Queer Doc (they/them): Hey everyone. Welcome back to the queer. See me vodcast. I'm like super excited to have Katherine yagle on today. Katherine is. Well, Katherine works in a field that I heard about years and years and years ago. And I'm just so excited to actually get to do like a deep dive and learn more. So, Katherine, I would love you to take over your introduction so I don't f*** it up.
Katherine Yagle: Sure, no worries. Um, yeah, so I'm Katherine Yagle or Kay I go by many nicknames and I use all pronouns, and I'm a surrogate partner and I'm a somatic sex coach. So my work is at the intersection of therapeutic healing and sexual healing.
Queer Doc (they/them): I'm like very excited to dive in. We do you know, Try to. Try to send our voices that are like part of our community as well. Do you mind sharing a little bit more about how you identify both like, gender identity and sexual orientation?
Katherine Yagle: Sure. Yeah. Um, I identify as non-binary but I also identify as a woman and I think those pieces.
Katherine Yagle: Come from different. Experiences in my life like I think internally I feel pretty gender fluid or the term androgen is a term that someone wants labeled me as which I think if it had been anyone else I would have been pretty offended. Someone labeling, my gender identity but this person was a an older trans woman who I just really Resonated with and she was like I'm an Andrew Gene. I see you you're an android gene and I was like Whoa I think you're right. Um, so that's always resonated for me. But I also do definitely identify as a woman just because I think socialization really had an impact on me. And I think there's a lot of ways that I perform the gender. I was raised and, you know, part of that is around white womanhood and performed helplessness, and the ways that my privilege shows up. And so,
Katherine Yagle: I don't want to totally distance myself from that because it feels like there's a lot of growth and accountability and healing and owning those parts of my identity as well.
Queer Doc (they/them): And thank you so much for such a like personal and vulnerable and nuance explanation of how you identify.
Katherine Yagle: Yeah.
Queer Doc (they/them): I really
Queer Doc (they/them): I feel like, Pretty grateful to get to be a part of that actually. So thank you.
Katherine Yagle: Oh yeah, totally.
Queer Doc (they/them): Yeah. Okay. And if you want to,…
Katherine Yagle: Oh, and you ask about my sexuality. Sure. Yes,…
Queer Doc (they/them): if you don't know I feel
Katherine Yagle: actually identify as queer. I think that's the easiest way to put it.
Queer Doc (they/them): like, My third obviously, I named all of my businesses, queer, something. So
Katherine Yagle: Mmm. Yeah.
Queer Doc (they/them): Fyi, all sexual identities and orientations are valid. None, queer is not more or less salad than any other one. It's just my personal.
Katherine Yagle: Resonates for you.
Queer Doc (they/them): Favorite word and yeah, same and yeah. And I like I said, I learned about Like somatic sex therapy or coaching or however, you want to title that. And We we met before this and I was telling you about that. I feel like it was like maybe Seven or eight years ago, I happened to like meet someone personally who is training in the field and and learned more about it. And was like, Wow, why is this not Like a like Why is this not more known about why? It's like That's not more available, This seems like such important work, you know? I Back when I did primary care, I often said, If everyone slept s*** and sex more the world would be a better place and
Katherine Yagle: oh,
Queer Doc (they/them): so, I just think, like the work you're doing is like A huge part of that. And so, Please explain to our listeners. Who are, you know, primarily medical practitioners, what your work is because I'm going to guess a lot of them. Like have not even heard of it.
Katherine Yagle: Yeah, totally. Um, so if I'm not mistaken, I think you were telling me that the person you met was a sexological body worker. Is that right?
Queer Doc (they/them): Yeah, I think so, I think that's what they were, how they termed that back eight years ago.
Katherine Yagle: Totally, yeah. So sexological Bodywork is still a totally it's it's a field that definitely still exists and is there's many amazing practitioners in that realm the feet. The one of the modalities that I studied in is called somatic Sex education and it sort of evolved out of sexological body works. So it includes the Sexological Bodywork curriculum but also goes pretty deep into Trauma-informed, care, and ethics and embodied consent and and like, the way systems of oppression affect our bodies, so that is one of my modalities. And so
Katherine Yagle: Sexological Bodywork and semantics. Sex education are basically hands on sexual healing modalities. Usually one directional touch practitioner to client touch and Yeah, all for all sorts of issues, you know, and it can be as short as like, a single session and a client comes in to talk about something or receive some touch on a massage table or it can be many many sessions over the course of months, and years to address like deeper issues.
Katherine Yagle: And my other modality which is sort of my home modality is called surrogate, partner therapy and that is a form of mutual sexual healing therapy where I'm a practice partner for a client and I collaborate with their therapist. So there's a triad in surrogate, partner therapy. That's one of the most essential parts of its structure and open communication between me and the client and the therapist. We're all meeting regularly in the clients practicing skills around emotional and physical intimacy with me and then processing that with their therapist. And the therapist and I are talking throughout to make sure the container is safe and supportive to the clients learning.
Queer Doc (they/them): I like, What? I'm like, I have like I have a thousand questions, also listeners, it's 9 am where I am and I'm like, apparently not had enough coffee yet. So, um, here with me today and I think the first one I would want to like, get on record for clinicians is like where can they go to? Like, learn more about these modalities. Like, just, like are there, like, kind of like, Organization. Like, I hate the word professional are there, like kind of collegial organizations or something like that that, you know, like you have like a thematic partner.
Queer Doc (they/them): I think I got the words wrong, but you have like, a of America association or whatever they could go and like learn more about it.
Katherine Yagle: Yeah, absolutely. So somatic the Somatic Sex Educators Association is the organization that Certifies. The Somatic sex education training and their website is a pretty good place to get educated about somatic. Sex education, somatic sex education shows up in like so many different ways. People have like some people have just like Coaching or counseling Businesses. That being certified in somatic, sex education, some folks do like sensual massage with it. So there's many, many different ways that it looks but the website is a great place to start and then you can also find the directory there and like look into the different. Fields that people bring that training into.
