Table of Contents

Table of Contents

Cover

Praise received for Gloria G. Brame, Ph.D.

SECTION ONE: Sex is as Complicated as the Adults Having It

Introduction

Three New Rational Rules of Sex

Dr. Brame’s 3 Rules of Sex

The Shame of It

Sex and Self-Esteem

The Urge to Merge and Consensuality

SECTION TWO: Diversity is Normal

Sexual Identity Crisis and Conflict

Sex Should Be What It Is

Labels, Definitions and Sex Models

Relationship Types

Marriage Customs Will Surprise You

A Concise List of Models of Partnered Adult Relationships

 Monogamy

Polyamory

Sex Acts

MOVA/MOA

Variations on MOVA/MOA

Kink, BDSM, and Erotism

Towards a Redefinition of Kink

Two Worlds of Kink: Erotism and BDSM

Erotism

BDSM

Technology-Dependent Sex and Future Sex

The Data on Diversity

Sexual Identity

Their Choices, Their Lives

Married to an Asexual

Bisexual Conflict

Sexual Identity Damage

BDSM/Fetish Identity

Seven Stages of Sexual Development in BDSM/Fetish People

Solving the Sexual Identity Puzzle

 Seven Stages of Sexual Development

Basic Schema of Sexual Identities

SECTION THREE: Everyone Can Have Good Sex

Optimal Model for Partnered Sex

A Primer on Partnered Sex

Before Sex: Two Rules of Sexual Etiquette

Foreplay and Touching

Touching Women

Touching Men

Touching for All

Tantric Touch Techniques

Oral Sex

Cunnilingus

Fellatio

Vaginal Intercourse

Positions

How to Move

Pleasurable Ingredients

Five Tips on Creating Intimacy

Anal Sex
 Sex and (some) Disabilities

Sex with Transgendered Partners

Sexual Enhancements and Intimacy Builders

How to Set the Sexual Stage

Sex Toys

How to Extend Intimacy

Three Ways to Slow It Down

About the Author

Back cover

A Note About Case Studies:

To protect the confidentiality of my clients, all case studies in this book are
composites of at least two to four different patients who presented with
similar problems. Names are fictitious to further protect their privacy.
 The Truth About Sex

A Sex Primer for the 21st Century

Volume 2: Sex for Grown-ups

by

Dr. Gloria G. Brame

CCB Publishing
British Columbia, Canada
The Truth About Sex, A Sex Primer for the 21st Century Volume 2: Sex for Grown-Ups

Copyright ©2013 by Dr. Gloria G. Brame

ISBN-13 978-1-77143-077-7

First Edition

Library and Archives Canada Cataloguing in Publication

Brame, Gloria G., 1955-, author

The truth about sex : a sex primer for the 21st century volume 2 : sex for grown-ups / by Gloria G.
Brame. – First edition.

Issued in print and electronic formats.

ISBN 978-1-77143-076-0 (pbk.).--ISBN 978-1-77143-077-7 (pdf)

Additional cataloguing data available from Library and Archives Canada

Cover artwork by David Ampola.

Extreme care has been taken by the author to ensure that all information presented in this book is
accurate and up to date at the time of publishing. Neither the author nor the publisher can be held
responsible for any errors or omissions. Additionally, neither is any liability assumed for damages
resulting from the use of the information contained herein.

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or
transmitted in any form or by any means, electronic, mechanical, photocopying, recording or
otherwise without the express written permission of the publisher, except in the case of brief and
accurately credited quotations embodied in critical articles or reviews.

Publisher:

CCB Publishing
British Columbia, Canada

www.ccbpublishing.com

Note: This book contains frank material on adult topics. It is not recommended for minors.
 Praise received for Gloria G. Brame, PhD

“Gloria is the most articulate woman I’ve ever met.”

--Helen Gurly Brown, former editor-in-chief, Cosmopolitan magazine

“If you don’t have a sex therapist on speed dial, Dr. Gloria Brame will be
your emergency contact. She plants a sex-positive flag into the American
landscape.”

--Megan Andelloux, Board Certified Sexologist and Sexuality Educator

“The first step in affirming sexual freedom as a fundamental human right is

one’s own sexual liberation. Dr. Brame’s work outlines a clear path toward
that goal!”

--Ricci Joy Levy, Exec. Director, The Woodhull Sexual Freedom Alliance

“Dr. Brame is simply the best tour guide I know for your travel in the world
of kinky sex. She is a superb scholar and a great human being -- I think that
her father must have dipped his joint in honey when he created her.”

--Dr. Ted McIlvenna, Institute for Advanced Study of Human Sexuality

“Dr. Brame’s mind is devastatingly erotic because it is embodied

philosophical eroticism repletive of the cardinals: wit, directness, reductive,
suffused with organic immediacy.”

--Godfrey Silas, Cinematographer/Producer, The G-Spot Project

“Dr. Gloria Brame brings a refreshingly original perspective to the study of

human sexuality in all its dimensions and permutations.”
--Dr. Sandor Gardos, Sex Therapist and Founder of MyPleasure.com

“Dr. Brame provides an honest and reassuring outlook on how healthy

sexuality is fundamental to building healthy lives, relationships,
communities and societies.”

--Nina Hartley, R.N., Author of Nina Hartley's Guide to Total Sex

 The way that most men deal with traditions

is to receive them as they are delivered,

without applying any critical test whatsoever.

-- Thucydides
 Section One

Sex is as Complicated as the Adults Having It

 Introduction

You’ve heard people say it a million times: “Sex is the most natural thing in
the world.” And it is – for every other species except humans.

For better and for worse, it has been humankind’s unique biological destiny
to have an unnatural relationship with sex. Unique to our species, we
intellectualize sex. We also feel shame and guilt about sex; we lie and cheat
about sex; and we think it’s noble to rise above our lusts and pretend sex
isn’t as important as it is to us. We are, when it comes right down to it, as
bizarrely repressed and baroquely ritualistic as it gets in the great wide
world of sex. If any of the species whose sexual antics we routinely giggle
over on YouTube knew what humans went through to get laid, I wonder
who’d get the last laugh.

In the first volume of this series, The Truth About Sex, I focused on the two
most basic and fundamental elements of sex: masturbation and orgasm. It
came as a surprise, I suspect, to people more familiar with my work on
BDSM and fetish sex, and my history of tackling unusual and radical sex
topics. For fans of my more radical work, this volume will clear up any
confusion about why I decided to start the trilogy at what I consider the
very beginning – the relationship each of us has with our own genitals and
sexual desires.

I also know a key step to a balanced sex life is to develop a more positive
view of orgasms, a harmless behavior long demonized for no rational
reasons, and now, in the 21st century, something all the sciences, from
medicine to sexology, can agree is healthful, and perhaps even key to
longevity. So I felt I should start my trilogy with a basic sex-positive primer
designed for both adults and their kids to gain familiarity with their own
bodies, and to develop good sexual health habits through education.
As masturbation is the fundamental building block of adult sexuality, and
the first type of sex most of us have, you’d think people would do it
naturally and not worry about it, but it’s the rare and fortunately uninhibited
person who feels that way. Most people are hung up about it, think it’s
wrong, can’t talk about it, get stressed out if their partners do it, and
essentially manifest all the fears and inhibitions you would expect in any
intensely sexually repressed culture. Years of clinical experiences have
shown me that people who find masturbation difficult or embarrassing bring
their inhibitions with them into their sex lives with partners. The ongoing
myths about masturbation and orgasm as somehow dangerous or unhealthy
activities that one should avoid have done more to screw up adult
relationships than most people will acknowledge.

It’s a basic principle of my therapy practice to help people emotionally

connect to the importance of loving our individual erotic potential and
embracing that potential by developing healthy, mature, and regular sexual
habits according to our individual needs. I consider it a basic requirement of
an adult’s sex education to know that masturbation is good for you, and that
orgasms are healthy. By the time you’re in a relationship or planning to
marry, you should also understand that sex is as complicated and magical as
love, and that sexual intimacy enhances our quality of life.

Instead, our culture and laws treat sex as something that is so dirty that we
need not only to be protected from it, but prevented from having it. We still
abide by 18th and 19th century beliefs that sex is a dangerous force which
has the power to pollute minds and drive adults mad.

As I see it, much of what we label as sexual dysfunction (meaning

inorgasmia or a woman’s inability to climax, and erectile dysfunction or a
man’s inability to sustain an erection until climax) are consequences of this
enduring perversion of sexual intimacy. When you grow up in a world
where depictions and descriptions of the beauty and fun of sex are
considered obscene, while ghastly sex crimes make national headlines, you
can’t help but come to believe that sex is fundamentally unsavory.

It’s a tragic social lie. Sex itself doesn’t contaminate anything. Real life is
not a Victorian morality piece in which pleasure invariably leads to
dissolution. In life, people can be celibate and still be monsters; or they can
screw every sailor who hits shore and still be saints. The number of blow
jobs you have performed and the number of people you have bedded don’t
factor into whether you are a good parent, partner, business associate,
colleague or friend in daily life.

To me, it’s sex-negativity that contaminates human behavior. One

commonplace in a sex therapist’s life is the client whose aggrieved
partner/spouse/fling is threatening to out them. I’ve had male clients whose
wives threatened to call their employers and expose information about their
husbands’ fetishes if they won’t give them up; I’ve had female clients
whose husbands threatened to expose their interest in swinging or kink to
win child custody cases. Worse, people on the sidelines often cheer the
bullies on, re-enforcing the notion that if someone doesn’t act the way you
think they should act in bed, you have the right to destroy their life.

Sexual blackmail, using sex as punishment, deliberately provoking jealousy,

and making sex the scapegoat for bad relationship skills has been the
human condition for thousands of years. But it doesn’t have to be.

MARISSA AND TOM fought over everything. I’ve never seen a

couple fuss at each other quite as much as they did. If one recalled
something happening on a Tuesday, the other was certain it was a
Thursday; if one remembered a restaurant called “Three Guys” the
other swore it was “Two Guys.” They fought over money (Tom
wouldn’t buy her the house she really wanted). They fought over the
house they had (Marissa never kept it clean enough to please him).
They fought over their dog, Mr. Wiggles, who Marissa considered ill-
behaved and Tom thought hilariously lively.

But they were seeing me because they believed they only had one real
problem: Tom’s anal obsession. As Marissa explained it, something
was wrong with Tom because he was always looking at anal porn of
men having things stuck up their butts. At first, she tried not to think
about it but then he started asking her to do it to him. When he
brought home a butt plug one night, she told him she was done with
the marriage. The way he pestered her for sex all the time was bad
enough but this was the final straw. In private, she told me she
thought he was gay. Who else but a gay man wants anal sex? She said
 their sex had never been very good but now she could barely stand to
be in bed with him.

Tom didn’t think he was gay. He knew other men had all kinds of
wild sex with their wives. Marissa wasn’t a prude when they first met,
but now after 14 years of marriage, she treated her vagina like a prize
he had to earn each time. To him, it wasn’t such a prize anymore. He
got tired of constantly asking for it. Marissa and Tom decided to see a
sex therapist as a last step before filing for divorce. It made them sad
to get divorced, but they couldn’t live like this.

Tom couldn’t look me in the face as he nodded and mumbled his way
through the session with his wife. But during a one-on-one alone with
me he found it easy to tell me things he never told his wife. As it
turned out, he became fascinated with anal sex after the spark had
gone out of their sex life. His wife didn’t seem interested anymore so
he went looking around the Internet for something new and different.
When he found the anal porn site, it turned him on so much he
convinced himself it was the answer to their sex problems. Marissa’s
hostility stumped him at first, then angered him. It was proof that she
didn’t care about their sex life and, by extension, about him. The
angrier she got, the angrier it made him that she wouldn’t have sex
with him. Meanwhile, he’d started feeling insecure about whether or
not he was normal.

This part of the problem is easy for a sex therapist to work on. In reality,
anal eroticism is very common, and therefore, should be considered normal.
Adventurous lovers have explored it since the beginning of time. It has
nothing to do with sexual orientation and everything to do with nerve
endings in the region which make it a particularly delightfully erotic
experience (done properly, of course). Also, because of the taboos around
the anus, for some people it’s an adrenalin high simply to traverse that
forbidden territory.

After individual sessions with them both, my assessment was that someone
with a robust interest in experiencing anal penetration was married to
someone who thought the adult anus was the puckered passageway to Hell.
We could fix that through education and information and reach a
comfortable compromise because that is just the technical side of sex. The
larger problem in this marriage was that they were incredibly angry people
who couldn’t communicate without fighting. It was the reason their sex life
was in a mess in the first place. They’d both behaved badly, and each made
the other feel unloved and unvalued. The fact that each of them could talk
more freely with me about sex than they could talk to one another was the
first problem I addressed – it told me that they were afraid to be naked with
each other. If you can’t be emotionally naked, if you can’t tell your sex
partner your secrets, if you’re too angry to tolerate each other, the chances
of a fulfilling sex life are virtually nil.

In Dr. Brame’s world, sex is a beautiful and bonding thing. It holds the
potential for people to find relaxation, intimacy, and connection, thanks to
the phenomena of sexual brain chemistry. In a happy, loving couple, sex
reaffirms the romantic bond and provides you with the best free private
entertainment known to humanity. It’s a privilege and a thrill to be so naked
with someone – not, as some couples treat it, an invitation to rejection and
criticism. Rather than a dangerous evil, sex is a natural resource adults can
exploit for the good. We can tap its potential to build deeper and more
lasting commitments. We can learn to communicate, negotiate, and become
team-players in ways that enrich permanent relationships.

The emotional and psychological importance of sex to human health is

consistently devalued by our culture. I am continually interviewed by
popular magazines on “creative quickies” or “adventurous positions for
orgasm” or one I did last week for Glamour on “10 places to touch him.” I
do my best to be anatomically accurate but honestly, telling people to have
sex in a certain way when you don’t know the people involved could be a
recipe for disaster. What if one or both are too tall, too short, too fat or too
skinny for a particular position? What if one of them is disabled and is
numb in the place you recommend licking? It’s like when food sites
promise you the recipe for a “perfect” meal and you find out it’s filled with
things that give you hives.

Nothing in sex is ever gospel, neither on a broad-scale nor on a one-to-one

basis. No matter how comprehensive one may try to be, sexual emotions
and responses are too varied and complex to be authoritatively catalogued.
There is much more to sex than techniques and anatomy. Sex is both private
and social. It is intensely private in that most people don’t talk about what
they do in the bedroom. But it is also very social, in that most people abide
by, or at least are aware of, “rules” set by society.

What most people don’t realize is that those rules are in constant flux and,
like all social customs, change, evolve, revert, and are subverted by
historical, political and religious forces. In the 21st century, I must also add
“technological” forces since the advent of a generation raised after the
Internet was invented, and in possession of gadgets to hook up and “sext”
with from puberty on, has altered the course of human sexual history.

When we look at the emerging data on sexual relationships, it’s still a chaos
of unanswerables. For example, a 2012 study reported that more women are
breaking their vows of monogamy than before, and that their number may
soon rival or even outpace the number of male cheaters. The way it was
reported and blogged about, one might think the news that wives are now
fooling around almost as much as husbands is proof that Western
Civilization is collapsing. The notion of women doing something men have
traditionally done is terrifying. Prepare for Armageddon! At least, that’s
how the story sounded, filtered through the minds of sex hysterics always
on the look-out for proof that the Rapture will be triggered by a lubricated
vagina.

As a sexologist, I take all such data to mean exactly what they mean: we are
looking at a snapshot of human sexual behavior at a moment in time and at
a particular place. Even if I trusted that this one study was definitive, it still
said very little to me about overall human behavior. It is interesting only in
that it suggests we live in a culture where American women feel freer than
they did 20 to 30 years ago to break their marriage vows.

The key difference between now and past times is not that we are
necessarily more permissive as a society: it’s that we keep more records
now. But we’ve only been gathering data on sex since the Victorian era and,
needless to say, have gathered it from a Victorian point of view, operating
from some of their assumptions, possibly asking the wrong questions, and
then acting alarmed by data that shows society is not living up to the
idealized model.
To my knowledge, no such survey existed at the time but it wouldn’t
surprise me to learn that female adulterers were numerous during the WWII
era. The draft and the War’s effect on ordinary civilians was what you’d
expect: an awful lot of lonely military wives left behind in the prime of
youth, surrounded by men yet to be drafted or soldiers passing through, at a
time when happiness was about what you could have now because
tomorrow might never come. If the statistics didn’t show massive amounts
of fooling around during the war years, I’d be surprised.

What we don’t know about the history of mating and sex will always be
greater than what we do know. We may know a period or place’s public
face of sex, according to the dictates and precepts of the dominating
religion or political system. The only assumption we can make with any
certainty about the past however is that despite different customs and belief
systems, humans have always been sexually creative, sexually diverse, and
very horny.

Even when religious fervor was at a pitch in Medieval Europe, and a

celibate monk named Albertus Magnus was describing the only correct
position (missionary) for married couples – a theory which later became
religious doctrine – there is abundant documentation that people carried on
then just as they do now. Unmarried sex, extra-marital affairs, threeways,
gay and lesbian sex and everything else many people still call abnormal
have always been pretty normal for humans. As someone who has looked at
tens of thousands of vintage porn photos, I’m absolutely certain that if there
were webcams in the Middle Ages, we’d have footage of debauched serf
orgies. Instead, we have to rely on Flemish paintings depicting them.

I find it grim how many adults are inexperienced or clumsy with sex and
how many limit themselves to a tiny, sometimes monotonous repertoire of
sex acts. Whether it’s the traditional couple who only have intercourse in
one position their whole lives, or the kinky person who obsesses so much
over toys, he or she never learns the basics of orgasmic sex, acquiring basic
techniques for giving and getting sexual pleasure is a litmus test of your
own ability to function as a satisfying, adult sexual partner.

If we really cared about supporting committed relationships and marriage,

we would encourage grown-ups to mature sexually. Like the rest of your
life, if your sex life doesn’t grow it will stagnate. In my perfect world,
adults would experiment with all the different ways they can climax – oral,
anal, manual, penetrative, non-penetrative – so they can have enough
variety in their sex lives to sustain them and keep them interested into old
age. The longer you are with someone, the more ways you should know
how to turn them on and get them off. That would be a more successful
model for permanent sexual partnership than telling people they can only
have sex in one or two positions for the rest of their lives.

I’m more flexible when it comes to frequency. Some experts claim there is a
fixed number of times it is normal to have sex. I disagree. I encourage
people to orgasm regularly but I’m content with whatever is regular for
them, without pressuring them to meet an artificial standard. The desire for
orgasms is one of the greatest variables in human sexuality. I’ve worked
with couples who had sex ten times a week and wished they had time for
more; and couples who didn’t want or need it more once or twice a month.
When all partners are satisfied with their pattern, their sexual health is
good, and they’re getting enough intimacy to feel content, there is nothing
to fix or change.

To me, frequency is not as important as respecting the importance of sex

and making it a regular part of your relationship, according to your and
your partner’s needs and schedules. The couples I worry about are the ones
who make sex their lowest priority, avoid it, never make the time for it,
don’t communicate about it, and thus don’t really sexually mature.

LARRY and JEAN-MARIE had been married for 45 years. They

were in my office because she didn’t want to have sex with him
anymore. While she sniffled into a hankie, he glowered as she said
that while she didn’t mind it too much, he wanted to have it every day
and after 45 years of it, she just couldn’t anymore.

My first thoughts, naturally, went to menopause and the thought that Jean-
Marie’s libido had significantly altered. But by the next session, the
problem came into focus.

In 45 years, they had never changed their routine. When Larry got to
bed at night, he always began by touching her breasts until he was
 aroused, and then penetrated her. Jean-Marie had come to dread that
breast-grab. She didn’t really know if she’d ever had an orgasm. All
she knew was that she was tired of having sex with him. Larry,
meanwhile, was hoping I’d tell them if there was a pill to make her
more sexually compliant. She wouldn’t let him touch her anywhere
but her breasts. Neither was open to making changes in the way they
had sex. Jean-Marie wanted to write sex off completely; Larry just
wanted what he wanted, a wife who’d let him get on top of her every
night.

Frankly, I would be tired of having sex too if it was that predictable and
unvaried. A common thread uniting many marriage partners who complain
of poor sex lives is that neither of them are actually very good at sex.
Sometimes, it’s because one partner is selfish in bed and doesn’t care as
much about how their partner feels. Sometimes they’re too shy to introduce
alternatives, too embarrassed to make themselves look foolish if they make
a mistake, or too inhibited or guilty to suggest variations that might make it
better for one or both of them. Sometimes, one partner’s shame or inhibition
casts such a chill over the bed that the sex itself is cold and anti-septic.

My clinical view is that the problem here was chronic sexual immaturity.
Larry was still a fumbling fratboy, trying to have the kind of sex he had at
age 20, with about the same success most men that age have (i.e., limited).
Jean-Marie had never reached her own erotic potential and she blamed it all
on her husband. No longer the newlywed drenched with hormones, she was
turning into a bitter old lady who had stopped caring about her husband’s
genuine need for intimacy and physical love.

For them to heal, they had to restart their sex life on a healthier footing, and
learn to spend more time on all the cuddly parts of sex – the fondling and
kissing and teasing. Jean-Marie had to let her husband touch her all over,
and Larry had to learn to go slow.

I designed a special behavioral challenge for them: they couldn’t have

intercourse again until they had each been able to make the other climax
with hands and mouth. It took them a while to get going because they both
avoided their homework for months. But once they began the exercise in
earnest, it was amazing how quickly things began to shift. Re-learning sex,
and focusing on new ways to do it, empowered them to return to intercourse
with a new sensitivity and understanding of the kinds of pleasure they could
give and receive.

Jean-Marie’s libido did not hugely increase as a result but they were able to
reach a happy compromise. Larry still wished it happened more often, but
Jean-Marie was now enjoying it. Getting such positive results from their
experiments convinced Larry to change his attitude about adding sex toys to
their intimacy. Though their intimacy was still more mild than wild, they
were tickled to death to think they were having sex like “the kids do today.”
It really changed their lives. The anger and resentment melted from Jean-
Marie’s face and Larry was so much more self-confident and upbeat. It was
a wonderful thing.

I attribute some of the lifelong sexual immaturity in couples to an

exasperatingly common cultural myth that “sex isn’t that important in a
relationship.” When I hear people say that, I take it to mean that they’ve
given up and think others should, too. For the rest of us, sex is important in
a relationship. If we are monogamous, then our sex life with our partner is
critical, because they are our only source of sexual intimacy. Take that one
source away or obstruct it, and the stability of the relationship becomes
unpredictable. Sooner or later, one or both partners may look for that sense
of sexual intimacy elsewhere.

KYLE came to me because he had been having an affair and his wife
had just found out. She accused him of being a sex-addict and said
that she would give him another chance if he went for counseling and
tried to fix himself. If he could come back to her, saying that he’d
dealt with it and he’d never cheat again, she would take him back.

Kyle told me he started the affair after his wife had their second child.
Her body had snapped right back after the first one, but after the
second, her breasts were droopy and her waistline was gone. He
accepted the changes as part of the price of having children and
wanted to get back to a regular sex life, but his wife pushed him
away, telling him she didn’t feel sexy with all the extra weight, that
she was too tired from taking care of the kids, and other excuses that
left him completely high and dry in the romance department.
 Being a 21st century man, he started visiting dating sites as a hoot, but
before too long, one thing led to another. He met a woman who
shared his libido, and they had started an amazing affair. The sex was
so much better than it had ever been with his wife. His girlfriend was
adventurous and playful in bed, whereas his wife had always acted
like sex was something she just went along with for his sake.

The problem was that he really loved his wife and he couldn’t stand
the thought of being apart from his babies. He didn’t know what to do
– he’d never had such great sex as he did with his girlfriend, but he
felt obligated to his commitments. Should he stay with the hot
girlfriend or should he go back to his wife, knowing in his heart he’d
never have really great sex again?

If there is any one theme which unites all the diverse people who see me, it
is their disappointment with their sex lives. They may come to me for an
issue concerning their genital function, but inevitably, there is an underlying
emotional reality we have to puzzle through. To help clients make smart
sexual choices, I have to understand who they are as human beings and
what their relationships are like. And that’s a big piece of what makes sex
between or among adults so complicated: we aren’t just dealing with body
parts. We are dealing with interpersonal dynamics and psychological
landscapes.

While we do not have all the answers, we know more than we ever did both
about the nature of sex and how to turn things around emotionally for
people. People can overcome inhibitions. People who are inorgasmic can
become orgasmic. People who fail with partners in bed can succeed with
partners in bed. People who cannot have penetrative sex can still enjoy
sexual intimacy. Most importantly, people can learn from their mistakes and
make better choices which will bring them much greater sexual happiness.

I’ve witnessed radical transformations in the course of therapy that leave

me in awe about our seemingly innate capacity for sexual resiliency and
recovery. Even when a person’s early sexual potential is damaged by
traumatic sexual experiences, such as rape or molestation, their underlying
sexual identity can become vibrant. It’s such an important message, yet so
rarely expressed: Good sex is as beneficial as bad sex is harmful. I’ve seen
people rehabilitate themselves and re-start their emotional lives through
better, more nurturing sex.

Clients may think I work miracles but mainly what I do is give them the
tools – the science, the education, the self-empowered perspective – to look
critically at the choices they’ve made in the past, and why they made them,
and then to start making smarter ones. It is by making better choices that
people heal from the pain of the past, regain their confidence and make the
changes necessary to get them to that next level of inner peace.

