Group of people laying in circleSeveral years ago, sex advice columnist Dan Savage coined the term “monogamish” to refer to long-term committed relationships that bend the rules of monogamy with the consent of both parties. Since that time, he has published thousands of letters from people in monogamish relationships, thanking him for giving them permission to try an arrangement that works better for them.

Last year, Showtime began airing a reality show called Polyamory: Married and Dating, which takes a close look at the lives of polyamorous people. Polyamory is the practice of loving more than one person at a time. The show stars a polyamorous triad—three people in a committed, long-term relationship—and a polyamorous married couple who have serious committed relationships with people outside of their marriage.

Both Savage and the participants in the Showtime series have experienced some backlash for their advocacy of nontraditional relationships. But when nonmonogamous relationships are loving and consensual, participants in them believe they can strengthen marriages, serve individual needs, and increase intimacy. Unfortunately, people in these relationships often face immense stigma and even legal problems propelled by myths about nontraditional relationships.

Myth 1: Nonmonogamous relationships are a free-for-all.

People who cheat on their spouse are, technically speaking, not in a monogamous relationship. But when nonmonogamy is entered into openly and on a long-term basis, all partners typically obey a variety of rules. In Showtime’s show, the polyamorous triad navigates the consequences of one member breaking the rules, and the result is increased communication. Nonmonogamous relationships don’t work without rules, and often the discussion and renegotiation of these rules can contribute to deeper intimacy.

Myth 2: Nonmonogamy is an excuse to cheat.

By definition, nonmonogamy means that people don’t have sex with only one other partner. But this does not necessarily mean they can have sex with anyone. Successful nonmonogamous couples establish strong rules about what is and is not cheating, and frequently have veto power over who their partners sleep with. While it’s certainly possible for one partner to be pressured into nonmonogamy, these relationships generally don’t work unless both partners enter into the relationship willingly and lovingly.

Myth 3: Nonmonogamy is bad for children.

With the divorce rate in the United States hovering around 50% and the number of single parents rapidly increasing, most children see their parents involved in multiple romantic relationships over a lifetime. So long as children have consistency in their caregivers and are not subjected to an endless parade of people to whom they become attached and who then leave, nonmonogamy is not harmful. Nonmonogamy, after all, does not mean an abandonment of all social mores and norms, and nonmonogamous parents are just as capable of keeping their sex lives private as monogamous parents.

Myth 4: Nonmonogamy harms women.

Well-publicized cases of polygamy abuse are often the first things people think of when they consider nonmonogamous relationships. But modern nonmonogamous relationships are consensual for all parties. In these arrangements, it’s not just men who get to sleep with other people. Given that more women than men report being bisexual, nonmonogamy can provide a healthy sexual outlet for bisexual women who might not otherwise have such an outlet.

Myth 5: Nonmonogamy harms marriages.

Many people involved in monogamish relationships have been married for decades. When one partner’s desire wanes, nonmonogamy can provide a sexual outlet that sustains the marriage. Because nonmonogamy must be carefully negotiated and constantly reevaluated, these arrangements can bring married couples closer together and encourage open, honest dialogue. Sleeping with other people also does not have to compromise the marital bond. Married couples sometimes have sex with friends periodically while still sustaining their primary commitment to their spouses.

References:

  1. Polyamory. (n.d.). Alternatives to Marriage Project. Retrieved from http://www.unmarried.org/polyamory.html
  2. Savage, D. (n.d.). Monogamish couples share their stories. Washington City Paper. Retrieved from http://www.washingtoncitypaper.com/articles/42014/savage-love-monogamish-couples-share-their-stories/

GoodTherapy | Sex, Lies, and Visual Stimulation: Debunking the Myths About MenAsk any armchair psychologist whether men or women are more sexual, and you’ll likely get an absolute proclamation that men are more visual, think about sex more often, and have more partners. These “facts” play into cultural mythology, that ties manhood to sexuality, and treats women as the fairer, less sexual sex. But research is increasingly showing that the things we all think we know about men and sex just aren’t true.

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Thinking About Sex

Many of us have heard the claim that men think about sex every seven seconds or every 15 seconds. But this statistic may be little more than a myth. A 2011 study found that men think about sex, on average, only 18 times a day—several thousand times less frequently than popular statistics claim. In fact, men think about sex only slightly more than they think about sleep, which crosses their mind 11 times a day, and as frequently as food, which also makes an appearance in their thoughts 18 times a day. But, according to the study, men still tend to think about sex more frequently than women. The women in the study thought about sex about 10 times a day, with individual numbers ranging from zero to 140 times daily. Individual men, by contrast, thought about sex between zero and 388 times each day.

Number of Sexual Partners

Men tend to claim more sexual partners than women, but upon careful examination, statistics on the lifetime average number of partners fall apart. Unless more men than women are gay or are having sex with a few of the same very sexually active women who aren’t represented in surveys, the averages for men and women can’t differ so dramatically. Several studies have shown that men are more likely to inflate their number of partners, while women are more likely to shave a few off the top.

Desire for Adventure

One famous study asked men and women if they’d be willing to sleep with an attractive stranger. A large portion of men said yes, while few of the women did. This study is often used to support the idea that men crave multiple sexual partners or new sexual experiences. But studies that ask men their desires don’t measure actual behavior. Men may say that they’re willing to sleep with an attractive stranger simply because this is the cultural expectation. Women may be hesitant to say that they’d have sex with a stranger because they don’t want to be perceived as promiscuous.

Are Men More Visual?

