Why Not Sex Therapy or Sex Surrogacy in West Africa?

In many parts of the world, sex therapy and sexual surrogacy are recognized as legitimate aspects of physical and mental healthcare. They support individuals and couples in overcoming sexual dysfunction, trauma, and intimacy issues. Yet, in West Africa, these practices remain virtually nonexistent not just in policy or infrastructure, but in public conversation as well.

Why is that? Why are such services, which are therapeutic and often transformative, so resisted or ignored in West African societies?

Cultural and Religious Conservatism
West African societies are deeply rooted in conservative cultural and religious values. The major religions in the region Islam, Christianity, and traditional African spirituality all carry strong moral views about sexuality, often promoting sexual modesty, abstinence, and family-centered unions.

As a result:
Sex is taboo: Open discussions about sex, especially outside the confines of marriage, are considered inappropriate.

Therapy is stigmatized: Mental health services, in general, are still climbing out from under a mountain of stigma. Sex therapy faces double the resistance.

Surrogacy is misunderstood: Sexual surrogacy, which involves physical intimacy as part of therapeutic work, is often misinterpreted as prostitution or immorality.

Lack of Professional Infrastructure
Even where the need exists, the region lacks a formal infrastructure to support these services:

Few trained professionals: There are very few certified sex therapists in West Africa. Most therapists are general counselors or psychologists, often lacking the training to deal with complex sexual issues.

No legal framework for surrogacy: Sexual surrogacy lies in a legal grey area or is outright illegal in many countries. The absence of regulation opens the door for exploitation or criminal charges.

Misconceptions About Sex and Health
Sexual dysfunctions, trauma, or intimacy challenges are rarely treated as medical or psychological issues in West Africa. Instead, they are often explained through:

Spiritual causes (curses, witchcraft, or “spiritual husbands/wives”)

Moral failure or sin.
Poor gender roles (blaming the woman or man exclusively).

This worldview discourages people from seeking professional help, and instead drives them to religious leaders, traditional healers, or harmful self-medication.

Risk of Exploitation and Ethical Concerns

In societies without strong legal protections or sexual education, introducing practices like sexual surrogacy without regulation could lead to abuse:

Surrogates may be exploited, especially women from low-income backgrounds.

Clients may cross boundaries, misunderstanding therapy for consent to sexual gratification.

Sex work laws may criminalize the surrogate, even if the intention is therapeutic.

The Silence Around Disability and Intimacy

One group that would benefit immensely from such services people with physical disabilities is often left out of sexual conversations altogether. In a society where even able-bodied adults struggle to talk about sex, individuals with disabilities face even more stigma and isolation regarding their sexuality.

Sex surrogacy, when done ethically, helps people with disabilities explore intimacy in safe and supported ways a need that is almost never acknowledged in West Africa.

A Missed Opportunity for Healing
The silence around sex therapy and surrogacy in West Africa represents a missed opportunity:

Couples continue to suffer in silence, leading to broken homes, infidelity, and depression.

Trauma survivors are left untreated, leading to long-term mental health struggles.

Young people turn to pornography or misinformation due to lack of open conversation.

What Can Be Done?
Education: Comprehensive sexual education needs to move beyond biology and into conversations about consent, intimacy, and emotional health.

Train professionals: West African universities and medical institutions should offer training in sex therapy and related disciplines.

Community dialogue: Involving religious leaders, traditional leaders, and community heads in rethinking the value of sexual well-being can help shift perceptions.

Legal clarity: Laws must differentiate between consensual, therapeutic work and exploitation, to protect both clients and professionals.

Conclusion
Sex therapy and sex surrogacy are not about promoting promiscuity they’re about healing, communication, and dignity. While West Africa has a long road ahead in accepting and regulating such services, the conversation must start somewhere.

As societies modernize and the younger generation seeks healthier relationships, perhaps the taboo will give way to understanding and from that, healing can begin.

By Mustapha Bature Sallama
Medical/Science Communicator
[email protected]

+233-555-275-880