To me, an optimum model of adult sexual health is one we have yet, as a

culture, to build: it’s a model that finds a place for all consenting adult sex
while supporting standards of health and safety that protect both the
individual and the public.

Thus the mission of this second volume, Sex for Grown-Ups: to provide
encapsulations of the theories and perspectives that have enlightened and
challenged my clients over the years, and which have transformed so many
lives for the better, happier, and more orgasmic. It’s my way of offering sex
therapy to people who’d never go for sex therapy, and sharing what I know
about sex to as many people as possible. This book is dedicated to my
clients, to my friends, to everyone who hungers for the truth, and to my
loving and beloved life-partners William Brame and Jennifer Kleiman, and
to my long-time friend, David Browde.
 Three New Rational Rules of Sex

One of the most irrational yet widespread assumptions about sex is that
there is a “right way” to have it. In the first volume of The Truth About Sex:
Sex and the Self, I devoted a section to the evolution of that assumption
from its roots in Roman philosophy, medieval theology, and Victorian
psychiatry, respectively. For most of Western history, our religious
doctrines, our national laws, our customs, and much of our thinking about
sex has simply assumed that missionary position heterosexual intercourse in
a monogamous marriage is normal and everything else is a deviation,
something that abnormal or sinful people do. Until the late 20th century,
psychiatrists too demonized everything from masturbation to homosexuality
as “diseases,” perpetuating Victorian ideology instead of relying on the
actual medical science which amply demonstrated otherwise.

Evidence shows that the only “wrong way” to have sex is to have sex that
you or your partner do not enjoy. Equipped with data and studies as we are
these days, sexologists can generally agree that psychological harm derives
from unwanted or non-consensual sex. Behaviors where all partners feel
fulfilled are acceptable, regardless of the precise way in which the partners
fulfill one another.

If you look at sex and relationships without moral judgment or religious

ideology, all sexual relationships which satisfy both partners are positive
sexual relationships – whether they are casual or permanent, straight or gay,
poly or monogamous or anything else. When it comes to sex between
consenting adults, there is only one important question: was it good for all
involved?

Over time, there have been so many false lessons about sex, and so many
arbitrary boundaries, that most people end up completely confused about
what is and is not acceptable. It’s not surprising that adults often look for
rules on how to have a functional sex life. Unfortunately, many of those
rules come down to pat clichés that are handed from generation to
generation without question, rules like “casual sex is bad for you” (nope) or
“fetishes are bad” (nope) or “open marriages are doomed” (nope, no more
so than monogamous ones).

No one has ever been able to make a rational case to explain why such
behaviors are bad quite simply because there is no rational evidence for it.
There may be reasons why people who enjoy casual sex or have fetishes
have problematic relationships but usually it’s because of judgment and
shame stemming from those unquestioned rules and standards about what
normal sex “should be.” I think many of our old rules about sex should have
been laughed out of existence around the time doctors stopped examining
the bumps on people’s heads to determine their mental abilities.

So I’m going to set out what I think are the only three rules you really need
to know about sex.

Dr. Brame’s 3 Rules of Sex

1. Sex is as complicated as the adults having it

A successful sex life depends on individual variations in the people having

it.

2. Diversity is normal

Everyone is wired a little differently.

3. Every adult can have good sex

Each of us has the capability to give and receive sexual pleasure.

These three rules are the framework for this book and for a complete adult
education (or re-education) in sex. They express the most important
concepts every adult needs to grasp in order to make their sex lives work
for them, individually, and to develop a more sensitive and optimistic view
of human sexuality in general. They apply across the board to every
sexually active adult, regardless of orientation, sex, gender, or sexual
identity.

The Shame of It
It’s strange how many people seem to believe that the solution to their sex
problems should be something you can bleat out in 25 words or less. People
want fast fixes, especially for problems they are embarrassed to talk about
in detail. Many is the time people have emailed hoping for magic bullets or
saying, “Just tell me what to do in bed and I’ll do it,” as if my telling them
to manipulate genitals in a certain way will resolve the lifetime of inhibition
that led them to a sex therapist in the first place.

Similarly, when a woman emails, “How can I get my husband to stop

masturbating?” expecting me to deliver a meaningful answer in a quick
email back, I take a deep breath, and ask her to make an appointment.

When I can spend an hour with someone, I take a full sex history. I can
delve into the circumstances that created the problem and evaluate all the
factors – is the behavior hurting their sex-life, is he compulsive about it,
does he lie about it? Only then can I provide advice that will work for that
individual couple.

I usually have to start with cold facts: so in the above case, I’d have to
mention that there is no way to stop masturbation (psychiatrists devoted
themselves to a cure for masturbation for a century until they finally,
grudgingly, accepted that it wasn’t a disease in the first place). Also, it’s
normal for adults to masturbate, married or not. What’s less common is for
a partner to worry about or interfere with their spouse’s masturbation. Until
I have a complete picture, it’s possible that the real problem is that the wife
thinks it’s a problem, and that it’s her issues, not his, that need to be
addressed.

Because people are generally unaccustomed to talking about the personal

details of their most intimate relationships, they often never find out if the
sexual behaviors they experience are normal or not. Instead, they base
decisions upon what they learned growing up. The problem is that when
you grow up in a culture where people are chronically ignorant about sex,
the dialogue about sex at home, at school, and certainly at places of worship
is often tragically out of step with real life.

Everyone pays a lot of lip service to the social rules of normality. And
many, if not most of us still measure ourselves, and our sex lives, according
to the model that our society holds up as ideal: a man and a woman in
monogamous wedlock, happily bouncing away in man-on-top bliss. But
how many of us actually live by that model? How many of us wait until
marriage to experience intercourse and then stick with that one “normal”
position for life? How many grown-ups are strictly monogamous and
strictly heterosexual? Actually, a minority of us.

Most adults experiment with other positions in bed. Most adults enjoy
sexual variety to some degree. Very few of us wait for a marriage license to
begin sexual activity. Many of us have bisexual experiences, especially in
youth. Even that segment of American culture which viciously demonizes
promiscuity and upholds virginity as the golden standard, can’t uphold its
own belief system in the real world. A 2009 study by the National
Campaign to Prevent Teen and Unplanned Pregnancy, for example, cited
data which showed that contrary to their core religious belief of chastity
until marriage, 80% of 18 to 20-year-old unmarried American Evangelicals
have premarital sex (as compared to 88% of other unmarried Americans in
that age group).

That Evangelicals turned out to be as horny as other people their age is,
well, basically what sex scientists like me would expect. Perhaps this is
disappointing to people who think we should all practice what we preach. I
think we should strike at the root, though, and learn to preach what we
practice.

A scientific way to look at the study is simply that human sexual identity
(needs, lusts, behaviors) trumps religious identity. Even though the study
group’s primary belief system explicitly prohibits pre-marital sex, 80% of
the surveyed adherents nonetheless chose sexual desire over religious
belief. If they were completely unconscious of that choice, or attribute their
behavior to magical spiritual forces, then it may suggest that the brain itself
is wired to prioritize sex drive above spiritual feelings and finds ways to
rationalize breaking its moral code. Where religious people may see
“temptation,” a sex scientist sees someone’s brain perceiving a mating
opportunity, and what they may call “the devil,” we acknowledge as the
brain merrily churning up the hormones that compel us to mate.

Sex really is the most natural thing in the world, its primal consciousness
buried in our deepest brain functions, and connected to a vast network of
fluids, organs, and nerves throughout the entire body system. Its reach is so
powerful that it may, at times, override other powerful human emotions,
like altruism, love, or piety. This power may, in fact, be stronger in the
moment than intellectual constructs, which may explain why sexual desire
can be stronger than our powers of reason and land us in sexual situations
we didn’t plan to get into in the first place. That may also explain why –
when a disinhibitor like alcohol is added – sexual behavior itself becomes
primitive.

There are very good reasons why we can’t allow humans completely free
reign over their sexual behaviors. At the same time, there are better reasons
why adults should learn enough about sex to make good choices, rather than
fear-based ones. In this atmosphere of cultural shame, all too many of us let
sexual fears and inhibitions dictate our lives.

It’s massively sad to listen to stories of people who, for lack of hard facts
and a soft shoulder, have sex lives that are frustrating, depressing, and
shameful. The inner feeling of being sexually viable (a nice way of saying
“fuckable”) is so deeply rooted in the primitive part of our brain that when
we feel sexually flawed or sexually inferior to others, the shame cripples
our ability to form solid partnerships. People who think they are sexually
unattractive in some way find it very difficult to integrate their sense of
themselves as basically good people with their sexual image of themselves.
I meet wonderful people sometimes who are ashamed to look me in the eye
because they are about to admit that they can’t sustain an erection, and
assume I’ll think less of them for it. This can be particularly painful to
anyone who doesn’t fit into the conventional model of what sex should be.

LOUISE, an accountant in her 30s, was terrified that people would

find out about the things she enjoyed in private with a man, including
being tied up and spanked with paddles and canes. She blamed it on
her profession: she worked in a very sensitive field and couldn’t risk
 being exposed, she said. She was afraid to keep BDSM toys in her
house so she only played in other people’s homes. She did not want to
meet any of her partners’ kinky friends, and was dead-set against
attending any BDSM events or clubs, lest someone she knew saw her
there. The list of rules and regulations she had created to shield her
innermost sexual needs from the possibility that anyone in the
“vanilla” world could use it against her was long.

Some of it was reasonable: being non-consensually outed can be extremely

traumatic for anyone. It was wise to keep her sex life and her business life
completely separate too. But, as we worked together, it was obvious that all
her social fears about BDSM had warped her self-esteem and caused her to
make bad choices.

Deep down, Louise really believed BDSM was dirty and shameful,
and that people would reject and criticize her if they knew that in the
bedroom she liked to be tied up and role play. Perhaps even more than
that, she herself couldn’t stand the thought of being known as “a
pervert,” because it was not how she saw herself. She saw herself as a
normal, regular person not the kind of person who needed to be tied
up and spanked to have an orgasm. Her perspective was that while
she liked kinky sex, she herself was not kinky. It was just something
she did, not who she was.

Her anxiety made her compartmentalize her BDSM life from the rest of her
life:

Louise never introduced her BDSM partners to family or friends. That

was unthinkable! She kept a non-kinky man in the picture to bring to
family occasions, although she didn’t really enjoy sex with him. In
private, she hooked up with kinky men she met on the Internet, using
an anonymous handle.

I was sympathetic to Louise’s fears. Some of them were justified: she had
signed a morals clause at work, and a scandal would cost her the job. But
some of them were self-sabotage. She was miserable: she was smart and
attractive and financially independent, and felt completely alone in life. I
knew that there were plenty of men out there who would welcome the
chance to get to know her – if only she let them. But since quality kinky
men were turned off by her secrets and games, she ended up with sleazy
ones who were just there to get their jollies.

Until you can accept that it’s really okay to need what you need in bed, that
your personal sexual needs are, well, “just the way you are,” not some flaw
or disease, nothing that says something is fundamentally freakish about
you, but rather your own mind and body’s natural biology, it’s pretty tough
to project the self-confidence that others find attractive. Not only did Louise
and I work on her own inhibitions about BDSM, but we worked on her
body language too. She walked around like a tight ball of fear, hands
frequently clenched, a frozen smile on her face. People like that are
predator magnets, radiating their insecurity and anxiety. As her mind
relaxed, she learned to let her body relax as well. It was a first step forward
towards projecting a sense of self-confidence and self-esteem, although the
underlying work – of gradually learning to accept her sexual self without
judgment – would take months.

Long before your conscious mind identifies what you really need sexually,
your mind is absorbing and processing information – physical, emotional,
erotic, and intellectual – that shapes your sexual identity. This is why many
of us remember behaviors in childhood that seemed completely innocent to
us at the time yet which we view as embarrassingly sexual when we’re
adults. Most common, of course, are the weird things little kids do with
their genitals – showing them to friends, exposing them in public, sticking
things into holes, riding toys obsessively, rubbing against walls or floors –
which, we later realize, is crazy perversion! What?! Though kids generally
don’t understand what they are doing or why they are doing it, what’s
important for adults to understand is that even when we are tiny tots who
don’t experience sexual feelings the way adults do, our primitive brain is
collecting information in preparation for that great day in the still-distant
future when our bodies are fully ready for actual, conscious sex.

Needless to say, when children are exposed to sexual trauma – whether

upon themselves or by witnessing it – their brains absorb and process that
information too.
 JERRY, a frail man in his 60s, said he had spent his life struggling
with his demons. He hit the sexual stress trifecta: Shame, Guilt and
Anxiety! For 40 years, he had tried to be something he was not and it
was killing him. Literally. He had high blood pressure, migraines,
chronic heartburn, eczema, was subject to panic attacks and some
days he had twitches and tics too. His doctors told him to take more
vacations. I told him that if we could get him to stop torturing
himself, it would be better than a vacation.

After several failed marriages to women, Jerry was trying to deal with
the possibility that he was gay. He wanted so much to be a good
husband, but the same pattern repeated itself every time: he loved
women, but after a while, they bored him in bed. He didn’t mind a
vagina, he said, but he was not that fond of them either. They were
okay. He preferred for his woman to perform oral, while he
masturbated her with vibrators and toys. When it came to intercourse,
he wasn’t always able to maintain an erection so he avoided it
whenever possible. This had made some of his wives very angry.

Every marriage had ended with him fading out of the sex life, and
then fading out of the relationship, generally blaming his ex’s bad
temper or demanding nature, and finding someone new to rekindle his
passions, at least for the first year or two. It was the fifth wife who
finally figured him out: she told him he was gay, and that she wanted
a divorce.

It wasn’t as if Jerry didn’t know. He just hadn’t wanted to accept that

because he had gay fantasies in his mind that it meant he had to have gay
sex in reality. He had chosen to lead a Christian life, he said. Then he told
me a story about his youth.

At the Baptist church in which he was raised as a boy, Pastor Kirk

was a hero to the kids, especially Jerry, whose own father was distant
and cold. The pastor, though, always had time for a smile or an
encouraging word, and possessed a natural gift for ministering to his
flock, especially the children, who were regularly invited to the
pastor’s home to play with his own progeny. Handsome, caring,
learned, and extremely charismatic, the pastor became Jerry’s role
model of masculine perfection. He wanted to be just like him when he
grew up.

When Jerry was thirteen, his parents abruptly announced that they
were quitting the church. Pastor Kirk was a bad man. No one was
allowed to speak to him ever again. No one was allowed even to
speak his name aloud at home. The law was laid down strictly and
when Jerry started to cry and question, his father sent him to his
room.

At school the next day, Jerry heard an incredible rumor. All the kids
were calling Pastor Kirk a fag, and claiming he left his wife for a
man. Jerry didn’t believe it. The pastor had been passionately
vituperative on subjects like infidelity and homosexuality. When he
spat out the word “sodomites” from the pulpit, the whole church felt
his revulsion. How was it possible that Pastor Kirk had left his wife to
live in sin as a homosexual?

Jerry was shattered. On some level, he was awed by the pastor’s

audacity – as Jerry saw it, the pastor had risked it all for love. It
seemed so romantic. Jerry was so conflicted he could barely eat for
three days. He was finally able to break the spell of misery when he
prayed to God and promised that he would never disappoint his
family, his church, and God the way the pastor did. Secretly, Jerry
was a little jealous of the mystery man who had captivated the pastor.
He began obsessing over what kind of a sex life two gay men might
have together, trying to imagine how Pastor Kirk looked without
clothes. By his mid-teens, he was regularly jerking off to fantasies
about Pastor Kirk and hating himself every time.

He convinced himself that jerking off to gay fantasies didn’t make

him gay. As long as he lived as a straight man, he could be one. And
so he resolved to marry a woman and to be faithful to her too. He felt
in his heart that he could do it through sheer will-power. That’s what
his faith told him. But now, sitting in my office, Jerry was finally
realizing that despite the promise he made to God at age thirteen,
despite all his striving to be someone he was not and to cover up his
 authentic sexual identity, he was a gay man who had lived a life of
self-hatred.

The timing of this traumatic event could not have come at a worse period in
Jerry’s biological life. Male puberty is a very vulnerable phase for most
boys. Boys don’t produce testosterone until they hit puberty (usually 10 to
13). But once testosterone production begins, it can soar to the high end of
adult normal. Suddenly, you have a little kid whose bloodstream is flooded
with androgens at levels that rival or exceed his own dad’s levels of
testosterone. Still, while their underlying biology is pumping adult-level
hormones, the boys themselves are still children. They think, feel and act
like children. They struggle to handle the underlying hormonal load – and
so do their parents! In those years, boys must feel as psychosexually
stressed as a woman during bad PMS. So if they are traumatized during that
period, it can wound their sexual identity in ways we have yet even to
comprehend.

There was only one positive option for Jerry now, and that was to find a
way to make peace with himself. He couldn’t go back and change his life;
he could not undo the damage of failed relationships; and he couldn’t make
up for all the decades lost to having sad sex with women instead of the
potentially joyful sex he might have had with men. I encouraged him to
date men but he was afraid of it – even if they did develop feelings for one
another, he could never live as a gay man. He didn’t know what to do with
his gayness but he had a long list of all the things he would not do, and that
included giving himself permission to love himself as he was. I was so sad
for him. While I am, by nature, an optimist who thinks it’s never too late to
find sexual happiness, Jerry was so broken and traumatized, he was just too
frightened to change.
 Sex and Self-Esteem

If you think it’s mainly sexually unconventional or differently wired people

– gays, lesbians, queers, kinksters – who naturally will be the most ashamed
of their sexual desires, you’re wrong.

How we feel, personally, about sex acts is certainly impacted by the

religious and social norms, of course. We can see the brutal evidence of that
in the high rates of suicide among gay and transgendered youth, for
example, who feel emotionally overwhelmed by the negative social
messages they get about their identities. The pain people experience by
feeling socially outcast, rejected or mocked by peers, treated as sinners or
mentally ill people, and denied their human rights on the basis of their
sexual identity, is enough to destroy anyone’s self-esteem.

But, interestingly, it’s equally, if not more strongly, influenced by how we

feel about ourselves. People with fundamentally positive views of
themselves tend to be self-accepting, no matter how quirky, edgy, or
sexually radical they are. They tend not only to ask for what they want, but
they expect to get it and on the whole get more of what they want out of sex
than other people. They don’t believe their sexual interests make them a
flawed person or less than others; indeed, it may make them feel more
creative and adventurous than others. In other words, people with good self-
esteem feel entitled to sexual pleasure in bed and seek it out on their own
terms.

People with a negative sexual self image tend to feel anxious and
inadequate. They find it hard to articulate what they want, and harder to ask
for satisfaction. They may be their own worst enemies – censoring their
fantasies, sublimating all their urges, and sacrificing their needs to please
their partners or their parents. They may struggle with shame for wanting
what they want, or wish they were more like other people, who they
imagine are having better sex lives. In the end, they never get as much sex,
or the kind of sex, they need to feel complete.

Resolving sex issues in relationships isn’t as hard as people believe it to be.

I think people are scared that sex will turn out to be too embarrassing or
mysterious for them to handle. They’re afraid that opening up about their
sexual needs and fantasies to their partners will hurt their relationship. My
clinical experience has been the opposite: secrets destroy otherwise
supportive, respectful, loving relationships.

BARBARA was a bio-engineer in her late 40s and married to her

high school sweetheart, Jim. She heard me on a Playboy radio show
talking about swinging and bisexuality, and wanted my opinion on her
marriage. About a year ago, she learned that Jim had been cheating on
her for the past 12 years. It was ugly at first. They fought and cried
over it, and finally, they reached a place of peace and forgiveness.
They still loved each other. They didn’t want to divorce.

She accepted responsibility for her piece of it: she lost her desire for
him about seven years into their marriage. She’d had some infections
and had to avoid sex on doctor’s orders for a year. After that, her
desire never really returned. First it slumped to once a month, then
once every few months and now it had been almost 15 years since
they’d had regular intercourse. When he finally confessed about
cheating on her, it hurt like hell but it wasn’t a total surprise.

When Jim told her that he’d been dipping his toes into the world of
swinging and group sex, Barbara said her ears perked up. She’d
always been curious about it. She made him give her all the details on
his experiences. Instead of feeling angry, she felt envious, even turned
on by the thought of group sex. She looked at Jim through fresh eyes:
it made him seem sexier now that she knew that other, younger
women had found him attractive.

They started making love again and that, too, seemed more exciting to
her than she remembered. After thinking about it for a few weeks, she
asked Jim how he’d feel about exploring the swinger lifestyle as a
couple. She’d always had bisexual fantasies and wished she had the
 nerve to try visiting a sex club. Jim was amazed and, of course,
enthused, and they began looking for an event they could attend.

On a whim, Barbara visited a psychologist to hear what a professional

thought about her situation. Was she crazy for feeling the way she
did? The psychologist seemed to think so. She was alarmed by
Barbara’s story and felt that Barbara’s sudden interest in swinging
must be a symptom of her grief. Or maybe Jim had secretly coerced
his wife into enabling his own sex addiction. She urged Barbara to
give herself a year, perhaps two, to slowly heal from her husband’s
betrayal and come in for weekly counseling to work on her
dependency issues. Barbara left that session feeling completely
rattled.

The possibility of an open marriage – something they’d never

considered before – was actually exciting to her. She saw it as a way
of not just getting back her sex life with her husband, but having a sex
life that would never bore her. Was she wrong to want that? Did I
agree with the psychologist that she needed to spend more time
grieving?

I understood the psychologist’s concern about the betrayal. In general, yes,

people need time to process grief and betrayal. For some, the shock of the
betrayal is so overwhelming they end the relationship there and then. Even
when partners negotiate a truce, they may still feel hurt and unable to
resume intimacy until trust is restored. Sadly, there’s no guarantee trust can
be restored after betrayal: that depends on a wide range of factors, from
someone’s capacity for forgiveness to his or her attitudes about sex. So
when you work with individuals, you have to figure out whether they fit the
general pattern or whether they break the mold.

Barbara and her husband were definitely mold-breakers. Their commitment

to their marriage was unshakeable and their attitudes about sex were liberal.
Barbara was hurt at first but, practical minded, she did not view sex outside
of marriage as a deal-breaker. Her husband was genuinely repentant. They
had already come through the worst of it and seemed more solid as a couple
than before. All those factors worked in their favor. They only needed one
rigid boundary: no more lies. Jim promised Barbara and Barbara chose to
believe him.

I don’t condone lying to your partner. I think it invariably creates rifts and
heartaches. But I could sympathize with Jim’s misery. Barbara rejected and
ignored his sexual being for years. That’s a wretched thing to do to
someone you love. I can understand when someone wakes up one day and
realizes they can’t live another day without the comforts of sexual intimacy.
That’s very human.

Ideally, Jim would have reminded Barbara that it was absurd to expect a
virile man to live like a eunuch. They could have either consulted a
professional or worked out a more satisfying compromise on their own.
They both would be grounded in the basic understanding that sex is a vital
part of every life. But in a less than ideal world, many adults are unable to
have genuinely mature conversations about sex. If a partner has sexual
inhibitions or low self-esteem, even raising the subject of sexual problems
with them may make them tight-lipped or angry.

What impressed me about Barbara and Jim was that, when the chips were
down, they rallied together and finally had their first serious, mature
conversation about their sex life. Barbara accepted her responsibility in the
mess: she’d settled into the same kind of sexless marriage her parents had.
When she first wed Jim, she had vowed to herself she would never let that
happen and yet she did.

Barbara and Jim were done grieving. What they needed at this point was
someone to reassure them that it was safe to resume their sex life. So I did. I
explained that sex itself can be nature’s best healing medicine. The intimacy
would revive and reconnect their sexual brain chemistry (or what some
folks call “sexual energy”). And if swinging was something that made their
blood pump right now, and offered them a hotter way to have sex, then
good for them. Maybe they had found THEIR key, that thing which could
make them happier than they’d ever been.

I speculated that perhaps the reason their old sex life failed was precisely
because they both had always craved greater variety. Barbara admitted
she’d always had bisexual fantasies. I found that interesting because I
believe the need for a high degree of sexual variety (such as swinging) may
be wired into some people’s sexual identity (as I’ll explain in depth in the
next section), much as I believe that homosexuality, BDSM,
transgenderism, and other so-called sexual perversions are, in fact, normal
biological differentials that travel with us from the womb to the grave. On
this theory, it was not impossible that Barbara and Jim were always wired to
be swingers. It certainly seemed that Jim was, judging by his choice of
sexual diversions.

From my point of view, the psychologist hadn’t really listened to Barbara.

She categorized her as “betrayed wife” and treated her accordingly. The
treatment was typical yet completely wrong-headed because there is no
monolithic model for a betrayed partner. I have worked with women and
men who grieve over their partner’s betrayals for years on end; and women
and men who shrugged and moved on with their lives. If Barbara had low
self-esteem, it’s more than possible that Jim’s adultery could have driven
her to act out in self-destructive ways or might have destabilized her
emotionally. If she’d been inhibited, his sexual adventures likely would
have been frightening, perhaps even disgusting, to her. If she hadn’t been
sexually aware, she might have stewed with rage over his experiences
instead of noticing that they were turning her on. But Barbara had her stuff
together. She was strong and self-aware. I saw no reason for her to stop
looking for the swing party of their mutual dreams.