Katherine Yagle: Surrogate Partner Therapy. I recommend checking out the surrogate partner collective. It's a new newer organization. There's an older organization that I got certified through but I'm a really big fan of the surrogate partner collective. That's the organization I'd recommend. There's also just not that much information. Both of these modalities are fairly young even though the the skills that they're teaching are ancient. You know these practices have been around thousands of years and there. You know, rituals that are part of many indigenous, cultures and religions and But the modalities themselves are pretty young, so there's not a whole lot of information, and my website has lots, and lots of information about both of them. I'm really into talking about and writing about what I do. So I have lots and lots of resources on there.
Queer Doc (they/them): A fabulous and I don't worry listeners and making sure I get all of these down and we'll put them in the notes under the episode. So you can get To be three.
Katherine Yagle: And I can also send those to you if you need.
Queer Doc (they/them): Um, great. So we have some resources for our clinicians to learn even more than what we're going to go over in this episode. And then, yeah, I think maybe it. Okay, you know. No, I think.
Queer Doc (they/them): I feel like you've done a phenomenal job of like, giving like an overview of what this is and what this looks like. And I think for some clinicians it might really help if you could like describe an example session of both of these modalities. So they really like have baby more visualization of like What an encounter experience looks like, is that that was not a question I talked to you for Okay.
Katherine Yagle: Totally. Oh no, I'd love to talk about that. Yeah, I think that you know so I think that This is a really not very well-known field. Every time I meet someone who's like, not in this world. They're like, Wait, what do you Like, what is that illegal? You know, like all the
Katherine Yagle: People are just shocked by it um, and yeah. So I mean, so a session will look so different based on what the client is coming in for and like how deep we are into the work. So usually in the surrogate partner therapy which is the bulk of my clients. Usually I'll start with just some basic like getting to know each other games, the ground, I always start every session with some sort of grounding or embodiment practice to like yes a little more present in the room and kind of drop whatever we're carrying with us and and then we usually do some sort of touch exercise in the early sessions. I'll equip clients with tools to tune into their body and tune into their, yes and no. And that's something that we practice again and again and again, throughout every session. So I use the window of tolerance and talk about the Green Zone, the Yellow Zone, and the Red Zone.
Katherine Yagle: Green Zone being like, Yes, this is my body is a go for. This is a green light, orange, and red zone, or I'm, you know, I'm triggered. Basically I'm activated my nervous. System is entering a pattern that is protective but not connective. And yellow zone is the learning zone, so it might be a little bit uncomfortable but this is where we grow. So we always want to have a foundation of green. We want to be building a solid base of. Yes, this is. This feels good. This feels comfortable. I'm engaged. I'm safe and I'm present. And then consciously choosing when we enter the yellow zone. So now we're going to do a touch exercise. Do you feel ready to choose something that is a little edgy or do you want to keep it really safe and green today?
Katherine Yagle: So usually the first touch exercise, I'll do just involves touching each other's hands for some clients even, that's too overwhelming and we'll start with just objects, like I'll choose a series of objects and have them practice touching them.
Katherine Yagle: And we really work a lot with Betty Martin's Wheel of Consent, which is a fabulous tool. And if anyone is in the sexual field and doesn't know about that, strong recommendation to go to Betty, Martin's website right now and watch her for 40 minute, presentation into a presentation on the wheel of Consent. Um, but yeah, wheel of consent working with take and allow touching for your pleasure and receipt and being touched for allowing the other person to touch you for their pleasure. And so really learning to practice, I'm not gonna get anxious about what the other person's experiences. We negotiate, the boundaries of the container. At the beginning, we agree on how we're going to communicate or something needs to stop. And then from there, we feel really free and empowered to touch in the ways that feels good for our body.
Katherine Yagle: And so yeah, we'll start with like the hands and then we slowly build our way up to other parts of the body. And then over many months we'll disrobe we do a lot of work about body image during that time. And then we slowly work our way toward more erotic touch and then start bringing back, mutual touch. So we start to bring back in. I'm touching you while you're touching me. I'm touching you for you. I'm touching you for me and kind of swimming in the hall erotic soup of it all.
Queer Doc (they/them): In the thick and I just want to point out to our listeners. Katherine did mention that this is like this kind of bi-directional touch is really housed inside of a triad with the therapist present. In the session.
Katherine Yagle: Bring it.
Queer Doc (they/them): I have that correct.
Katherine Yagle: The therapist is not present in the session.
Queer Doc (they/them): Okay. Okay, no. Great.
Katherine Yagle: No, no, no, that's yeah. That's a really critical detail. So the client. So the original the very first session. The initial session will do on zoom usually and the therapist and the client and I are all together. Talking about the goals of the work etc.
Queer Doc (they/them): Okay.
Katherine Yagle: After that, we only meet one-on-one and…
Queer Doc (they/them): Okay.
Katherine Yagle: the therapist, and I will talk about the session afterward and review. What was Pleasurable and easy for the client. What was triggering for the client. And then the client in the therapist me as well. And usually,…
Queer Doc (they/them): Got it.
Katherine Yagle: they were talking about everything going on in their life. In addition to our work, You know, when our work gets more challenging, they might spend more of their session with their therapist focusing on it.
Queer Doc (they/them): Got it.
Katherine Yagle: And then, yeah. And then we meet again, based on all the things that an integrate, all the things that we talked about over the course, the prior few weeks.
Queer Doc (they/them): Nice. And then
Queer Doc (they/them): and so like, what are examples of like, what people might seek out this kind of healing encounter for
Katherine Yagle: Mmm, sure. So and then for far, and away The most common reason that folks pursue, this work is erection challenges. which, Is a fairly easy thing to fix and surrogate partner therapy. But I don't find all that interesting. And so I'm very selective about which of those cases I take. Personally, my passion is much more working with queer clients and working with folks who have trauma histories. so, And any variety of reasons, you know, a lot of my clients experience to neglect or abuse as children and are learning a lot around, just like how to form healthy connections and how to feel safe during intimacy. Um,
Katherine Yagle: you know, I have lots of clients who just have never been partnered. Never really learned the skills kind of missed the boat on dating in their teens and early 20s and now feel just really behind the times. And Starting at square one.
Queer Doc (they/them): Which is I'm going to interrupt you just for a second to point out. Sarah Clinicians is actually like, not uncommon for trans young youth and young adults, right? And like the limited research we have on trans youth like sexuality is that they do delay, sexual intimacy, physical intimacy with other people until they very often have access to gender affirmation. Right. Particularly medical interventions and so which kind of makes things like if we just think about like what dysphoria is and if you have discomfort and dysphoria around your body, if it doesn't fit for you if it you know when you're disroving or when you're with other people and I like a physical or intimate space in your, body isn't what it's supposed to be for you. It makes sense that you would like maybe postpone those encounters…
Katherine Yagle: Here, please.