We’ve all heard that men are more visual than women, and this is used as justification for everything from looking at porn to ogling strangers. While most research does show that men are more visually stimulated than women, the interpretation of this data is much more complicated than it seems. One 2008 study, for example, emphasizes that sociological factors play a strong role in men’s visual stimulation. Men are taught from an early age to emphasize physical appearance, and the same study found that men tend to be more aroused by contexts in which they can objectify another person—a tendency that is probably learned.

Sex and Masculinity

Myths about men’s sexuality tend to stick around because they make sense in light of social roles and gender ideology. Although women are becoming increasingly sexually assertive, sexuality in women is still less acceptable than men, and women are often taught to feel some shame about sex; this can affect what they report to researchers and whether they share sexual thoughts. Sex-based myths can make women feel that sexual feelings are deviant and abnormal, and can support puritanical ideas about women and sex. But men are also harmed. Men who don’t meet masculine ideals by being hypersexual or craving multiple partners can feel less manly, while men who want a healthy sexual relationship with a single partner may feel pressure to engage in promiscuous or objectifying behavior.

References:

  1. Jordan-Young, R. M. (2010). Brain storm: The flaws in the science of sex differences. Cambridge, MA: Harvard University Press.
  2. Kolata, G. (2007, August 12). The myth, the math, the sex. The New York Times. Retrieved from http://www.nytimes.com/2007/08/12/weekinreview/12kolata.html
  3. Men more willing to have sex with stranger than females: Study. (2011, September 04). Indian Express. Retrieved from http://www.indianexpress.com/news/men-more-willing-to-have-sex-with-stranger-than-females-study/841459
  4. Men think about sex just 19 times a day – nearly as much as food. (2011, November 29). The Telegraph. Retrieved from www.telegraph.co.uk/health/healthnews/8924988/Men-think-about-sex-just-19-times-a-day-nearly-as-much-as-food.html
  5. Rupp, H. A., & Wallen, K. (2008). Sex Differences in Response to Visual Sexual Stimuli: A Review. Archives of Sexual Behavior, 37(2), 206-218. doi: 10.1007/s10508-007-9217-9

Girl sitting and talking with her motherI watch Lifetime movies. Yes, I help people get their lives back on the “straight and narrow” and be healthier with themselves, their emotions, and their relationships, but I still like to indulge Lifetime movies. That feels good to write!

The Pregnancy Pact is about girls who become pregnant. The issue makes the news, and a reporter tries to not just get the story but to also increase awareness about teen pregnancy. I recommend checking out Lifetime for the rest of the story.

The issue that I want to present today is parents’ responsibility to speak with their children about safe sex—abstinence, using condoms (if they do decide to have sex), and sexual health—and not just leave it to the schools.

It can be a scary thing to talk to your children about sex, but the reality is that they are going to ask because they are curious about their bodies and what they see on television. They don’t want to know that they shouldn’t have sex; they want to know why they should not have sex at a particular age. As a parent, it is part of your job to teach your kids about sexual health. I believe you get the picture.

There is a lot to think about, and no parent is ever truly “ready” to talk with a child about the “birds and the bees,” but again, it’s a necessity—and your child may, in fact, ask you. Of course, they will go to their friends, but they’ll come away with a lot of misinformation. You will give them the facts and help them make a healthy, well-informed decision. Yes, the child may still go out and have sex, but when he or she is informed with the pros/cons, the facts, etc., he or she can make a wiser choice.

When to Start
It’s best to start at a young age. My son will be 2 years old next month. At bath time, I show him how to clean himself, and he does a pretty good job. The other day, we had a conversation about him and Daddy having a penis, but not Mommy. That was it. I also said that only Mommy, Daddy, and a doctor would be able to see it, if needed. In the bath, we talk briefly about making sure our bodies are clean head to toe, and that’s one way to take care of our bodies.

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If your child is older, it might be good to ask what he or she knows about taking care of his or her body. This is part of sexual health, self-respect, and beginning to set healthy boundaries. Our bodies are important, and we need to keep them as healthy as possible.

What to Share
If the child is older, ask what he or she knows first, or what kids are talking about at school. Ask if peers are talking about who’s having sex, if there’s pressure, etc. This will help in pointing you in the best direction to help your child. Of course, if your child is in a sex-education class, and you have waited that long, use it to open up the discussion.

Be calm. Listen to what your child is saying. Observe how he/she is responding to your questions, the looks on his or her face. You need to know what he or she knows and what you will need to correct it, if the information is wrong. Try to limit your responses so that your child does not give you the glazed look on his or her face when you have said way too much or he or she is not interested anymore.

Share Your Beliefs
I grew up in church and was raised to not have sex before marriage. I grew up knowing what the Bible says about premarital sex, what my parents expected of me, and these things helped me develop my beliefs and standards about who I give my body to (or not). It also taught me to keep my kisses for people who are going to respect me and not just what I can give them.

That is definitely an important aspect of sexual health: teaching your child that his or her virginity is important, and whom they choose to have sex with may either take it or nurture it. Kids need to know that when they have sex, they need to make sure that the person receiving their virginity will protect it, respect it, and not take advantage of it.

I am not trying to stand on a soap box or anything like that, but the reality is that kids are having sex—a lot more than statistics will probably show, and sex is not to be used for random wants. Oral sex is often not perceived as “sex,” but it still involves the giving of oneself. There are feelings involved, even with a one-night stand. Whether you go to church or not, you have your own morality about sex, and all parents want their children to make healthier decisions than they did.

How Each Parent Can Help

There are many more points that can be discussed on this particular topic. I wanted to highlight that it is the parents’ job to help teach children about sexual health, potential diseases, and all that encompasses choosing to have sex. Sex-education classes alone may not be enough.