The psychologist also took the draconian but common point of view that
swinging itself is weird and may therefore be a symptom of a psychological
problem. I assured Barbara and Jim that this was a long-outdated way of
looking at sexual variations. The urge to swing isn’t symptomatic of
anything except an urge to swing. But whether or not they chose to take
their marriage in that direction, Barbara had learned the hard way that a
sex-negative life is not a natural, healthy way for anyone to live. She will
never make the mistake of letting her sex life with Jim go dead again.

But what happens when you do have low self-esteem?

LLOYD, an engineer in his late 30s, was one of the most stressed out
fetishists I’d ever worked with. He knew he was different, he said,
even when he was five or six. While other kids played with toys, he
 loved playing with shoes. By the time he was in high school, he was
as excited by girls as any normal boy, but also extremely ashamed of
himself. Other boys talked about girls’ breasts, but Lloyd was much
more interested in their feet. His biggest fear was that a girl would
notice him staring at her feet and call him out as a pervert.

He was financially successful and didn’t have trouble meeting women

but he felt it would be wrong to inflict his disturbing fetish on a
decent, regular woman. When the fetish itch needed scratching, he
visited professional dominatrices. He loved to watch them model
exotic footwear, and always felt grateful when one of them allowed
him to masturbate to orgasm while kissing their feet, a rare but much
appreciated indulgence.

Until a few years ago, this had been enough for him. But now he
seemed to be losing all interest in sex. He couldn’t maintain an
erection long enough, or find a fantasy sufficiently thrilling enough,
to get him over the top during intercourse. He tried Viagra and
although it kept him physically hard, it felt like he was just pushing a
sausage into a soggy sleeve. It felt numb. The only thing that turned
him on now was his play-time with professionals. He felt doomed: all
his dreams and ambitions to have a family, and a normal life with a
woman who loved him, were now completely impossible.

Since I specialize in kink and fetish in my practice (and my life), I knew

something Lloyd did not: that he was normal for a fetishist. Some clients
laugh in delight and others squirm in discomfort when I tell them that, but it
is true.

Virtually all fetishists experience a similar sexual arch in their lives. As

children, they are either openly or secretly fascinated by something that, at
the time, is merely intriguing because their minds are not yet mature enough
to perceive a “mating opportunity.” In puberty, that fascination becomes
more consciously connected as hormones flood the body and change
internal reproductive biology. When they begin masturbating, and
throughout their teens, their early fascinations take a central place in their
masturbatory fantasies, and by early adulthood they begin experimenting
with partners when possible.
Adulthood is where innumerable variables change that arch, particularly the
life choices that people make. Some people follow through on their sexual
needs and form relationships with people who accept them as they are.
Others (the majority, in my experience) don’t accept their quirks and form
relationships with people in hopes they will “get over it” and be able to live
according to the culturally idealized model.

But the overall pattern is pretty similar: by adulthood, a fetishist finds it

increasingly hard to feel fully satisfied unless there is some fetish activity in
their intimacy. As noted above, it’s common for all people to lose interest in
sex when the kind of sex they have is not giving them the kind of
fulfillment their brains crave. For men, this may also lead to impotence,
difficulty maintaining erections, and the kind of penile dissociation that
afflicted Lloyd and made his genitals feel alien to him.

From clinical experience, it seems to me that the more self-hating the

fetishist, the more it’s likely they partner with someone who is sexually
conservative, even rigid, about maintaining the social model of normality in
their bedroom. I’ve often wondered if they subconsciously choose the last
person in the world to accept their fetish precisely as a way to police
themselves and prevent themselves from yielding to temptation. When and
if the fetishist finally reveals that they like to wear panties or want their
partner to wear boots to bed, their conservative partner is usually appalled,
angry, shocked, betrayed, disgusted or all of the above. It’s a sad dynamic
I’ve seen played out hundreds of times in hundreds of ways.

Lloyd was in a very bad, sad place. The picture I got was of a man who had
never once in his life known the complete fulfillment of good sex. Since he
never told a woman what he really needed and wanted, the real women in
his life were never even given the chance to turn him on. By confining
himself to a fantasy world of cruel women always dressed in latex and
ready for fetish play, he had missed real-life opportunities to bond with
women who both accepted him sexually and might want to form a
permanent commitment with him too.

He was sabotaging himself from getting what everyone needs: that

combination of thrilling sex AND bonded intimacy that can only come with
being in the arms of someone you really want to be with and who really
wants to be with you. Sex-workers provide many services but seldom
trigger the intense brain chemistry that flows when partners are joined
together uniquely by mutual lust. Wondrous but true: studies on the human
brain and endocrine system suggest that we get the biggest chemical
benefits from sex when we and our partner are both totally into it. It doesn’t
require marriage; it doesn’t require that you know the person; the sex
doesn’t have to be technically great; you just both really have to want it to
happen and enjoy the way you do it together. Our brains reward sexual
enthusiasm.

Unfortunately, that means it punishes pessimism. Lloyd was so ashamed of

his fetish – which was really mild and completely harmless – that he’d
convinced himself no woman would ever love him if she knew everything
about him. It wasn’t the fetish itself that stood between him and a happy sex
life. It was his self-hatred that had rendered him literally impotent. I want to
contrast Lloyd with Harry.

HARRY was a cute guy in his mid-30s with lots of positive energy,
one of those people who greet you with a big smile and warm hello. I
wasn’t sure if he was just turning the charm on to impress a therapist
at first but, no, Harry was just a through-and-through sweetheart,
easy-going and honest to the core. He brimmed with self-confidence
as he flashed some great gadgets and talked about the Internet
company he started and how well it was doing.

When it came to sex, Harry was just as upbeat. Harry loved

masturbation. He jerked off at least two or three times a day, more
when he had the time for it. He was an unapologetic consumer of
porn, and didn’t mind spending money at strip clubs either. His
girlfriends always played along with his fondness for masturbation.
Some of his best experiences had been himself and a girl secretly
giving each other handjobs in clubs and dark bars when no one was
looking.

If a woman criticized him for it, he didn’t remember. He certainly

never dated her again. All the ones that stuck around were “free
spirits,” who embraced his sensuality and admired his ability to get
hard again and again. He felt that his skill at manipulating his cock
 and balls had turned him into a super-lover, with exceptionally good
control over his own orgasms. Apparently, women agreed because he
was very popular.

The only reason he was seeing me was because he’d been dating a
submissive woman who he really cared about. He thought she could
be “the one.” She had been so giving and playful about his
masturbatory obsession that he wanted to fulfill all her fetishes and
fantasies. He loved the idea of being dominant with her but didn’t
want to make any big mistakes. So he was talking to me in hopes I
could give him some insights and tips to help him become as good at
BDSM as he already felt he was at straight sex.

As I said, Harry was a sweetheart. At no time did he express the least bit of
shame over his interests. He expected that a woman who really cared about
him would accept his sexuality as it was. He was aware that some people
might judge him but he frankly didn’t care. He never lacked for girlfriends
and the ones he picked liked him for himself, as he was, and didn’t need
him to change. Similarly, he didn’t blink when he found out his girlfriend
was kinky. Well, maybe he blinked but it didn’t bother him. It just sounded
like a new arena for erotic adventure to him. I guess he already knew that
we are all created equal but different, and it is OK to pursue sexual pleasure
on your own terms. I wish everyone was as wise as him.

Sometimes my clients are so naïve I wish I could have been their mother so
I could have spared them years of unnecessary heartache and confusion.

LISA, a part-time realtor and full-time mother of three, had lost all
interest in sex with her husband, Tim. She blushingly explained,
through stammers and pauses, that while she loved him, she never
liked sex as much as he did. She had talked to some of her girlfriends
and her mom, so she knew it was normal to lose interest and that sex
was really more for the man. She had tried hormone treatments and
herbal remedies. Nothing worked.

She blamed it on the kids. Since the last one, her drive never came
back. She felt bad for Tim. She hated disappointing him all the time.
 It made her feel broken. If not for Tim, she would give up sex
altogether. The whole thing was just too much stress.

I listened carefully to her. When I hear a wife tell me that sex is “for the
man,” I know it’s going to be a long haul. I know that before I can help her
work on her sex life with her partner, I have to work with her on her
personal relationship with her own sexuality.

There is NO evidence to suggest females don’t “need” sex. Quite the

contrary: orgasms are our friends. They are beneficial to the human
organism (heart, brain, circulatory system, skin, reproductive organs),
regardless of biological sex. That full-body flush – the increased
circulation, the cocktail of beneficial and calming brain chemicals, the relief
of the pressure which builds in the lower anatomy – is an organically
healthful experience for humans, as any honest medical doctor can tell you.
Remaining sexually active is essential for women who want to be able to
have sex in old age too. Regular orgasms are a natural way to ward off the
effects of aging on female genitals – your doctor may not tell you this, but
the science says that exercising your pelvic floor muscles and encouraging
blood flow to the region helps women prevent the post-menopausal risks of
vaginal atrophy and inorgasmia.

Similarly, while we don’t know nearly as much about estrogen yet as we do

about testosterone, we know enough to understand that it too is a powerful
natural chemical which makes women either seem wildly horny or
viciously disinterested in sex or strangely emotional about sex (among
many other alternating moods which may occur during ovulation, PMS,
pregnancy, perimenopause, and any other significant hormone swings
which naturally occur in women’s lives).

The theory that women are less sexual by nature than men is a myth that has
haunted our culture for thousands of years. It’s based on religious teachings
which presume that men are closer to the divine, and therefore superior in
all ways to women. It is the male seed which must be carried on, and
woman’s function is to be his lesser vessel. Her needs don’t matter because
she doesn’t really matter, at least not until she proves her worth by
producing children, and demonstrating that she is a worthy vessel.
That, in an alarmingly magical nutshell, is how most western religions have
continued to view the difference between male and female for thousands of
years. Moreover, that mythology was accepted, whole cloth, without
questioning, by the great Victorian scientists who first essayed to organize
and define human sexual behaviors. And it may be how most of the people
around you understand sex, more or less: that it is mainly men who get
horny, while women are more ethereal. At least the decent women are.
Those others, the ones who are all sexed up, are something else entirely.
(Which is to say, a little scary to a lot of people.)

It may seem innocent enough on the surface but really it is poisonous. Our
cultural assumptions about female sexuality are largely rooted in patriarchal
Catholic dogma that has long since ceased to be relevant to western cultures
and religions, including to the post-Vatican II Catholic church itself.

From a sexological point of view, it’s a form of ignorance which causes

social harm by rationalizing sex crimes against women. Example: I think
it’s one of the underlying assumptions of the date rapist’s mentality that
women never really “want” sex and therefore it’s a man’s right to coerce
her. Rapists feel justified in taking what they want from women because, to
them, women are sexually inferior and created for their pleasure.

This isn’t just something we can blame on religion. It’s also in line with the
way medicine and psychiatry have traditionally treated female sexuality, as
I detailed in Sex and the Self. Much of 20th century psychiatric theory still
depended on the early theories of Sigmund Freud who, by the 1960s, had
become something of a cult-figure in the United States, and assailed as the
person who definitively had plumbed the depths of the human sexual
psyche. If you’re old enough, you may remember that “Oedipus Complex”
and “penis envy” were as much a part of popular language as Gangnam
style is today.

Ah, Sigmund, the sex genius who could never figure out what women really
wanted because he never could wrap his giant mind around the fact that
women wanted sex. He and his colleagues knew that orgasms relieved
women: many doctors offered the service of pelvic massages (i.e.,
masturbation) to “cure hysteria” and “alleviate female neuroses,” which is
what we today would call “needing it bad.” Time and again, physicians
from the late 19th century to the late 20th century did not accept that
women’s needs and desires were as strong as men’s and that those desires
were just as likely to be varied too. They refused to acknowledge that
women grew depressed and dysfunctional when they were forced to stifle
their own sexual identity and live up to a false, non-sexual model. Instead,
they diagnosed women as neurotic and masochistic and frigid when they
didn’t act as obedient vessels should.

The irrational idea that men are sexual and women are not has done more to
fuck people up over what sex is than any other ideology in human history. It
has also impacted the public health and well-being of adults. Big drug
companies who spend billions studying testosterone and how to restore
erections have barely studied female libido or how to improve female
function. Male reproductive medicine is very advanced. We understand a lot
about how the penis works, what makes male orgasm happen, and between
the range of services offered by sex therapists and sexual medical doctors,
we can restore erectile function in more men than ever before in history. No
such progress for women. As some female science bloggers have dourly
noted, the sexual function of pussies has been radically understudied and
ignored by medicine.

Science just doesn’t like to think about the vagina, at least not as a
beautiful, fully alive, sexual organ. Science prefers to see it, when it sees it
at all, as a baby hole. All the ingrained cultural vagina-negativity, all the
undermining and mockery of female libido by society, has infected women
as much as, sometimes even more, than men. It makes women ashamed of
their own vaginas and that shame is the root cause of a lot of bad sex lives,
reproductive diseases, and rotten quality of life.

But to get back to Lisa: even though she had made some bad assumptions
about her own capacity to be a more sensual and sexual person, it occurred
to me that it was possible that hers might just be a sticky case of
incompatible libidos. I’ve worked with some disappointed partners who
only realized after falling in love with someone that their sweetheart doesn’t
want as much sex as they do. There is not a lot one can do to help people
who have incompatible libidos. It is not a disease to have either a high
libido or a low libido. Some people need to have a lot of sex to feel really
great and some people feel contented to go without for stretches.

My own rule of thumb for “normal” for any couple is first to take a look at
their baseline sexual pattern. That means the basic frequency of their sexual
activity. There may be weeks or months or even a year when they have a lot
more sex or a lot less sex, because of life stresses or circumstances, but
overall, I want to know how many times per week or month they are likely
to have sex.

If the pattern seems stable, and all involved are content with it, I consider it
a normal sex life. BUT if there’s a lot of change and instability in their sex
lives (most commonly, a ton of sex at the beginning that dwindles to
nothing over time) or if one partner complains of frustration or the other
complains of feeling oppressed by demands for sex, that signals to me that
there’s a good chance their libidos may not match. When you have two
people with different levels of desire for sex, and they commit to a
monogamous relationship, the only way they can both get what they need is
to negotiate a compromise that keeps the horny one happy while giving the
less-horny one more emotional rewards.

Lisa found it so difficult to talk about sex, getting information from her was
a long and arduous process. She herself had never realized there were so
many dimensions to sex, and her amazement more than anything, I think,
kept her coming back for sessions. I thought she was brave! I was
determined to figure it out for her, so I kept poking.

Were there any big stresses – major illnesses, job insecurity – in the
background? Was there anger or resentment in the household? Were the
kids doing okay? Did Lisa feel good about being a full-time mom or did she
resent Tim’s busy professional life? Was she withholding intimacy as a
punishment? Any and every life problem can creep into a couple’s
bedroom. When the impulse to have sex comes on, people with low libido
may find it impossible to feel aroused or remain focused on sex because
their conscious mind is worrying about other things. But Lisa was happy
with her life, adored her children, and thought her husband was wonderful.
She just didn’t want to sleep with him.
So I turned to Lisa’s claim that things changed for her after giving birth to
her last child. While most women return to their former pattern of sex after
giving birth, some take a while to rekindle their passions, and others will
never feel quite the same, physically or psychologically, once they become
mothers. Inside the brain, the same multitudes of tiny differentials that
make some women experience post-partum depression while others glow
with joy at the achievement, will also influence how women feel about sex
after giving birth. For some women, the responsibilities and the brain
chemistry of motherhood may overwhelm their sense of themselves as sex
partners, and push sexual activity to the bottom of the emotional priority
list.

Meanwhile, the physical health of the mother and of her vagina will also
play a key role in when and whether her desire for sex fully rebounds. In
France, where new mothers receive routine medical treatment to help them
restore their vaginal muscle strength after birth, recovery is somewhat
predictable. In the United States, where people are too freaked out even to
discuss the subject openly, not only is recovery unpredictable, but some
women never get back to complete vaginal function.

So when it comes to motherhood and libido, there are an array of variables

that influence when and how much a woman will desire sex. A good bit of
it depends on the woman’s own attitude towards sex and her eagerness to
resume vaginal sex with her partner, but some of it is a matter of biological
differentials – different brain chemistry, different hormone levels, different
recovery rates, different body types, and so on.

Despite Lisa’s claim that things had changed after the last birth, when I
made her reconstruct her sex life with her husband after the other births, she
realized that things had actually begun to change significantly earlier than
that. She thought it changed when she gave birth the first time. Then she
realized things had actually started changing in her first pregnancy. She
confessed, for the first time, that she exaggerated her symptoms sometimes
to get out of having sex with him, complaining of migraines or back pains
she didn’t really have. After further probing, Lisa was finally able to dredge
up the awful truth she’d buried long ago: actually, she always kind of tried
to avoid sex with Tim, from the day they got back from their honeymoon.
I think she was more surprised by her revelation than I was. From my
perspective, when people reach the point in a relationship where they avoid
sex with their partner, more often than not it’s one of two things: either that
they have fallen out of love with their partner or the type of sex they are
having is awkward and dissatisfying. Since Lisa was very much in love
with Tim I had an immediate intuition that their honeymoon must have
completely turned her off and that, while she started out eager enough,
something happened that made her retreat into a shell she still hadn’t poked
out of yet. That made me question her intensely until she finally – with eyes
half-closed – finally told me how they actually did IT.

She told me they did it the same way every time and had developed a
routine. Maybe once or twice a week, usually on the weekend, Tim
would reach for her breast in bed. If she wasn’t in the mood, she’d
push his hand away or say no. If she was in the mood, she’d curl up to
him and they’d kiss. He would then strip off his shorts and climb on
top of her. He then put it in her and pumped until he was done. He
made love to her until he was done and then went to the bathroom to
wash up immediately afterwards.

It was dull but nothing I hadn’t heard before: two painfully shy,
inexperienced people who develop a quick and silent way of making love,
so they don’t have to actually talk about sex or become too familiar with
their partner’s body. If Lisa had been the exact same kind of person as Tim,
someone who could be instantly aroused at the thought of making love, and
satisfied by a few minutes of penetration, she would not have needed to talk
to a sex therapist. They could have continued to have a sex life that I found
dull but which worked perfectly well for them because there is no rule book
which says everyone must be creative in bed. The only rule for sex should
be that the adults having it are good to each other and have a wonderful
time together. If mutual pleasure can be achieved in a few wordless minutes
of penetrative bliss for a couple, that’s awesome. For them.

Unfortunately, Lisa was more typical than atypical and I was beginning to
wonder if the real reason she didn’t like sex was she didn’t like the way
they were having it. If her brain was saying “I don’t think so,” her vagina
was not going to long for him. For most adults, mind and body must both be
fully engaged for sex to be great. If our minds are not on the right page, our
genitals won’t be writing anything today.

A basic, healthy model of female sexuality is that sex needs to begin

(emotionally, psychologically) before penetration. The wisdom is a woman
needs “romance,” and I guess that’s one word for it. A more accurate way
to see it is that adults, and women in particular, need warming up: their
sexual brain chemistry has to be stoked. A healthy, organic model of female
orgasmic function begins in the mind (she has to feel receptive to her
partner). Biologically speaking, female genitals take longer to reach full
arousal than male genitals, so encouraging blood flow by touching is
essential for most females. Stimulation to erogenous zones (breasts, thighs,
ass, vagina) accelerates female arousal and leads to lubrication (along with
swelling in the labia, a primary signal that a woman is on the right path to
orgasm). And while penetration is important to some women, even those
who love it the most still want to feel held, kissed, and handled during the
sex act, and not just penetrated. Cuddling with an appreciative partner
afterwards is the best way to complete a sexual experience: not running off
to the bathroom as if you’ve been contaminated by toxic waste.

It sounded like Lisa had fallen into a sex-negative rut. Slowly and
unknowingly, couples can create their own negative feedback loops by
repeating frustrating or disheartening sexual experiences over and over
again, until they just can’t stand having sex anymore. Instead of accepting
that they need to make changes or perhaps learn to have sex in new and
better ways, they live with the secret pain and reassure themselves that sex
doesn’t really matter.

And that’s when Lisa dropped a bombshell.

Lisa had never touched her husband’s penis. She had grazed it with
her hand a few times, and sort of fumbled at it, but she had never
actually held his pulsing erection (or his soft cock) in her hand for
more than a few seconds. It was too embarrassing. She had never let
him touch her vagina either. He was usually hard by the time he got to
bed, so he always tried to steer his penis into her without ever having
to touch her.
So never mind about what may or may not be a normal libido for Lisa,
whether or not everything’s perfect in the home, and never mind that sex
hasn’t been as exciting since delivery. They’d never caressed each other or
had oral sex. Ever!

The simple fact is that no matter how many times you have sex with your
partner, you cannot have a good sex life if are afraid to touch your partner’s
genitals.

After enduring an entire marriage of mind-bogglingly bad sex, the “fix”

was getting her and her husband to learn the fundamentals of touching each
other. I suggested they build body comfort and intimacy by spending time
together naked with the lights on, until they were fully comfortable being
naked together. As usual, they hemmed and hawed at the beginning but
once they did their homework in earnest, it did not take very long for them
to make significant changes in their sexual interaction. Lisa learned how
much fun sex could actually be for a woman when she gets foreplay, kisses,
oral sex, and orgasms. It’s a whole different world then. She felt like a
newlywed again.

The Urge to Merge and Consensuality

In the first volume of this trilogy, Sex and the Self, I talked in detail about
the difficulties in defining sex. The word itself means different things to
different people, depending on their own moral codes and views about
intimacy. The best approach, therapeutically, is to let couples define what
sex means to them, and to work from there. But I’m going to offer a single
definition in this section, for the purposes of understanding why and how
sex may go wrong for people.

Sex is the drive to make an erotic connection with something

outside ourselves and to mitigate that urge.

In other words, sex is a combination of two things: 1) your biological drive

to form an erotic bond with a partner and 2) you relieving your craving for
that erotic bond.
The exact ways people choose to relieve their cravings at any given time are
so multitudinous and varied as literally to be undocumented. They range
from masturbation to baroque scenarios. Variations in themselves never
indicate a problem, no matter how weird or unappealing they may sound to
people who don’t find them arousing.

The old way of thinking about sex, the way Victorians and psychiatrists in
the past and plenty of sex-negative ignorami in the present think about it
still, is to assume that a variation was an anomaly or abnormality. Variations
were viewed as the root causes of sexual dysfunction, marital unhappiness
and relationship woes. Example: psychiatrists assumed that masturbation
was symptomatic of a mental disorder until the early 1960s, so if a husband
or wife was found to enjoy self-pleasure, they might be diagnosed as
neurotic perverts. Homosexuality and lesbianism were assumed to be
mental disorders in themselves (for no valid scientific reasons whatsoever,
by the way), along with a wide range of sexual behaviors people in the 21st
century generally consider acceptable.

Today, we know that the correct way to assess the well-being and
functionality of a sexual relationship is by examining how well the partners
function together as a unit. We can evaluate it according to a simple
standard of intentionality. It is the intentionality of an act – not the act
itself – which ultimately determines whether a sexual experience is
affirmative or destructive.

Take the act of sexual intercourse between man and woman, for example.
Among well-intentioned people who are eager for the experience and do
their best to give as much pleasure as they get, intercourse can be one of the
most sacred and blissful pleasures imaginable. But in a couple where a
partner is aggressive or emotionally cold, or conversely feels manipulated
or intimidated into sex, the same act can be damaging and brutal. It is, of
course, one of the toughest things for victims of domestic violence to
explain in court – that even though they technically consented to sex,
psychologically they felt raped and were left with the same emotional scars
as the victim who can provide forensic proof of violence.

Non-consensual sex is, by this definition, sick, perverse, and damaging. It

goes against our brain chemistry, which is designed to encourage
affirmation and joy through sexual bonding. Because non-consensual sex is
so contrary to human biology, it triggers fear and stress responses that can
distort how we see ourselves, our opportunities and even our entitlements in
life. It makes some people literally feel like damaged goods and invariably
diminishes their sexual function. In light of our growing understanding of
the brain, it is more than likely that a painful, frightening sexual experience
actually changes something in its structure. Victims of sexual abuse or
violence share a wide range of post-traumatic symptoms, including chronic
depression, higher risks for suicide and substance abuse, stress disorders,
and stress-related diseases. It is probable that one day, brain scientists will
be able to detect how their brains were altered by their experience of sexual
trauma.

That’s why I believe that everyone who manifests sex drive in anti-social
and deliberately harmful ways needs intensive counseling at the least and
permanent separation from society at the worst. Conversely, I think it’s a
maddeningly irrational social injustice to criminalize any form of
consensual sex between adults – and, in this category, I include everything
from swinging and spanking to sex-work and adult porn consumption.

Again, it’s about intentionality. The image of someone tied up during sex,
for example, bothers a lot of people. They associate bondage with images of
people held captive against their will (such as hostages) and imagine the
person doing it as unfeeling or vicious and the person tied up as self-hating.
But bondage people do bondage for all the same reasons straight people do
straight things: it gets their blood flowing, it makes their hearts pound, it
fills them with excitement, gets them aroused, and makes them feel
intensely bonded with the person they’re doing it with.

