases She Treated, thought to be the first book on the topic, and something clicked. &amp;quot;I thought, Oh my God! This is exciting. And then it was dominoes.&amp;quot; It comes as a bit of a relief to learn that Cohen Greene has her limits. There are lines she will not cross, clients she rejects. One was a therapist who rifled through her notes while she went to the bathroom, violating her privacy. Another complained about his bill\u2014today she charges $300 for two hours\u2014sniping, &amp;quot;I shouldn&amp;#039;t have to pay! You enjoyed it more than I did!&amp;quot; There are scarier instances, too, like the pedophile who told her during the touching part of their session that he intended to rape a little girl across the street. Cohen Greene persuaded the man to leave, then called his therapist, who reported it to the police. &amp;quot;And I never worked with her again,&amp;quot; Cohen Greene says. &amp;quot;She&amp;#039;s supposed to screen these people for me, and here she put my life in danger.&amp;quot; Cohen Greene&amp;#039;s second husband, Bob, it turns out, is the subject of chapter 11 of her book, &amp;quot;More Than a Client.&amp;quot; They met when she was still married to Michael, whom she eventually divorced and who has since died. An acne-ridden, insecure teen, Bob shipped off to Vietnam, tried (and failed) to lose his virginity in a brothel in Bangkok, and returned home unable to have an intimate life. Finally, a sex therapist referred him to Cheryl. In their seventh session, Bob lost his virginity, and at their eighth and final session, he presented her with a gift: a camera. A photography buff, he offered to teach her how to use it, and they started dating shortly thereafter. However sweet the story may be, it raises questions. Just what are the ethics here? More to the point, doesn&amp;#039;t Bob mind that while he&amp;#039;s at work, she&amp;#039;s rolling around in their sheets with someone else? &amp;quot;No,&amp;quot; she says with utter nonchalance. &amp;quot;He knows this is my work.&amp;quot; But even if a surrogate\u2014and her own partner\u2014can so neatly compartmentalize their feelings, can clients be expected to? In The Sessions, when O&amp;#039;Brien obviously falls for Cohen Greene, and she returns at least some of the sentiment, it seems almost inevitable. Here is a man who has never been loved or sensuously touched before. Why would he not love back? &amp;quot;Sometimes, during a session, a client might say &amp;#039;I love you!&amp;#039; and I might say it too. And mean it, in the moment,&amp;quot; Cohen Greene says. &amp;quot;But they&amp;#039;re supposed to take that newfound confidence, that love, and go out into the dating world and find a real-life partner.&amp;quot; The risk that they won&amp;#039;t be able to make that leap, though, &amp;quot;is one of the reasons why I don&amp;#039;t work with surrogates,&amp;quot; says New York City\u2013based clinical psychologist Judy Kuriansky, PhD (aka radio advice host Dr. Judy), who was a Columbia Medical School\u2013based research scientist on the team that helped Masters and Johnson design their treatment evaluation protocol in the early &amp;#039;70s. &amp;quot;There&amp;#039;s a trade-off between the confidence [the client] develops and the mastery you get and then the rejection you feel when you leave your last session. It&amp;#039;s a deep emotional connection, and the surrogate is the perfect woman. No woman is going to be that understanding and so willing. And that&amp;#039;s the dilemma. It&amp;#039;s not that the surrogate didn&amp;#039;t do a good job. She did too good of a job. Some people struggle to adjust in the dating world, and their symptoms return. So I had to ask myself, is it worth the risk? And to me, it wasn&amp;#039;t.&amp;quot; Cohen Greene takes on a fair share of risk too, opening herself up time and again to her clients. &amp;quot;Cheryl lives in love, in this openhearted way,&amp;quot; says Blanchard. &amp;quot;She has the capacity to love like a wide-eyed child.&amp;quot; But listen to her war stories\u2014say, the client who grabbed for her throat while he was on top of her because she reminded him of his ex-wife\u2014and you&amp;#039;ll wonder: Why invite this chaos and confusion into your home? Your bed?! But this is her life&amp;#039;s mission. &amp;quot;The greatest gift is seeing the change in a client, to show them how to love and be loved,&amp;quot; Cohen Greene says. &amp;quot;I always say, &amp;#039;I&amp;#039;m one woman,&amp;#039; but if I can get through to them\u2014that this is what women want, this is what you need to do\u2014and teach them how to listen to women, then aren&amp;#039;t we all better off? If I can get through to a few of them, what could be more gratifying than that?&amp;quot; "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.elle.com/life-love/sex-relationships/advice/a12548/sex-surrogacy/>