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Cheryl Cohen-Greene

Cheryl Cohen-Greene is an American certified clinical sexologist and therapist based in , who has facilitated therapeutic sexual experiences for clients struggling with intimacy and physical disabilities since 1973. Her practice involves structured, therapist-supervised sessions that progress from touch to intercourse aimed at resolving psychological barriers to sexuality, distinguishing surrogate partner therapy from through its clinical goals and oversight by bodies like the International Professional Surrogates Association. Cohen-Greene gained prominence for her work with Mark O'Brien, a poet paralyzed by and reliant on an , whose 1990 article detailing their sessions led to the Oscar-nominated 2012 film The Sessions, in which portrayed her. She chronicled her career in the 2013 memoir An Intimate Life: Sex, Love, and My Journey as a Surrogate Partner, emphasizing empirical outcomes in client sexual functioning despite ongoing debates over the of compensated sexual contact in . A and mother, Cohen-Greene has advocated for surrogacy's role in addressing disabilities and aging-related intimacy issues through and training.

Early Life and Background

Childhood and Family Origins

Cheryl Cohen-Greene was born in , and raised in a French Catholic family. Her childhood involved strict adherence to Catholic rituals, particularly , amid emerging fears of her body's sexual impulses. On Sundays, she sought out different priests to absolve her lengthening catalog of sins, including , reflecting the intense guilt fostered by her religious environment. At age 10, Cohen-Greene confessed to masturbating and was rebuked by local priests as a , an encounter that underscored the tension between her physiological development and doctrinal prohibitions against sexual expression. This pattern persisted into her teenage years, when she rotated through various churches weekly for , viewing as the paramount sin within her faith's hierarchy of offenses.

Education and Initial Influences

Cohen-Greene grew up in a rigid Catholic environment during the , where teachings emphasized that sexual desires were sinful and unnatural, fostering early internal conflicts over her bodily urges. She frequently sought from different to address her growing awareness of sexuality, which instilled a of and fear around intimacy. These formative experiences contrasted sharply with the liberating ethos of the , during which Cohen-Greene, then in her twenties, began exploring alternative expressions of sexuality and relationships. This period marked a pivotal shift, as personal realizations about the role of physical touch and emotional vulnerability in human connection redirected her toward professional pursuits in sexual well-being. Her formal education reflected this evolving interest. From 1980 to 1982, she studied and at Antioch West in . This groundwork culminated decades later in 2004, when she obtained a Doctor of (DHS) from the Institute for the Advanced Study of Human Sexuality.

Personal Life

Marriage and Family

Cheryl Cohen-Greene maintained a long-term marriage with her husband, Bob, a former , described as happy and enduring over 33 years as of 2012. The couple prioritized time together, often spending weekends close to home in . She was a grandmother, reflecting a multigenerational structure amid her personal commitments. Cohen-Greene had a daughter who faced peer-related challenges tied to public perceptions of her mother's work; at age 10, the daughter came home upset after a friend labeled Cohen-Greene a "," highlighting familial experiences with . Despite such incidents, accounts emphasize the stability of her marital relationship over decades.

Health Challenges

Cheryl Cohen-Greene faced from childhood, which contributed to difficulties in school and was not diagnosed until adulthood after she had two children. This affected her reading and writing abilities, requiring adaptations in her personal and educational pursuits. In 2006, at age 62, Cohen-Greene was diagnosed with and underwent treatment that included . She also survived , though specific details on its and treatment timeline remain undocumented in available accounts. These diagnoses necessitated medical interventions that impacted her physical health during recovery periods. By age 68 in 2012, she had achieved survivorship status for both conditions and resumed daily activities, including family engagements as a grandmother.