Consensual sex, no matter its expression, provides the body and mind with
that unfathomable, seemingly divine cocktail of natural chemicals that
make us feel more alive. As I see it, we’re all looking for happiness – we
just take different paths to get there. What we do share is the primal joy of
having great sex: it feels like sunshine in the human soul. So, does it matter
to me if one person has to wear a diaper to feel it, while another must be
plunged deep in his boyfriend’s ass, and another finds ultimate pleasure in
being vaginally penetrated by her one and only true love? No. All of us are
looking for happiness through sex: we just take different paths in our
individual journeys to get there.

Clinical experience has shown me that when clients with negative patterns
of sexual behavior start having positive experiences, it quickly begins to
improve the quality of their inner emotional lives. With abuse victims and,
really, anyone who is unhappy with their sexual relationship, the first step is
building a positive new sexual feedback loop that makes the connection
between sex and joy. The more positive experiences they have, the more
confidence they build about their ability to perform well in bed. The more
success they have in the bedroom, the more optimistic they feel about other
realms of life. While the science isn’t there yet, in my clinical experiences,
repeated experience of happy sex balances and heals the mind.
 Section Two

Diversity is Normal
As yet, the biology of sexuality is, in its entirety, unfathomable. It may be
decades before we begin to understand how our brains perceive sexual
stimuli or how neurons process the vast network of psychological and
biological phenomena associated with sexual response, from the first flicker
of sexual desire in the invisible recesses of our nervous system to a
conscious awareness of desire and visible signs of arousal.

We don’t even understand some basics, like sexual attraction. We don’t

know why a person gets turned on by Ms. A and not Ms. B, when Ms. B is
equally attractive. Maybe you’ve seen Internet studies showing that facial
symmetry is important, or certain features or testosterone make men more
attractive to women than others, and other such scientific curiosities. I place
very little faith in them as indicators of sexual success, because the real
mysteries of attraction are rooted in deeper forces than just noticing that
someone’s hot. Indeed, sometimes ordinary looking people are sexier to us
than technically beautiful people.

Over the decades, I’ve increasingly departed from standard psychiatric

definitions of sexuality and developed my own models for normality. The
old definitions and ways of thinking about sex are out of step with the
science and keep people ignorant and unaware of sexological advances. The
evidence we do have, which our forebears did not have, points strongly
away from all the traditional teaching that “men are men” and “women are
women” and “intercourse is the only normal sex.” Instead, the more data we
see, the more evidence we have that human sexuality is a fluid matrix of
variations in sexual and gender identity. Diversity is really the norm, not
– as psychiatry still treats it – the perversion. Indeed, conformity is a
perversion, because it forces people to behave unnaturally for no reason
other than the ideological belief that one type of sex is better than another.

Though study after study show that sexual variation is the norm, most
reporting, writing (and laws and medical treatment) continue to assume that
sexual conformity is the norm, and thus the ideal. Science and medical
researchers routinely use “sex” interchangeably with “sexual intercourse,”
as if other sex acts don’t count. Some of the studies I cited in Sex and the
Self which correlated orgasms with reduced risks for cancer and other
diseases, didn’t report whether men achieved orgasm from sex with
partners, with their hands, or some other way. This is exasperating to sex
scientists who want to know whether some acts are more beneficial than
others, so we can help people derive the most benefit from their sex lives.
Similarly, studies seldom make allowances for natural variations among
groups. When a report states “men prefer women who are XYZ,” my first
question is whether that sample included gay, transgendered, and bisexual
men and, if so, how their responses were factored in.

I have long opposed the American Psychiatric Association’s position that

some consensual behaviors may be pathological. To me, their authoritative
clinical reference guide (the Diagnostic and Statistics Manual) is so
scientifically backwards on matters sexual that it’s almost irrelevant to sex
therapists. I’m on the side of the scientists in Scandinavia (Norway,
Denmark, and Sweden) who, in recent years, have removed all consensual
adult behaviors (including consensual sadomasochism and fetishism) from
their version of the DSM. Their position reflects the 21st century science
and not the 19th century ideology that the American psychiatric
establishment still clings to.

To effect positive change in people who are suffering over sexual identity
conflicts or struggling with their needs and desires, I operate off two new,
evidence-based principles.

1. Sex and gender differences are NOT diseases or biological “flaws.”

They are normal manifestations of human sexological diversity.

2. Accepting one’s core sexual identity is key to personal happiness.

This boils down the sex therapy process into two parts: I use education and
facts to wash away shame and ignorance about sex with knowledge and
understanding. And, since people can’t be happy until they make peace with
their sexuality, I encourage them to embrace their core sexual identities and
make rational, healthful, affirmative choices based on what they really
need. As I tell my clients, sex therapy isn’t about changing who you are but
about becoming who you really are.
 Sexual Identity Crisis and Conflict

TERRI was a modestly dressed woman in her early 40s, suffering

from depression and chronic fatigue syndrome. But that was not why
she had driven 200 miles to see me. She had come because she was
unhappy with her sex life with her husband, Bill. Some nervous
explorations on the Internet had helped her realize she really wanted
kinky sex, and she wasn’t sure how to broach it with him. She was a
conservative Christian, and her equally religious husband was a
deacon in their church.

Another problem plaguing Terri was that she had had a deeply
troubling, long-term lesbian relationship in her youth. Her girlfriend
turned out to be psychotic and violent, and Terri literally had to flee
her. She didn’t feel safe again until she met Bill, a soft-spoken, kindly,
undemanding teddy-bear of a guy. She prayed that marriage would be
her salvation. But now that their only child was out of the house, she
felt empty and alone, and she’d been thinking a lot about being with a
woman again.

She couldn’t talk to her church pastor; she couldn’t even attend
services in good faith anymore. It was church gospel that people
“choose” to be homosexual. She didn’t choose it. Did she? She felt
like she was falling apart on the inside.

Terri was so distraught, it was all she could do to wheeze out her story
between sobs and trembles. As I took her sex history, I realized that the
angst-ridden woman sitting across from me in a crisp white shirt and neatly
ironed pants with tiny pearl studs in her ears, tiny gold cross around her
neck, and sensible pumps on her feet, was likely a kinky lesbian submissive
in denial.
 Though Terri believed that gay people should have freedom, she
believed in it for other people, not for herself. She had always lived as
her family and community expected her to live, and not as she,
secretly, wished she could live. She couldn’t imagine another life. She
wasn’t a “lesbian” lesbian. She could live without it. She had proven
that she could have a normal marriage to a man. Yes, she could only
climax with him if she was thinking of women, but she enjoyed the
sex with him anyway.

There’s a peculiar misconception that if you are gay or lesbian you are
incapable of performing with the other sex. Not only can some gays and
lesbians perform very well in bed with members of the opposite sex, some
enjoy the occasional heterosexual romp. As I’ll be explaining in the second
part of this section, there are hundreds of shades of gayness, lesbianism,
bisexuality, and everything else. Emotionally, it even made sense that Terri
would have decent sex with her husband. It was the first and only mutually
respectful sex – with someone who was always gentle and kind – that she’d
ever experienced. They loved each other and wanted to please each other.
They may not be the ingredients for complete fulfillment but they are the
basic ingredients for mutual pleasure in bed.

The more Terri talked, the more the history of her disastrous lesbian affair
took center stage. Terri had made a lot of assumptions about sexuality based
on that affair.

She was worried that her fantasies of being spanked and tied up by
women were signs that she really wanted to be abused. Why else did
she stay with her violent girlfriend for so long? Still, she always
fantasized about women when she had sex. In real life, they terrified
her. She didn’t even feel comfortable making friends with women at
church.

I did my best to address her immediate concerns that day, including better
stress management, advice on broaching BDSM with Bill, and masturbation
exercises I thought would be fun for her and help with the stress (you can
find samples of those exercises in the first volume, Sex and the Self). But I
knew it was like applying band-aids to septic wounds. Until Terri was ready
to confront the real issue, that she was trying to be someone she wasn’t, our
work together would not go far.

We may never find a “gay gene” or other definitive explanation for why
people are gay or lesbian, but the historical evidence is conclusive.
Homosexuality and lesbianism are normal sexual orientations that have
been amply documented since the beginning of human history. No matter
the time or place, no matter the community standards or religious dogma,
homosexuality is, always has been and always will be well within the arch
of normal human sexual experience. The story of how and why our culture
has come to believe that gayness isn’t normal is not a rational history but
rather a series of belief-based fears about the meaning of sex based on the
idea that the Supreme Being only wants people to have sex in a way that
produces babies.

It was the Victorians, seeking to put a more scientific face on the irrational
and condemnatory religious attitudes towards sex, who came up with the
idea of dividing human sexual behaviors into categories. They sought in
earnest to end sexual misery, but their narrow dogma only prompted new
forms of misery. They labeled everything that varied from reproductive sex
in marriage as pathologies, including jerking off, oral sex, and even lust in
women. They were dead wrong about it all.

Anyone who has spent a minute on the Internet knows that real people have
sex for pleasure, that pleasure takes a million different forms, and that we
all want to look at it even when it isn’t our cup of tea. We all know it, but
our culture and laws still operate on their patriarchal, religious assumption
that sex for pleasure is evil, and that its depiction, whether through art or
pornography, is obscene. I would love to see Freud on the Internet and
wonder what he would make of sex in the 21st century.

When societies proceed on the basis of fundamental sexual ignorance and

ludicrous, unscientific theories, we all feel the burden. Public sexual health
suffers and puts a strain on the health-care system. Sex acts that don’t
conform to the model are hidden, whispered over, laughed at and
condemned. If you’re born to be a little different from the mainstream
expectation, that burden can become very personal.
I call it a sexual identity crisis when we internalize the way society tells us
we’re supposed to be and that image clashes with the person one is inside.
The vast underlying biological realities of our brain structure, DNA, and
individual responses to environmental stimuli from birth to death (all of
which are contributing factors in sexual identity) cannot be shut down
without negative consequences. Repression, denial, and avoidance make us
feel helpless and often lead us to deceive others about who we are. They
take a huge toll on our self-esteem and, over time, can warp our self-image
and our relationship to the world. Sooner or later, people who suppress their
innate sexual identity are bound to experience a sexual identity crisis.

For me, the five hallmarks of a sexual identity crisis are

1. A constant nagging sense that something is missing from your sex life
with your partner.

2. Fantasies or sexy thoughts that are both deeply arousing and deeply
emotionally troubling.

3. Feeling that if the adults who are close to you knew the “real” you
sexually they would reject you, so you have to wear a mask.

4. A pattern of loss of interest, instability or cheating in relationships.

5. A pattern of avoiding sexual intimacy.

Although these symptoms may all be explained by other diagnoses, in my

opinion, people who can say “that’s me” to all of the above are likely
struggling with an underlying sexual identity crisis.

I couldn’t tell Terri that her personality was now collapsing under the
burden of her efforts to live a life that was completely counter-intuitive to
her identity. It’s not as if a gay person learns she’s gay and says, “Eureka!
I’m gay! That solves all my problems!” (Although in Dr. Brame’s perfect
world…well, wouldn’t it be nice if connecting with your authentic self was
a positive value in our world, something people looked forward to as part of
the process of adulthood?)
Given how invested she was in her view of the world, even telling her she
was lesbian at that stage might have shattered her. While most gay and
lesbian people are aware they’re different from heterosexuals even as little
kids, they may not know what homosexuality is or feel it really applies to
them. If they grow up believing that being gay or lesbian is a bad thing or
an impulse they must repress to be loveable, their true identity may be so
deeply buried, even they can’t fully access it.

I knew a wall was the only defense system Terri had ever developed. I knew
she built that wall around her authentic sexual identity to protect herself
from threats both real and imaginary. Part of the process of healing from a
sexual identity crisis is redefining which threats are real and which are
based on ignorance or fear. Until Terri could build a new, better defense
system, one that really did protect her from genuine threats (such as
predators and violent homophobes) while letting in good stuff (such as
potential loving partners), that wall was her only true security.

There was another reason I didn’t want to give Terri a label that day. While
“kinky lesbian submissive” may sound pretty darn specific to some, to me,
it’s clinically generic. There are too many kinds of kinky, too many kinds of
lesbian, and too many kinds of submissive for the “kinky lesbian
submissive” label to be more than a starting point for me, and a general
guide to understanding Terri as a flesh and blood human being. Only real-
life experience would establish what worked best for Terri emotionally.

Terri’s story has had such an inspiring arc since that day, almost 10 years
ago, when she first drove through the foothills of the Georgia Piedmonts to
talk to me. Her journey deserves its own book. She never gave up on
therapy, no matter how painful and depressing it was at times. Eventually,
she didn’t need me to tell her who she was or give her a label – she knew
exactly who she was. It didn’t make life easier – there was so much safety
in staying where she was. But it inspired her to make change and take the
risk that she could and maybe even would find happiness after all this time.

And – not by miracle, not by twists of fate, but by believing in herself, and
knowing that she deserved to be loved as she was made, and making
choices that respected and honored her value as a human being – she
succeeded beyond all expectations. She got a very amicable divorce, came
out to her family (for better AND worse), moved to a bigger city, joined a
Lesbian/Gay-friendly church, and after some mighty bumps in the road,
finally met a beautiful, loving sexy dominant woman. They just celebrated
their fourth happy anniversary. These days, that weepy hopeless church
lady is a radiant, cheerful, and incredibly strong church lady. It’s a beautiful
thing.

Coming to terms with your authentic sexuality identity is a process of small

changes and big insights. A sexual identity crisis can be healed when people
integrate what they know about themselves in their head with the choices
they make in life. Step by step, they can make life choices from a place of
education and self-awareness. They can break with the pattern of
disappointment they came to expect as their lot in life, and start growing a
life with a new assumption – that every adult is entitled to sexual
satisfaction.

This applies as much to mainstream heterosexuals as it does to anyone else.

Countless couples live in a state of sexual anxiety, feeling dissatisfied,
frustrated, confused, scared or sexually abandoned, treating sex like a
Molotov Cocktail rather than a normal and routine part of intimacy, or a
great topic for conversation with your partners.

Sexual identity crisis usually takes a different form though among those
who, at least superficially, conform to social expectations.

MARC R., a medical supply salesman from the Midwest, said he did
everything he could think of to make his wife happy. He bought her
the house she wanted and a new car every two years. He helped
around the house too. But no matter what he did, she always found
reasons to criticize him.

Their sex life was as dead as a doornail. He hadn’t touched her in

three years. No great loss. She was so unresponsive in bed, it was like
fucking a corpse. He loved her but there was nothing sexual there for
him anymore. His big secret, and the reason he was really seeing me,
is that he had been going to sex-workers. He felt bad about it, but,
unlike his wife, sex-workers always knew how to make him feel
 good. Escorts made sex simple and fun, the way he thought it should
be. His wife wouldn’t even go down on him.

I realize some people might, at that point sit up and say, “You selfish swine!
You, Sir, are a sex addict!” However, I was more interested that he had
found deeper satisfaction and intimacy with strangers than with the one he
claimed to love and to whom he had vowed fidelity. I wanted to know what
that meant and how this situation evolved.

Figuring out why people behave badly so you can help them to make better
choices isn’t about jumping to easy judgments. It makes me livid when I
hear experts in media leaping to bone-headed conclusions about human
behaviors on the assumption that we are all cookie-cutter versions of one
another. I am not saying that Marc sounded like a stellar character but I also
knew there was more to the story.

I was interested in his wife’s unresponsiveness in bed and how it made him
feel. Being with a partner who doesn’t reciprocate your passion or
demonstrate some basic enthusiasm through words or acts has a strangely
dejecting effect on people, and can be murderous to our self-esteem. We are
at our most vulnerable during sex because we are at our least rational. If
Marc was a fragile or wounded person, his wife’s obvious distaste for
physical intimacy might have shut him down emotionally and made him
change his perception of her from an exciting sex partner to an obstacle to
his pleasure.

No doubt, his wife would tell a different story. Marc hadn’t brought her
with him because, as he confessed, she’d leave him if she found out about
the affairs. On one hand, that would be fine by him; it would be a decision
he could live with. On the other, he didn’t want to hurt her by telling her the
truth.

Whether or not she found out, I knew he was not the man she thought she
had married. And if your therapist knows it, the person you live with
probably knows too, even if they don’t know or understand the reasons
behind it. Marc wasn’t the guy who vowed monogamy and meant it
anymore. He might pretend to be the same guy on the surface but he had
changed. I could hear the anger and frustration in his voice when he spoke
of her. I’m sure she heard it when he spoke to her too.

It was time to come clean. His wife deserved to know that truth. It was
moral fraud to let her believe that he still believed in the promises they once
made. He was, in effect, deceiving her into staying married to him. Marc
agreed but was so ashamed of himself he couldn’t face her. He had come
close to blurting it all out once or twice, but always held his tongue at the
last minute. When it came right down to it, he was afraid of losing her, even
though he found more comfort in other women’s arms.

This helped me understand part of what was driving him to sex-workers: it

was much easier to talk to people who were uninhibited and sexually
experienced. He felt better about himself talking to people who had so
much more, and so much more varied, sex than himself. He didn’t feel
abnormal when he was around them. Sex-workers, porn stars, strippers, and
yes, even nerdy sex therapists, provide something most people can’t get at
home: explicit and emotionally stress-free conversation about sex. For
Marc, cheating on his wife had opened the door to a kind of sexual
openness he’d never known and which he now craved.

Cheating is not one monolithic phenomenon, but the consequence of a

series of bad choices whose reasons vary from one adult to another. Here is
a list of the 10 most common reasons I’ve heard in my office and email
since I’ve been a therapist:

1. My partner doesn’t like sex as much as I do.

2. My partner doesn’t like the kind of sex I like.

3. My partner tries, but just doesn’t “get” what I need.

4. I tried, but nothing I did ever seemed to really work.

5. My partner and I never talk about real things.

6. My partner doesn’t make an effort to initiate sex with me.

7. All I get at home is criticism and negativity.

8. Even though I’m lying to him/her, my partner wouldn’t really mind.

9. My partner cares more about (“their job,” “the kids,” “the pets,” “the
financial security”) than me.

10. I feel deeply lonely in my relationship.

For better or worse, adults may feel any or all of the above at moments,
even in great relationships. Human moodiness makes long-term committed
relationships a challenge unto themselves. But when such feelings are
chronic, the pleasure of sex with a partner is gradually replaced by feelings
of alienation and true intimacy vanishes.

Instead of sex being a hot, affirmative, loving connection that brings joy
and release, it is a quiet nightmare of performance anxiety and self-
fulfilling prophecies of sexual frustration. Unfortunately, when your
expectations of sex are low, you usually end up having dissatisfying sex.
And when you are dissatisfied with sex, it sends negative emotional ripples
through your psyche, which can destabilize your self-image (What’s wrong
with me?) and erode your self-esteem (Maybe I’m not good enough?).

At that point, all bets are off on how adults will handle their emotions. The
spectrum of human responses to sexual frustration (or feeling sexually
thwarted) is literally mind-blowing. Some people bow to circumstance and
suffer in quiet. Most people live with it uneasily and bitch about it until
they’re tired of bitching. Others get so angry, they rationalize breaking their
own moral codes and cheat as a form of revenge. (Needless to say, in a
mentally unbalanced person, once rage is triggered, the outcomes may be
violent. I think of most violent sexual crimes as a “sexual snap” – that
moment when a fragile personality can no longer handle the stress and
tension of feeling sexually thwarted and becomes blinded by primal ape-
like rage.)

Marc was a very angry man. He was angry at his wife for failing to satisfy
him and at himself for failing to be a good husband. Guilt twisted his
perspective. The more he cheated on her, the worse he felt; the worse he
felt, the more he blamed her; the more he blamed her, the more he cheated
and the angrier he got. It was a desperately self-destructive cycle.

Marc’s biggest problem, however, was not the cheating per se but his own
moral compass. He had to take responsibility for his own choices. Being
angry at his wife for “making him” cheat, for example, was lame. He could
have made other choices, including seeing a counselor when the problems
first began. On the other hand, his frustration and loneliness were
understandable. The real question we would ultimately work on was who he
really was and what kind of life could he live with. I know it sounds funny,
but it’s the reality of adult life. Nothing is perfect but we can find a place of
peace with our core sexual identities even if we can’t live out all our
fantasies and dreams in the real world.

Even in high school, Marc liked dating different girls and playing the
field. By college, he was sleeping with as many female classmates as
he could. He gave up his wild ways when he got married but during
the last several years he’d made up for it with paid encounters of
every type, from hot-chat on porn sites to web-cam models, escorts
and happy ending massages whenever he traveled – which was
weekly. Apparently, on the day he decided it would be okay to cheat,
he returned to his bachelor ways with a vengeance.

That he had managed to conceal his alternate life as a sex shark from his
wife actually told me as much about the wife as it did about Marc: she did
not question his weird work hours, did not check any of his bills, and never
mentioned their sex life, perhaps because she herself was relieved it was
gone. I explored the early sex history of the marriage. Like a lot of my
clients, at first Marc painted a rosy picture of their honeymoon bliss but as I
asked pointed questions – How often did they have sex in the first year of
marriage? What activities did they try together? – the bloom faded off that
rose in a hurry. She had never wanted to experiment or try anything outside
of intercourse. He got married assuming it meant he could have sex every
night. She was more of a once-a-week girl. He remembered fights they had
when he’d try to get her to watch porn with him or try sex toys. She
threatened to divorce him once when he tried to get her interested in a
three-way, so he dropped that idea permanently.
It sounded to me as if the real issue was a sexual identity conflict with his
wife. I call it a sexual identity conflict when there is a clash between what
one person wants and needs to be sexually fulfilled and what the other one
wants and needs. Shared sexual orientations or preferences does not
guarantee sexual compatibility if your brain is not receptive to and aroused
by your partner.

Marc wasn’t just hornier than his wife, and more experimental than his
wife, he was strongly driven by the need for variety. His wife simply was
not wired that way. My guess is that his constant pressure on her to do more
and different things ultimately made her retreat from him altogether. She
probably felt she would never be able to give him all the sex he needed. She
was right about that. A person who needs and wants sex every day cannot
be completely satisfied by a partner who likes sex only once a week, and
someone who constantly craves new sensations is a tough match with
someone who just likes meat and potatoes.

The sad thing is that people blame themselves, or get angry with one
another, over natural, normal variations in desire. Some people blame the
more sexual partner (“Why can’t he/she control him/herself?). Some say it’s
because the less sexual partner is too inhibited. In my view, that’s all just
moralizing. We don’t know enough about sex to know whether people are
born to be monogamous. We know that most people vow monogamy but
data shows that about 50% or more of them can’t keep that vow.
Monogamy is a traditional (and ancient) cultural value; but promiscuity is a
traditional (and ancient) human behavior.

I’m inclined to follow the behavior trail, not the social values one. Instead
of looking at cheating as a sign of some mental disorder or “emotional
problem,” or (heaven forbid) a “sex addiction,” I see the need for variety in
partners as a common adult behavior, as in line with our natural biology as
monogamy.

I first started thinking about compatibility issues in monogamous

heterosexual couples while mulling over some BDSM research. One of the
truisms of kinky sex is that it isn’t enough to be kinky, your kinks have to
line up. For example, just being a BDSMer doesn’t mean you are kinky in
the same way as everyone you meet and can therefore enjoy sex with
everyone who shares your kinks. A bondagist, for example, who is agog
over shibari and adores weaving exquisite rope webs for hours is not a good
match for someone who just wants the restraints slapped on so the sexual
teasing can begin. Put another way, one woman’s ecstatic bondage is
another one’s utter boredom.

So it makes sense that heterosexuals are born to be different from one

another in the minutiae of preferences and turn-ons. I’m not talking about
sex drive per se, but about variations in how it is expressed. Some adults are
only comfortable with intercourse, but far more adults and others can’t be
happy without oral sex, while some need role-play and fantasies, but others
are turned off by anything artificial in bed. I had a client who was so
physically sensitive, anything more intense than light hugs or firm touches
made her shrivel up in discomfort. She liked a lot of gentle arousal and
kissing, followed by a few minutes of gentle penetration. She actually had a
wonderful sex life with her husband, because he was happy to be very
gentle and soft with her in bed. But I’ve known plenty of people who can’t
even begin to imagine having sex and not giving love bites, or pinching
someone’s nipples, or banging them into exhaustion.

We are generally taught that sex flows from romantic love: that when we
fall in love with that one right person, sex is the expression of that love. At
least that’s how it’s always depicted in books and movies. In real life,
romantic love is a by-product of the sex chemicals in our brains. It is not the
“heart” which desires: it’s the brain. Passion is a poetic term for a series of
biological processes and brain functions operating in symphony. We first
consciously realize we are attracted to someone after we’ve reacted to them
biologically. Those sweet little human behaviors of holding hands and
sharing a first kiss are tentative mating gestures which help us determine
whether the physical connection is real, and – emotionally important to all
humans – whether your partner’s interest and arousal is reciprocal.

Yet even when you think someone is hot and the kiss is good, you may still
feel differently once you are in bed together. Their smell, the taste or texture
of their skin, the quantity of body hair, their grooming and cleanliness, and
multitudes of other minute differentials can change how much they turn you
on. Studies have shown that females are repelled by certain male smells and
turned on by others. No one knows why a whiff of one man’s sweat arouses
one woman and makes another gasp for fresh air. We do know, however,
that when females ovulate, and their hormones change, even male smells
that turned them off before now smell pretty good.

In healthy people, when the sexual chemistry is right, passion sweeps over
us. It feels mystical but it is really our blood stream being doped by our sex-
o-centric brain. The fly in the sex ointment is that our primal mating
biology is not a predictor for good human life choices. You also have to be
able to make rational and realistic decisions about what to do with those
feelings. Whatever may be going on subconsciously, our realities and lives
are built on the conscious choices we make when we interact with other
human beings.

