Developing a Sex-Affirming Counseling Framework
The primary tool in addressing sexual shame with clients is the counselor’s ability to embody a sex-affirming stance within the therapeutic relationship. Notably, affirming beliefs about sexuality may not come naturally to counselors due to their own personal histories of sexual shame. Consequently, it becomes imperative for all mental health professionals first to examine their own beliefs, values, and biases about sexuality critically and consider how these attitudes may impact their ability to approach sexuality from a positive, empowering perspective (Wilson, 2019). Scholars have demonstrated how sexual beliefs that are rigid, rooted in conservative religious ideologies, and discriminatory in nature (e.g., sexist, heterosexist, transphobic) can be deleterious to affirming therapeutic relationships (Author, 2019; Bidell, 2014; McGeorge, Carlson, & Toomey, 2013). Thus, it is vital that counselors seek out opportunities to increase their sexuality knowledge and self-awareness through continued sexuality education, sexuality-focused supervision, peer consultation, and personal counseling (Author, 2020; Russell, 2012; Wilson, 2019).
A sex-affirming framework of counseling centers on the assertion that sex is a natural part of the human experience and offers important contributions to clients’ mental and emotional wellbeing, relational health, and overall life satisfaction. Counselors can exemplify a sex-affirming stance with clients by normalizing the topic of sexual discussion with congruence and comfort. Sexuality is also viewed as expansive, emergent, and pluralistic—that is, counselors acknowledge that sexuality is experienced in innumerable ways that are shaped by the client’s unique social, cultural, and environmental contexts. Although values related to consent, equality, and responsibility are emphasized, sex-affirming counselors also recognize that there is no one “right” kind of sexuality and that all individuals create their own meanings related to sexual morality. In other words, sex-affirming counselors regard all sexual behaviors occurring between informed and consenting partners as potentially healthy and beneficial forms of intimacy.
A sex-affirming approach to counseling is also responsive to multicultural diversity and intersectionality. Clients that possess marginalized identities (e.g., LGBTQ+ individuals, people of Color, people with disabilities, people from impoverished backgrounds) often face increased sexual health risks, such as decreased access to sexual healthcare and increased sexual stigmatization (WHO, 2011). As such, counselors must recognize how discrimination systems such as white supremacy, patriarchy, and cisheteronormativity inform societal values about sexuality, as well as how discriminatory sexual norms may impact clients’ sexual wellness. As each client possesses multiple identities that contribute to their unique position of privilege and oppression, counselors should explore the sexual health implications of their clients’ intersectional lived experiences.
Table of Contents
- Introduction
- Sexual Shame
- Factors That Influence Sexual Shame
- Deconstructing Sexual Shame in Counseling
- Developing a Sex-Affirming Counseling Framework
- Common Issues Related to Sexual Shame
- Addressing Sexual Shame in Therapeutic Settings
- Specific Strategies to Enhance Sexual Empowerment
- Referral to Specialists
- Attending to Countertransference
- Conclusion
- References