Recently, I saw an article titled “What Your Doctor Wishes You Would Ask About Sex”.  In it, I found some really disquieting statistics:

“Despite the countless ways sex saturates our culture — from overt mentions in music and on TV to ads touting male performance boosters — talking about sex mechanically and medically can be awkward, especially for women.

Studies show that anywhere from 40% to 75% percent of women have a sexual health concern, regardless of age. And other studies show doctors rarely ask about the issue or delve into details to answer patients’ questions.”

This reminded me of articles I had previously read about the difficulties many therapists have in talking about sex.  For instance, in “The Importance of Addressing Sexual Issues in General Therapy”, Dr. Sara Rosenquist stated:

“A whole lot of marital therapists are uncomfortable talking about sex, so they don’t ask or they don’t create the kind of climate in their sessions that would give patients the idea that they can talk about anything or bring up sexual issues”

The article goes on, explaining:

“She said for certain mental health issues, it can be likely that the clients also have sexual issues to address. ‘If a patient is on antidepressants, there is about a 67 percent chance that they have sexual side effects, such as inability to orgasm, which is very frustrating and causes people to avoid sex to avoid the frustration,’ Rosenquist said. ‘If one partner is depressed, there is a 50 percent probability that the other one is, too, and a high probability that the relationship is affected, particularly the sexual relationship.'”

Putting all of these articles together, many people have sexual problems but few of them are talking about it and those that do may encounter a therapist or doctor who is unable or unwilling to help them further examine that issue.  Why, in our sex-soaked culture, is opening our mouths to honestly and openly talk about sex sometimes the hardest thing to do?

Sex can be a topic fraught with shame, fear, and confusion and plagued by unhelpful assumptions. People in a relationship may have entirely different assumptions about what constitutes a healthy sex and these differences may lead to crossed wires and miscommunications.  In “The Importance of Keeping Sex in the Conversation”, Moushumi Ghose, MFT, explains:

Pervasive in our society is the inability to talk about sex, awkwardness, and embarrassment, which in turn leave us often bereft of the coping skills required to handle sexual issues in our relationship as they come up. When we avoid talking about sex with our partners, it can lead us down the path of avoiding talking about lots of other things as well. We all know that open, honest communication is key in successful relationships, so the absence of conversation and inability to talk about sex with our partners can be like a ripple effect in the breakdown of communication in a relationship.  And when we go to therapy and our therapist also doesn’t feel comfortable talking about sex, the therapist in turn perpetuates what society has taught us—that sex is too taboo to talk about.

These issues are why I propose one simple sounding, but difficult to execute, solution: Let’s talk about it!  Talking about sex while in therapy is particularly important because, as Ghouse puts is beautifully succinctly,

In treating relationships, sex must be addressed. Sex is not always everything, but in relationships it is definitely something.

Sex is a part of almost all intimate relationships.  Even in relationships between asexual people there may be differences in the level of physical intimacy each partner expects.  Barring psychic abilities, the only way to determine where both partners stand, what they want, what they need, and what makes their toes curl is to talk about it.

Many times when we first try to talk about something the words come out in a jumbled mess.  We may not have the vocabulary at first to express our desires or our concerns.  Yet this learning curve is no reason to shy away from these discussions.  At first, one or both partner(s) may feel uncomfortable or embarrassed; keep talking!  If one of you is still struggling with how to ask for what you need, keep talking!  If you’re in the middle of things with your partner and things aren’t working, keep talking!

If you’re finding you’re having trouble starting the conversation (or even knowing where to start), the guide found here may be a great tool for you.  If you’re still struggling, or if you’d like an impartial third party, working with a therapist to help the conversation along (either alone or with your partner[s]) can also be helpful.  Just remember, even when it’s a challenge, the short-term struggle is worth it for the relationship you’ll get in the end.

Let’s talk about sex!

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