As a parent, you are very important in your child’s life, even if he or she is not going to admit that. Keep the discussion about sex open with your child. Keep listening. Give the facts. Be there.

Happy older couple outsideIn a world saturated with sexual imagery, appeals to the effects of sexual attraction, and arguments about the way sex affects society, it is difficult for some people to believe that not everyone harbors an interest in sex or feels sexual attraction. But asexuality undermines common beliefs that sexual feelings are universal. While there have always been people who felt little or no sexual desire or attraction to others, the concept of asexuality is relatively new.

Is Asexuality a Sexual Orientation?
It’s easy to confuse asexuality with celibacy or discomfort with sex, but asexuality is distinctly different. While celibacy may be a choice or a result of life circumstances, asexuality is driven by a lack of sexual attraction. People who are uncomfortable with or intimidated by sex generally still feel sexual attraction, even if they are unable to act on it. Asexual people, however, are not interested in sexual relationships with other people. They may still form long-term commitments and get married, but these relationships are typically built around mutual respect and affection rather than sexual attraction.

Asexual people frequently are faced with intrusive questions about why they are uninterested in sex, and some people point to the fact asexual people may later identify as a different orientation or may begin identifying as asexual after engaging in sexual relationships. Asexuality advocacy groups, however, point out that this does not mean that asexuality is not a distinct orientation. Heterosexual people occasionally engage in homosexual relationships, and some people change their sexual orientation later in life. Asexuality seems to function like other orientations, and people who identify as asexual emphasize the importance of respecting asexuality as an orientation, not a mental “disorder,” temporary choice, or product of sexual trauma.

The Path to Asexuality
There is a lot of sexual pressure in our culture. Many asexual people begin to identify as asexual only after having romantic relationships and sexual experiences. Sometimes asexual people have sex to please partners they care about, perhaps because of social pressure or because they haven’t yet learned to consider their own desires. The common denominator among asexual people, however, is no desire for sexual relationships.

This does not mean that asexual people aren’t affectionate or that they can’t engage in romantic relationships. Some asexual people show affection to their partners by massaging them, kissing them, holding hands, or participating in other nonsexual physical practices.

Asexual people who discover their orientation while involved in a romantic relationship often have a difficult road to navigate. There are a variety of ways to deal with disparities in sexual interest, and while some relationships end due to asexuality, partners sometimes agree to arrangements that allow both members of a couple to express their sexuality in a way that is comfortable for them.

Differences in Feelings and Expression
Asexual is not a type of person, just as heterosexual and homosexual people don’t represent specific “types.” The expression of asexuality varies greatly from person to person. Many asexual people experience strong attractions to others and enjoy spending time with specific partners. However, their attractions aren’t fulfilled by sexual interactions. Others experience regular sexual arousal, but feel no need to act on that arousal. Some asexual people find sex extremely off-putting, while others are simply disinterested.

References:

  1. Gordon, O. (2012, November 11). The moment I realized I was asexual. The Telegraph. Retrieved from http://www.telegraph.co.uk/women/9651265/The-moment-I-realised-I-was-asexual.html
  2. Overview. (n.d.). The Asexual Visibility and Education Network. Retrieved from http://www.asexuality.org/home/overview.html

For decades, research addressing the mental health of gay men has grouped bisexual and gay men together. This is a disservice to the LGBTQ community, and to bisexual men in particular. There are significant differences in behavior, identity, and attractions between gay and bisexual men. While gay men are attracted to other men and identify as homosexual, bisexual men can be attracted to either sex. And although it has been shown that disclosure of sexuality is beneficial to mental health for gay and bisexual men, bisexual men are more likely to conceal their sexuality than gay men. Therefore, they report lower levels of psychological well-being. This could be due to the fact that many bisexual men are in committed relationships to women and are torn between their desire for that relationship and their attraction to men. Or perhaps bisexual men are at war with their own homophobia.

To explore why bisexual men do not reveal their sexuality as often as gay men, Eric W. Schrimshaw of the Department of Sociomedical Sciences at the Mailman School of Public Health at Columbia University in New York recently conducted an online survey of 203 bisexual men. He asked them about their levels of social support, mental health, internalized homophobia, and general demographics. He found that the men with the highest incomes were most likely to conceal their sexuality. This was also the case for men in committed relationships with women or those who identified as heterosexual. Concealment was also associated with more frequent female sexual encounters for bisexual men. Overall, the men that concealed their sexuality had poorer mental health than those who disclosed their sexuality.

Schrimshaw believes that these findings underscore the delicate nature of sexuality for bisexual men. Internalizing homophobic beliefs and lack of emotional support may be more dangerous to the psychological well-being of bisexual men than concealment alone. However, concealment can indirectly affect those domains. Although disclosure appears to be beneficial for gay men, this may not always be the case for bisexual men. Rather than interventions that focus on encouraging men to disclose their bisexuality, “Interventions addressing concerns about concealment, emotional support, and internalized homophobia may be more beneficial for increasing the mental health of bisexual men,” said Schrimshaw.

Reference:
Schrimshaw, E. W., Siegel, K., Downing, M. J., Jr., and Parsons, J. T. (2012). Disclosure and concealment of sexual orientation and the mental health of non-gay-identified, behaviorally bisexual men. Journal of Consulting and Clinical Psychology. Advance online publication. doi: 10.1037/a0031272

GoodTherapy | Getting Naked: It's Not Just About the SexI’ll never forget the first time my friend took me to Elysian Fields, a “nudist colony” in Topanga Canyon in the Santa Monica Mountains near Los Angeles. I was twenty-something and petrified; I’m not sure why. I guess I was convinced that everyone would be staring at me and evaluating my body. What a surprise to discover that when we’re naked we all look pretty much alike!

