Introduction

Introduction

Introduction

Over the last decade, topics related to sex and sexuality have experienced a resurgence. As counselors began to shift their focus away from the medical model, a new, holistic, sex-positive worldview emerged. The medicalization of sex therapy was replaced with a more salutogenic view of sexual health. The dominant model for sex-positive counseling focuses on achieving or maintaining sexual health (C. Murray, Pope, & Willis, 2017; Southern & Cade, 2011). Because sexual health is intimately linked to wellness across the lifespan (Flynn et al., 2016), the ways in which topics related to sex and sexuality contribute to mental health disorders are of paramount importance within the counseling profession. Although topics related to sex, sexuality, and intimacy represent important areas of foci within clinical and research areas, many mental health professionals lack basic competence and comfort to address sexuality issues (Harris & Hays, 2008; Russell, 2012) due to the complexity of these topics and lack of training in counselor education programs (Authors, 2019, 2020; Russell, 2012).

The construct of sexual health represents more than the relative absence of symptoms and considers opportunities to obtain sexual fulfillment (Southern & Cade, 2011). According to the World Health Organization (2002), sexuality represents a central aspect of being human and encompasses sex, gender identity and roles, sexual identity, eroticism, pleasure, intimacy, and reproduction (para. 7). While clients often seek counseling to address sexuality-related concerns (C. Murray et al., 2017; Southern & Cade, 2011), many counselors struggle to address these issues in ways that produce meaningful change (C. Murray et al., 2017). Given the expansive definition of sexual health in combination with the apparent need to increase counselor competency in this area, counselors are called to develop a sex-affirming counseling framework and learn strategies to address sexuality concerns successfully within the therapeutic setting. The authors define a sex-affirming counseling framework as a therapeutic relationship characterized by unconditional acceptance and celebration of salutogenic human sexuality wherein clients are empowered to achieve a worldview about sex, sexuality, and intimacy without the presence of sexual shame. The following article identifies contributing factors to the development of sexual shame including the influence of religious messages, social messages, and sexual trauma. Next, the importance for deconstructing sexual shame in counseling is described. Specific strategies to help counselors develop a sex-affirming framework and common issues related to sexual shame are provided. The article concludes with ethical considerations as they relate to referring clients to specialists and feelings of countertransference.

Introduction

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