Professional Development

Entry into Human Sexuality Field

Cheryl Cohen-Greene began her professional involvement in in 1973, establishing a private clinical practice in , as a and consultant. This entry coincided with the field's development following the work of and Virginia Johnson, whose research on human sexual response had gained prominence in the and early 1970s. Cohen-Greene underwent training in the modality, which focused on observational and behavioral interventions for sexual issues, adapting these principles to her consultative role. In parallel, she became a member of the Sex Information Training Staff, serving for 20 years in a capacity that involved educating the public and professionals on accurate sexual information. This affiliation provided a platform for disseminating knowledge amid the era's expanding discourse on sexual health, including responses to the sexual revolution's emphasis on openness and destigmatization of intimacy. Her shift to professional practice built on this educational foundation, positioning partnership as an extension of therapeutic support for individuals facing intimacy barriers. The timing of Cohen-Greene's entry aligned with institutional efforts to address through integrated clinical approaches, distinct from purely psychological counseling. By 1973, surrogate had emerged as a niche practice, often in collaboration with licensed therapists, reflecting causal links between physiological research and hands-on intervention strategies validated in controlled studies by .

Training and Certifications

Cheryl Cohen-Greene earned a of Human Sexuality (DHS) degree from the Institute for the Advanced Study of Human Sexuality in 2004. She is certified as a Clinical Sexologist, a that underscores her specialized expertise in . Greene served as a member of the Sex Information staff for 20 years, contributing to educational programs on sexual health and information dissemination. She received in the approach to , which emphasizes behavioral techniques for addressing sexual dysfunctions. In her practice as a therapist, Greene adhered to a collaborative model requiring referrals from licensed therapists, ensuring integration with broader psychotherapeutic oversight. This protocol aligns with established standards in therapy, where clients are typically directed by mental health professionals for structured intervention.

Sex Surrogacy Practice

Methods and Therapeutic Approach

Cheryl Cohen-Greene's methods as a emphasized a collaborative three-way therapeutic model involving the client, a licensed referring , and the to address sexual dysfunctions such as erectile issues or intimacy avoidance through hands-on . Sessions, typically numbering six to ten per client, progressed gradually from verbal processing to escalating physical contact, ensuring clients built comfort incrementally without rushing into sexual activity. This structured escalation differentiated her practice from mere physical encounters, prioritizing psychological integration over isolated symptom management. Initial sessions focused on non-sexual elements, including , relaxation exercises, and light touch like hand-holding or to desensitize fears of . Cohen-Greene often incorporated ambient aids such as candles and soft music to cultivate a sensual yet safe atmosphere, facilitating clients' attunement to bodily sensations and emotional responses. As trust developed, techniques advanced to caressing, kissing, and eventually when aligned with therapeutic objectives, always under the surrogate's guidance to model healthy boundaries and communication. This tactile progression aimed to rewire maladaptive patterns by embodying acceptance of one's sexuality in real-time interactions. Central to her was confronting root causes—such as or trauma-derived inhibitions—through embodied practice, fostering clients' intrinsic comfort with their sexual selves rather than relying on alone. Cohen-Greene maintained that this experiential method enabled deeper , as clients internalized relational skills via direct enactment rather than abstract discussion. with the post-session ensured alignment with broader treatment goals, reinforcing the surrogate's role as a temporary bridge to autonomous functioning.

Notable Client Engagements

Cohen-Greene's engagement with poet Mark O'Brien in the 1980s stands as one of her most publicly documented cases. O'Brien, paralyzed by since age six and dependent on an for respiration, contacted her at age 38 seeking to experience for the first time after a lifetime of isolation from physical intimacy. Their collaborative sessions, spanning several months and involving gradual physical and emotional exploration, enabled O'Brien to achieve intercourse and subsequent orgasms, which he chronicled in essays such as "On Seeing a Sex Surrogate" published in 1990. Over her 38-year career from 1973 onward, Cohen-Greene worked with more than 900 clients through , with a substantial portion involving men facing physical disabilities or chronic intimacy barriers. In March 2013, she conducted sessions with , a 45-year-old engineer who remained a virgin due to and lack of romantic experience. Referred via a documentary production titled "40-Year-Old Virgins," Clive flew from the to Cohen-Greene's practice for intensive , culminating in his first during the filmed process.