Unfortunately, the biology of sex does not coincide with our cultural belief
systems, which makes adults feel like freaks for not conforming when, in
fact, variety is the way of human life, whether expressed in our appetites for
food, how we style our hair or what clothes we wear, or our individual
sexual preferences. One of the most common problems I’ve seen in couples
with sexual identity conflicts is that when they first met or married,
everything seemed great because their hormones made them so horny for
each other.

There is a ton of research now about ‘newlywed sex,” showing that in the
first two years of a marriage (but, really, any romantic relationship) partners
are coasting on a kind of natural high from the mix of elevated hormones,
opiates, and feel-good chemicals flooding their bloodstream.

Researchers have said it takes about two years for that hormonal haze to
subside back to more normal adult levels. In my experience, that tracks well
with the timeframe for subtle signs of sexual incompatibility to emerge. It
usually begins harmlessly. Perhaps one partner isn’t in the mood as often, or
suddenly life is so busy that sex gets shuffled to the bottom of the priority
list. Or there’s an unexplained drop in the temperature of your sexual
connection. Maybe one partner starts noticing the other one’s flaws or
doesn’t feel as turned on as before.
More hurtful is when one partner declares, by fiat, that they will no longer
have a kind of sex they formerly indulged. It’s an extremely common
complaint among men that their partners were happy to do XYZ during the
courtship phase, but once they settled down, the partner pulled the rug out
from under them.

ARDEN was a shoe fetishist who had married a woman in part

because she was so sexually free. She let him buy her shoes, she let
him kiss her shoes, she even let him buy himself matching shoes in a
larger size so they could wear their shoes together. [I know,
ADORABLE!] She was fun and frisky throughout their engagement
and for a few years into their marriage. But one day – for reasons he
never understood – she dramatically collected every sandal, boot and
shoe associated with their sex play and threw them all away. She told
him she only wanted “normal sex” from then on.

I’ve heard hundreds of iterations on this theme, and it’s hardly limited to
fetishes. Sometimes, even small sexual favors become grounds for war,
with couples spending more time fighting over it than it would’ve taken for
them to have some tension-relieving intimacy and move on with life.
Husbands often complain that their wives were willing to engage in oral
sex, or group sex or other spicy variations when they first met. They felt
bewildered and betrayed, as if they’d been lured into marriage under the
false pretenses of a happy sex life.

My guess for Arden’s wife was that once her flush of hormones faded, her
genuine sexual identity, the one she had before she met a man she wanted to
marry, resurfaced. Though Arden had assumed she enjoyed the footplay, I
knew there was always the possibility that her hormones and brain
chemistry made her more accommodating and willing to stretch her own
boundaries for the sake of pleasing him.

It is sexual nature that when hormones run high, people will go to extremes
to achieve intimacy. That is my nice way of saying people will do anything
to get laid. It really shouldn’t be a mystery because biology is pretty clear
on that front: from the instant the brain perceives a mating opportunity until
the brain feels fully completed it drives us – through hormones and other
brain chemicals – to mate.
The two-year hormone cycle – a distinct phenomenon that repeatedly shows
up in reproductive medical studies - raises a new question for me: does our
brain chemistry incline us to be ready for a new mate after a couple of
years? If it’s an established pattern that many (though certainly not all) of us
lose desire for our partners, is this a flaw of our sexual biology or a feature?
Either way, acting on it is usually disruptive if not catastrophic when you
are in a committed monogamous relationship.

What about the happy couples who never run out of juice for one another?
Does that mean that some of us are wired for monogamy and can be
completely sated and turned on for life by one partner? We don’t know yet
if there is a biological explanation for sexually blessed couples or whether
it’s a function of environmental, psychological and emotional factors,
including common interests, shared values and good communication. We do
know, however, that because of greater emotional and social factors, people
choose stability in relationships, even when they aren’t sexually compatible;
and that some people, luckily for them, are absolutely satisfied with one
partner for life.

Emerging research suggests that simply having good sex with someone for
a long period of time may alter our internal biology sufficiently to make us
want to stay monogamous. There are psychiatric studies about brain
structure changing through repeated positive experiences; there are
endocrinological studies showing that chemicals released during sex
promote bonding and nurturing (both of which subtly encourage
monogamous behaviors); there are emerging studies on the positive
bonding effects of ingesting semen during sex too. Add them all together
and it’s not out of the box to speculate that the more fun you have in bed
with your partner, the more your biology feels “rewarded” by the
connection, and the better your scenario for fulfilled monogamy. The
opposite holds true as well: the more negative or dissatisfying the sex, the
more likely it will promote the brain chemistry to make you feel restless,
lonely, and ready for someone new.

Many people have explained to me their feelings upon meeting someone

exciting after a sexually dry marriage. It is like a spiritual awakening: they
feel younger, more energetic. Passions they thought had died long ago
suddenly fill them once more. They feel sexier and more sexually alive than
when they were young. Suddenly, the world is a more beautiful place. The
future seems more hopeful. Life has more meaning.

We can explain that phenomenon: natural drugs. The reason people feel
born again when they have affairs is because their brains are once again
gurgling with delightful chemicals, stronger than their conscious minds.
They really do have more energy and more optimism: they are high on
nature’s own, best anti-depressant, oxytocin. Although much has been
written about the benefits of oxytocin to new mothers, there are five distinct
effects which influence sexual behavior in all adults.

The Production of Oxytocin

1. Encourages emotional attachment and bonding

2. Increases sexual arousal

3. Triggers protective instincts

4. Improves communication skills

5. Raises level of generosity

From a sexological perspective, all of these are key ingredients in a truly

successful, bonded relationship: we want adults to find someone to love, we
want them to be aroused by their partners, we want them to feel protective
(i.e., caring and tender) about their partners, we want them to communicate
openly and clearly. Meanwhile, generosity is of profound psycho-sexual
value in a permanent relationship – it makes us feel the other person loves
us enough to indulge us. It’s fascinating to know that oxytocin contains the
vital ingredients for romantic love in chemical form.

The longing for new and different is normal. The idea that we should all
conform is perverse. In light of new research, it’s inhumane. The old
paradigms, and quite a bit of Eastern medicine today, shared the belief that
we each possess identical potential and can thus be guided towards an ideal
model. We know this underlying assumption is false. We each have
individual potential and that potential varies in its minutiae, making some
people natural athletes and others natural nerds.

An article on identical twins published in 2012 (in the journal, Progress in

Neuro-Psychopharmacology & Biological Psychiatry) showed that even
when identical twins’ environments were identical, “genetic factors
[account] for 35 to 50 percent variance in human happiness.” This makes
sense to me: when it comes to questions of personal happiness, we really
are all created differently.

What each of us does have is the potential to find a model that is ideal for
us as we are, not as someone else thinks we should be. When adults feel
compelled (by society, religion, family or peers) to live a lie, inner peace
seems almost unimaginable. But it is not only imaginable, it is attainable
when you learn who you are, accept who you are, and make life-affirming,
positive, and satisfying choices based on the truth about yourself.
 Sex Should Be What It Is

I look at sex as it is, not as it should be. Thus, I often wonder why culture
continues to insist that sex be things it is not.

For example, a truly impressive new study from the Kinsey Institute
provided great data to support what sex researchers had always suspected:
only about one-quarter to one-third of all women have orgasms from
vaginal intercourse. The data may be new, but the understanding that
women need more from sex is at least a century old. Away from public
view, sex counselors, activists and educators have been guiding women to
discover their true orgasmic potential through non-penetrative sexual
pleasures since the early 20th century. Yet 20th century science, medicine,
law, and religious teachings remained rooted in the assumption that vaginal
intercourse is a woman’s only “normal” and legitimate pathway to sexual
pleasure. The result: large scale inorgasmia and female sexual dysfunction.

In my book, Come Hither, I talked about a study which claimed that 40

percent of all women were sexually dysfunctional. I speculated then that
instead of labeling women who weren’t orgasmic from intercourse as
dysfunctional, we should be asking if another type of sex would bring them
to climax. At the time, I was thinking of kinky women, who often are more
orgasmic from BDSM acts than intercourse. It seemed unfair to label a
woman “dysfunctional” if she had orgasms from spanking or nipple torture,
even if she didn’t have one while making love.

The Kinsey study affirms what other studies have shown: most women need
more than the act of penetration for orgasm. Ironically, very few women
seem to know that (and even fewer men). More often than not, when a
client comes to me complaining of inorgasmia, and I ask her whether she
can climax from masturbation, she reports that she never masturbates.
As I detailed in Volume I, a quick way for a sexologist to discern whether
someone’s sexual dysfunction is organic (has an underlying cause, like a
disease or disorder) or psychological is by finding out if they can climax
from masturbation. Masturbation is a baseline: if you can get yourself off,
your problem is likely to be partner-related. If you cannot climax from
masturbation, the problem is likely with you. If you don’t know how to give
yourself pleasure, or are too inhibited to do it, the problem is definitely with
you. When I have clients who have no baseline for sexual performance, we
have to establish one before I can begin to figure out the nature of the
problem.

I’ve gotten many a woman to begin that process as a necessary first step to
finding true sexual happiness with a partner. If, as a culture, we really cared
about improving female sexual function, we’d openly discuss women’s
need for sexual variety. Doctors, therapists, and psychiatrists would
question female patients about their oral sex lives and amount of time spent
on foreplay before writing a prescription. We would stop blaming women
for being uptight or labeling them when they can’t climax during
intercourse. Most importantly, women would stop blaming themselves.

Next, let’s look at cultural standards on remaining chaste until marriage. A

2008 academic review of 35 different longitudinal studies on pre-marital
sex (Zimmer-Gembeck and Helfand, 2008) yielded the information that
between 70 and 90 percent of us are sexually active by the age of 18. So
why do we persist in upholding “abstinence until marriage” as a national
standard of virtue when only 10 to 30 percent abide it – roughly the same
percentage as those who think the earth is flat? Are we deliberately trying to
make people feel bad about themselves?

Scientifically, human sexuality should never been arranged on a hierarchy,

with some types of sex being “better” or “healthier” or “more virtuous”
than others. But the Victorians saw the whole world as a system of
hierarchies. They thought that males were superior to females; that white
men were superior to black men; that rich people were superior to poor
ones; that people with good health were superior to people with poor health.
And they thought the kind of sex their preachers and priests told them was
proper was therefore superior to all other forms of human intimacy. In fact
they were sure of it.

The pity of it for tens of millions of people since then is that they were
tragically wrong. Sexual variety isn’t a template for moral judgment. It isn’t
a hierarchy. It’s an index of hope that all adults can experience sexual
pleasure. Look how diverse we are! How cunning, creative and adaptive.
Humans are sexually amazing creatures, capable of extraordinary
adaptations and fantastically complicated sexual relationships. Nothing is as
psychosexually and biologically complicated as two (or more) people
having sex.

And it is precisely because partnered sex is a collision of mysteries that we

all can effect positive change in our sex lives. Diversity is our salvation. It
opens doors to endless possibilities, allowing people of all ages and
capabilities to experience pleasure. Our biology wants us to know sexual
pleasure. That’s why humans have so many different ways of deriving
pleasure from their bodies and the bodies of others. It’s what we were wired
for. I acknowledge some types of sex or relationships as different -- in the
sense of being rarer, less common -- but view ALL expressions of
consensual sex for pleasure as normal and affirming.

From Here On
This section, RULE 2 (Diversity is Normal) now takes a totally different
textual direction, because I want to talk about my theories and views of as
many of the different variations and common ranges of sexual experience as
possible without turning this section into an encyclopedia. That means a lot
of lists and short paragraphs as I go through variation after variation, across
sexual identities, gender identities, and sexual behaviors. Some are
incomplete works in progress; some areas (such as BDSM and polyamory)
are personal interests and therefore get special attention if only because I’ve
researched them so extensively over the decades.

These are models I’ve developed over the last 20 years, set in words for the
first time here… but NOT set in stone. In my opinion, nothing authentic in
the study of sex can or should be set in stone: it should be open to question,
debate, refinement. When I’m working in the office I don’t use matrices or
charts: I use intuition. But since my goal here is to give you a complete
education in the varieties I’ve seen and studied, I’m going to split things up
into charts and lexicons to spell it all out.

If you or someone you know wants to debate my definitions, or wants to tell

me about research I should factor into my models, follow me on Twitter
(http://twitter.com/drgloriabrame) and tweet me the good word. Your input
may make it into future editions.
 Labels, Definitions and Sex Models

I’ve never found a full set of sex models that I could use, or a matrix that
actually worked for me in my practice. Models from other disciplines (such
as sociology and cultural anthropology) don’t hold up under sexological
scrutiny. Models from the past are unreliable. Even the best sex research is
always going to be flawed somewhat by our inability to truly and absolutely
study sexual behaviors objectively.

This is the biggest conundrum when you study sex. It’s like trying to study
someone who’s in love: you may observe that they’re happier, smiling
more, acting different, but that doesn’t explain why they fell for this person
and not another, or how that person makes them feel inside. Nowadays, we
can put people in MRIs to observe how their brains work during orgasms,
but we still can’t understand fully how they felt physically, emotionally,
psychologically about their orgasm.

How people feel about their experiences or even react to the same
experiences is unknown and possibly unknowable, at least in quantitative
terms. One reason is linguistic. Have you ever tried to describe an orgasm?
Somehow, when you try to put it into words, you can’t quite capture it.
Meanwhile, how your orgasm felt to you is not how his or her orgasm felt
to your partner. And how your orgasm feels today may not be the way it felt
yesterday or last year, or the way it will feel tomorrow.

Sex in humans is deeply personal, deeply emotional, and infinitely arbitrary

and inchoate. That’s why I think it’s so tough for people to reach consensus
on what labels mean and who they apply to. My focus therefore is on
staying true to yourself, and not worrying about labels or definitions that
don’t feel right to you, whatever your reasons. Here are quick summaries of
some of the clients I’ve worked with to give you a tiny taste of the diversity
I see.
 TAN and MAI were Christians whose kinks and fetishes were
clinically BDSM behaviors yet who did not see themselves as
BDSMers because they felt the BDSM world’s moral values
conflicted with their own. Their relationship was strictly private. I
was the only other person who knew they had a Master/slave
relationship in the bedroom.

CARESSA had struggled with her gender identity since puberty. She
mainly lived as a biological man but periodically would feel she had
to commit to her female identity, and would live as a gender woman.
Eventually she’d drift back to her male identity, in part or fully, then
she’d crave to live as a female again. She finally grew to be
comfortable with fluidity, but still never liked any of the labels. “I’m
CARESSA!” she said. “That’s enough of a label for me.”

JOHN had sex with his friend Doug but he didn’t consider himself
gay. He liked to set up threesomes with Doug and another woman. If
they couldn’t find a woman, they helped each other out. To him, gay
meant you fell in love with men. He didn’t feel romantic about men,
only about women. He actually felt heterosexual, though he accepted
that his behavior was technically bisexual.

One could, of course, argue with all of the above people, and show them
textbooks which have names for them. But why? I understand the purpose
when it’s a disease or a mental illness: if you know the illness, you may
have a reliable treatment plan or protocol you can follow. But sexual
variations aren’t illnesses, and no one who knows the sexological literature
tries to “cure” homosexuality, consensual sadomasochism, or any other
normal sexual variations.

At the same time, understanding the differentials in how people relate, the
structure of their relationships, how they identify their own needs and
desires are all important factors in helping them build happier, more
empowered sex lives.

Here is a summary of the five key areas I assess when helping people
resolve relationship conflicts:
1. RELATIONSHIP TYPE: What kind of relationship are they currently
having (married, long-term, casual, etc.) and what is their history of
relationships?

2. SEX ACTS: What kind of sexual intimacy are they currently having in
their relationship and what was their history of sexual experiences with
others?

3. SEXUAL SELF-IDENTITY: Where do they think they fall on the

range of sexual expression – do they identify as straight, gay, bisexual, etc?

4. SEXUAL PERSONALITY: What are all the little extras that make this
person’s sexual needs unique to him/her (such as level of libido and attitude
towards sex)?

5. SEXUAL FUNCTION: Are they able to have satisfying sex? How often
do they have satisfying orgasms?

An optimal model for a long-term relationship’s health therefore should

comprise the following: (1) a relationship which affirms all partners’ needs,
(2) a sex life with enough variety to keep both partners excited, (3) a shared
or compatible sexual self-identity between partners, (4) compatible sexual
personalities (5) sexual satisfaction. My goal is to help clients integrate
these five areas and maximize their overall sense of well-being with their
partner.

In my experience, people who are in strong, happy marriages and other

long-term bonded relationships are able to agree that they are on track in all
five areas. As someone who’s been married for 24 years to a fellow kinky
person, these are the five touchstones that have kept us awfully happy about
sticking it out. Through good times and bad times, our fundamental
compatibility and shared values keep us focused on what really matters.

If you look at your own relationship(s) and find that you are lacking on
several fronts, chances are that you already know you are unhappy with the
state of your personal life. Hopefully, if you go through the five
components carefully you will figure out what area is causing issues and
you can begin to work on a solution.
 Relationship Types

One of my personal beefs about the contemporary family and relationship

models for adults is that they leave everyone who isn’t a straight
monogamous heterosexual up a tree on what kind of structures or families
are possible for them.

When I was young, it never even occurred to me I could find true love and
kink in one relationship because my impression of kink was so negative.
Like most people, I believed what I read about the shadiness and mental
instability of kinky people. It disturbed and embarrassed me that all my
fantasies involved bondage and fetishes. It led me to split myself in two,
dating non-kinky men but always secretly hungering to find someone who
really “got me” sexually, meanwhile having furtive affairs with kinky men I
couldn’t bring home to meet my parents.

The turning point came when I realized that I could have it all – a loving,
romantic partner who shared my values and world-views and also loved hot
kinky sex. It transformed not just my life, but my perspective on life. It
made me realize that I too was entitled to the happiness others seemed to
find in vanilla, traditional relationships. Everyone was wrong about kink! It
wasn’t the end of love: for me, it was the beginning.

Now, nearly 30 years later, I know that no one sexual identity or family
structure has ever proven globally to be better or worse than another. The
worst one may say about sexual non-conformists and non-traditional
families is that by resisting the officially sanctioned models of how adults
should live, they face persecution and loss of civil and human rights. The
only way to turn around the injustice is to deal with sex as it is, not as
people believe it to be. As a therapist, I let facts and evidence guide me.
Helping people function better sexually usually means helping them to
function more authentically. If you can find what it is that really truly floats
their particular boat, and understand what environment they need to feel
safe enough to really let go, that’s your best assurance of guiding them to
optimum sexual performance. That’s why all such advice has to be relevant
to individuals and not – as some non-helping professionals operate – out of
a book on “what to do when X happens.” It would have been in insult, for
example had I urged Tan and Mai to spice up their lives with threesomes
and swinging. I worked within their moral framework to find solutions that
integrated with their larger, conservative Christian identity. Similarly, I
didn’t force Caressa or John to accept labels they couldn’t live with, or
demand they pick one role and stick to it. Nor did I insist that either of them
must be in a defined permanent partnership to be “normal.”

Traditionally, relationships, marriages and romantic partnerships have taken

a multitude of forms, not one single standard of conformity. So I think that
all models of romantically bonded relationships between loving adults are
normal and positive. I believe in monogamy for monogamists and
polyamory for polyamorists and everything in between. In a rational world,
we would accept the simple fact that so-called non-traditional relationships
are, in fact, an ancient human tradition, well-documented in every major
historical text in Western history, and most notably in the Bible.
 Marriage Customs Will Surprise You

One of the key arguments against granting marriage and parenting rights to
non-heterosexual/non-monogamous families has long been that marriage is
properly defined as being between a biological male and a biological female
locked in monogamous union for life. Did you ever wonder where the
definition came from? It is not in the Bible or any other scripture. In the
United States, marriage was not legally defined this way until the 19th
century. Until then, the government did not get involved in marriage
contracts or private sex lives, nor did legislators give a hoot about adultery,
promiscuity, or prostitution unless it won votes.

If we take a broad cultural survey of marriage rituals and customs around

the world, an authentic picture of the amazing diversity of relationship
forms and types emerges. Below, some snippets of research I’ve shored up
over the last couple of decades, starting with some North American history:

- Polygamy was legal in the United States until Congress, under intense
pressure from Protestant clergy, passed the Morrill Anti-Bigamy Act of
1862 as part of political crusade against Mormonism. It stands as the only
hate crime enshrined into U.S. law and transformed into national social
custom.

- Washington, Jefferson and other framers of the U.S. Constitution viewed

marriage and sexuality as matters of religious belief, not government
affairs.

- According to 19th century records, 40 different Native American tribes

practiced sororal polygyny. In Native American tradition, the eldest
daughter married a man first, and then her sisters became her co-wives
when they reached the age of marriage.
- Bundling – wrapping a male suitor and his fiancée-to-be in blankets and
letting them share a bed – was a common courtship practice in colonial
New England, where suitors had to travel great distances to visit potential
mates and overnighted with their hosts. They were supposed to use the time
to talk and get acquainted. Not surprisingly, contemporary studies have
shown that a significant number of bundled women were pregnant by the
time they got married.

- Sexual freedom was always the right of kings. Harem women, concubines,
female slaves, prostitutes, erotic dancers, and same-sex partners were
historically enjoyed by European nobles and Eastern pashas throughout
history. In ancient cultures – dynastic Egypt, dynastic China, the Roman
Empire and among Jews of the Old Testament – socially prominent men
freely enjoyed multiple sexual partners of all ages and genders (male,
female, and transgendered or transsexual).

- The infamous libertinism of Pope Alexander VI (Borgia) has been made

the subject of a popular television series but the Vatican was notorious for
its sexual excesses in its first centuries. According to papal historian Bishop
Liutprand of Cremona (in Antapodosis), early Vatican officials “had rich
banquets with dancing girls … and retired with these shameless whores to
beds with silk sheets and gold-embroidered covers.”

- Homosexual love has been in and out of favor since the ancient Greeks.
No society has developed a consistent approach to gayness because no
matter the restrictions or laws against it, it is a natural biological
phenomenon which cannot be repressed. So at times it was considered
grounds for castration or execution; during other times it was tolerated,
even celebrated. Alexander the Great was openly bisexual, and promulgated
a gay-positive culture in 4th century BC, but when Emperor Nero ascended
to power in Rome a few centuries later, his flamboyant homosexual
marriages earned him eternal condemnation.

- Polygamy remains traditional throughout the Middle East. Although

modern Moslems are more likely to be monogamous, fundamentalist
Islamic cultures encourage men to follow ancient traditions and take four
wives.
- In the Wodaabe people of Africa, men may marry four times, but only the
first marriage is “official,” arranged by the parents of the bride and groom
specifically to forge important socio-economic bonds between families.
Additional marriages are love matches, intended to prevent adultery. Men
may take up to three more wives and those women accept a lower status in
his life. It is also accepted custom for adolescent males to hold hands, kiss,
and sexually experiment with male cousins of the same age before
marriage.

- Some Tibetans still practice the ancient tradition of fraternal polyandry,

which is when the bride’s parents arrange a marriage between their daughter
and a young man and his brothers. She becomes a wife to them all in
adulthood. Polyandry (one woman, more than one husband) has been
documented throughout the world, from the Arctic Circle to South America
and Sri Lanka.

- Among the matriarchal Mosuo people of China, family units are

comprised of women, their daughters and their sons. The traditional
household is female-led, and women hold most of the financial and social
power. Several generations of women may share their residence with sons,
brothers, or uncles (incest is strictly taboo), but lovers and fathers live
separately. Men’s role in Mosuo society is largely limited to providing food
(fish and livestock) and sexual companionship. Though incest is taboo,
women sleep with the men of their choice whenever they like.

It’s always good to remember that there are no absolutes when it comes to
human desire. Our leanings and even our ideas of perfection are shaped by
the culture we live in and the traditions we practice.

For reference, a quick summary of the anthropological labels and

definitions for traditional polygamous relationships:

Polyandry, Polygyny and Polygamy:

polyandry = more than one husband

polygyny = more than one wife

polygamy = more than one partner
 A Concise List of Models of Partnered Adult
Relationships

Below is my working list of the types of adult partnership relationships. It’s

based on a combination of life experience, clinical observations, and sex
history research.

When I work with clients, understanding the basis of their relationship(s)

helps me assess if they are in the kind of relationship(s) that brings them
comfort and peace (and good sex too) or whether they need to re-think their
life choices.

Monogamy
An agreement or legal vow of sexual fidelity between two intimate partners
(whether single, domestically partnered, or married). In the case of legal
marriage, the vow of monogamy is for life and is legally enforceable
(adultery is grounds for divorce).

Although strict monogamy is the most widely-upheld form of monogamy,

people are still people. This means that even for those whose over-arching
structure is monogamous, either or both partners may have outside
experiences. The most common forms are:

Open Marriage with disclosure: some acknowledgement that one or

both partners are sexually active outside the relationship.

Example: Don’s business kept him on the road almost half the year.
His partner, Lou, knew that Don probably fooled around. As long as
Don kept it separate from the marriage, and didn’t bring home
diseases, Lou accepted it as part of their lifestyle. He occasionally
hooked up too when Don was away.
 Open Marriage with non-disclosure: a “don’t ask, don’t tell”
approach to infidelity.