When it comes to human intimacy (or lack thereof), there are different types of nakedness. During one-night stands, getting naked means exposing a lot of skin—usually rapidly.

A client once told me that she figured she could strip and shower in the locker room with no problems, so why not strip and hook up with a partner she found attractive? She did this several times until she began to tire of the shallowness and yearn for a partnership with more depth—as she put it, “someone who I can be emotionally naked with.” Years later she found that person, and discovered that true nakedness was both challenging and rewarding.

Often, people assume that their sessions with me are going to be focused on what/when/where with their genitals. They’re often surprised when I suggest we discuss “the importance of getting naked.” A great deal of honesty and trust can be generated when you are nude with one another, something that rarely develops if the sole purpose of getting naked is to have intercourse.

If you and your sweetheart are new together, or trying to resurrect the newness and the thrill of physical intimacy, here are some thoughts and ideas for getting naked together:

Being comfortable in your own skin is an important part of being comfortable and intimate with your partner. If the idea of just being naked together is scary, you may want to consult a therapist. If it’s exciting, go ahead and try it!

Hearts in a spiralDon’t wait for trouble to set in when it comes to the enriching elements of your life, such as sensuality and sexuality. Often, we are draining ourselves of the essence in our sexual, erotic selves through seemingly small, inconsequential thought and behavioral patterns.

This article addresses some of the most common drains to our sexual energy. I encourage you to use it as an awareness-raising exercise and to begin to investigate your own energy drains. In response to what you learn from your own self-reflection and investigations, you may begin to compile and act on antidotes to your drains.

So, what stories are you telling yourself? What habits need a little tweaking in order to replenish your sexual energy? I encourage you to monitor your own thinking and behavior patterns, and note what drains you and what replenishes you. Enjoy!

Letters s e x on keyboardAccording to comScore, which measures Internet traffic, 66% of Internet-using men between the ages of 18 and 34 look at online pornography at least once a month. Does it really matter if you watch pornography? Does it really impact marriages and relationships? Two-thirds of divorce lawyers say the Internet has played a significant role in divorces within the past year, with excessive interest in online pornography contributing to more than half of such cases. That does not even speak to the impact pornography has on physical and emotional intimacy in relationships.

Consider these five reasons pornography can hurt your love relationship:

  1. Men who view pornography can experience “sexual anorexia”! What? Indeed, the results of a study in Italy that surveyed 28,000 porn users seem to corroborate the notion that too much porn has a negative impact on sexual performance. Apparently, men become so accustomed to the unrealistic images they see in pornography that they can no longer get erections. Many men don’t realize their brain’s sensitivity is declining toward “normal” sex because web-based erotica delivers endless dopamine hits—making erection and climax possible where normal encounters would not. When they try to have actual intercourse and cannot, they understandably panic. The brain changes that cause porn-induced erectile dysfunction arise from actual, physical addiction processes (among them, numbing of the pleasure response of the brain).
  2. With porn, partners are always willing and ready for sex! Where sexual drive varies in individuals, porn creates the unrealistic illusion that your partner should always be ready, willing, and able. Imagine the pressure this puts on your partner. It leaves no room for emotional connection, real-life circumstances, and the fun of pursuing each other in ways that are meaningful to each other rather than with only one objective in mind. If your partner has had a tough day at work, fought traffic, made dinner, taken care of the kids, done laundry, and prepared the family for the next day but then felt too tired for sex and consequently got replaced by porn, is this going to build intimacy or destroy it?
  3. Porn creates scenarios that just aren’t real! Here are some conclusions from a study by the surgeon general: The values expressed in pornography clash with the family concept, and potentially undermine the traditional values that favor marriage, family, and children. Pornographic scripts dwell on sexual engagements of parties who have just met, who are in no way attached or committed to each other, and who will part shortly, never to meet again. Sexual gratification in pornography is not a function of emotional attachment, of kindness, of caring, and especially not of continuance of the relationship, as such continuance would translate into responsibilities, curtailments, and costs. Now what if I told you that study was conducted in 1986? Consider how much more widespread pornography is today with the Internet, social media, etc. Porn sets up couples and families to fail because as one becomes more immersed in the false “reality,” true reality suffers and is shamed.
  4. Real-life partners can’t compete with embellished pornography! Porn creates an environment in which everyone is beautiful or handsome. Body parts are perfect, accentuated, and responsive in extreme satisfaction. How can anyone’s spouse or partner compete with that? If someone is indulging in hours of pornography, how can it not affect his or her reality when looking at a spouse or partner? The partner will begin to feel inadequate, judged, and compared, and might shut down or withdraw. This only leads to more disconnect on both parts and, for the one viewing porn, can start the path to even more sexual dysfunction.
  5. It is not only the partner who can’t live up to the porn standards! So you view pornography, watch how “perfect” things are, how every encounter is desired and accepted, every act brings mutual satisfaction, and the performance never fails, never disappoints. How can anyone live up to that? The truth is, you can’t—and you are not supposed to. In a true relationship, you accept each other for who you are, you make it special for each other, and there is understanding and compassion, not fear and judgment. Pornography is NOT reality, and forcing oneself to watch unrealistic situations over and over and then expecting yourself to perform the same way is setting yourself and your partner up for disappointment.