Queer Doc (they/them): until you're feeling more comfortable in your own skin. And so that's like a really interesting application to think about, for Some of our transient adults.
Katherine Yagle: Absolutely. Yeah. So, yeah, that's a common experience today. Encounter as clients, who are kind of like, finally, at a place of accepting themselves and like feeling empowered and embodied and want to learn how to be in relationship now that they have kind of conquered, those parts of their journey and Yeah, I'm trying to think about like what other reasons. There's I mean, there's just so many reasons that people come to this work.
Queer Doc (they/them): Yeah.
Katherine Yagle: You know. One of the things that I In the training. So the Masters and Johnson were the ones, that developed surrogate partner therapy back in the 60s and 70s. And at that time, they really developed it as like
Katherine Yagle: For folks with like really explicit sexual dysfunction and actually originally, they only had it available for married, couples. They developed this what we call sense8 focus, which if any excuse me, just a second.
Katherine Yagle: Yeah, so that they developed Masters and Johnson developed Sense8, focus as like a as a kind of touch therapeutic amount to touch base. Therapeutic modality to help married couples who are having sexual issues worked through those. And then they discovered that, you know, they were getting contacted by single people who are like, Wait, We really need this because we can't even be in a partnership, you know? So then they started training folks, like mostly like nurses, and healing practitioners to be surrogate partners. And they found that the results were way better, like way more productive when it's a trained professional, then when it's a married couple, who is coming in with all their emotional challenges and, you know, baggage and stuff. So that was the beginning of that.
Queer Doc (they/them): Yeah.
Katherine Yagle: And in the decades, since it's really expanded from being these more like clinical,
Katherine Yagle: So we're getting pregnant therapies expanded from treating more clinical issues, like, vaginismus and erectile dysfunction, which it's still. I still have plenty of those clients too, but to being much more comprehensively, you know, like a trauma, healing modality and, you know, emotional content as well which you know, sexual issues, usually are tight, emotional content. And yeah I think a big learning for me, you know, I went into this thinking like it's a very kind of niche specific offering and I've discovered that many of the skills that I'm working on with my clients are things that we all need to learn. And that I wish that they taught in like middle school, sex, Ed? You know, they're not, they aren't like niche.
Katherine Yagle: Out there. Things, there are things that are just like basically basic like how what are the yes, feel like in my body and How do I start to pay it? How do I pay attention to when that's shifting out of yes, into maybe and when is it, maybe something that I can negotiate. And when is it actually a no and I'm just like pretending it's not a no. You know.
Queer Doc (they/them): Yeah. Wouldn't that have been a really useful sex education? And I think,…
Katherine Yagle: Wouldn't it? Oh,
Queer Doc (they/them): you know what you're saying is so reflective. You know, I hosted a panel last month of trans patient who discussed what they wish their healthcare clinicians knew about their sexual health care needs.
Queer Doc (they/them): It was like very basic and what like the primary message that was repeated it over and over by the four panelists and was I need you to listen to me. It wasn't like I need you to know about like the advanced inner workings of you know. The genitalia after exposure to hormone therapy and like x, y, and Z like that wasn't even the ass because we're so far away from that. Like the ask is still just like, I need you to listen to me. I need you to understand that. I'm an expert in my own body, and I need you to not dismiss things. I bring up to you, right? And so,
Katherine Yagle: Yes.
Queer Doc (they/them): Not niche, not not. That is not like niche to trans patients. That is not niche to sexual health, right? That is like, always the thing that I think we want from any other human and…
Katherine Yagle: Yeah.
Queer Doc (they/them): any experience in our life. But I especially from our Healthcare team, right? Especially from our our people, we come to for healing encounters and…
Katherine Yagle: It totally.
Queer Doc (they/them): So I feel like there's a parallel to what you're describing and Oh the work we do in training healthcare. I definitely though. Do thinking of like who is like a great referral to like the work you do and I'm gonna think that probably would also fit in either modality like the somatic sex education or the surrogate partner therapy and you know
Queer Doc (they/them): One of the things I talk about a lot with my patients and we're doing informed consent counseling. Is that there are, you know, typically for most people taking hormones changes and how they experience sexual attraction sexual pleasure,…
Katherine Yagle: Mmm. Yeah.
Queer Doc (they/them): how they how they're genitals will function, what's going to get them off? What's going to feel good and some of my patients, like definitely move through that process, like, pretty comfortable and like, you know, dive in and figure out what works for them and what doesn't? And then some of our patients really struggle to find like, what feels good after hormones, start affecting like their genitals and their orgasm, right? Like with clitoral management on testosterone the nerves, get displaced, you know, things get stretched out, things are in different orientation and definitely You know. particularly like, Some patients really had like a way that they like their go-to for getting off, like they knew this was all gonna work. And for right for most people with a clitoris that involves clitoral stimulation.
Queer Doc (they/them): And suddenly to have that part of your anatomy, just functioning differently, and it can, it can be a little confusing for people to figure out. And so having the support of a trained clinician right to like,…
Katherine Yagle: That's the
Queer Doc (they/them): go through that process, could be, particularly people are feeling nervous, uncomfortable, unsure, Afraid scared, you know, confused. I think that could be like a really beneficial Like process. For for patients.
Katherine Yagle: yeah.
Queer Doc (they/them): And similarly people with like, you know, a phallus who have generally associated erection and orgasm and then suddenly we've done some things that really Prevent erection or…
Katherine Yagle: Okay.
Queer Doc (they/them): erections, like are not as firm or as frequent because right, we know you can definitely separate erection and orgasm, but if someone's body has never done that before and they have to learn how to do that and they're having to learn how to do that. While also learning how to like move through the world, you know, in a different way and a body, that's changing. And in a hormonal seat, that's changing and emotional state, that's changing. I think again having the support of a trained clinician, Could be such a. Such a boon.