Client Demographics and Outcomes

Cheryl Cohen-Greene's clientele primarily consisted of heterosexual single men facing challenges with intimacy, including those with physical disabilities such as , , , or , as well as individuals dealing with psychological barriers like , histories, or late-life . Over her 40-year career starting in 1973, she estimated serving approximately 950 clients, the majority of whom were men seeking to overcome relational or sexual inhibitions through surrogate partner therapy integrated with licensed therapists. While she occasionally worked with couples, married individuals, or women, these represented a minority compared to the predominant focus on single male clients with - or psychology-related obstacles to intimacy. Reported outcomes from Cohen-Greene's practice emphasized self-reported improvements in clients' , body confidence, and capacity to form subsequent intimate relationships outside , often described as enabling clients to transition from to partnered sexual experiences. Clients frequently cited gains in overcoming specific barriers, such as of physical touch or genital , leading to enhanced relational skills, though these accounts remained anecdotal without standardized metrics or third-party verification. No controlled clinical trials or longitudinal studies tracked long-term efficacy specifically for her clients, distinguishing her results from broader research that occasionally reports high short-term success in symptom relief but lacks rigorous follow-up on sustained relational outcomes. Evidence of benefits thus relies on practitioner and client testimonials, with variability noted in individual responses rather than uniform success rates.

Publications and Public Engagement

Authored Works

Cheryl Cohen-Greene co-authored the memoir An Intimate Life: Sex, Love, and My Journey as a Surrogate Partner with Lorna Garano, published on November 13, 2012, by Soft Skull Press. The book details her 40-year career in surrogate partner therapy, incorporating first-hand accounts of client sessions that illustrate therapeutic breakthroughs in addressing sexual dysfunction and relational barriers. It also traces her personal trajectory from a restrictive Catholic upbringing marked by sexual repression to her role as an advocate for open discussions of intimacy and human sexuality. The memoir emphasizes themes of empowerment through physical and emotional intimacy, drawing on Cohen-Greene's experiences to challenge societal taboos around non-traditional therapeutic practices. Released during a period of heightened public curiosity about sex surrogacy, it offered readers unprecedented access to the profession's inner workings without delving into prescriptive methodologies. No other major authored works by Cohen-Greene have been documented in primary publication records.

Media Representations and Speaking Engagements

Cheryl Cohen-Greene served as a consultant for the 2012 film The Sessions, directed by Ben Lewin, which dramatized her real-life work as a surrogate partner with poet and journalist Mark O'Brien, who relied on an iron lung due to polio. In the film, Helen Hunt portrayed the character "Cheryl," a professional sex surrogate guiding O'Brien through intimate experiences as part of his therapy, earning Hunt an Academy Award nomination for Best Actress. Cohen-Greene participated in promotional interviews for the film, including discussions on The Takeaway radio program where she described the accuracy of the depiction and the therapeutic boundaries involved. Following the film's release, Cohen-Greene engaged in on and , delivering a TEDxFidiWomen talk titled "Sexuality & Disability—A Seat at the Table" on December 11, 2013, emphasizing the need for inclusive approaches to sexual fulfillment for people with disabilities. She also appeared as a keynote speaker at events addressing and intimacy therapy, drawing on her professional experience to advocate for ethical practices in the field. In media interviews, Cohen-Greene defended surrogate partner therapy, particularly for clients with disabilities; in a July 23, 2013, Huffington Post piece, she asserted that "disabled people must have the right to sexual expression," positioning as a vital tool for addressing barriers to intimacy when traditional relationships prove challenging. She featured in outlets such as Radio on March 1, 2013, where she elaborated on the therapeutic model and its distinctions from , and in ABILITY Magazine, discussing the film's portrayal and broader implications for sexual access. These appearances highlighted her role in normalizing amid ongoing debates over its legitimacy.