This is the reality of the impact pornography has on your loved one and your love life. There is the argument that moderation is the key, but too many studies show that it typically does not stay at moderation—it escalates, requires more intensity to meet sexual gratification, begins to have a negative impact on sexual experience with your partner, and eventually causes a disconnect in relationships that is difficult to overcome.

Sure, it is easy to brush it off and say it won’t happen to you, but before coming to that conclusion, take an honest look at what pornography has already done in your life, in your partner’s life, in the area of hiding the habit, shame on you and your partner … if you want a truly honest response, have an open mind to what your partner thinks of your viewing of pornography. Based on real studies, real facts, real impacts on relationships, what are you going to do? It is never too late to get help through counseling, support groups, and accountability to begin the path of personal and relational healing.

Unisex door symbolAfter decades of intense and relentless criticism by advocacy groups, gender identity disorder will finally disappear from the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. Many transgender and gender nonconforming individuals have been diagnosed with gender identity disorder, but this diagnosis can contribute to the pathologization of gender nonconformity–which is not a mental health condition. Gender dysphoria, the diagnosis replacing GID, attempts to reduce stigma and prevent pathologization by focusing on the incongruence between an individual’s actual gender and the gender assigned at birth.

Gender Identity Disorder vs. Gender Dysphoria

The American Psychological Association has incorporated a number of significant changes into the latest revision of the DSM to differentiate gender dysphoria from the previous diagnosis of GID. Some of the diagnostic criteria remain the same, but while the diagnostic criteria for GID placed more emphasis on an individual’s behavior and outward manifestations of gender, gender dysphoria primarily takes into account the sense of incongruence between the gender assigned at birth and actual gender identity, and any associated feelings of distress, whether these feelings occur as a result of body dysphoria or social dysphoria.

Under diagnostic criteria for GID, a person assigned female at birth who engaged in stereotypically masculine behavior or dressed in stereotypically masculine clothes met some of the criteria for GID. However, the person in this scenario would not be diagnosed with gender dysphoria without also experiencing a sense of incongruence between the gender assigned at birth and the gender actually identified with. [fat_widget_right]

Reasons for the Changes

As people become increasingly aware of gender-related issues, there has been a strong push to avoid pathologizing those who are transgender or gender nonconforming. Many mental health professionals and transgender rights advocates have pushed to remove any form of gender nonconformity as a mental health diagnosis, but others argue there are benefits to leaving some form of diagnosis in the DSM. 

Individuals who have a gender identity that differs from the gender assigned at birth may choose to pursue hormone treatment or gender confirmation surgery to align their physical characteristics with their gender. Doctors who prescribe hormones or perform gender confirmation surgery may not do so without an associated diagnosis from a mental health professional, and many insurance companies will not cover any part of the surgery if the individual seeking surgery or hormones has not been diagnosed. Thus, removing the diagnosis from the DSM entirely may effectively bar a number of people who wish to physically transition from doing so.

Gender Dysphoria as a Diagnosis

Many transgender rights activists have pointed out the potential harm in diagnosing people with a mental health condition based on gender identity.  The inclusion of gender dysphoria as a diagnosis aims to reduce stigma and harm by removing some of the emphasis on gender nonconformity and providing a diagnostic term that instead places more focus on the ways gender incongruence can impact an individual. Transgender and gender nonconforming individuals diagnosed with gender dysphoria may experience feelings of distress or discomfort with certain of their physical characteristics, feel as if they are in the wrong body, or experience distress when others misgender them or call them by the wrong name.

The DSM-5 will give gender dysphoria its own chapter, in recognition of the fact that it is not a sexual dysfunction, a paraphilic disorder, or a mental disorder of any kind.

Some critics, however, believe the new diagnosis does not go far enough to reduce stigma or the view of gender nonconformity as a mental health condition. Diagnostic criteria still use phrasing such as “desire to be of the other gender/some alternative gender” and largely emphasizes “thinking” or “feeling” like “the other gender,” which may not accurately reflect the knowledge transgender individuals have of their true gender and may also reinforce the false concept of a gender binary. However, the DSM-5 does include some language supporting the broader, now widely upheld idea of a gender spectrum.

Though the new diagnosis of gender dysphoria may not completely eliminate stigma toward transgender individuals, this change is largely considered to be a significant improvement over the diagnosis of GID and a positive step forward in health care for those who are of a different gender than the one assigned at birth and who may experience distress as a result.

References:

  1. Beredjick, C. (n.d.). DSM-V to rename gender identity disorder gender dysphoria. Advocate. Retrieved from http://www.advocate.com/politics/transgender/2012/07/23/dsm-replaces-gender-identity-disorder-gender-dysphoria
  2. Decuypere, C., Knudson, G., & Bockting, W. (n.d.). Response of the World Professional Association for Transgender Health to the proposed DSM-5 criteria for gender incongruence [.PDF]. World Professional Association for Transgender Health.
  3. Lowder, J. B. (n.d.). Being transgender is no longer a disorder. Slate Magazine. Retrieved from http://www.slate.com/articles/health_and_science/medical_examiner/2012/12/dsm_revision_and_sexual_identity_gender_identity_disorder_replaced_by_gender.html
  4. Winters, K. (n.d.). The proposed gender dysphoria diagnosis in the DSM-5. GID Reform Weblog by Kelley Winters. Retrieved from http://gidreform.wordpress.com/2011/06/07/the-proposed-gender-dysphoria-diagnosis-in-the-dsm-5

Woman leaning on wall and man standing in backgroundThought distortions are common thinking “crutches,” or thinking habits, we fall into despite the lack of reality and truth in the thought. There are 10 common thought distortions we can all be victim to, according to Dr. David Burns, author of the self-help book Feeling Good: The New Mood Therapy. This article will address how common thought distortions can impede our sensual and sexual selves.