Katherine Yagle: Yeah. Yeah a big piece of what I view as my work and surrogate partner therapy and semantics. Sex education is actually decentering the genitals. I almost never say that explicitly to my clients but you know we don't incorporate the genitals till many many months into the work. And that's because we're starting to try to build capacity for pleasure through all the senses throughout the whole body. I work with a lot of disabled clients and one of the things that I've learned powerfully through that work is that there's so many ways to orgasm, orgasm is a brain function, not necessarily tied, to any specific part of the body other than through practice and patterning. And so there's this amazing set of videos.
Katherine Yagle: about spinal cord, injury, and sex and I can send those that I actually make many of my clients watch because it really talks about Reconceptualizing pleasure, like reframing. Pleasure that it's like it doesn't have to be, you know, P and V intercourse is one very, very specific type of sex and there's so many types of sex and really sex is just so ever feels good for you and the person that you're having sex with and so yeah that's a big piece of wood. I'm working on with my clients. It's like How are what are the myriad ways you can experience pleasure
Queer Doc (they/them): Yeah, I think. very, you know, very similarly like
Queer Doc (they/them): I have like a clip up on tiktok or something where I say, like, sex is defined by the people who are having it and so. And one of the things like I often talk about with patients when we are like having these like struggles around orgasm and pleasure is like yeah, like what other parts of your body are feeling good right now. Like estrogen tends to make your skin softer than or more sensitive. So like let's explore. Like you have the largest organ in your body, is your skin, like how, right? How, how can you incorporate that sensation and and I, I think,
Queer Doc (they/them): Also rate this shift in like it's really interesting because I think sometimes we think of some of these things of like stereotypes or tropes but like really the shift for most of my patients, right? When we start estrogen-based therapy is like visual stimulation becomes less important and mental stimulation becomes more important when they're like engaging and and see pleasure. Right? And like for testosterone-based therapies like people do become a little more visually stimulated which is just like again like Binding your pleasure where it is not necessarily where it was in the past.
Queer Doc (they/them): I think is just like an interesting journey for patients as they explore or their ways. Everyone like, one of my partners started testoster and they were never really into my boobs. Like it wasn't a huge thing for them. Historically, hadn't been significantly into boobs and then like started testosterone therapy and like could not look at my face when we were having conversation. Like, literally, I'd be like, I mean, like, I'm up here, like we're talking we're talking and, and it's just interesting because I do think sometimes we talk about socialization and we talk about,
Queer Doc (they/them): stereotypes and like some of these things do seem possibly rooted in some of the effects of hormones on our brains, and I feel like we're getting into like a very Touchy subject. And I am wondering what kind of comments I'm gonna get about about this this conversation…
Katherine Yagle: this is,
Queer Doc (they/them): but but
Queer Doc (they/them): again, I think Working with the clinician rate, who is giving someone permission.
Queer Doc (they/them): To explore that and to just follow it, where it is. And and to, like, work through
Queer Doc (they/them): Some of the baggage we all carry around those kind of messages from society or from our family of origin or from trauma, or from previous partners. And right, I think, I don't know. I I am not by any means a therapists or…
Katherine Yagle: Yeah.
Queer Doc (they/them): a healer in the way that you are. But I find so often so much of what like My patients are my community.
Queer Doc (they/them): Really wants. Is that permission and that safe space, right? and…
Katherine Yagle: oh,
Queer Doc (they/them): none of us really mean that permission in the context of like,
Queer Doc (they/them): you get to, you know, be who you are but like to have that affirmation from someone another human. Like we are like social creatures, right? Like and it's so important. And so to have someone who's really like Here for this work, present for this work and creating this space. For this work for you just has to be so powerful for your clients.
Katherine Yagle: yeah, just for being witnessed and being yeah. I've always like one of the things that I love most about circuit partner therapy, is the that I'm accompanying my clients on their journey. Rather than like I'm a practitioner and their client and you know at the beginning I think the work inevitably is a little bit structured in that way because I have the tools and I'm teaching them. But by the end and I talk really explicitly about this with my clients is that the end of the arc is that we want to really be peers, you know, we want to be doing this together. So even very early on, I'm always offering clients choices. And we're using that Green Zone yellow zone red zone. Like, what feels safest? What feels edgy. Let's not rush through to the hardest thing. We don't need to dive into the deep end. We can wait gently into the water, even though we're not trained to do that under capitalism.
Katherine Yagle: And you know, and then by the end of the arc, we're really co-creating the sessions. So what do you feel like doing today? What do you feel like doing? You know, and we're choosing together?
Queer Doc (they/them): And how does the somatic partner therapy look different than the somatic?
Katherine Yagle: Hmm. Yeah,…
Queer Doc (they/them): Sex education? Let's explain that to our listeners.
Katherine Yagle: so I mean you know smex education is sort of an umbrella modality like I mentioned involved it evolved out of sexological body works. It's really rooted in this one, directional touch modality. Psychological bodywork is almost like going to the chiropractor are going to the acupuncturist but for sexual healing work, right? So somatic sex education, evolved out of that but it it really is an umbrella modality and so people come to it from all sorts of different backgrounds. There's therapists who are working with these tools. There's massage practitioners people who have done some attic experiencing and are now bringing this more sexual healing component. So we get pregnant with therapy. Arguably could fall under the umbrella of somatic sex education and certainly
Katherine Yagle: So many of the tools that I learned in somatic, sex education are ones that I wish I'd had from the beginning of my surrogate, partner therapy training, because I trained as a surrogate first. But in terms of the way I practice the two modality is the key difference for me is this partnership piece? So surrogate partner therapy. I am the practice partner and that's why we need a therapist as like the third leg of the stool is because it's really, really challenging to hold the role of the prep partner. And The role of the practitioner and obviously, to some degree. I'm always doing that a mentor of mine. Once said, When you're a surrogate partner at all times with your client, you're both dancing on the dance floor with them and you're in the balcony above watching them.
Katherine Yagle: Which is true, but that's really hard to do. And there are inevitably times that I'm gonna get triggered like my own bag, it's just gonna come up and, you know, my baggage is relevant, unlike a therapist, where I might be like, checking my stuff at the door or more in order to support the client and I'm a practice partner. I'm really bringing in my stuff. I'm gonna be like, you know, if I'm having a bad day and I'm not feeling very sexual, I'm gonna tell my client, I'm gonna be like it might take me longer to, like, get into a space where I want to connect physically today because I I'm going through some stuff, you know. Um and so that piece really requires a therapist there to support me to support the client and really to hold this container of like this is for healing, right? This is a This is goal-oriented work.
