Surrogate partner therapy: ethical considerations in sexual medicine

J Sex Med. 2014 Feb;11(2):321-9. doi: 10.1111/jsm.12402. Epub 2013 Nov 22.


Introduction: Surrogate partner therapy (SPT) is a controversial and often misunderstood practice.

Aim: The aim of this study was to review the history and evidence-based literature regarding SPT, describe and provide a model for ethical SPT practice, and present two case examples illustrating ethical concerns.

Methods: Literature review and report of clinical experience were the methods used.

Main outcome measure: Results of literature review and clinical experience were assessed for this study.

Results: Sex therapy pioneers Masters and Johnson introduced surrogacy in sex therapy; however, there is a lack of published evidence supporting treatment efficacy and ethico-legal questions have limited the practice from becoming a common intervention. SPT can be an effective intervention that may enhance sexual medicine practice. However, SPT must be offered according to legal, professional, and ethical standards.

Conclusions: Sexual medicine practitioners should consider SPT based on the ethical paradigms offered, and sex therapy practices utilizing SPT should collect and publish outcome data.

Keywords: Ethics; Sex Therapy; Surrogate Partner Therapy.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Behavior Therapy / ethics*
  • Behavior Therapy / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Sexual Behavior / ethics*
  • Sexual Dysfunction, Physiological / therapy*
  • Sexual Dysfunctions, Psychological / therapy*
  • Sexual Partners*