Example: Bert discreetly enjoyed short-term but friendly affairs when

the opportunity arose. He suspected his wife did the same but they
never discussed it. They made an agreement early in the marriage not
to tell if they cheated, and he felt that gave him lifelong permission to
safely explore other relationships.

Open Monogamy: some couples occasionally walk on the wild side

together.

Example: Mara and Hugo were trust-fund babies with lavish

lifestyles. During one notable drunken escapade, they brought home
two strippers from a dance club, paid them for private sex shows, and
ending up having sex with them..

Fluid-Bonded Monogamy: an agreement that flirting, playing and

eroticism are okay outside the marriage but that all acts involving
sexual fluids (i.e., oral sex, penetrative acts) are strictly preserved for
the marriage bed.

Example: Meena and Gene were BDSMers who loved going to

bondage events, both because of the neat toys and the chance to tie up
or be tied by interesting new people. Their agreement was that as
long as nothing directly sexual occurred, they could each play and
experiment with other bondage enthusiasts.

Polyamory
As noted in my little history section above, polygamy and polyamory have
had a long and rich historical tradition. That doesn’t mean those traditions
are better or worse than ours. Just as people of today don’t question
monogamy, people raised in polygamous cultures may not question their
traditions either. My guess is that every polygamist society has unhappy
monogamists who just want to be with one true love, just as today’s
monogamist society has unhappy polygamists who need variety to feel
satisfied.
So when I talk about polyamory (as below), I’m talking about 21st century
Western polyamory, which is its own new tradition and not the product of
foreign cultures or religious traditions. In our culture, polyamorists are
people who make the conscious choice to negotiate relationships that allow
them some measure of sexual freedom. Usually they are, by nature, people
who never felt monogamy was genuinely that important and who are
aroused not only by having multiple partners but (depending on the
relationship) pleased or aroused by knowing their partners have other
partners.

What’s the Difference Between

Polygamy and Polyamory and Swinging?

Polygamy is usually the product of a particular tradition or religious

teaching (such as with some Moslem sects). If you’re raised in a
polygamous culture, its values and its model for adulthood are as normal to
you as monogamy is to Europeans and North Americans. Polygamy usually
implies multiple formal marriages, often entailing inter-family negotiations,
particularly on property and inheritance issues. In most non-Western
cultures, parents and other elder relatives may be the ones who engineer and
assist in ensuring their children make important family and financial
connections through polygamous marriages.

While polygamy involves a formal (religious and/or legal) marriage to

several opposite-sex partners, polyamory simply means “many loves.”

Most contemporary polyamorists are either bisexual or bi-flexible (willing

to perform with a same-sex partner, even if an opposite-sex partner is more
desirable). Some polyamorist units are strictly gay or lesbian. Some
polyamorous units are heterosexual, with the same-sex partners “sharing”
the opposite sex partner separately, and not engaging in threesomes or
same-sex relations. Many men in the swinger community (a significant
subset of the polyamorous world) identify as heterosexual even though they
enjoy group sex situations with other naked men. Frankly, the more
polyamorists one talks to, the more variety one finds in the particulars of
how their minds and their relationships operate.
Yep, now’s a great time to remember Dr. Brame’s little rules: Rule 1:
Nothing in Sex is Black and White. And Rule 2: Diversity is Normal.

Contemporary polyamorists tend to be sexual free-thinkers who consciously

choose to structure their adult relationships to allow for what they recognize
as their innate need for variety and sexual experimentation. Opening their
relationships allows them to explore different roles, different experiences,
and different people while maintaining the integrity of a bonded, committed
relationship and all the comforts (stability, support, love, companionship)
that go with family. Although the conventional wisdom has long been that
open marriages and relationships don’t work, the facts tell a different story.
The swinger community probably has more people in it who have been
married for 20 to 30 years or more than the typical big box church on the
highway.

By the way, some people use the terms “swinging” and “polyamory”
interchangeably. It is more accurate to see swingers as a subset of the
greater world of polyamory. In other words, all swingers are polyamorists,
but not all polyamorists are swingers. Polyamory itself takes a multitude of
forms and is actually larger than the kind of sex people have or who they
have it with. Polyamorists, like monogamists, have full relationships with
their permanent partners.

Since all the work on 21st century poly is still so new and fresh, here are my
personal working models to help sort out the most common forms poly
relationships take.

Structured Polyamory

Usually consists of a primary partnership (a couple) plus one or more long-

term secondary romantic/erotic partner. It may also be two couples in a
four-way union or any other formally agreed and negotiated relationship
structure involving more than three adults.

Some structured polyamorists are Swingers. Swinging, or The Lifestyle,

evolved out of the private wife-swapping parties of the mid-20th century (as
depicted in the popular TV show “Mad Men”). In the 1950s, suburbanites
with a taste for adventure might arrange a “key party,” where the men in the
room dropped their car keys into a bowl, and passed the keys to the car
(and, by implication, to their wives) around the room.

Today’s swing scene is oriented towards hedonists, not repressed

housewives traded randomly over martinis. Swinger women today take an
active role in seeking out the experiences they want, with or without male
partners at their side. The swing ethos values warm, respectful, no-strings
encounters for the sake of mutual adult pleasure.

One thing that hasn’t changed: swinging has a special appeal to people who
are in long-term relationships and marriages, so it’s common to find a very
high percentage of established couples at parties and events, and common
for couples to pair up with other couples for the night.

Another form of structured polyamory is a three-way marriage, or three-

way relationship, known as a Triad. Often gay or bisexual, but sometimes
heterosexual. Some triads are open or amorphous and may welcome outside
partners or allow for casual encounters; others are closed, with all three
members faithful to the triad.

Some structured polyamorists are into Cuckoldry, which has become an

extremely popular fetish in the 21st century. It is a mostly monogamous and
heterosexual lifestyle in which the wife has sex with another man while the
husband gets pleasure from watching them. There are overlaps between
cuckoldry and BDSM for some people (if the wife is sexually dominant and
if the husband is subjected to humiliation) but not for all.

A “leather household” is yet another, albeit less common, kind of

polyamorous configuration. Depending on the household, they may engage
with outsiders or operate as a family with commitments to fidelity. Leather
households often cross gender/sex lines since the emphasis is on BDSM
dynamics.

Unstructured Polyamory:

A free-form structure, and a more communal lifestyle, where primary and

secondary relationships shift and evolve over time. It is most common
among single polyamorists but not exclusive to singles.
Unstructured polyamory in couples can take innumerable forms. A very
short list includes

- Partners both sleep with whomever they wish, but keep other people away
from their personal relationship

- Partners share new sex partners but don’t form emotional relationships
with them

- Partners are open to expanding their household to a third or fourth partner

if the right person(s) come along

- One partner exerts more sexual freedom than the other (a negotiated
relationship, usually between people with different needs or preferences)
and has sex experiences outside the home

Again, these are just a few of the ways people structure their personal
relationships to suit their greater emotional needs.
 Sex Acts

What people actually do together in bed is one of the great forbidden topics
in our public dialogue. It’s also the topic most germane to personal
satisfaction.

All the data in recent years confirms what researchers since Kinsey have
known: vaginal intercourse is not the most popular or most frequent means
of relieving sexual desire in couples. Statistically, masturbatory and oral sex
acts are more common than intercourse.

My acronym for the four most common types of heterosexual sex acts is
MOVA (manual, oral, vaginal, anal), and it’s arranged according to
popularity (with manual and masturbatory stimulation the most common
and anal sex the least common of the four).
 MOVA/MOA:
The Four Most Common Types
of Partnered Sex Acts

MOVA: Masturbation, Oral, Vaginal, Anal

MOA for people who don’t partner with women

Masturbation: direct stimulation to your partner’s genitals and surrounding

region (thighs, testicles, outer labia, etc.) using your hands, a sex toy, or
friction (humping or grinding).

Oral: using your mouth – lips and tongue primarily – to orally stimulate
your partner’s genitals and surrounding region.

Vaginal: penetrating a female vagina with a penis, a hand (including

“fisting”), or a sex toy (usually a dildo).

Anal: penetrating the anus with a penis, a hand (including “fisting”), or a

sex toy (usually a dildo or butt plug).

These are the four basic types of ways people give and receive direct
sexual pleasure.

Since we know these are the four physical acts humans commonly perform
to achieve climax, a rational basis for evaluating sexual function would use
MOVA (or MOA) as the basic template for normal sex acts. Instead, much
of medicine and psychiatry still focuses on vaginal intercourse as the
bellwether of sexual function for men and for women.

When you compare the realities of sex to the way we treat it socially, it’s no
wonder that our culture is so messed about the subject. For example, since
most people will grow up to get off on MOVA, why teach them that
intercourse is the only or best sex to have? Treating oral sex as sinful, dirty
or wrong when it’s an important component of sexual pleasure in adults is
both counter-intuitive and spiritually destructive. The idea of raising people
to remain abstinent until their wedding nights, and then insisting they derive
all their partnered joy from a sole act goes against everything we know
about human nature.

What traditional advice fails to acknowledge is that sex is experiential, not

intellectual. No one can know which sensual and sexual acts give them the
greatest sense of pleasure until they experience it. If you remember back to
your own youth, before you had intercourse for the first time, and recall
your expectation, my guess is that the reality was surprisingly and
significantly different.

One can compare it to learning about fire: we understand its lethal potential
the first time we get burned. Until then, fire looks so pretty and harmless.
Sex may look pretty or it may look scary, it may look desirable or it may
look gross; until you have an experience with it, though, you can’t be sure
that your body agrees with your emotional opinion.

That’s why making a decision about the type(s) of sex to explore before
actually allowing yourself to experiment often leads to sexual boredom in
relationships. It’s pitiful that we treat sex as if expanding our erotic
repertoires with partners were dangerous things that could destabilize
relationships. The opposite is true. No one has ever come to me
complaining of a partner who was too creative and sensual in bed.

Variations on MOVA/MOA
Any catalogue of sexual behaviors has to start with the Internet’s Rule 34,
“if it exists, someone’s made porn about it.”
The staggering variety of documented sexual behaviors on Internet porn
sites is a sheer delight to a sexologist because it demonstrates a few things
that ideologues and conservatives have historically denied, such as:

- All kinds of sex, including kinds we may personally find strange or

distasteful, are enjoyed by average, normal people.

- Diversity is abundant and therefore normal.

- Pornography has universal appeal.

- The thirst for sexual variation crosses all religious, racial, social and age
barriers.

In my books Different Loving and Come Hither, I made the brave attempts
literally to catalogue known fetishes and kinks. Now I am older and wiser.
There is no catalogue that can completely encompass the breadth of
individual sexual variations. The minute one starts compiling such lists,
exceptions will either come to mind or, down the road, an exceptional
person will send a righteously ticked-off email.

Think of it this way: right this minute, someone somewhere is inventing

something new – a new sex toy, a new shoe style, a new way to fasten
clothing. Ten or twenty years from now, other people will develop fetishes
for the new invention. Ten or twenty years after that, there will be porn sites
devoted to it. That is Rule 34 and it’s a good rule. Sex is as infinite as the
human imagination itself.

Of course, I can’t help myself from still trying to organize things just a
little, if only to be meticulous.
 Kink, BDSM and Erotism

A British tabloid once asked me to guest a sex advice column for a week,
and advertised it as “ask the kinky sex expert.” Expecting queries on
bondage and fetishes, I was taken aback when the majority of questions
were about blowjobs and threesomes. To a dominatrix, it doesn’t start to get
kinky until someone’s screaming for mercy. So I learned a valuable lesson:
to people with traditional Victorian-based beliefs, anything outside of
vaginal intercourse may look kinky, including oral sex and bisexuality.

So what is kinky? Or, more pertinently, what is kinky now, in a post 2 Girls
1 Cup-viral video world?

Towards a Redefinition of Kink

While BDSM has increasingly become a portmanteau these days for almost
everything that isn’t MOVA/MOA, there are innumerable sexual variations
that most people would agree are kinky, or kink-ish yet which do not fall
under the heading of BDSM.

In past works, I’ve cited (with reservations) Kinsey’s estimate from the
1950s that as many as 50% of adults have had some kind of SM-oriented
sex. I think 50% is too conservative. As long as I’ve been researching sex,
I’ve never met a sexually active grown up who did not have at least a
passing experience or interest in something that clinically falls into the
“BDSM” category.

More than that, while the number of people who secretly have sadistic
and/or masochistic fantasies is unknowable, it is a VERY safe guess that
these impulses are universal, whether or not people act on them, or even
admit it to themselves. (If Fifty Shades of Grey proved anything, it is that
the innately human fascination with sadomasochism can be triggered if the
context or spin is right.) Most adults will never self-identify as BDSMers,
even when they do things we can all agree are BDSM-y, like tie up a partner
or wear leather boots to bed. They may see it simply as a sensual urge they
enjoy acting on, not a behavior which defines them.

Fetishism is also folded into BDSM, because so many BDSMers have

fetishes. But not every BDSMer has a fetish, and a lot of people who have
fetishes are not BDSMers. Furries, Fat Admirers, Bears, Splosh (Wet and
Messy) are clinically fetishes but absent a conscious and consensual BDSM
dynamic (meaning the people self-identify as BDSM and an open exchange
of power is involved), they are not BDSMers. Hundreds of communities
devoted to unusual sexual variations have made a point of distinguishing
between themselves and the BDSM world.

I realize some therapists and helping professionals think it’s because

everyone is in denial. From my point of view, the clinical definitions were
untrustworthy in the first place, and how people self-define – particularly
when it’s an entire community of people who self-define – is as valid as
clinical terminology that was predicated on the idea that reproductive sex is
the only normal sex.

The fact is that clinical definitions have not yet accounted for the diversity
and dimensionality of adult sexuality. Rather than labor to create rafts of
new definitions to account for the burgeoning categories of observable
sexual variations, I try to keep it simple. I use the word “kink” as a term of
art to refer to everything adults do together to achieve sexual satisfaction
outside of the basic (genital/anal oriented) sex acts in MOVA/MOA.

It allows me to acknowledge and respect how people define themselves,

and to create room for a more nuanced picture of sexual diversity.

NOTE: in private, kinky people commonly complete their encounters with

MOVA/MOA too. But their ability to climax depends on the sexually
powerful emotions unleashed either by fantasizing about kinky things or
acting out their fantasies.

KINK includes (but is by no means limited to):

 Dressing a certain way for sexual fun.

Acting out fantasies through role-play.

Enjoying full-body sensations.

Enjoying very specific or particularized acts or sensations.

Creating or building sexual tension by using objects or garments.

Expressing an erotic persona (dominant, submissive, animal,

object, fantasy creature, acting a different age, etc.).

Experiencing a need for unusual sexual experiences or

unusual/exotic sexual partners.

By the way, please note that having sex with someone of the same sex is not
kinky unless you are using chains. Seriously. Being gay, lesbian or bisexual
doesn’t make a person kinkier than a heterosexual. If it fits into
MOVA/MOA, it is a typical and non-kinky (i.e., “vanilla”) expression of
human sexuality.
 Two Worlds of Kink:
Erotism and BDSM

I see two basic groups within the greater world of kink, one I’m calling
“Erotism” and one we all call BDSM.

Erotism
I think we need a category for people who technically qualify as kinky or
“kink-ish” yet who do not feel any sense of identity or affinity with BDSM.

To me, Erotism puts the focus on imaginative sex (rather than

MOVA/MOA per se), and helps me mentally classify people who, for
example, have an adult diaper fetish but do not in any other way manifest
interest in BDSM dynamics (such as master/slave or dominant/submissive);
or who or have a preference for specific physical/body types (e.g.,
amputees, giantesses, BBWs or Bears), but don’t engage in BDSM acts or
power dynamics.

It’s an important distinction to make: Erots are not seeking BDSM

relationships, even when their fetishes overlap with fetishes common in the
BDSM world. So I’m calling the unknown millions of adults who embrace
creative and unusual but non-BDSM eroticism as “Erots” and their type of
sexual expression “Erotism.”

As with BDSMers, sex drive in Erots seems profoundly intertwined with

sexual imagination – the mental landscape for sex is as important as its
physical realities. As with BDSMers, Erots are turned on as much, if not
more, by their preference/fetish as they are by sex itself (even though, also
like BDSMers, they may still only achieve climax from direct genital
stimulation). But, unlike BDSMers, they do not seek out power exchange
relationships or any of the typical accouterments associated with leather and
sadomasochism.

BDSM

21st century BDSM is best understood as a two-headed phenomenon:

1. A community of inter-connected networks of clubs, parties, and

organizations by and for people who identify as BDSMers.

2. Erotic stimulation from a wide range of risk-aware activities, such as

bondage, spanking, role-play, sensation play, sensory deprivation, power-
ex-change relationships, goddess worship, and fetishes for latex, leather or
with a power dimension.

The acronym BDSM stands for Bondage and Discipline (B&D),

Dominance and Submission (D&S) and Sadomasochism (SM). Although
sadomasochism is folded into the acronym, not all BDSMers are sadists or
masochists. Some BDSMers are fetishists, some are bondagists, some are
spankers, some are into sensual eroticism.

Clinically, only a small percentage of people in the BDSM world meet the
diagnostic criteria psychiatrists use to label sadomasochists. More
commonly, BDSMers defy the clinical standards, if only because there is no
accepted clinical definition (yet) which allows for sadomasochists to have
healthy and functional relationships. In other words, emotionally stable
BDSMers are not yet accounted for in the psychiatric literature.

As a community, the BDSM world spreads a wide net which covers

everyone from curiosity seekers and voyeurs to hedonists, fetishists and
long-time, experienced “lifestyle” BDSMers. One can be in the BDSM
community without having a sadomasochistic sexual orientation; one can
do all the same things as BDSMers privately yet never participate in the
BDSM world; and one can seldom do BDSM acts yet feel a sense of
devotion and commitment to BDSM/leather culture based on other needs.
 Technology-Dependent Sex and Future Sex

We think of sex as active, as something we DO or something that is done to

us. But with the advent of sophisticated communications technology, most
of the sex in 21st century people’s sex-lives is happening via their gadgets,
and most of what they do is fundamentally masturbatory (or exhibitionistic)
by nature and technological limits.

Technology has triggered a tidal wave of rapid sexual evolutions on the

Internet. In 2013, you can meet someone, hang out with them, see pictures
of their pets or their ride, tell them the crazy sex stuff you’ve done, and jerk
off together without every sharing a single germ (or real name). And then
you can do it all over again with someone else a few clicks later. You don’t
even have to leave your house to be a world-class exhibitionist. You can
post your penis as a profile picture.

Our increasingly technology-dependent sex culture is already producing

people who think and feel very differently about sex than any previous
generation in history. Sexting, sexy emails, sexy voicemails, chat-rooms,
sexy phone pics and instagrams, webcams, Skype, dating sites, fetish sites,
swing sites, live-cam sites, amateur porn sites and the profusion of sexually
explicit viral videos are creating dramatic shifts in how adults communicate
about sex and ultimately think about sex too.

As technology continues to astound, our ability to engage with long-

distance partners will grow increasingly immediate and personal. In the past
30 years, we’ve gone from 300 baud modems and email delivery times of 2
to 3 days, to live video chat-rooms and instant text. Twenty years ago,
uploading an explicit data file to UseNet took longer than it takes today to
hook up on Craig’s List.
Future sex, if it can be predicted at all, will likely include the possibility for
people to experience remote partnered stimuli and three-dimensional
simulations. Computer scientists and engineers have been tinkering with
“technodildonics” and other remote-controlled sexual stimuli as long as
there’s been an Internet. It’s inevitable someone will succeed and when they
do, the market for those future technologies will be adults who already
cannot imagine having a relationship without text and video.
 The Data on Diversity

I mentioned a massive Kinksey study early. It’s known as The 2009

National Survey of Sexual Health and Behavior (NSSHB). Conducted by
the Center for Sexual Health Promotion at Indiana University, sex
researchers surveyed roughly six thousand people, ages 14 to 94.

Skeptical as I am about small-scale sexuality studies, the Kinsey data

sample is sufficiently large to make their results compelling. Even if some
of the percentages are slightly off, there’s nonetheless a large enough
sample size to establish quantitatively that, yes, these are genuine trends,
and things we should factor into our way of thinking about sex.

So, for example, I am gratified to know that their study offers data that
backs up one of my contention that people need a range of stimuli in bed,
and not just intercourse, to feel satisfied. The research showed “enormous
variability in the sexual repertoires of U.S. adults,” and recorded
descriptions of 41 sex combinations.

Relax – this does not mean that everyone studied reported they had sex in
41 different ways. Nor does it mean that there are only 41 ways to have sex.
It means that when they tried to categorize the different ways all 5,865
participants had sex, they were able to catalogue 41 different ways that
adults combined masturbation, oral sex, vaginal intercourse and anal sex to
achieve orgasms. Hypothetically, one combination might be mutual
masturbation and vaginal intercourse; another combination might be oral
sex and vaginal sex; another combination might be oral and anal sex; and so
on.

The acknowledgement that people have sex in at least 41 different

combinations contradicts the popular notion that most people derive full
satisfaction from man-on-top vaginal intercourse. When added to reams of
supporting data from previous studies, the Kinsey study proves that a
varied, sensual and uninhibited model of adult sexuality is the true norm.

I was especially delighted that the researchers specified what they meant by
sex (rather than assuming sex was vaginal sex). It never occurred to me that
one could count combinations for the acts I think of as MOVA/MOA. Nor
am I sure how the math worked to derive 41 combinations from 4 basic acts
but it’s a wonderful new base-line for the typical range of ways couples
have sex.

Better still, since we know there are thousands of sexual variations people
include in their repertoires which were NOT included in these statistics
(from young lovers’ frisky games to hardcore fetish sex), the math then
suggests that, all told, there are likely thousands of possible erotic
combinations that adults routinely enjoy.
 Sexual Identity

The argument over nature v. nurture (are people born to be gay? kinky?
poly?) has been debated since the 1880s, when Krafft-Ebing published his
epic work, Psychopathia Sexualis, comprised of case studies and new labels
for chronic masturbators, homosexuals, fetishists, sadomasochists and other
adults he and psychiatrists for a century afterwards considered to be
psychosexually diseased. The classifications of so-called sexual anomalies
and paraphilias were undertaken for forensics purposes. Scientists hoped
that the new nomenclature and scientific theory that perverts were “born
that way” would help some sex criminals get lighter sentences.

Although we have, in the last few decades, started to overcome the

entrenched collective fallacy that non-reproductive sex signals some form
of mental disorder, the ongoing battle between whether sexual behaviors are
hard-wired or products of the environment has become a political football
in the 21st century.

Some camps now argue that since people are “oriented” a certain way,
“they can’t help being who they are.” That’s true and false. All the medical
science suggests that people are born with sexual tendencies and
orientations but life experience suggests that many, if not most, people fight
their sexual orientation if it conflicts with their social milieu. Put another
way – unless we’re mentally disordered, we can all help being who we are.
That doesn’t mean we’re happy about it, but most of us can lead lives of
sacrifice if we must.

Other camps argue that nobody is “oriented” to have non-reproductive sex

and therefore it is an “immoral choice” to act on “sinful desires.” That’s
false and true. People are in fact born with individual preferences and
needs. However it’s true that they could choose not to be themselves. The
evidence is universal: hundreds of millions of people, perhaps billions, have
denied who they are in order to please their families or societies.

What both camps seem to forget is that it isn’t a question of how we think
biology should work theoretically. The way it works in real life is that
people are born to be different – in their tastes, their needs, their
personalities, and their sexuality. Some are born to prefer same-sex
partners, some have bigger appetites for sex than others, and so on.
Encouraging adults to deny their deepest and most powerful emotional
needs by forcing them to conform to models that make them personally
unhappy is pointless and cruel.

The Holy Grail of sex counseling is personal pleasure. As long as they are
not harming others, my clients’ personal happiness is the only relevant
subject. It is also one of the toughest walls to climb because so few of them
feel they even deserve to have the kind of sex they really want. Sometimes
the role of a sex therapist is literally to be the permission giver: you give
your clients permission to do things they feel too shy or embarrassed to do
on their own. Years of censoring and judging themselves at every step
makes people insecure and prudish. They draw a mental line around their
genitals and avoid thinking about them unless absolutely necessary. You let
them know that masturbation is a good thing, and that trying new things in
bed can be fun. If they are sexually unconventional, you help them develop
a comfort zone around their sexual needs so they can have better, more
engaging relationships.

Knowing what my clients were born to be – what they would be, could be,
might be in a perfect world – is helpful as a pointer to their erotic potential.
Remarkably, though, it’s still only one piece of the bigger picture of who
they are. Equally vital to understanding a person’s sexual identity is to learn
about that person’s unique experiences in life: his journey, the mistakes he’s
made, his best successes, his fantasies, and how he defines personal
happiness.

I delved into details about the unbreakable bond between personal identity
and sexual identity in “Sex and the Self.” Briefly put, your image of
yourself as a sexual being influences your perceptions of your life in
general. Sexual identity impacts self-image, self-esteem, body image, trust
issues, social function, and an as-yet immeasurable span of human emotions
and behaviors.

