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Sex therapy is a specialty within therapy that focuses on addressing issues related to sexuality. While sex therapy is considered a specific subset of care, it's incredibly diverse with different providers, themes, topics, approaches, interventions, and outcomes.
As a field of practice, sex therapy has expanded to meet the broad spectrum of identities and experiences within human sexuality. Additionally, sex therapy works with the realms connected to human sexuality: Culture, political climate, religion and spirituality, intersectionality, region, and so on.
When we hear the term 'sex therapy,' issues regarding sexual activity and intimacy come to mind. These issues may include the following:
Common sexual and reproductive concerns include: Painful sex, concerns with orgasming, and concerns with sexual interest and arousal. People experiencing sexual and reproductive concerns are impacted by several factors (physiological, psychological, and sociocultural.).
Kink is an umbrella term to describe a range of sexual identities, erotic behaviors, sexual interests and fantasies, relationship identities, relationship orientations, and relationship structures between consenting adults not accepted by the dominant culture. While more than 50% of US relationship-systems have expressed interest in at least one aspect of kink culture, kinky communities are highly stigmatized and pathologized by society.
Relationship-systems commonly benefit from working to deepen intimacy, cultivate more meaningful and effective communication, process issues that may be impacting partners' experiences with one another, safely explore shared sexuality, and establish boundaries. A common reason relationship-systems initially seek help stems from an infidelity that has occurred by one or more partners in the system.
Consensual nonmonogamy (CNM) refers to the practice of engaging in romantic, sexual or other intimate relationships with more than one person. Polyamory refers to the practice of bonding with more than one person. Polyamorous refers to a sexual identity of being attracted to and/or longing to bond with more than one person.
Mismatched desire refers to the discrepancy between sexual desire and actual frequency of sexual activity. Mismatched desire is a common experience in relationships and may be negatively impactful on a deeper level when at least one partner is experiencing mismatched desire-related distress.
Clients reporting problematic sexual behaviors have always been underserved by clinicians. In recent years, a number of providers have proposed a treatment that views out of control sexual behavior (OCSB) from a sexual health lens as opposed to one steeped in pathology, religiosity, and/or moralistic views of sexuality.
However, sex therapy encompasses everything in the realm of sexuality, which may include the following:
Intersectionality, coined by Kimberlé Williams Crenshaw, is an analytical framework for understanding how aspects of a person's social and political identities combine to create different modes of discrimination and privilege. These identities include gender identity, race, religion, and disability. While inequity exists in every relationship, relationships holding diverse identities are more vulnerable to internalized forms of oppression and external discrimination.
Sexuality plays a significant role in each human developmental stage. However, cultural and moral beliefs limit how sexuality is treated and expressed based on age, gender, race, ability, class and other identities.
Sexually diverse people in identity and expression have been historically discriminated against, dismissed and erased from the sexual narrative in Western societies. Sexually marginalized communities include people engaging in sex work, polyamory, consensual nonmonogamy, kink/BDSM communities and people existing in large or fat bodies.
The 2SLGBTQIA+ community is broad and diverse, including sexually and gender diverse people. I work with clients to help them explore their sexuality and gender, ranging from identity to expression, to transitioning, pod-mapping, cultivating family support and accessing affirming healthcare and community services.
Common themes that arise include: Supporting sexuality through an access-centered lens, expanding sex education, exploring sexual identity and expression while combatting that stigmatized ways disabled people have been pigeon-holed within sexuality (abuse/victimization, purity, etc.); and unpacking ways that ableism and erotophobia stop disabled people from developing and maintaining intimacy/relationships.
US society stigmatizes and tries its best to prohibit sex-positive education with children. However, this does not diminish the importance and responsibility of caregivers to support their children through a sex-positive lens. I strive to destigmatize discussion of sexuality and sexual health between generations. I encourage age-appropriate, empowering, respectful and informative sex education for all family members, regardless of age and role.
Shame can impact sexuality in many ways, including sexual dysfunction, performance anxiety, out-of-control sexual behavior, concerns with sexual organs, sexual expression and interests, as well as gender and sexual identity. I work clients to help them unravel shame from their sexuality. I strive to destigmatize sexuality and sexual health while helping clients develop sexual integrity and acceptance.
Like many other aspects of human experience and identity, body image is deeply embedded in sexuality. Working to build an empowering, safe relationship with our sexuality commonly asks for our attention to our relationship with our body, and intuitively, our body image. I work with clients to support them on their journey of body liberation, respect and self-acceptance. I work to dismantle and dispel fatphobia and diet culture with clients.
The American Association of Sexuality Educators, Counselors and Therapists (AASECT) is a not-for-profit, interdisciplinary professional organization. With its history of impeccable standards for training, experience and ethical behavior, AASECT is increasingly recognized as the guardian of professional standards in sexual health.