It is my belief that we are sensual and sexual beings throughout our life span; however, thinking patterns develop that can impede this essential part of the human experience. Falling into a pattern of thought distortions without being aware of them can prevent us from fully embracing our health and relationships.

The aforementioned 10 common thought distortions, as outlined by Burns, are as follows:

  1. All-or-nothing thinking impedes sensuality and sexuality when, for example, we believe we must have “fireworks” sex in order for a sexual encounter to be worthwhile. According to Metz and McCarthy, only 40% to 60% of “well-functioning, satisfied married couples” surveyed report good-quality sex, and sometimes for only one partner. So if you are waiting for the perfect timing—when you aren’t tired or stressed, or when your  to-do list is minimal—to engage in intimacy, start breaking this thinking habit and get reconnected.
  2. Over-generalizations come in the form of “always” and “never” thinking. When this distortion is applied to sensuality and sexuality, it may create unrealistic expectations. You may think or hear phrases such as, “You always want to have sex, that’s all you want from me,” or, “You are never romantic.” Over-generalizations create undo resentment and distance between intimate figures.
  3. The “mental filter” gets us stuck dwelling on the negative details and filters out the positive of a situation or experience. This thought distortion promotes selectively abstracting facts, which makes for a challenge to emotional intimacy, sensuality, and sexuality. An example of a mental filter is when a person fails to see gestures of attention and romance. Sure, shoveling the walk for you or ensuring the dog is walked isn’t what fairy tales and romance movies are made of, but if we didn’t filter these gestures, could they be acts of attention and romance or other wants and needs? Another example of a mental filter that can impede our sensual and sexual selves is not engaging in a bid for sexual engagement because the last time you wanted sex, your partner wasn’t interested. Don’t allow your mental filter the power to filter out the other times your bids for sexual engagement were responded to.
  4. Disqualifying the positive is a thought distortion that converts compliments or positive gestures into “flukes” or merely an anomaly, whereas any negative feedback or gesture is proof of one’s negative attributes. This is a good example of why it is important to do our own work as individuals and ensure we are showing up in a relationship with an understanding of ourselves. If we rely only on relationships, intimate partners, or sexual experiences to fortify our positive self-image, we may be more susceptible to this thought distortion.
  5. Jumping to conclusions. This thought distortion is evident when we think we know what someone is thinking—“mind reading”—and then we interpret the person’s (assumed) thoughts as what someone is feeling. Take this example: A man jumps to a conclusion about his partner’s thoughts regarding love: “I know I’m not as exciting in bed as I used to be, so you aren’t in love with me as much as you used to be.” How impactful to be operating in a relationship with such a serious false conclusion. What about this set-up allows for emotional or physical intimacy?
  6. Magnification and minimization. Commonly described as the “binocular trick,” in which we exaggerate our errors, mistakes, and imperfections while we see our strengths as small, unimportant, and insignificant. The common result of this thinking habit is to feel inferior or inadequate. How much do thoughts of being “not a good enough (fill-in-the-blank)” keep us from fully embracing our sensual and sexual selves?
  7. Emotional reasoning is the thought distortion we engage in when our emotions are the truth, reality, and facts of a situation. When we engage in emotional reasoning, we do not challenge our emotions and we allow them to guide us as if they are facts. Consider this: A single parent feels lonely and isolated. Emotional reasoning enters the picture when the experience of loneliness and isolation is “proof” that this person is undateable, unattractive to anyone, and certainly not a sexual and sensual god/goddess. See how the cycle feeds itself? Emotions are not always related to the facts.
  8. “Should” statements are fiercely common. “Should” statements are used as motivators; the cause that pressures us to act, which often results in resentment. In addition to resentment, “should” statements can result in apathy, reduced motivation, frustration, self-loathing, shame, and guilt. When we apply “should” to others, we can be left feeling bitter, self-righteous, and perhaps let down. As a sex therapist, I am often asked, “How often should my partner and I have sex?” or, “Should do stuff I don’t really want to do to make him/her happy?” “Should” statements are pressure and energy-draining. Talking in “wants/needs/desires” is far more holistic in and outside the sensuality and sexuality realm.
  9. Labeling and mislabeling is another common thought distortion that can be considered extreme over-generalization (see No. 2). “I am a (fill-in-the-blank): messy person, bad person, liar, good person, perfect person, loser, better person than her, worse person than him …” How are the labels you give yourself and others, or your relationship, impeding your sensuality and sexuality?
  10. Personalization creates guilt and forces us into a role of taking responsibility for the negative. When we engage in personalization, we think what happens reflects on our own inadequacy. This is a high sense of responsibility for something we may have influence over but are not in control of. Whether we are in a relationship or not, as with all of these thought distortions, we are susceptible to personalization. Personalization is a small wound we inflict on ourselves through our own thinking. By forcing ourselves into a role of taking responsibility for the negative, we are not basking in the positivity and light of our sensuality and sexuality.

So what is a person to do? The first step toward any change is awareness, so I advise you to read the preceding list a number of times. Next, start observing your own thought processes and challenge yourself to alter your thinking in order to positively impact your intimacy and your relationships with others—as well as your sensual and sexual self.

Couple in front of flagAccording to Diane Falzone, author of a recent column, the “deployment sex pact” is a long-standing military arrangement. Essentially, the pact gives permission for partners to engage in sexual relations with someone other than their spouses during long periods of deployment. There are no hard and fast rules; each couple makes guidelines that are acceptable to them. Falzone, however, believes such agreements may cause more pain than pleasure.