The three most important questions I gradually lead all my clients to answer
for themselves are:

1. Who are you as a sexual being?

2. Do you accept yourself as you are?

3. How can you integrate your sexual identity with the rest of your life?
 Their Choices, Their Lives

To illustrate how people may find themselves in relationships where there

are no easy sexual answers, I thought it would help to provide short
glimpses into a range of clients I’ve worked with who were in unique, and
uniquely complicated, situations. My purpose is to show how nuanced and
morally gray adult life really is as compared to the models and lessons we
were taught as kids.

At the end of each personal story below I’m going to do a corny academic
textbook kind of thing and pose some questions to help you think critically
about your own assumptions and responses to these stories.

Married to an Asexual
SAL has been happily married to his college sweetheart for 20 years.
For the first time in his marriage, he was having non-stop sexual
fantasies about other women. He caught himself staring at women on
the job. Recently, a co-worker came into his office to fix something
on his computer and when she bent over, the tops of her breasts
surged from her blouse. In an instant, he imagined unzipping his pants
and sliding his penis between them. His fantasy scared the bejesus out
of him. Was he losing his mind? Having a breakdown? What if he had
succumbed to temptation and grabbed her?

As soon as I took his sex history, the reason was obvious. His beautiful wife
didn’t like sex. At all.

Sal explained that he knew when he married her that she’d had a very
rough childhood. In 20 years of married life, they had only made love
once or twice. She sometimes enjoyed cuddling and occasionally
 helped him with masturbation. For the most part, however, his sex life
consisted of masturbating in private.

He occasionally wondered whether he made the right choice in

trading sex for the security of being with his best friend but for the
most part, he was happy. His recent spate of fantasies about other
woman bewildered him and made him feel like he was losing control.

Sometimes sex therapy depends on simple logic. Take an adult who needs
and wants sex, deprive them of the opportunity, and sexual frustration will
cause them stress. Stress affects each of us differently: some of us melt
down over small things, while others have an extremely high tolerance to
absorb and endure stress. Since Sal had gone so many years without
thinking about cheating, he was obviously one of those people who had a
high tolerance for sexual frustration. So what had changed?

It turned out that Sal was under emotional pressure in several areas of his
life. His mother’s health was declining, his wife’s car was stolen, and his
company was facing a potentially nasty lawsuit. I suggested that these extra
stresses in his life may simply have pushed him past his usual ability to
cope with sexual frustration.

I assured him that many other men would have been fantasizing furiously
all along if their wives were not interested in sex. It seemed likely that he
was overloaded right now. Since his wife was not a source for relief, it
wasn’t surprising that he was projecting the feelings onto the closest warm
body.

Some might say that Sal’s sexual problem was that he wanted sex and his
wife did not, and that he needed to leave her and move on with his life. For
some couples, that is exactly how it works. Sal’s not the only client I’ve
worked with who was fully committed to a sexless marriage.

My advice focused on better stress management strategies, and encouraging

him to masturbate more frequently during periods of high stress. As long as
he, as a healthy, virile man, was alive, chances were he would always desire
orgasms; and if he remained married to his wife, he would have to learn
how to nurture himself sexually. Since his wife was always up for a cuddle,
he should ask her for more of that and more happy endings too. With only a
few small behavioral changes, he could manage sexual stress through more
orgasms plus stress-busters like yoga and exercise.

Analysis: Sal and his wife had a sexual identity conflict but because of
other bonds and commitments, Sal was willing to compromise his sexual
identity in order to keep his marriage whole. He compensated with a
combination of private masturbation, assisted masturbation and non-sexual
intimacy.

Questions: Do you think Sal was a bad guy for lusting after women when
he was married? Do you think he made the right choice in staying faithful?
Would you stay in a relationship with someone whose sexual identity
guaranteed you’d always feel frustrated?

Bisexual Conflict
LILA got married because it was what she was supposed to do. She
had planned her wedding dress since childhood. It’s how she was
raised: find a nice boy and marry him. The only problem is that their
sex life was kind of boring. They had sex almost every night and it
was nice, but she kept waiting for fireworks that never came. Was
something wrong with her or was that normal?

It’s very rare but once in a great while I have to lower someone’s
expectations: they have been waiting their whole lives to have the orgasm
they think they are supposed to have instead of the one they can have. It
was possible Lila had unrealistic expectations of how it should feel; it was
also very possible that she had not yet experimented with enough positions
with her husband to figure out which one gave her the right stimulation to
get her over the top. I asked if her husband gave her oral sex.

Lila’s husband gave her oral sex whenever she wanted it. That was
her favorite way to climax. Still, she couldn’t always stay focused on
what he was doing.

“Did you ever hear fireworks with anyone else?” I asked.

 Lila had a fling with one of her husband’s female cousins in the
months leading up to marriage. She didn’t know how it happened, just
that one night the cousin was helping her pick out flower
arrangements and the next thing they were in bed, fooling around. It
was the first time Lila was ever with someone and, on one hand, she
was grateful it was a girl, because it didn’t feel as much like cheating
as if it had been a guy. On the other hand, it was confusing because
she remembered it being better than sex now with her husband. This
conflicted with what she wanted – a normal life, stability, maybe even
kids some day. Why couldn’t she get this other woman out of her
head?

My guess is that she was bisexual and that the very simple reason she had
better sex with her female lover than with her husband was that being with
a woman naturally turned her on more than being with a man. On the other
hand, she loved her husband, their sex life wasn’t bad, and while she was
willing to accept that she was bisexual, she didn’t know what to do about it.

Lila confessed the affair to her husband before they got married. She
was terrified he’d break off the engagement but he forgave her and
shrugged it off to youthful experimentation. Lila always wondered if
he was even more open-minded than that. She knew he was very
socially progressive and supported LGBT marriage, so he was very
accepting. But how accepting? Was it possible he’d accept her
occasionally being with another woman, or would that ruin their
marriage?

I suggested we find out. When Lila was ready, she asked her husband to
attend therapy with her. As I suspected, he was neither surprised nor
uncomfortable when his wife told him about her ongoing interest in women.
All he wanted to know was whether this meant she wanted to leave him.
When she told him that what this meant was she’d like to occasionally have
threesomes to start, he started laughing.

He always thought she was the one who felt ashamed and regretful for her
lesbian adventure. To him, it was the hottest thing in the world, and had
often been a part of his fantasies about his wife. The idea that she wanted to
actually invite another woman into bed with them blew his mind.
Analysis: Lila learnt to accept her own bisexuality and chose to come out to
her husband. Her husband was accepting and bi-positive, and welcomed the
opportunity to expand their married sex life to include threesomes.

Questions: Was it wrong for Lila to get married to a heterosexual knowing

she desired women? Should Lila’s husband leave her for a heterosexual? Is
her husband wrong to accept his wife’s offer of threesomes? Do you think
Lila and her husband can make this arrangement work out in the long-
term?

Sexual Identity Damage

CAREY had been avoiding sex for months. His understanding wife
nudged him to see a therapist. She knew he had been molested by
another man when he was a boy and thought he needed to talk to a
professional.

When he was 12, his 17-year-old step-brother told him that in order to
become a man he had to masturbate. The older boy then showed him
what to do first on himself, then on Carey. At the time, Carey was so
naïve, he thought this was normal, and that his step-father had
arranged it so he could learn about adult sex. It wasn’t until much
later that he realized that what had really happened was that he’d been
molested by a sick pedophile. He never told his parents, because he
felt it was his own fault for being stupid enough to believe his crazy
step-brother’s story in the first place.

Since then, he hated his penis. When he ejaculated, it was more like
opening a release valve than experiencing pleasure. His sex organs
disgusted him. At the same time, he saw himself as a weakling and a
terrible husband for not being able to deal with his fears.

People who feel an extreme revulsion to their own genitals may spend
years, even a lifetime, not realizing that there are explanations for how they
got there or that there are possibilities for positive change. Two of the most
common reasons are either an emotional trauma linked with their genitals
(such as the molestation Carey suffered); or feeling that one was born in the
wrong body.
 Carey often wondered if he was gay, or made gay, by that encounter.
He looked at men sometimes, trying to figure out if he felt attracted to
them or not. He didn’t really like their genitals any more than his
own. On the other hand, he thought women’s bodies were incredibly
beautiful. He loved everything about them, especially breasts.
Sometimes he wished he had breasts. That thought frightened him and
confused him even more.

The fact that Carey could objectively try to decide if men turned him on
was enough to convince me he wasn’t gay. We all know what we like when
we see it, and it doesn’t take a rocket scientist to know when the rocket has
risen. His enthusiastic ode to female beauty told me where his true
attractions resided.

In general, people’s passing sexual fantasies and thoughts are just that –
random bubbles floating through our sexual consciousness. We are a
sexually curious species, hard-wired to be intrigued by possibilities,
fascinated as much by similarities as by differences. So it’s pretty common
for women to wonder what it’s like to have a penis or testicles and for men
to wonder what it’s like to have breasts or a vagina.

But for Carey, thoughts about having breasts, wishing he was born female,
questioning his sexuality, and hating his own genitals were themes which
had haunted him since early childhood. As it turned out, long before his
step-brother molested him, as early as first grade, Carey knew he was
different from other boys.

Carey recalled that he had always wished he was a girl, as far back as
he could remember. He always secretly preferred playing with his
sister’s dolls and tea-sets to his guns and trucks. When his mother was
out of the house, he’d sneak into her room and dress up in her clothes.
It made him wonder if the reason his step-brother victimized him was
because he saw that Carey was more like a girl than a boy.

As a man, Carey had over-compensated in every way – working harder,

playing harder, and fighting harder than other men for what he wanted. As a
result, he was extremely successful in public life. The only place he had not
been able to disguise his self-loathing was in his sex life.
 He didn’t want to be a man anymore, but he didn’t want to give up his
life as a man either. It would mean the end of his career and his
marriage. He didn’t know how to move forward. No matter what he
decided he knew he was doomed to misery.

It took Carey years of excruciating self-analysis and exploration finally to

accept that he was a transsexual (male to female) with a preference for
female partners. Ultimately, Carey began the long process of transitioning
to Carrie. Now post-surgery, Carrie is adjusting to life as a newly biological
woman and setting her financial life in order. Her marriage ended amicably,
and her wife soon remarried a biological male. Carrie has just started dating
and is looking for a woman who will love her as she is.

Analysis: Carey was born transsexual but the molestation triggered fears
about his sexual preferences, which compounded his existing gender
identity issues. Coming at puberty – a time of peak emotional vulnerability
for children – the abuse made him feel worthless, unempowered, and weak.
Over time he associated all those bad feelings with his gender identity as a
female. Once he realized that his gender issue was separate from the abuse,
he was able to stop fighting himself and resisting the person he was (or
rather SHE was) born to be.

Questions: Should Carrie have tried to keep her secret and continue to
maintain her public life and marriage? How do you think it feels to be born
knowing that your physical body doesn’t match your personal identity? Do
you think Carrie is a strong person or a weak person for following her
heart?

BDSM/Fetish Identity
BOYD was experiencing erectile dysfunction for the first time in his
life and it was depressing him to hell. After spending 12 years in a
rocky marriage, he entered the BDSM lifestyle in his early 40s, and
was enjoying the status of being an attractive, well-liked male
dominant. He had several female partners and had the money and
leisure to throw himself into the party life. Everything went great at
the clubs, and he loved getting blowjobs, but when it came time to
penetrate, he couldn’t get as hard as he wanted.
Since testosterone levels in men may begin subsiding as early as their 30s,
and commonly after age 40, occasional erectile dysfunction (ED) is a
normal part of the aging process. There are now several drugs (Viagra,
Levitra, Cialis) which are highly effective in improving blood flow so men
can have more youthful, firmer erections. But pills don’t help everyone, and
some types of persistent ED require more extensive treatment. When Boyd
acknowledged that he didn’t have any difficulty getting fully erect when
masturbating or receiving oral sex, though, I knew the problem was
psychological, not physical. I asked him more about his BDSM history.

Boyd was a late-comer to the BDSM community, but not to kinky

fantasies. He was fascinated by bondage and ropes since boyhood,
and read everything he could about his hero, Harry Houdini. In his
teen years, any movie that had a scene showing a girl tied up
immediately got him hard. But when it came to real life, he didn’t feel
it was something he could ask for in bed. He thought women would
think he was a serial killer or something. Despite the ED, he was
happier now than he’d ever been. After a lifetime of fighting his
feelings, meeting women who actually begged him to tie them up was
a dream come true.

I asked Boyd how he felt about fucking. Was it something he used to enjoy?

He enjoyed it, sure, but as a teenager, he mainly fantasized about

bondage – being tied up and tying up. By his 20s, he wanted to be the
one who did the tying but he still felt guilty about it. Avid browsing of
Internet sites also made him realize how much he was turned on by
erotic enemas, spanking, and other fetishes he hadn’t even realized he
had. But when he met his wife, he put all those fantasies away and
focused on a normal life. It was great for the first few years, but the
sex got really boring. That’s why he couldn’t understand his problem
now. It was much more exciting to have intercourse with submissive
women than it had ever been with his wife. Why didn’t his penis get
that?

A clear picture was coming together for me and it is one I have researched
and pondered for twenty years: the basic stages of sexual development in
people who are BDSM/fetish kinky. From working with, socializing with,
and gathering research about BDSMers, and going by my own life
experience, most BDSM people seem to share an eerily similar, seven-stage
erotic arch over the course of their lives.

Seven Stages of Sexual Development in BDSM/Fetish People

1. In early childhood, they have innocent (non-sexual) but unusual

(fascinated or excited) reactions to taboo behaviors (notably bondage and
spanking), to body parts (especially feet, rear ends, and body hair), or to
objects (shoes, undergarments, clothing made of leather or rubber, etc.).

2. In puberty, as their bodies begin the swift march to reproductive

capability, they may notice that things that once merely intrigued them are
becoming mysteriously associated with erotic responses and sexy fantasies.
If they masturbate during this stage (not all kids do), elements of the things
that excited them as little kids will replay in their fantasies, now in a more
sexualized, albeit crude adolescent form.

3. In their teens, fetish or kinky themes begin to pervade their sexual

fantasies. If they masturbate (as most teens do), they may discover that they
climax when fantasizing about a BDSM/fetish scenario. They may also
notice that they are sexually different from their peers, who place an
emphasis on intercourse and oral sex, acts of less interest to young
BDSM/fetish people less than power relationships, fetishes and roleplay.

4. In young adulthood (18 to 26), sexual development yields to social

pressures. Young people often make choices they believe will please their
elders and earn them a place in mainstream society. Thanks in large part to
the proliferation of kink-aware information on the Internet, more people
today feel empowered to seek out safe, wholesome consensual kink
relationships than when I was growing up. However, shame and negativity
remain so pervasive throughout our culture that it’s still common for young
BDSM/fetish people to keep their true desires secret even from their most
intimate partners and to stifle their urges for the sake of a “normal”
traditional marriage.

5. In the “settling down years” (I’ll liberally say ages 18 to 35), the choice
of a partner will shape the course of one’s erotic destiny because partners
are half of a romantic equation. BDSM/fetish people who partner with
people who are sympathetic and responsive to their needs seldom show up
in my office. I have worked with hundreds of people, however, who married
partners who rejected their sexual identity. In my clinical experience, they
tend to be at high risk of self-destructive behaviors. The most common one
I’ve observed among kinksters who struggle with shame and inadequacy as
a result of rejection is a compulsive stress cycle of binging and purging on
their personal kinks or fetishes. Like addicts, they indulge in their kink to
excess and then vow never to do anything again, struggling with uncertainty
and self-hatred at every turn.

6. By the age of full sexual maturity (usually 25 to 35), the need for kink or
fetish sex is fully defined and occupies an important place in people’s erotic
imaginations. Orgasms may occur more easily when BDSM/fetish sex is
involved. For some, orgasms may occur only when BDSM/fetish sex is
involved. And while some BDSM/fetish people will always have an
appetite for MOVA/MOA, the urge to live out their kinky identity generally
rivals or exceeds their lust for “straight” sex. In fact, for many BDSM/kinky
people, the drive for specific BDSM/fetish experiences is so intense and
defined, it may override their usual preferences in sex, gender and body
size, allowing them to expand their pool of potential partners.

7. Post-Prime: the older BDSM/fetish people get, the greater their need for
kink/fetish sex to achieve complete sexual satisfaction. One of the most
common complaints I hear from kinksters over 50 is that they can’t get fully
aroused or have orgasms unless some form of BDSM is involved, even if
it’s all in their private fantasies. Interestingly, it’s not uncommon for people
to be BDSM “late-bloomers” and wait to explore their fantasies until their
40s, 50s, and older. Contrary to public myth, it isn’t because older people
are jaded and therefore need more stimulation to get off. It’s usually
because, given all the cultural prohibitions against adventurous sex, it takes
some people that long to overcome their fears and inhibitions and give
themselves permission to explore their authentic sexual identity.

Since I’ve noticed patterns of similarity in BDSM/fetish sexual developed, I

explained my model to Boyd. From my perspective, he was (as I love to put
it) “totally normal for a kinky person.” He was amazed at how much of his
own experience was mirrored by the model, from his own kink awakening
as a youngster to his years of self-doubt and his final realization that he
could not be happy without kink in his life.

I thought he should try to focus on his BDSM passions until he built back
some self-confidence.

Boyd was not happy with this advice. The submissive woman he was
involved with expected him to take her “like a man,” he said. She had
rape fantasies she wanted him to fulfill. He knew that after a long hot
BDSM session, she expected him to give her a hard orgasmic ride. No
one ever complained about his size but he was springing rubber. He
doubled up on the Viagra the last time but it was an effort to keep it
up to the end.

Nothing disturbs penile blood-flow like fear of failure. For a dominant

person like Boyd, who craved to be seen as an in-control, take-charge type,
it was irksome and humiliating and baffling too that his dick was not acting
as macho as his brain. Naturally, the less his penis cooperated, the more it
sapped his self-confidence, and the less likely he would be able to maintain
his erection.

This pressure to perform and his belief that he couldn’t satisfy a partner
unless he could pound her like a stallion had become a new whip for his
back. He needed to cut himself some slack and face up to two indisputable
mitigating factors. First, he was too old to coast on the testosterone spikes
of his youth that pushed him to completion even when the sex was
mediocre. Second, who was he kidding? He was never a big fan of
intercourse. He was judging himself by a false model and, in essence, still
punishing himself for being kinky. Only now, instead of feeling guilty for
lusting to dominate a woman who wanted intercourse, he felt guilty for not
having intercourse with someone who lusted for him to dominate her.

Trying and failing at vanilla sex was destroying his self-esteem. Boyd
needed to return his focus to the BDSM acts that first enamored him and
work on defining what sexual fulfillment meant to him, personally, without
getting hung up on false labels and standards. He also needed to
communicate more with his submissive before assuming that she had
expectations about vanilla sex.

Analysis: Boyd was hard-wired to be a BDSMer but was still emotionally

tuned to vanilla expectations that were unrealistic for him. Although he was
playing in the BDSM world, mentally he had not made the transition to
believing that he was fully entitled to seek out pleasure on his own terms.
Boyd was still living in the mental prison he built for himself when he felt
guilty about his sexuality. By fully accepting that being BDSM really meant
being different from vanilla, his erectile function began to improve and
when he did have failures, they just didn’t seem as earth-shattering
anymore.

Questions: Do you think male sexual dominance is wrong? Should Boyd

have tried to change his sexuality? If you were Boyd, would you have
followed my (admittedly slow) plan of sexual empowerment through self-
acceptance or would you have looked for someone who could write a (fast)
prescription?
 Solving the Sexual Identity Puzzle

One of the weirdest aspects of being human is that since so much of who
we are is built into our biology, we aren’t conscious that systems are in
place. It’s only when something we took for granted stops working that we
become aware of what’s going under the surface.

Some systems are physical, like our kidneys or knee joints. Some systems
are metaphysical, like our personality or spirituality. And some systems,
like our sexual identity, are so invisibly woven into the fabric of our lives,
even when we are conscious of being sexual, we can neither control nor
predict our sexual responses.

Our sex life actually begins in our DNA. If you synthesize enough data
across enough disciplines it becomes exceedingly evident that people were
born with sexual traits, tendencies, orientations, dispositions or whatever
else one wishes to name the phenomenon (or, more likely, phenomena) that
helps shape the kind of sex, and kind of partner, we will crave when we
grow up. It’s exceedingly evident that it happens but we don’t understands
why it happens much less how it happens. In order to gain understanding,
we will first have to figure out why different brains interpret the same
stimuli in completely different sexual ways.

For example, we don’t know how or why it is that when Woman A’s brain
sees another woman she feels aroused, while Woman B sees only
competition for a male. We don’t know why one woman thinks her husband
is the hottest thing on two feet when all her girlfriends think he’s a creepy-
looking bastard either. We say “beauty is in the eye of the beholder,” but it’s
really in the brain’s neurological processes.

Still, while aspects of sexual identity are the product of DNA, what happens
to us in the world dictates the life-choices we make and the people we
ultimately grow up to be. Sexual identity keeps evolving and changing
throughout our lifetimes. Positive sexual experiences make people feel
sexually self-confident and prepare them to make appropriate, self-
interested choices. Traumatic or depressing experiences create inhibitions
and diminish a person’s belief that things will ever work out okay for them.
By the time we are grown ups, our sexual identities are aggregates of all the
unseen forces that shaped us, from our innate biological identity to the
emotional realities of the lives we have led and the treatment we have
received in the world.

I shared my schema for typical BDSM/fetish identity above. It is a highly

refined version of my basic seven-stage template of developmental stages
of sexuality. I adapt the model to different identities because I’m looking
for different things at each stage. But generically, and barring any medical
issues that compromise natural development, all human beings go through
these seven stages of sexual development.

Seven Stages of Sexual Development

Pre-puberty - before we have consciously sexual thoughts (this

typically ends by ages 8 to 11).

Puberty - when we first begin associating sexual behaviors with

sexual thoughts (typical range: 8 to 13).

Adolescence - when self-experimentation and first experiences with

partners begin (typical range: 13 to 19).

Young adulthood - when we actively pursue partners and have more

adult emotions about sex (typical range: 16 to 26).

Mid-life - when we settle into routine patterns of sexual behavior

(typical range: 23 to 45).

Maturity -- hormones beginning to ebb but not necessarily the need

for sexual bonding and intimacy (typical range: 40 to 70).
 Elder sex – the spirit is still willing and the bonding very important,
but our flesh is getting tired and our sexual chemistry is no longer
vital. (typical range, with decent health status, 68 to end of life).

Note: age range estimates based on current data on sexual maturity

rates and life expectancy rates in the US.

You’ll notice that the age ranges I estimate for each category spread out
more dramatically with age. This is because while early development can
be easily correlated to biological stages, later ones are largely impacted by
the life-choices we make and our natural physical health. Thus, I’ve worked
with clients who were old – physically and mentally – by age 65 and clients
who were still working it and looking good in their late 70s. (For a lot more
on the subject, see Volume 1 of The Truth About Sex.)

In a clinical setting, I try to gather as much information as people can

provide from each of the stages they have experienced, kind of like a
forensic scientist sorting through a crime scene: is there a nugget that will
tell me something? A clue my client missed to his own identity?

To a sex therapist trying to dig out the reasons why a man grew up to lead a
publicly heterosexual life and a second secret life of dissatisfying and
ultimately depressing anonymous gay encounters, I want to know what he
learned as a child, how peer pressure affected his self-image in his teens,
what kind of sexual experiences he had as a young man and in adulthood.
By piecing the stages together, I can get inside his reality and understand all
the factors that shaped him.

The variables in his life, from negative messages received at school, home
or church, to trauma or rejection, will influence whether his need for social
status and perceived respectability is more emotionally important than his
innate biological programming. We see it all the time with public figures
who are suddenly, scandalously revealed to be gay after years of
maintaining a convincing, sometimes even anti-gay, heterosexual front.
They want desperately to be straight, for whatever combination of reasons.
Honestly I feel sorry for them and furious at the people who pander to their
delusion that one can magically wish oneself to be something one is not.
I advise my religious clients to pray away the vanity that anyone can
explain why they were made this way, and to accept that this is the hand
they were dealt and it’s up to them to play it well.

Although sex researchers commonly estimate that gay people comprise

about 10% of the general population, the Kinsey study I cited earlier noted
that while less than 10% of their sample identified as lesbian, gay male, or
bisexual the number of people who actually have had gay, lesbian or
bisexual sex is actually much greater. Put another way, and as embarrassing
as it is to admit, we really don’t have a clue how many people are gay or
gayish or homoflexible, lesbian or “lesbian until graduation” or bisexual or
“bicurious,” bipossible,” biflexible” and any of the other MYRIAD of
labels people now apply to help sort out what in the world is going on.

I credit the Internet and new media for making it possible for us to speak
freely about the sex we actually enjoy, as opposed to the sex psychiatrists
once insisted we must have to be diagnosed sane. People of previous
generations were taught that homosexuality was a mental illness. Being gay
or lesbian in the 1950s automatically put you at risk for arrest as a sex
criminal and for involuntary commitment to a psychiatric institution.
Indeed, this fear continued to hover over the heads of lesbians and gay men
well into the 1980s, when then President Reagan signed legislation to
outlaw involuntary commitment for the mentally ill. It took nearly 20 more
years for the psychiatric community to agree that being gay isn’t a mental
illness and, even as I type, the U.S. Supreme Court is deciding on whether
or not gay people are entitled to equal rights.