AASECT affirms the fundamental value of sexuality as an inherent, essential, and beneficial dimension of being human. In general, AASECT opposes all psychological, social, cultural, legislative, and governmental forces that would restrict, curtail or interfere with the fundamental values of sexual health and sexual freedom that we espouse. AASECT also opposes all abuses of sexuality including, but not limited to, harassment, intimidation, coercion, prejudice, and the infringement of any individual's sexual and civil rights. (AASECT, 2023)
AASECT Certified Sex Therapists are licensed mental health professionals, trained to provide in-depth psychotherapy, who have specialized in treating clients with sexual issues and concerns. In the absence of available licensure, they are certified, registered, or clinical members of a national psychotherapy organization. Sex therapists work with simple sexual concerns also, but in addition, where appropriate, are prepared to provide comprehensive and intensive psychotherapy over an extended period of time in more complex cases.
To become a Certified Sex Therapist through AASECT, a mental health professional meets education, licensure, training (human sexuality, specific sex therapy, attitudes/values/biases), supervision and experience providing sex therapy services over a minimum of 18 months. (AASECT, 2023)
All AASECT-Certified Professionals have completed a minimum of 90 hours of academic coursework and/or continuing education in sexuality in human sexuality. Furthermore, AASECT-Certified Sex Therapists have completed a minimum of 60 hours of training in specific sex therapy treatment.
Finally, AASECT-Certified Sex Therapists have participated in a minimum of 14 hours of structured group experience consisting of a process-oriented exploration of the applicant's own feelings, attitudes, values, and beliefs regarding human sexuality and sexual behavior. These group experiences are commonly referred to as Sexuality Attitude Reassessments (SAR). (AASECT, 2023)
AASECT-Certified Sex Therapists have completed a minimum of 50 hours of supervision with an AASECT-Certified Supervisor of Sex Therapy. This Supervision relationship lasts for a minimum of 18 months, and includes both individual and group supervision.
Furthermore, AASECT-Certified Sex Therapists have completed a minimum of 300 hours of supervised clinical treatment of clients who present with sexual concerns. This clinical experience exposes AASECT-Certified Sex Therapists to a variety of sexual concerns, themes, and topics with a diverse array of clients (both individual- and relationship-focused).
Individual care is done on a one-on-one basis. Our work may include: Expanding your perspective on sexuality and sexual health; processing past experiences and beliefs; strengthening your support system; exploring the interpersonal, community and societal impacts on your health and sexuality; gaining support in accessing 2SLGBTQIA+ affirmative healthcare; gaining support during life transitions that may impact your sexuality.
Our work may involve participation with two or more family members, biologically-related and/or chosen. Our work may include the following: Helping family members to accept and become aligned with your identity, needs and goals; helping you to feel more confident in discussing sexuality and sexual health with your children and/or loved ones.
Our work may involve participation with your significant other(s), who may be sexual, romantic, or non-sexual in nature. Our work may include the following: Working toward deepened intimacy; cultivating more meaningful and effective communication; working through issues that may be impacting your experience with your partner(s); safely exploring your shared sexuality and establishing respectful and empowering boundaries.
Critical Race theory refers to collective critical views of how US macrosystems are inherently racist. Critical race theory rejects colorblindness and political neutrality and prioritizes dismantling white supremacy, which operates at the direct and persistent expense of communities of color. Queer theory focuses on unlearning conditioned beliefs and reimagining identity, wellness versus sickness, psychopathology, gender and sexuality.
Relational–Cultural therapy (RCT) is a form of therapy that emphasizes the importance and transformative power of our sense of self and our connection with others. RCT believes that humans naturally grow toward and through connection with others. RCT highlights the role our families, community and society play in forming our identities and beliefs about ourselves.
Attachment theory is a therapeutic perspective based on the role of attachment in our lives. Attachment is a deep, enduring bond that connects us to our loved ones across time and space. We are believed to have attachment-styles based on the quality of our relationships with our caregivers as children.
Transgenerational family therapy is a form of therapy that focuses on the interactions of family members across generations as a way of understanding current functioning and struggles and preventing those struggles from enduring in future generations.
Emotionally-Focused therapy (EFT) is a form of therapy that focuses on the value of engaging in emotional experiencing in the present moment. EFT believes that a safe, clarifying and meaningful connective experience has the power to heal and transform our senses of self and intimate relationships.
Interpersonal Neurobiology (IPNB) explores the adaptability, resilience and transformative power of our brains. IPNB focuses on our conscious mind, our relationships and our embodied brains. Our brains continue to grow and adapt across the lifespan, as they are capable of creating new neural pathways, or new ways of thinking and relating in our lives.
Mindfulness-based practices give us a chance to focus our attention on the present moment. When we engage in mindfulness, we experience our senses, thoughts, feelings and emotions, physical sensations, and behavior in a curious, compassionate and nonjudgmental way.
Somatic Therapy encompasses a group of therapies that view healing as a "bottom-up" approach that promotes mind-body connection and the inclusion of body-centered practices, movement, and embodied inquiry in mental health treatment.
Cognitive-Behavioral Therapy (CBT) is a form of therapy that focuses on the relationship between our thoughts, emotions, and actions. CBT can be a powerful tool that helps us to identify and transform potential disempowering beliefs we hold about ourselves and others that may be negatively impacting our quality of life.
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