In our sex-shaming and sex-phobic culture, it’s important to find a sex-positive therapist who can provide a safe haven allowing you to explore your creative sexuality and your diverse relational interests. Differences are not disorders, and many health care providers and therapists think in terms of “health as normalization and conformity.”
Many clinicians sling around popular terms without truly exploring the problematic values they stem from and reinforce. Mental health diagnoses, like most norms in our culture, are built on white male cis-hetero values. Explaining health in these specific terms stigmatizes all minorities.
There was a time when psychology saw masturbation, homosexuality and transgender identity as disorders requiring therapy for elimination. Hopefully we are moving towards a place where we see that differences are not disorders but strengths, and that sexual diversity is a healthy and beautiful part of life.
When you’re in the market for a sexually healthy, sex-positive therapist, here are 12 valuable questions to ask them:
1. How many hours of training in human sexuality do you have?
Many people in the mental health field are not sexually healthy — often they’re even worse than most. Academia has done a poor job of educating mental health students in sexology, sex therapy and human sexuality, with either no class requirements at all or sometimes only a pass/fail one-off class. Any training for sex-related therapy tends to be via specialized programs outside the university system. Some it is good, some of it isn’t.
2. How do you feel about porn and sex work?
There are therapeutic uses and health in porn. Like all forms of art, it has different capacities, and studies show that cultures with permissive attitudes towards sex and porn have less sex crimes, lower rates of teen pregnancy and lower rates of STDs. Watching body-positive and more ‘female gaze’ porn can increase body esteem for non-normative bodies, can help find new ways to be sexual, gives sexuality to single people, helps those with a higher sex drive and reminds people that solo sex is not owned by their partner.
The assumption that sex workers are sex trafficking victims or “broken” is far from true. The mental health issues with sex work are related to the social stigma they face, a lack of cultural support and sex shaming. These revolutionaries are a needed social counterbalance and teach us all what sexual autonomy and freedom look like, and a sex-positive therapist knows this.
3. How do you feel about non-monogamy and casual sex?
You were probably taught that sex was always between only two people in a monogamous relationship, and that the main goal of sex and dating was to work toward marriage and reproduction. Healthy sex and relationships can be open, non-monogamous or poly. They can be about fun and companionship, and can be short-term with nothing committed in mind.
4. Have you worked with trans clients?
Various gender presentations and diverse bodies exist, and not everyone’s gender exists within the male/female binary. Most intake forms still only offer two options for gender, and offices still have segregated bathrooms. Some clits are called dicks, and some men have vaginas and give birth. The real disorder is in seeing gender as solid and fixed, with a gendered brain, and in not challenging gender roles and gender norms (especially within sex, dating and relationships).
5. Have you worked with the LGBTQIA community?
A sex-positive therapist supports and promotes dating and sex with all genders, bodies and sexualities. A sexually healthy therapist has the ability to discuss non-penetrative sex, sex with strap-ons, anal, fisting, PrEP, sex apps, same-sex parenting and avoids bi-phobia.
Most therapists use a heteronormative model with non-hetero clients. There is no “gay psychology” or “gay psyche”; intersectionality teaches us that no one leads a single-issue life, and that other identities determine many vast differences. No one’s identity should be reduced or seen as only about their sexual attractions.
6. What types of sex do you consider dysfunctional?
Not only with the use of the sexually abusive term “sex addiction,” the mental health field still devalues sex as legitimate intimacy building (“have less,” “wait to have it”) as an appropriate form of “self soothing,” entertainment or work, and it ignores how sex can be therapeutic and healing.
Healthy sexuality is about a variety of options and full confidence in diversity of sexuality, including BDSM and kink. Sexual minorities do not need to honor cultural majority puritanical definitions of how they should exist in the world, especially not sexually, in order to be seen as healthy.
7. Are you a sex-positive therapist? Please explain what that means to you.
Your worth is based on your character and whether you improve the world by being in it. It is not based on your sexuality (unless it’s unethical or non-consensual). In fact, having more sex makes you healthier and more authentic because of the psychological work it takes to be sexually confident in our culture. Your therapist needs to know that the real issue is often not sex; it’s cultural anxiety and suspicion around sexuality.
8. How do you define female sexual empowerment?
The suspicion of anyone who enjoys sex openly, has a lot of sex or prioritizes sex is so great that most of us immediately problematize it without any critical exploration, especially for women. Health can mean having as many sex partners as you want. There is no “correct” amount of sex to have, but slut-shaming runs rampant, and hearing about a woman having too much sex or too many partners upsets a lot of people.
9. What role does masturbation play in healthy sexuality?
Sex is one of the best ways to self-soothe, cope with difficult emotions and stress and to entertain oneself (or others). If it’s healthy to read a book, do yoga or play basketball with your buddies, it’s the same for sex. Daily masturbation is good for your psychology, your pelvic floor and your mood. Masturbate more and often (but do it right)!
10. Do you support the idea of more than two genders and self-identification?
Gender is not only a social construction and not real, but gender norms and gender roles — along with concepts like a male and female brain or psychology — problematically collapses highly complex and diverse ways of being, along with multiple intersecting identities, into one monolithic identity. There are infinite genders, along with infinite labels, and every person gets to decide on their gender, its label and then have it respected and celebrated. Your sex-positive therapist should understand this.
11. Do you support bisexuality, asexuality, solo sexuality, sexual fluidity and fetish sexuality?
As a sex-positive therapist, I work with clients needing confirmation that it is OK to be asexual, solo sexual (interested in masturbation only), pansexual, fluid and into objects rather than people because not all of the mental health world knows that “difference is not a disorder.”
12. Do you support or use the “sex addiction” diagnosis or treatment model?
The “sex addiction” diagnosis has become a wastepaper basket for all non-normative and relational sexuality. I have worked clinically with many patients who spent years in sex addiction treatment, and our work becomes about deprogramming all the sex shame instilled in them. The sex addiction treatment model proposes all monogamous and hetero values as healthy sex and ignores other sexual minority norms and values (masturbation, porn, kink, hooking up, sex worker use and sex for emotional regulation). This is sex shaming, bigotry and sexual abuse.