When Falzone first wrote about it, she had readers who were for it and others who vehemently opposed it. Some wrote that vows were vows and deployment doesn’t change that. Others stated that permission to have sex satisfies natural, biological urges without putting the relationship at risk. Falzone begs to differ, even though she believes every couple has the right to determine the limits of their own relationship. “But it’s my belief that if you cannot be faithful for the 10-18 months of a given deployment, perhaps you should reconsider the fundamentals of what makes a relationship,” she said.

Having guidelines and regulations in the military is one thing, but extending them to infidelity within the marriage is another entirely. And what about discipline? Doesn’t the military teach discipline, restraint, and sacrifice? If a soldier can adhere to those tenets in the field, can’t he or she uphold those same character traits within his or her marriage?

Relationships are founded on trust and honesty. Even if partners believe they might be OK with the idea of a sex pact initially, they may find themselves becoming secretly jealous of their spouses. A deployed partner might develop romantic feelings for someone else and not be willing to divulge that information to his or her spouse. The military marriage and potentially other relationships could be at risk, and there are additional threats such as sexually transmitted disease and unintended pregnancy. Falzone believes finding love is hard enough. She suggests that when you do find that special someone, don’t commit to conditional infidelity—commit to being faithful.

Reference:
Falzone, Diane. Should military marriages include a “deployment sex pact”? (n.d.): n. pag. Fox News. 26 Nov. 2012. Web. 26 Nov. 2012. http://www.foxnews.com/opinion/2012/11/26/military-marriages-and-deployment-sex-pact/

GoodTherapy | Shame: the Silent Killer of Relationships

We all know the feeling, but few of us want to talk about it. Shame often runs our lives and undermines our relationships, but we often keep it hidden. We’re ashamed of being ashamed. I felt it today when my wife reminded me of something I had said to her that was unkind. I pride myself on being a sensitive, caring man, and when she pointed out this shortcoming, I could feel the shame rise up in me. I felt myself getting warm. My first thought was, “I didn’t do it.” My first words were, “I never said it.” I felt confused and off balance. I wanted to run away and hide. I wanted to disappear.

I was awash in my shame, but I tried to cover my discomfort. Shame is such a wretched feeling, most of us try and deny we are feeling it, hoping that if we don’t look at it, shame will magically disappear. But shame is stubborn. The more we deny it, the more it sticks to us like glue.

Recent research shows that shame is conceptualized as a multidimensional construct, manifesting in various physical and emotional ways. Shame manifests physically in a wide variety of forms. “The person may hide their eyes; lower their gaze; blush; bite their lips or tongue; present a forced smile; or fidget,” psychotherapist Marc Miller said. Other responses may include irritability, annoyance, defensiveness, exaggeration, or denial. Research indicates that the strongest correlates of shame across studies include individual differences in nonacceptance of negative emotions and expressive suppression. Because the effect of shame often interferes with our ability to think clearly, we may experience confusion, being at a loss for words, or a blank mind.

“Man is the only animal that blushes,” Mark Twain once said. “Or needs to.” He reminds us how central shame is to the human experience.

Find a Therapist

bench near harbor

When couples come to me for counseling, they rarely mention shame as a cause for their difficulty. Yet I’ve found that shame is a major factor of relationship problems. Research shows that shame can have a severe negative impact on intimate relationships, leading to negative shame loops between partners. We know that couples often fight about money and sex. He gets angry when she spends money on things he thinks are not important. Underneath his anger we often find feelings of inadequacy. Beneath her spending patterns may be feelings of loneliness and unworthiness.

Key Insight: Nathanael Schlect, Licensed Associate Counselor “Shame often operates alongside other vulnerabilities such as fear, grief, or insecurity rather than existing in isolation.”

One partner wants more sex, and the other feels tired or withdrawn. One gets angry. The other feels hurt. Shame is rarely discussed, but is always present. One may feel like a lousy lover. The other may feel unattractive.

Recent umbrella reviews show that a relative majority of studies conceptualize shame as a multidimensional construct, representing what Helen B. Lewis, a pioneer in recognizing the importance of shame to psychotherapy, argued was an entire family of emotions. This family includes humiliation, embarrassment, feelings of low self-esteem, belittlement, and stigmatization. Shame is often experienced as a critical inner voice that judges us as “damaged goods,” inadequate, inferior, or worthless.

Shame in Men and Women

backpacker in forest

I’ve found the things that trigger shame differ in men and women. Research confirms that gender stereotypes maintain that women experience more guilt and shame than men, with meta-analyses showing small but significant gender differences (d = -0.29 for shame). Women often feel shame when they are unable to do all the things they think they should do. They must be a good mother, a sexy wife, a successful breadwinner, a caring friend, a good sister, and more. Studies show that women avoid the shame they may have if others observe that they overestimated themselves, while men do not seem to be similarly shame averse, possibly due to different societal expectations where men are expected to be overconfident.

The list is smaller for men. Shame usually manifests when we don’t feel strong. Dr. Brené Brown, an expert on shame, says, “While women are faced with a web of many layered, competing, and conflicting expectations, there seems to be one major expectation for men—do NOT appear weak.”

I’ve also found that men and women often react to shame differently. Research indicates larger gender gaps in shame with trait versus state scales, and gender differences in shame about domains such as the body, sex, and food tend to be larger than other domains. While individual responses to shame vary widely and are not strictly gender-bound, often women often blame themselves when they feel ashamed. They look embarrassed. They turn inward. Men often blame others when they feel ashamed. They often look angry. They may explode outward.