Controversies and Criticisms

Ethical and Moral Objections

Critics of sex surrogacy, including Cheryl Cohen-Greene's practice, have equated it with due to the direct exchange of sexual acts for payment, arguing that the therapeutic rationale serves merely as a veneer for commercial transactions. experts on platforms like have described such engagements as blurring essential boundaries between professional therapy and paid sex, with one professional labeling it a "dangerous practice" that risks ethical lapses by prioritizing over psychological resolution. This perspective holds that compensating for sexual contact undermines the intrinsic non-commercial nature of human intimacy, reducing relational healing to a purchasable service regardless of . Moral objections extend to the potential inherent in targeting vulnerable clients, such as those with disabilities or sexual , whom Cohen-Greene served over her 38-year career. Detractors contend that surrogates capitalize on clients' physical or emotional frailties—exemplified by her work with polio-afflicted poet Mark O'Brien—by monetizing access to touch and sexuality that these individuals may lack through organic means, thereby perpetuating dependency rather than empowerment. From traditional ethical standpoints, this of bodily closeness violates principles of human dignity, treating intimacy as a commodity akin to any market good, which erodes mutual respect and authentic connection. Religious and conservative viewpoints amplify these concerns by framing sex surrogacy as a profane instrumentalization of sexuality, contravening doctrines that reserve physical union for covenantal, non-transactional bonds. Cohen-Greene's own Catholic upbringing, marked by early repression of sexual urges, underscores a cultural backdrop where such practices clash with longstanding moral taboos against selling the body, potentially normalizing deviance under the guise of . Critics argue this not only desecrates the sacred aspects of eros but also risks broader societal erosion of familial and spiritual values by endorsing paid surrogates as substitutes for genuine partnership. The practice of surrogate partner therapy operates without standardized licensing or regulatory frameworks in the United States, distinguishing it from licensed professions that require state-approved , examinations, and supervised hours. Surrogate partners, including those associated with the International Professional Surrogates Association (IPSA), depend on referrals from licensed therapists and adhere to voluntary ethical codes rather than governmental oversight. This absence of uniform has prompted debates on professional accountability, with IPSA providing training programs since 1973 to establish competency standards in the absence of legal mandates. Terminology within the field shifted from "sex surrogate," prevalent in the and , to "" to underscore the emphasis on developing relational and intimacy skills over isolated sexual encounters, countering perceptions that undermined professional legitimacy. This evolution addressed concerns that the earlier label fostered misconceptions, potentially limiting client access and complicating boundary definitions in therapeutic contexts. Central to legal discussions is the tension with anti-prostitution statutes, as most U.S. states criminalize payment for sexual acts, placing in an undefined gray area absent explicit prohibitions. Proponents differentiate it through its triadic structure—involving a supervising , , and client—with sessions prioritizing , progressive goal-setting, and emotional integration, where physical intimacy constitutes only about 13% of interactions per estimates. In 1997, Alameda County District Attorney stated that such remains legal when involving consenting adults under licensed referral. A rare enforcement example occurred in late-1980s , where a psychologist's was revoked for employment due to perceived pandering risks, though no comparable state-level restrictions persist today. Cheryl Cohen-Greene, who held certifications as a sex educator and clinical sexologist and served in IPSA leadership, defended the modality by framing it as a supervised extension of focused on holistic skill acquisition, not commodified sexual release, thereby insulating it from equivalency.

Empirical and Efficacy Concerns

Despite the reported successes in surrogate partner therapy (SPT), the practice lacks substantiation from large-scale, peer-reviewed randomized controlled trials assessing causal or long-term outcomes beyond initial client sessions. Existing evidence is limited to small, studies and self-reported data, such as a 1970s analysis by of 28 men with showing 63% success for primary cases and 78% for secondary, without control groups or blinded assessments. A later of 150 SPT participants found 73% maintained improvements six months post-therapy, but low follow-up response rates and self-selection limit reliability. Similarly, a survey of 501 clients reported 89% resolution of sexual issues, yet relied on unverified self-reports without comparison to alternative interventions. No published controlled trials exist to isolate SPT's effects from , natural recovery, or concurrent therapies. Short-term client testimonials, often highlighted in SPT advocacy, contrast with the absence of rigorous longitudinal data, potentially inflating perceived efficacy through where participants credit the surrogate interaction for unrelated improvements. For instance, small case series, like one involving 16 women with achieving 100% pain-free intercourse after SPT (versus 74% in partner-involved ), demonstrate short-term behavioral gains but fail to address sustained psychological integration or recurrence rates. Risks of arise from the triadic emotional bonds formed, with separation potentially causing distress or attachment disruptions, particularly for vulnerable clients with psychiatric instability or relational insecurities. Ethical reviews note emotional challenges for both surrogates and clients at therapy termination, though empirical quantification of harm remains unexplored due to methodological gaps. Comparisons to established interventions underscore SPT's evidentiary deficits: () for , supported by meta-analyses, yields moderate to large effect sizes in improving overall sexual function (standardized mean difference = 1.34), desire, arousal, and satisfaction across diverse populations, with durable effects post-treatment. These findings derive from controlled trials contrasting against waitlists or , enabling causal inferences absent in SPT literature. While SPT may accelerate behavioral desensitization in select cases like , its integration of physical intimacy introduces untested variables, such as , without evidence surpassing non-contact modalities like exercises within standard .