Katherine Yagle: When I'm in the semantics sex education role, when I'm like wearing my coaching hat, I'm the practitioner. So I'm not dropping into the partnership role unless that's like for a very contained specific activity that we're doing. I'm much more and there as a as a practitioner to support the client both modalities. Obviously hold the clients healing as the center the core thread of the work but they just approach it from these different ways.
Queer Doc (they/them): Yeah, I think. You know. I talk about.
Queer Doc (they/them): You know, I work with fourth year medical students and learners at other levels as well. But with my fourth year medical students, I talked about how hard the shift is for them from being a medical student to being a physician because up into the point of graduating medical school,…
Katherine Yagle: Mmm.
Queer Doc (they/them): you're success and your field entirely relied on you being the expert in the room and…
Katherine Yagle: Right.
Queer Doc (they/them): having the answer to every question. Right? Like we take challenging like examinations like rate, that is how we succeed, We get the answers right on tasks. Like that is literally all medical schools. Over supplication, but whatever. And then suddenly You graduate. And now you're a doctor. Whoo. And you're sitting in the room with another human and you are a expert, but you are not the only expert in the room, right? Because the other human in the room is the expert in themselves. And When you're trying to, like, deal with your own.
Queer Doc (they/them): Like a lot of things you'll have, you know I don't know if imposter syndrome is the right word because you're actually just really an experience. And like you know I feel like imposter syndrome is often when we and…
Katherine Yagle: Hmm.
Queer Doc (they/them): our experience we are well trained we are ready for a thing and then we still feel like we're not versus like when you're just new in your career like you feel like you don't know what you're doing because you don't actually know what you're doing and and that's that's okay. That is like the journey of, you know, an experience to experience but you're still dealing with all of that fear and doubt and insecurity in yourself and you feel like One. You've had this whole like, at least seven years where having the answer was the only way you succeeded. And so suddenly you're sitting across from someone and they ask you a question, you don't have the answer to and that like threatens your sense of self, your identity yourself worth your ego and you also probably have some fear that if you don't have the answer for them, they're gonna doubt you. They're not gonna like trust you, they're not going to feel safe with you. The therapeutic relationship isn't gonna like build
Queer Doc (they/them): I like talk about how important it is to like let go of that to let go of having that answer and to let go of that ego and just recognizing that like you are too humans in a room together. Right? And you're both experts in different things. And like, one of the most powerful and important skills, you will learn as a clinician is to say, like, I don't actually know the answer to that and right, and then the follow-up is, Um, this is the way I'm going to help figure it out, right? Like, I'm either I know someone who does know the answer to that, so I'm going to connect you with that person or, you know, give me a few weeks. I'm gonna do some research and we'll meet back and and we'll go over what I've learned.
Queer Doc (they/them): and just kind of how important that is like in our evolution and as clinicians. To be able. To really just be another human on a journey with another human and right where we are trying to help guide each other. And one of us isn't like the practitioner with the power and like a paternalistic system where I know what's best for you and right and I think
Queer Doc (they/them): you modeling that like you know I'm not having the best day and I'm not feeling so sexy like that is like such a learning opportunity for your clients. In so many ways, right? Because when they get to watch someone model like honoring their own body, honoring their own experience, honoring where they're at, and like it's gonna give them skills to do that when they're feeling that way. It's also giving them skills, like, how to respond to the people in their lives who are having those days, right? Like NSA space. I just think that's like such a powerful.
Katherine Yagle: Yeah.
Queer Doc (they/them): You showing up as a human as a partner, such a powerful like therapeutic encounter. I can only imagine…
Katherine Yagle: Yeah.
Queer Doc (they/them): because I feel, you know, the further I am in my career the more I bring that into my work as a clinician like, The better. That experiences are.
Katherine Yagle: Yeah, it is it's really powerful in it it's really unique in that offering. You know that I'm that's my role is to be the partner rather than to like hold the hold them as a practitioner and You know, for that reason I it is, I believe it is the most intense form of therapy. One can do, like, it goes so deep. Because partnership goes so deep. Physical and emotional intimacy with another human is one of the most vulnerable. States, you can access and we don't usually do that with our practitioners. You know, I get vulnerable with my therapist but not in the way that I do with my partners.
Katherine Yagle: Yeah, you know, I think that one thing I've really discovered, you know, so I've in the process of getting trained to somatic sex educator, you do you receive a lot of the work and through doing that. I've done a huge amount of my own healing and I also discovered I was like, Whoa, I don't think I could I don't think I'm ready to receive surrogate partner therapy like that's too. Thanks for me like.
Katherine Yagle: Some access coaching is a much more like accessible sort of like you could just hop in for one session we can like talk about what's coming up for you. We can do some gentle touchwork and feel into where your body's enthusiastic about touching where it's blocked but surrogate, partner therapy is like you're committing to, you know, usually about a year sometimes more of work of really intense. Like Go in deep. It hits on all your childhood wounding and trauma memories and like, if it's there it's coming up and sorry, a partner therapy so it's a, It's an intense commitment. And yeah, the partnership element is absolutely what's so powerful about it and it's what makes it so intense.
Queer Doc (they/them): Yeah. It's really um you know and you said your specific interests and passionism trauma healing as well as one of them and rate. We know transgender diverse patients and community and members. We all have higher rates of trauma than our assist peers, right? Like
Queer Doc (they/them): Even four times more likely to experience, physical violence was the last statistic I read on that. And then like, intermittent partner violence happens at higher rates. I want to think it's like, Um, and over, I want to say 70% of transgender diverse patients, have reported sexual trauma. It's like the statistics are very, very high. Um, so I hear the statistics and I still think sometimes they're like underreported because like, I don't know. Like personally,…
Katherine Yagle: You yeah.
Queer Doc (they/them): in my personal community right out of all of us, like I don't know. A member of my community that doesn't have At least one episode of sexual trauma. So like when we say 70%,…
Katherine Yagle: Totally.
Queer Doc (they/them): I'm like Oh no. 100%.
Katherine Yagle: We all don't all humans, like.