Key Insight: Nathanael Schlect, Licensed Associate Counselor “While patterns can differ across socialization, people of any gender may turn shame inward or outward depending on personality, history, and context.”

In fact, male violence is often an attempt to ward off shame. Recent research shows masculinity threats lead to emotions including shame, guilt, and a reduction in empathy, and these masculinity threats predict harmful behaviors such as men’s aggression, sexual violence, anxiety, shame, self-harm, and homophobic attitudes. Dr. James Gilligan has spent more than 30 years researching anger and violence in men. His research traces the role that shame plays in the etiology of murder and shows how feelings of shame cause violent and vengeful behavior. He says, “I have yet to see a serious act of violence that was not provoked by the experience of feeling shamed and humiliated, disrespected and ridiculed, and that did not represent the attempt to prevent or undo this ‘loss of face.’ ” Respect is important to all of us, but for men it is essential. Recent research on masculinity and violence shows that when men were targets of partner violence, many described feelings of weakness and shame, reflecting assumptions that men should be dominant and not victimized. Feeling disrespected or “dissed” can cause a man to strike out in rage.

young woman on phone guilt

Self-Disclosure and Empathy

The most difficult thing in the world to do when we are feeling down on ourselves is to admit how we feel. Yet self-disclosure is what we need to do to stop the cycle of shame and blame that so many of us get caught up with. Recent research on intimacy shows that self-disclosure, a fundamental component of intimacy, occurs only when vulnerability is met with acceptance rather than rejection. However, shame disrupts this process by inhibiting vulnerability and promoting defensive strategies. It’s harder than hell to say to my wife, “You’re right, what I said was unkind. I’m sorry.” But that’s the key to washing the shame away.

Attachment research shows that shame loops within couple relationships may not only be triggered by negative cues, such as criticism from a partner, but can also innocently be triggered by a partner seeking connection or even offering comfort. It feels counterintuitive. We’re afraid that if we admit our faults, we’ll feel even more ashamed. But the opposite is true. The more we’re able to say, “Yes, I messed up,” or, “Yes, I made a mistake,” or, “Yes, I’m sorry for what I said,” the better we feel about ourselves.

We all know the good feeling we get when we can own our mistakes and be forgiven. But that takes empathy on the part of our partner. Our partner has to be able to feel with us, not blame us or put us down. Recent clinical trials of Emotionally Focused Couple Therapy show significant improvements in intimacy and reductions in shame when couples learn to address these dynamics. For men, it often means admitting our weakness. And for women, it means accepting that we can still be strong, adequate men, even when we are weak.

Men need also to practice empathy with the women in our lives. We have to understand the things we do that shame them, the subtle ways we may put them down. And we all need to be more empathic with ourselves. We don’t have to be successful at everything, all the time. We don’t have to be strong all the time and hide our weakness. We can learn to love and accept the wonderful, flawed, human beings we all are.

References:

  1. Mirzazade, Z., Molazade, J., & Hadianfard, H. (2025). The effect of emotionally focused couple therapy (EFCT) on shame and intimacy in couples: a randomized controlled trial (RCT). BMC Psychology, 13, 1111. https://doi.org/10.1186/s40359-025-03415-3
  2. Frediani, M. J., et al. (2024). Seeking connection can trigger shame loops in couples: An attachment-based understanding. Family Process, 63(1), 34-47. https://doi.org/10.1111/famp.12888
  3. Vescio, T. K., et al. (2025). Masculinity threats sequentially arouse public discomfort, anger, and positive attitudes toward sexual violence. Personality and Social Psychology Bulletin, 51(1), 3-20. https://doi.org/10.1177/01461672231179431
  4. Stanaland, A., Gaither, S., & Gassman-Pines, A. (2023). When is masculinity “fragile”? An expectancy-discrepancy-threat model of masculine identity. Personality and Social Psychology Review, 27(4), 285-315. https://doi.org/10.1177/10888683221141176
  5. Swerdlow, B. A., Sandel, D. B., & Johnson, S. L. (2023). Shame on me for needing you. Emotion, 23(3), 737-752. https://doi.org/10.1037/emo0001109
  6. O’Donnell, S., et al. (2024). Masculinity and violence interconnectedness: Defining and reconciling the gender paradox among men with cumulative lifetime violence histories. SAGE Open, 14(3), 21582440241266998. https://doi.org/10.1177/21582440241266998
  7. Else-Quest, N. M., Higgins, A., Allison, C., & Morton, L. C. (2012). Gender differences in self-conscious emotional experience: A meta-analysis. Psychological Bulletin, 138(5), 947-981. https://doi.org/10.1037/a0027930
  8. DeSantis, A. J., Eshelman, L. R., & Messman, T. L. (2025). Emotional dysregulation, anger, and masculinity in men who have experienced lifetime sexual violence. Journal of Interpersonal Violence, 40(21-22), 5199-5222. https://doi.org/10.1177/08862605241301790
  9. Deshmukh, A., Mehta, R., & Acar, Z. (2024). Perceived criticism and intimacy avoidance in couples: The mediating role of shame. Research and Practice in Couple Therapy, 2(1), 1-10. https://doi.org/10.61838/rpct.2.1.1
  10. Bardi, L., et al. (2024). Conceptualization and assessment of shame experience and regulation: An umbrella review of synthesis studies. Clinical Psychology Review, 113, 102436. https://doi.org/10.1016/j.cpr.2024.102436
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