Even as women are becoming more sexually empowered—and maybe because they are becoming more sexually empowered—more are turning to sex surrogates for help with their physical and emotional sexual health issues. In the past, surrogates say, they were primarily used by male patients.

Vena Blanchard, president of the International Professional Surrogates Association told MyHealthNewsDaily that there has been a rise in the number of requests from women for surrogates and an increase in certified male partners. And it’s not just an American trend. Forty percent of cases referred to the The Tel Aviv Sex Therapy Clinic are now female patients—up from zero when it started in 1989, according to clinic head Ronit Aloni.

Surrogacy seemed to be on the downward slope—Blanchard says that the IPSA once had between 200 and 300 members and now only has 50 (Viagra is cited in the piece as one of the reasons for the decline in surrogacy). One of its drawbacks is that clients might fall in love with the surrogates, but it also has numerous benefits, including enabling patients to form just those kind of attachments if emotional trauma has been an issue. Shai Rotem, a Los Angeles-based therapist, told the website that sessions are well-planned and less anxiety-provoking for patients than real-world sexual encounters, where anything can happen. “[This] is way safer than meeting strange men in a bar,” he said.

For the inside skinny on sexual surrogacy, check out Diary of a Sex Surrogate by The Beautiful Kind on SexIs.