Queer Doc (they/them): Yeah. Yeah. so, and rate what like At one, thanks so much for explaining some of the work you do and helping our listeners. Understand and helping me learn more and Too. Yeah, let's dive in for our clinicians who I'm sure are wondering like, is this legal and is this covered under insurance like two of the like big questions. I'm sure people have and
Katherine Yagle: Yeah.
Queer Doc (they/them): And yeah. So My understanding of, well, I'm not even gonna try. Tell.
Katherine Yagle: Great questions. So yeah, unfortunately, it's not covered by insurance and that's something that I really would love to see change in the course of my career and there's a lot of movement happening around making these modalities. Like bringing them more into the limelight and Having trying fighting to get them, more accepted by like the mainstream clinical communities. So there may be shift around that and coming years. My strategy for now is to just offer a really really steep sliding scale so my highest paying spots are quite expensive and then I have some much much lower sliding scale spots for trans queer. Disabled clients and people of color.
Queer Doc (they/them): Yeah.
Katherine Yagle: So that's my strategy for now which, you know, still doesn't cover everyone. It's still costs money. So And the question of whether is legal, is really complicated one. You know, I think a lot of surrogate partners are like, yes, adamantly. This is legal to give like the more honest answer. I think it's an illegal gray zone and it really, I think it breaks it really breaks down to, like the culture of the place that it's happening. So I live in Massachusetts now. I used to live in California, I was trained in California, and in California, it's as good as legal. There's like a quote from Kamala Harris. Back in the day when she was the da of California saying that she believes this work is legal. There's a huge existing network of therapists to work with surrogate partners. And that's where surrogate partner, therapy trainings are based. And so,
Katherine Yagle: There's a very, very little risk out here where I live now. It's much more like Puritan State and I get asked about it a lot more. Um, I've consulted lawyers, I feel pretty risk free, but or I feel like very low risk in terms of the impact I think that The more. The the more that people see that this healing impacts of this work, the less it's questions, like the more media coverage of it. There is the more folks receiving this treatment the more widely accepted it is, but for me, You know, a really core part of the approach are bringing to this. Work is
Katherine Yagle: You know, I do identify as a sex worker and I really believe that all sex work is valuable and that the only reason we look at sex work as shameful and bad is because we think sex is shameful and bad. And if we didn't view sex, is this inherently taboo thing, then we wouldn't criminalize the folks who do that as their work. Um so I think sex work that is just for pleasure is so important and beautiful and I just happen to bring an approach that's much more focused on the therapeutic and the healing elements of this. But yeah, I think it all matters.
Queer Doc (they/them): Yeah, I think. Not only is sexy legal, right? Because
Queer Doc (they/them): the taboo is around sex but also like because of misogyny and like our culture and the people in power are terrified of, you know, Powerful film presenting people who are are most common sex workers, right? And so I think. I'm curious like the field like as a whole. How? Is there solidarity with like movements to? Yeah. Okay.
Katherine Yagle: You…
Queer Doc (they/them): That's not gonna be my guess.
Katherine Yagle: Yeah, which has a lot to do with why I've distanced myself from the Surrogate Partner therapy community.
Katherine Yagle: Yeah. You know, I think that in the early years when surrogate partner therapy was like really trying to make itself more of like professional which I also hate that word and there was a lot of like throwing sex workers under the bus to try to legitimize our profession, you know, which is awful. Especially, because so many sex workers are surrogate.
Queer Doc (they/them): Yeah.
Katherine Yagle: Partners, like people…
Queer Doc (they/them): Yeah. Yes.
Katherine Yagle: who come from that background have the skills to do this work. But yeah no no surrogate partner as far as I know has ever been prosecuted or like suit or anything like and so I think we're in a fairly safe arrow with it and most of the younger surrogate partners. I do find it really important to like be in solidarity with the sex work community, you…
Queer Doc (they/them): I hope.
Katherine Yagle: while. So like owning acknowledging the privilege we carry, that's we're much much safer than The average sex worker.
Queer Doc (they/them): Now. Yeah. And I think, let's just gently call in all of your community. That is not in solitary with sex workers and like, like look at History of marginalized people. Anytime like we, you know, Try to punch down like one. We look like f****** assholes and…
Katherine Yagle: Hmm.
Queer Doc (they/them): to, it doesn't serve any of the communities. Well, right? Like, It's like solitary and everything, right? It's like human rights for all of us or human rights for. None of us. Like, it's just
Queer Doc (they/them): Yeah. Yeah, I've been like, unrelated, I've been doing a lot of advocacy around telemedicine, prescribing because that's changing right now and definitely some of the people. in the field who work with transfusions are really like, Well, we shouldn't make special asks for our community and we should be kind of quiet. We don't want to like, put a target on this work and I'm like, What version of America are you living in? Because there is already a target, like, I get death threats, we get bomb threats. Like there's, there's the target one.
Katherine Yagle: Yeah.
Queer Doc (they/them): The target has already happened to win win and queer history, or any marginalized history has silence at like a federal advocacy level. Ever saved our lives. You know, like we have like such queer. History lessons of science, particularly coming out of queer history and violence killing us, right? Like HIV and…
Katherine Yagle: Yeah.
Queer Doc (they/them): AIDS, like the silence of the federal government, the silence of all of the people and power is part of why. So many this game and died, right? And so, I just like, Solidarity and everything like that and like, we're just going to have a little PSA here.
Queer Doc (they/them): And I'm like, also very thrilled that like, the person I had on as a guest. Has.
Queer Doc (they/them): Values that I'm like. So please to hear about and okay. all right, we talked about insurance coverage, we talked but I'm gonna imagine the therapeutic part in surrogate partner therapy where they're doing their sessions with their therapist like those are therapeutic sessions and so those are probably In their insurance plan, cover it, or if they're out of network, they can maybe get a super build like all the traditional stuff you do with mental health therapy.
Katherine Yagle: Totally, I require that my clients have already been working with their therapist for quite a while before they work with me. So they usually have their whole system down and then the therapist and…
Queer Doc (they/them): All that figured out.
Katherine Yagle: client usually just work out separately, how they want to deal with the, my cult, my one-on-one calls with a therapist. You know, sometimes I just do a quick call with the therapist or at the beginning of their session. So it's like within that insurance covered time.