Legacy and Impact

Advancements in Sexual Therapy

Cheryl Cohen-Greene advanced sexual therapy by integrating practices into treatment for individuals with physical disabilities, enabling hands-on that complemented traditional talk-based approaches. Over her four-decade career, she worked with clients facing conditions such as , , , and , facilitating gradual progression from non-sexual touch to to address barriers like limitations and lack of prior intimacy experience. This approach expanded therapeutic access for those unable to benefit fully from cognitive-behavioral methods alone, emphasizing embodied practice to build sexual confidence and functionality. Through her leadership in professional organizations, Cohen-Greene influenced training standards in surrogate therapy. As a long-standing member and vice president of the International Professional Surrogates Association (IPSA), founded in to certify and regulate surrogate partners, she contributed to establishing ethical protocols and collaboration between surrogates, therapists, and clients. Additionally, her 20-year tenure on the training staff of Sex Information (SFSI) and consultations with therapists disseminated surrogate techniques, promoting integrated models where surrogates report progress to overseeing clinicians. Despite these innovations, empirical validation of surrogate therapy remains limited, positioning it as a niche adjunct rather than a primary . Small-scale studies, such as one on patients, reported higher success rates in achieving with surrogates (100%) compared to couple therapy (75%), though statistical significance was marginal (P=0.1). Broader reviews highlight a scarcity of randomized controlled trials or large cohort data supporting efficacy across conditions, with pioneers like introducing surrogacy concepts but lacking robust outcome metrics. Thus, while Cohen-Greene's work filled experiential gaps for select populations, it has not supplanted evidence-based therapies like or , underscoring the need for further rigorous research to substantiate long-term benefits.

Broader Cultural Influence

The 2012 film The Sessions, portraying Cohen-Greene's work with polio-afflicted poet Mark O'Brien, elevated public awareness of sex surrogacy as a means to address intimacy barriers for individuals with severe disabilities. The movie's Oscar nominations for actors and John Hawkes, alongside its festival acclaim, catalyzed broader media examinations of how physical impairments intersect with sexual expression, framing surrogacy as a potential avenue for human fulfillment rather than mere medical intervention. This depiction drew from O'Brien's real-life experiences, highlighting surrogacy's role in confronting isolation, though critics noted the film's comedic tone sometimes softened underlying ethical tensions. By normalizing conversations around disabled sexuality—often sidelined in mainstream discourse—the film and Cohen-Greene's associated interviews challenged entrenched taboos, encouraging advocacy for inclusive . For instance, post-release discussions in outlets like emphasized surrogacy's capacity to model relational skills, prompting some communities to demand greater access to such services amid historical desexualization of the impaired. However, this visibility also amplified counterarguments, with skeptics in ethical and religious spheres decrying as a of intimacy that blurs therapeutic boundaries and risks , sustaining resistance particularly among conservative viewpoints wary of non-traditional sexual interventions. Cohen-Greene's influence persists in niche advocacy for alternative therapies, influencing ongoing surrogate training programs and sporadic policy debates into the 2020s, yet it faces mainstream professional rejection due to concerns over efficacy lacking randomized trials and potential legal liabilities akin to statutes in many jurisdictions. While her model inspired limited expansions in sex-positive counseling for marginalized groups, broader cultural adoption remains stymied by empirical gaps—such as unverified long-term relational outcomes—and institutional biases favoring conventional talk therapy over hands-on approaches.

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