Both sexual surrogacy and conversion therapy continue to be employed in many states. Sexual surrogates can be contacted by referral from therapists or even found in the phone book in New York and California. To ensure the professionalism of the occupation, surrogates created an organization known as the International Professional Surrogates Association (IPSA), which licenses its members on a three-tiered ranking system based on levels of training, experience, and knowledge. The group aims not only to set standards within the field, but also to distinguish its members. As of 2003 though, the group had only 30 members. Most of these lived in California, although it also had member-practitioners in Florida and Idaho.

In New York some call girls falsely advertise themselves as trained sexual surrogates.

Of course, that a surrogate is trained and knowledgeable does not mean that she (or, rarely, he) is not engaged in something which could be construed as prostitution. One of the best-known institutes for sex research faced this question when the husband of one of its surrogates sued the institute under the common-law legal doctrine of "alienation of affections" a long-recognized concept which holds that having sex with a married person or inducing another person to do so is a violation of conjugal rights and privileges. As the case was settled out of court before trial, this issue has never been fully legally resolved.

Sexual surrogates' own romantic lives and relationships are typically fraught and difficult. For while they view themselves as healers and medical practitioners, society most often deems them as whores, and their boyfriends and husbands must deal with the knowledge that they aren't their only lovers.

These conflicts were part of the subject matter of the award-winning 1985 documentary film "Private Practices: The Story of a Sex Surrogate," directed by Kirby Dick. This movie examined the life of a Los Angeles-based sexual surrogate named Maureen Sullivan. Ms. Sullivan was seeing ten patients per week. In her sessions, she would try to build or rebuild the men's sexual confidence, while teaching them how to perform or how to perform more ably. The film showed her genuine sympathy and warmth for her patients and her own complex and unhappy feelings about her father--scenes which raised the obvious question of how well-adjusted she herself was. The movie ended by noting that when she later found a boyfriend she was happy with, she elected to work far less.

Surrogates serve not only as an alternative to pharmacological treatments for male impotence like Viagra and Cialis, but also to help men who are overly shy about their bodies and to work with patients whose sexual confidence has been damaged by unexpected disability. Vera Blanchard, the President of the IPSA, says that about half her patients are late-life male virgins, like the "40-year-old virgin" portrayed by Steve Carell in the movie of the same name. These men are trying to acquire experience and confidence so they can finally have sexual relationships.

One pointed fact about treatment programs using surrogates is their high success rate. Talk therapy has nowhere near the success rate in dealing with sexual dysfunction as treatment by a surrogate. Simply put, it seems that talking about sex is far less efficacious than engaging in it.

Surrogacy is unlike other psychological treatment in that transference must take place for it to work and is not to be avoided. Transference is also deliberately aimed for in conversion therapy, a widely discredited practice now frowned upon by the American Psychiatric Association (APA), although it is still widely employed by Christian ministries and others. The history of conversion therapy includes such ghastly episodes as the transplantation of testicles from straight men into the bodies of gay men by Viennese physician Eugen Steinach in the early part of the twentieth century. Freud, however, regarded conversion therapy as unnecessary or impossible.

The APA officially classified homosexuality as a mental disorder until 1973, and conversion programs were employed by well-established and well-regarded physicians and psychologists into the 1970s. These treatment programs used sexual surrogates in some cases and training with images of opposite sex partners in others. Claims for the success of these programs were often based on patient self-report.

A more credible assessment came from a psychologist who studied these programs, who concluded: "Individuals undergoing such treatments do not emerge heterosexually inclined; rather they become shamed, conflicted, and fearful about their homosexual feelings."

The question of what effect watching sex tapes has on the capacity for romantic love and desire is both an explicit and an implicit one in my new play--as it increasingly is for Western society given the explosive growth and vastly increased dissemination of hard-core pornography.

I hope my play provokes audiences to question all of these things. I promise that those attending will not be bored. Those wanting to see the play, I should add, can go to our website for tickets: www.sexualhealingplay.com.

Jonathan Leaf is a playwright and journalist living in New York. His previous productions include The Caterers and The Germans In Paris. His current play, Sexual Healing, opened on January 6th, 2010.