Queer Doc (they/them): Yeah. Also like I don't know if this is true for therapists. This is something to look into for. Um, Me as a medical clinician. So, you know, most of my work is outside of the insurance based system as well and similar to you. We have a slighting scale and that's how how we approach it and and but one we we are we in Alaska, I work with a clinic, that's a little built insurance and so, um, I can actually build insurance for like phone calls to other specialists. Like I like, And I don't have to have the client there. I don't have a patient there like it's just like, you…
Katherine Yagle: You know,…
Queer Doc (they/them): there's a five minute call there's a,…
Katherine Yagle: that's great.
Queer Doc (they/them): you know, 10 to 15 minute call and so I don't know if you're mental health workers can do that as well as medical workers, but it's something for them to maybe explore,…
Katherine Yagle: Mmm. Yeah,…
Queer Doc (they/them): um, that that got more.
Katherine Yagle: it's cool.
Queer Doc (they/them): Coverage of that kind of thing. Got more expensive as televised and got more expansive. So it's definitely something, you know that has changed in the past. Few years worth looking into.
Katherine Yagle: Interesting.
Queer Doc (they/them): Yeah. Um, Okay, let's see. I know There was another question I wanted to yeah, like i, I feel like every time I talk to you, Know specialist. And
Queer Doc (they/them): The fields like when I ask like who should we think about referring or who she would think about recommending to this? Like a lot of times like right and I did it some work with a couple pelvic floor, physical therapist recently and it's like everyone has a pelvis and and but like in general,…
Katherine Yagle: Mmm.
Queer Doc (they/them): like, when would be, when we're talking to someone, when should be like, kind of the things that were like, Oh, oh, we're hearing this, we're hearing this, we're hearing this, this would be a good time to think about talking about this modality and a referral, you, or…
Katherine Yagle: Yeah, absolutely.
Queer Doc (they/them): someone in your field.
Katherine Yagle: Yeah, well, definitely. I agree everyone. All right like Yeah, I think specifically for somatic sex coaching everyone could benefit from it. God, I've benefited from it so much, but yes, specifically, I think of clients are expressing
Katherine Yagle: You know, questions about their sexuality or confusion around their body or like frustration, without their body is sexually responding, if they're having struggles, like, expressing their know, or knowing when they don't want to do something and they're feeling traumatized after sexual experiences, and or on the opposite side of the spectrum. If it seems like they're pushy in sexual experiences or not respecting other people's know, I think all of those could be good reasons to come to some XX education. I think a lot of people come just because they are seeking empowerment around their sexuality. They just want to find their voice and connect to themselves on a sexual level. Or improve their sex lives. So all those reasons I think are great. For surrogate, partner therapy.
Katherine Yagle: Most of the clients who come to me are in some way at the end of their rope and I think that makes sense given how much of a time and financial and emotional commitment. Surrogate, partner therapy is so that work, I recommend, I mean, I think it, anyone who is interested? It's worth a try, but I definitely recommend it for folks who are finding major blocks to being an intimate relationships and are just feeling unsatisfied with their romantic or sexual life.
Queer Doc (they/them): I love, I love that kind of
Queer Doc (they/them): parameters around, like, Kind of having someone who has tried many other things and really, that hasn't gotten them. The solution that they need because the investment in the work is high. I think that, you know, I'm in recovery and I think that's something like we often talk about in recovery, right? Like you, I'm specifically on top program. It's like you don't come into the rooms of AA like, because you're doing real great having a good day.
Katherine Yagle: Totally. Yeah.
Queer Doc (they/them): Um, right. And I think one of, you know, I think one I've worked in addiction medicine. I think there are many past recovery. I do not think I told supper absence Base program is the only path. It's just the path of his word for me and…
Katherine Yagle: For sure.
Queer Doc (they/them): I want to be very clear about that and to write like, the work we do in a 12-step program is like Pretty intense, right? It's a program based on rigorous honesty and…
Katherine Yagle: All right.
Queer Doc (they/them): you have to learn how to be rigorously honest with yourself first, which is like Real f****** hard.
Katherine Yagle: Yeah. Yeah. Mmm.
Queer Doc (they/them): And right. And so, a really like, Not having a lot of other options makes that work more tolerable. Right. And so if I've exhausted the other options, like it makes kind of like, as you were saying,…
Katherine Yagle: He's your commit to it.
Queer Doc (they/them): You're not really? Yeah, you're not really ready for circuit partner Eric.
Katherine Yagle: So time. Yeah. Yeah.
Queer Doc (they/them): It's really intense. And so
Katherine Yagle: And yeah, I think the, I think the kind of defining feature that often most often were therapists or clinicians refer clients to me, is there like I can't help you pass to this point. We have talked about this.
Queer Doc (they/them): Yeah.
Katherine Yagle: I've encouraged you to try dating apps and go on dates and try Meetups and Boulevard and something is just not lining up for you. You need hands-on practice and that is where they end up referring to me.
Queer Doc (they/them): Love it. I love that extra. Yeah. Okay, I love this. and I feel like, I only had two booked for an hour and we're like there, but I have a couple more questions…
Katherine Yagle: I didn't. Sure. I can probably do another 15 minutes.
Queer Doc (they/them): if you have time, but if not, I'm happy to let you go. yeah, I just wanted to like very specifically touch on kind of how because I know you're specifically, I know you're doing work in this area but also like, I am trying to bring this up with all of my gas like how your work is. honoring like intersectional identities and like you've mentioned already you enjoy and you've done a lot of work with people with disabilities and so like very specifically like you know the most marginalized people in our community are trans people with intersectional identities, black trans people, that trans people disabled, trans people people who have all of those intersectional identities and so You know, kind of how does your work support that and, and where has that journey been for you?
Katherine Yagle: Yeah, totally. Yeah. So I mean systems of oppression are so deeply tied up in healing work, right? I mean, we talk about how we can. None of us can heal if the system is completely broken. So like, you know, if you Individual self-work as like the personal manifestation of like, social justice and antidepressive work.
Katherine Yagle: And so, I've always viewed those two as an inherently tides. And it's always struck me as so odd that in so much of the healing and like, wellness community. There's this, like, it's all you, like, almost like a pull yourself up by your bootstraps mentality, but in like a very, woo way. Right? It's like just manifest, it like manifest. Well, then it welcomed not. I like, I use that language. Like, I'm not opposed to it but like, yeah. There's like a spiritual bypassing kind of effect that I find in a lot of these communities of, like, Yeah, it's just about finding your inner light and then you can make it happen and that like really denies and gaslights the existence of all these structures that make that really hard that make healing and accessing pleasure. And joy, really really challenging for so many people.
Katherine Yagle: So yeah, I From the beginning of my practice. And I mean, I you my former career was in food, justice work. And I worked on like urban farms. That was in, like, the food movement was really my whole field before this when I made the switch to this. it was not from a lens of like, Self-work. It was like, how do we solve structural inequities and sex and sexual healing. Just happens to be the lens because of my own trauma journey. That speaks to me and that has like always called my passion.
Katherine Yagle: Yeah, I've been continuously frustrated in this field. How little that is the case amongst many, many of my peers. And it has led me to leaving behind many of the communities that I've been part of somatic. Sex education is probably the most explicit of any of the trainings I've taken in. Incorporating systems of oppressed systems of oppression awareness and like Anti-oppressive practice into its curriculum, but it still has a long way to go and the three the three founders of the program are all white and they're all queer, but so it's great and like, gender and sexuality stuff, but it's like lacking in a lot of like racial and stuff, and they're really trying to build that out. But, but I took a step back from that because I was feeling so frustrated. So, I've kind of continuously encountered.
Katherine Yagle: Frustration in this field while trying to incorporate it into my individual practice. I've built like a big piece of being sustainable sustained. Spiritually in the work of antipressive practice in my in my practice is Building community who's, like values. Aligned with me in that. So, I'm like amazingly blessed to be, just so supported by peers who. Who's I didn't who's value systems align with my own? So I think for me it's about kind of like accountability practice and staying in check. I'm in a like a regularly meet with a group of other white sexual, healing practitioners who are working to unwind our own internalized racism, through sematic practice. I have a peer who I have a super, like a peer supervision call with each week and we just, like, talk through whatever we're struggling within work and kind of, you know, hold each other in both support and in accountability,
Katherine Yagle: And yeah, you know, I mean, in terms of how that shows up in my practice, it's something that I'm talking about with my clients. I offer this really steep sliding scale, so my practice is really diverse, which keeps it engaging and rewarding for me for sure. I almost burnt out a couple years into my practice because I was working with almost exclusively white cis, men. And I was like, I got it. Change it up. So I did through a lot of conscious effort. but yeah, those are some of the ways that that shows up in my practice
Queer Doc (they/them): and I think one of the things you that, Just really want to like call the importance of it, for our listeners. Like one, if you don't have intentional practices in your own work, as a clinician that really center on internal work around anti-racism antirepression. maybe consider like, changing that like, maybe consider actually incorporating some intentional components there and and I think, In medicine, we love like a one hour training and feeling like we've accomplished something in the work is done. And I think Katherine just demonstrated an incredible lifelong commitment, right? Like these systems Are something we interact with every day of our lives. And so a one hour training is not enough to undo them because they're
Queer Doc (they/them): Here every day,…
Katherine Yagle: Totally.
Queer Doc (they/them): every moment, every minute and so like, when just like the intentionality Katherine is bringing to that. I think it's something like we could all strive to incorporate in our work as clinicians. And I think to the other thing that I heard you say that like I feel like mirror, some of my own experience in my career, is that
Queer Doc (they/them): You didn't say it this way. This is how I have experienced this sometimes, right? Like when I'm in a room with other clinicians who I often Right? When I'm in a room with like general practitioners, I don't necessarily anticipate having a lot of shared similar values or like being on the same page a lot of times like you know, because I know like a lot of general practitioners like don't even understand my work, right? But when I'm in a room full of clinicians who Audio. Gender firming care who are all like I tend to think like on the same page around a lot of values as me. Like I so often still feel like very other. Like I still feel like everyone in the room is over here and I'm over here going like but wait why? And and I think
Queer Doc (they/them): You know, I've had that moment and advocacy lately where people are saying like, maybe we should be quiet and I'm like over here shouting and screaming. And I'm like, I don't, I don't think now is the time to be quiet, and I think two things always happen for me when I'm having that. Women of Otherness like one. I think it's a really good time to stop and examine like is this otherness?
Queer Doc (they/them): Because I have just like, made up some weird. maybe unfactual or inaccurate like Theory in my head, about healthcare or advocacy or whatever, right? The topic is like Am I actually wrong? Like, if everyone else is saying I'm wrong, Am I actually wrong? Like This is a really good time to examine that. Um, and I think Katherine really pointed out. One of the ways we examine that is, we do surround ourself with other clinicians who share our values, right? Like, I always say surround myself with people admire and all, if I surround myself with people, I admire all become someone, I admire, right? And so really check in with them. Like, am I off base here? Am I, the person who's wrong? And then
Queer Doc (they/them): I think what the other thing you're saying is about is like What I have often found, is that? I am I'm not wrong, right? Like, what is happening,…
Katherine Yagle: oh,
Queer Doc (they/them): is my values aren't necessarily aligned with the values of everyone else in the room. And so it's so important that I do intentionally build a community that shares those values. And so that I don't burn out or feel gaslighted or like really lose sight of of my values, right? I don't know that, I said that exactly how I was planning on saying it, but I think, And we just pointed out from like, really important things. For all clinicians, not just clinicians in your field. All humans.
Katherine Yagle: Yeah. Yeah. True. Yeah.
Queer Doc (they/them): Yeah. Thank you so much for coming on today and getting a little extraction with me.
Katherine Yagle: Yeah, thank you for hosting.
Queer Doc (they/them): And like educating all of our clinicians. I'm super excited to
Queer Doc (they/them): try to like, keep this in my bank of brain like, you know, When a client is talking to me, when a patient is talking to me like Oh maybe this would be a good time to think about this. And having having this encounter with you will definitely help with that. And I hope a lot of our listeners as well. And I wrote down all of our resources and including Katherine's website. It's y'all If you have questions Katherine, are you okay with people reaching out to you on your website?
Katherine Yagle: Oh yeah,…
Katherine Yagle: please totally.
Queer Doc (they/them): Cool. Sweet,…
Queer Doc (they/them): awesome. Thank you. Much.