If we’d been able to speak freely about sexual variations decades ago, by
now everyone would know, for example, that more people are clinically
bisexual than straight or gay. I am using a RIGID definition of bisexuality
to include any and all erotic experiences involving a same-gender
partner. This includes (and is definitely not limited to) the orgies of your
misguided youth, drunk frat parties you can’t remember, what you did that
time in Vegas, threesomes, making out with friends, plus common youthful
experiences like circle-jerks at summer camp or comparing genital or breast
size with your best friend. Bisexuality takes innumerable forms and does
not imply a complete sexual encounter. It simply means that the person is
likely to be sexually adaptable, and able to perform with either sex
depending on circumstances.

Dr. Alfred Kinsey’s long-established model of sexual orientation has

become the preferred scale used to classify adult sexual behaviors. On the
Kinsey Scale, the gayer your are, the higher your number. “Exclusively
heterosexual” is at the top (as 0) and “exclusively homosexual” is at the
bottom (ranked as a 6). In between the two, he lists gradations of gay, such
as “Predominantly heterosexual, but more than incidentally homosexual”
(2) and “Predominantly homosexual, but more than incidentally
heterosexual” (4). For years, psychiatrists and psychologists have been
using this as a template for diagnosing sexual identity.

To me, the Kinsey guide is a curiosity piece, outdated and based on bad
assumptions. For one, it doesn’t account for the natural fluidity and changes
that occur throughout our lives. People may live as a 1 or a 2 (or a 3 or a 4,
etc.) at different times in their lives. Sometimes homosexuality is a product
of circumstance, as we know from studies of prison populations where
people become gay or lesbian during their incarceration even though they
live as heterosexuals on the outside. Sometimes heterosexuality is a product
of pressure from family or society to fit in, as we know from the vast
numbers of gay men and lesbians who’ve told their stories of coming out.

Nor does the Kinsey scale make room for transgenderists, who may be gay
in one gender but straight in another, or whose sexual preferences may shift
after transition. Similarly, folding lesbianism under homosexuality is an
insult to lesbians. Lesbian sexuality isn’t the same as gay male sexuality,
because, you see, lesbians are women and gay men are men.

But my biggest problem with the Kinsey Scale is that, well, it’s ridiculous
in light of 21st century research. For one, there is no intrinsic importance to
being more or less “incidental.” How does one even decide whether their
gay encounters were more or less incidental? Looking at human sexuality as
a scale where straightness and gayness are at polar extremes is a 19th
century conceit. Its underlying assumptions are that male sexuality is more
important than female sexuality and that homosexuals are the “opposite” of
straight men.
Ironically, the emphasis on gay v. non-gay obscures what the Kinsey Scale
itself suggests: bisexuality occupies a central, possibly even majority, role
in human sexuality. Yet Kinsey does not acknowledge bisexuality as its own
sexual identity, but rather as subdivisions of homosexuality and
heterosexuality.

What if Kinsey’s premise is backwards: what if homosexuality and

heterosexuality are subdivisions of bisexuality? Contemporary research and
studies are leaning that way.

Basic Schema of Sexual Identities

Note: All my definitions are works-in-progress, based on my own
research and understandings of sexuality. All my identity models,
therefore, are fluid and in flux, and sensitive to the chance that as new
data emerges, things will need refining and reworking.

I don’t believe in fixed matrices for sexual identity. It is the rare person (and
one I have never personally met) whose sexual identity does not evolve,
mature, and alter throughout each stage of life, from youth to middle age to
old age.

I know it is possible for people to live out one sexual identity and then,
years later, to live out a different one. Sometimes, people who wanted a lot
of sex at one stage in their lives don’t want sex at all in other stages and
vice versa. Sometimes people go through phases in their lives where,
because of circumstance, their peer group, or curiosity, they experiment
with new sex acts. Some new sex acts become part of people’s permanent
sexual repertoire while others just live on in memory as once-in-a-lifetime
experiences. And sometimes, as is fairly common among intersexed and
transsexed individuals, people mask their sexual or gender identity until
they feel old enough and secure enough to act on it.

Still, I feel we need to stop relying on outdated models and take a fresh look
at sexual identities. So for the purposes of this book, I am going to distill
my basic take on the categories of sexual identity into a visual aid and
provide a chart for you to ponder.
When I assess sexual identity with a client, I evaluate three factors:

1. Are they monogamists or polyamorists?

2. What sexual behaviors are the most arousing for them?

3. What is the sexual nature of their partnership(s)?

Visually, it looks like this:

I depart from traditional research by starting with what I consider to be a

fundamental question when trying to determine how to integrate your
sexual identity with your life choices: do you want one partner or many
partners? It is universally assumed that everyone is looking for ‘their
special someone” and, actually, most adults are – but sexual exclusivity
may not necessarily go along with “love and commitment.” While people
can’t always live their dreams, I want to know the dream so I can help them
achieve acceptable compromises.

Next comes sex: not the sex you necessarily are having right now, but the
sex you wish you were having or try to have as often as possible because
it’s what turns you on the most. If you fantasize about “doing it” you’d fall
into the MOVA/MOA category; if you need to get into a furry suit or wipe
down the bondage chair first, let’s face it, you’re kinky.
The third key component in an ideal sex life, of course, is your partner.

For the sake of explaining it in a sex primer, I’ve boiled human sexuality
down into six strictly defined categories. Please don’t contact me to tell me
the definitions are narrow: I know! It’s deliberate, as I’ll explain at the end.
Here are my working definitions for each of the categories listed on my
chart.

Bisexual: People who are sexually attracted both to men and women,
though seldom to equal degrees. Some bisexuals are only content
when both sides of their desires are satisfied; most bisexuals are
contented to settle into monogamy, particularly if they are family-
oriented. Some bisexuals lead a gay or lesbian lifestyle; most
bisexuals lead a heterosexual one.

In common parlance, “bipossible” means people who have the

potential to be bisexual, “bicurious” are people who are
inexperienced but interested in exploring, and “biflexible” are those
who enjoy bisexuality more as a spice than an entrée.

Heterosexual: People who only sexually desire opposite-gender

partners. No exceptions.

Gay Male: Men who only sexually desire same-gender partners. No

exceptions.

Lesbian: Women who only sexually desire same-gender partners. No

exceptions.

Transgender: I’m not brave enough to define it. We have barely

scratched the surface of what gender fluidity and gender identity
really mean. I strongly believe it should be acknowledged as a
separate sexual identity. Newer, better and more objective research
has demonstrated that gender variances are common. We also now
know that there are many more gender fluid people in existence than
ever acknowledged. All my work leads me to see gender fluidity and
transgender identity as another normal expression of human sexual
diversity.
 What we call transgenderism is expressed and lived in so many
different ways, no one has even catalogued it all (if such an enterprise
is even achievable). But one thing is certain: people with gender
variations think, feel, and act on sexual impulses differently from
their biological peers. Thus their choices in partners may be fluid or
transitional (hooking up with partners according to their own stage of
gender development rather than the partner’s secondary
characteristics, for example); their own sexual identity may shift
throughout life or may be as static as a conventional heterosexual’s;
or they may go through periods or stages of asexuality,
heterosexuality, lesbianism or gayness.

To further emphasize the diversity and range of transgenderist

identity, my short of list of people in this category include people who
identify as intersexed, transsexual, transvestite, transwomen,
transmen, drag queens, drag kings, gender queer, third gender, and bi-
gender. I also include people who are primarily attracted to
transgendered people. Many people have traditionally dismissed fans
and fetishists who lust after differently-gendered people. I don’t. I see
them as people who may have a hard-wired fascination for gender
fluidity, even if they themselves are comfortable with their own
gender.

Asexual: I include asexuality as an isolated sexual identity in this

schema. The science is still new but I’ve heard from enough self-
identified asexuals to believe that they deserve recognition as a kind
of stand-alone phenomenon in the world of sex. Asexuals do not
experience desire, arousal and passion the way others do. Many of
them forego sex altogether (including masturbation), some
periodically indulge for the sake of emotional closeness with a
partner.

I’ll finish up by backtracking to my reasons for offering up such narrow,

definitions and why I grant no exceptions for, say, the heterosexual woman
who only goes down on other women when her Master orders her to, the
straight guy joining a gang bang, or the gay guy who dates post-op
transwomen. Yes I know they identify as straight and gay, respectively, and
may live that way most of the time. I respect their self-identification.

That said, sex studies repeatedly suggest that the boundaries between
straight, bi, gay and lesbian are plastic and easily permeated by outside
forces.

In the real world, individual sexual identities overlap categories. In the real
world, tons of gay and lesbian people have had sex with opposite-sex
partners. In the real world, tons of heterosexuals have had homoerotic and
lesbian experiences. In the real world, bisexuals aren’t people who can’t
choose between two orientations either. Seen from a statistical vantage, in
the real world, most of us actually are bisexuals. What motivates us to form
permanent relationships is such a complex and individualized brew of
emotions, perceptions and triggers that the relationships we form may not
even reflect our intrinsic erotic personality.

The secret to sexual happiness is the same as it is for personal happiness: be

true to yourself. That means accepting your authentic sexuality and working
with what you’ve got to tap your maximum potential for pleasure and
intimacy.
 Section Three

Everyone Can Have Good Sex

In my years as a therapist, I’ve come to the conclusion that what makes sex
more or less satisfying to people depends a great deal on how much they
know and understand about sexual technique and how comfortable they feel
with their own and their partner’s anatomy.

Many of the relationship problems I see in my office stem from our cultural
ignorance and negativity about sex. Adults are discouraged from learning
about their own erotic capabilities. They are poorly educated on sexual
hygiene, and more intimate acts – like how to jerk someone off or how to
satisfy them orally – are treated like mysteries that require tomes to fully
explore.

Since I would never let anyone finish therapy with me without feeling some
certainty that they knew enough to have a happy, safe, exciting time in bed,
I can’t finish this book without giving you a short and snappy education on
basic partnered sex techniques.

All the advice in this guide is predicated on the following model

for a healthy and mutually rewarding sexual relationship.

Optimal Model for Partnered Sex

It’s simple

1. Partners are both eager

Good sex requires clear consent. Great sex requires enthusiasm.

2. Personal health is a priority

People who don’t protect themselves do not protect others. Take

responsibility for your OWN protection and always use barriers
(condoms/dams).
 A Primer on Partnered Sex
Before Sex: Two Rules of Sexual Etiquette
Two simple commonsense rules most parents never teach us about sex:

1. Cleanliness is next to sexiness. Shower, bathe, use a bidet or, in

emergencies, towels and a sink, so you can thoroughly cleanse yourself
front and rear. Get into all the nooks and crannies where sweat, urine or
fecal matter may lurk. Do not use sprays to conceal odors or pre-
moisturized wipes with a nasty taste. Clear clean water and lots of it works
fine and leaves you smelling (and tasting) naturally fresh.

2. Politeness is erotic. Two of the sexiest words in any language are "thank
you." No matter how raunchy the sex, or hardcore the role-play, courtesy
and consideration show that you respect your partners and value their
company. It makes you look classy. It may also make them trust you more
because you are showing that you care about them as human beings.

Foreplay and Touching

Every adult has his or her preferences, and those preferences come first.
These are basic “best practices” to make foreplay hot – literally. Foreplay
will increase blood flow to your reproductive and genital system so that
your sex organs can perform at their best.

Touching Women

- It takes longer for blood to fully engorge female genitals than male
genitals, so the goal is to make foreplay last at least until full readiness
before penetrating. Full readiness in females means the outer labia swell
and the inner folds grow slippery with natural lubricant.

- Adequate lubrication is key to adult female pleasure. Since female

hormones fluctuate routinely, women don’t always produce enough natural
lubrication to keep sex really enjoyable. A good sex lube will help her.

- Begin with basics: kiss her softly, and begin gently to fondle her breasts
and buttocks.

- Women typically have sensitive nipples but still vary in the degree of
stimulation they like. Some women love hard pinches and others hate it.
Always start with gentle simulation, kissing, fondling, tweaking and lightly
sucking.

- The entire genital region (the pubic mound to the buttocks) is responsive
to touch. Cradle or grip the area in your palm and rub it sensuously.

- While the clitoris is the most sensitive part of a woman’s genitals, take
your time getting there. Using the palm of your hand, press gently on the
outside areas surrounding the clit (on top of the pubic mound, over the hood
of the clit), and softly grind.

- Stimulation to the clit is entirely partner-dependent: some women literally

can’t stand direct stimulation, others want you to tug on it (or may have a
pierced hood). Don’t make any assumptions – learn your partner’s body as
you go.

- When your partner is lubricated, insert your middle finger into the vagina
or squeeze fingers together and slowly work more than one in. Slowly
pump your fingers in and out, and rest your palm over the front of the
mound, pressing down softly.

Touching Men

- An erection is, in simple terms, an extension of the circulatory system:

when hormones signal a sexual opportunity, blood rushes to the groin. The
process can take seconds. For this reason, men do not need (as much)
foreplay to be physically ready for sex. However, they do need and enjoy
the emotional intimacy, bonding and affirmation of touch.

- Kiss him and fondle him. Men generally respond positively to warm,
passionate gestures. Stroke his muscles, his ass, thighs, shoulders and back.
- There are natural biological variations in male nipples. One third of men
have sensitive nipples, and the other two thirds get limited pleasure from
their nipples or may even find stimulation annoying.

- The male perineum (between the testicles and the anus) is very receptive
to gentle stimulation. Caress and tease him under the testicles and between
his thighs.

- Most men stimulate their balls during masturbation so ask them if there
are any special sensations they like. It’s generally safe to cup testicles in
your palm and gently roll or rub them, and to gently tug on the loose scrotal
skin.

- The penis is the most sensitive feature of male sexual anatomy. Start with
light touches all over it. Fondle and caress up the shaft to the head of the
penis (the most sensitive part of the penis), then down again. Trail your
fingers around it, squeeze the shaft gently, stroke it back and forth, and see
how he responds. Or use both hands to elevate his arousal: circle the base of
the shaft securely with one hand and use the other to stroke the shaft.
Control his excitement by gently squeezing on the head of his cock or
removing your hand and letting him cool down.

Touching for All

People who dive straight for the genitals may get their orgasmic goals met,
but adults who want a complete experience of intimacy should include
sensuality and touching in the mix. My advice borrows from Western
science, Western Tantric practices, and a range of touch therapies (Reiki,
acupressure, Carezza, and others).

SKIN: The largest organ involved in sex is our skin. Nerve-endings in skin
receive and transmit pleasure to the brain. The skin is stimulated during
intimacy both on the outside (from caresses, kisses and other sensations)
and the inside (from increased blood flow). Ideally, your skin and muscles
should feel relaxed and warm during sex.

- Always start with soft touches, then build to the intensity you both enjoy.
The limit on intensity should be consensual: don’t assume your partner likes
to give or receive at the same intensity level as you. If you’re seeking
intensity, make sure you discuss it before scaring them or confusing them in
bed.

- Caress, stroke and lightly knead and massage your partner when you kiss
and hold each other.

- Learn to slow touch: linger to caress or rub for an extra 10 to 20 seconds

at sensitive parts of the body and joints.

Tantric Touch Techniques

You will be using your fingertips for these touches.

FRONT

Beginning just below your partner’s belly button, slowly trail your
fingers up the center of their body, circling their breasts/chests in
wide circles, then narrow the circles to lightly caress the outsides of
the nipples.

Trace a line to their neck, gently brushing the area under their chin
and to their ears, then tracing the line back down the center of their
body to their genitals.

Hold their hand in yours and softly push your thumb up the inside of
their arm, from wrist to underarm, pausing to gently rub inside the
elbow before moving up the bicep to the shoulder; then reverse and
come back down to the wrist.

Lightly tease and pinch the lips, and draw soft lines up and across
their foreheads, temple to temple, pausing to gently rub the temples.

BACK

According to Tantric traditions, sexuality is curled up at the base of the

spine. According to Western medicine, the base of the spine is typically a
sensitive (and stressed out) spot in adults. The following factors in both
traditions:
 Beginning at the neck, relax your partner’s muscles with gentle
touches in the shoulder area and around the rotator cuffs.

Trail fingertips around the back of the neck, then cradle it in your
palms to make it warm.

Trace a line down the spine: gently walk your fingers down the length
of your partner’s spine, lightly pressing the muscles on either side.

Bring warmth to the entire region. Press your thumbs lightly into the
base of the spine for 10 seconds, then move to the buttocks and knead
them gently. Repeat a couple of times to fully relax and awake your
partner’s senses.

Oral Sex
For some lovers, oral sex is not just foreplay but the primary type of
intimacy. This is a basic guide to using your mouth to give a partner sexual
pleasure. As always, ask your partner for guidelines to their individual
preferences and delights, and never assume one method or technique will
work for everyone.

Cunnilingus

Best positions include kneeling between her legs while she sits up on
a chair or edge of bed; or lying on your belly between her legs as she
reclines on her back.

Begin by kissing just below the navel, and continue down to the
thighs. Gently part the legs and kiss the insides of the thighs, the
outside areas of her sex and any other places she responds to
positively.

Work your lips, tongue and mouth slowly around the region and let
your partner’s reactions be your guide. Do not assume you know how
much intensity she will like.
 Look up at your lover and, if possible, maintain eye contact. Her
facial expressions will tell you what she is enjoying the most, and
assists you both to communicate your excitement and pleasure with
your eyes.

Fellatio

Best position is kneeling between his legs while he stands or sits up

straight. In bed, you can perform oral sex on a man in a wide range of
positions (lying on your sides facing each other, in the 69 position,
lying flat between their legs, etc.).

Begin by rubbing your face below his navel and continuing down to
his thighs. Kiss and lick around his genitals, and continue down to the
insides of the thighs.

Work your lips, tongue and mouth slowly around his testicles and
perineum, flicking your tongue around as you go.

Lick the shaft of the penis, start from the base up. Kiss it all over with
soft lips, and work your way to the head. Take time to lick slowly and
make small sucking kisses until you work your way up to surrounding
the entire head with your lips. Continue sucking the penis into your
mouth as far as you can comfortably manage.

Look up at your lover and, if possible, maintain eye contact. Let his
facial expressions help guide you to giving him maximum pleasure.

Vaginal Intercourse
Positions

The three most popular positions for vaginal penetration are man on
top (missionary), woman on top (female dominant), and rear entry
(“doggie style”).

Only one third of all women get orgasms during vaginal intercourse.
However you can improve your woman’s chances of climax by
 adding manual stimuli to the mix.

Missionary style sex is the least likely to result in orgasm but works
best if the woman’s hips are slightly elevated (a pillow beneath will
help), and penetration is deep enough that the pubic bones of both
partners meet. In addition to pumping and rolling, grinding against a
woman will increase stimulation to her clit and her chances of
orgasm. Don’t forget to kiss her.

Woman on top is a better position for female orgasm because she can
move around until she finds the most pleasurable position and angle
for her pleasure. You may also enhance her arousal by caressing her
breasts and nipples.

Rear entry (with the woman bent over and the male either standing
or on his knees behind her) in itself is the least likely to give a woman
an orgasm – but offers her partner the opportunity to reach out to the
front with his hand, and stimulate her by hand. Using your hand on
her front while penetrating her from the rear may push her over the
top.

Other popular positions include lying side by side (in bed) and having
sex standing up.

While the Kama Sutra offers dozens of suggestions for exotic

positions, most of them are awkward and none of them produce better
orgasms. Most adults ultimately settle on one of the top three
positions listed above as the most comfortable and most reliable
positions for mutual pleasure.

How to Move

As always, let your mutual preferences guide you. These are starting points
for you to experiment with different movements and rhythms to intensify the
pleasure of making love

Pleasurable Ingredients
 Penetrate slowly and deliberately. Fast thrusting (and particularly
pulling all the way out and plunging back in) is dangerous if the man
misses the entrance. Instead, guide your penis in by hand (or ask your
partner to do it for you or with you), and pump slowly and steadily
until complete penetration.

Moving the hips is very good – so move them in different directions:

side to side, up and down, in and out, in slow, gentle, deep grinding
movements.

Don’t forget to kiss, hug, and fondle your partner while making love.
Diverse sensual stimuli during love-making pushes the level of
passion up a notch.

According to medical studies, intercourse (from moment of

penetration to final withdrawal) typically lasts between 4 and 7
minutes. Although going longer may extend the pleasure, adults who
go too long risk losing sensitivity or getting sore. To remedy
temporary nerve or tissue fatigue, take a short break to let your
genitals recuperate before trying for that orgasm again.

Five Tips on Creating Intimacy

There’s more to sex than just “doing it.” Feeling it and enjoying it are
equally important.

1. Don’t just hold and hug your partner’s body: hug the person inside.

2. A good sex partner is an ally, not an adversary to conquer.

3. Save your complaints, criticisms, and petty thoughts for another time.
Negative words create negative sexual dynamics.

4. Don’t hold back on praise, compliments and kind thoughts. Positive

words create positive sexual dynamics.

5. Be your partner’s best friend in bed: figure out what they really like and
encourage them to be themselves.
Anal Sex
The male and female anuses are identical until you penetrate to the
prostate. Here are some tips on exploring this type of sensuality:

Begin by gently rubbing the anus with a moistened finger, and then
inserting it. If your partner is reasonably relaxed, insertion should be
easy. Most people can accept a finger but if they are clenched, help
them relax and use lube.

Adequate lubrication is essential for anal sex, and since the anus does
not naturally produce its own, this means applying the lube of your
choice in generous quantities.

The two key ingredients for a safe anal-sex encounter are relaxation
and lubrication. Once the orifice is slathered with lube, slide a finger
in and try to work in a second finger, very gently pumping them in
and out. If it hurts, stop: either your partner is too tense, you need to
add more lube, or you’re doing it too roughly. Anal sex should feel
sensual not painful.

Experiment with fingers before inserting a penis or large toy. Re-lube

before insertion and proceed slowly and gently.

IN MEN: deep penetration may reach to the prostate, which itself is

extremely responsive to sensation but also sensitive to injury if you
push too hard. An involuntary orgasm may be triggered by
stimulating the prostate so be gentle and sensual if you reach his
prostate, and you may be able to give your man an orgasm from the
rear.

Sex and (some) Disabilities

Partners with physical challenges may have special needs in bed too. I can’t
cover all, obviously, but here are some basic tips on common physical
challenges that crop up.
1. If you don’t already know, ask your partner about their medical
limitations and build your sexual experience within those boundaries. Some
disabled adults sexually compensate for what they either lost or never had
by being able to receive erotic stimulation in areas other than their genitals.
Find out if your partner has unexpected erogenous zones, either by asking
or gently exploring.

2. A stable, comfortable surface is of the utmost importance. Depending on

the nature of the disability, you may need to furnish the bed with extra
pillows or other devices for extra support.

3. If your partner is hearing-disabled, keep a light on so you can see each

other’s facial expressions. If your partner is vision-impaired, make sure you
can hear each other at all times. If your partner has conditions that require
frequent or unpredictable medicating, keep supplies at hand. It’s also handy
to keep a bedpan within reach if it’s going to be a big deal for the person to
get to the bathroom.

4. If your partner has a spinal cord injury, he or she may be unable to

reciprocate touches but can still receive pleasure and may – depending on
the injury – be capable of erection, intercourse and orgasm. Some women
have reported increased orgasmic ability after spinal paralysis. Boost
intimacy through verbal communication, soul-gazing, and kissing. A
paralyzed partner may also enjoy watching you move their hand over your
body and between your legs.

5. Whether or not it causes disability, obesity creates distinct physical

challenges in bed. Big cushy pillows are a necessity. Use them to prop up
body parts and to lean on for support. For love-making, use pillows under
the ass to angle the pelvis and brace the lower back. Rear entry should not
be an issue but if it is, again, prop your partner up so the genital/anal region
is as exposed as possible. Lean them over a table or use pillows on the bed
to help them find a comfortable position they can maintain for love-making.
If direct genital contact is difficult there are still hundreds of loving
variations to explore.

6. I also recommend expanding the repertoire to include creative variations

like role-play, where a nimble mind is more important than a nimble body.
Sex with Transgendered Partners
There are unique challenges that go with transgenderism that can make
negotiating a stable sex life difficult. The actual sex is no different from
other adults’, but identity issues can be tricky. Here are some basics to help
negotiate some of the typical rough patches:

1. Make no assumptions about a TG person: in order to understand *your*

TG partner ask them to tell you how they identify and what that means to
them.

2. Gender identity and sexual identity are two different entities. In simple
terms, sexual identity is the biological package you were born with; gender
identity is the sexual identity your brain believes is right for you. Unless
they specify differently, treat your transgendered partners according to their
gender identity.

3. A transgendered person may be gay, straight, bisexual, homosexual, or

lesbian. Or he or she may transition through all those phases in the course
of a lifetime. Transgendered people are not more or less likely to be kinky
than anyone else.

4. Some transgendered people go through asexual phases or choose

asexuality because their sexual identity issues stress them out or they have
been hurt by relationships. Respect their choice and give them room to be
who they are right now.

5. Depending on where they are in their transition, transgendered people

may be sensitive or shy about parts of their body. So help your partners feel
sexy no matter where they are in their journeys. Support their gender reality
by focusing on the beauty of their gender and giving them positive support
for becoming themselves.

Sexual Enhancements and Intimacy Builders

How to Set the Sexual Stage
If you have time, energy or creativity for it (and particularly if you are
courting someone new), you can enhance the environment where you’re
going to be having sex in several ways:

Clean linens make people happy so when possible, please your

partner with a freshly-made bed. You can also add a furry or silky
throw on the bed to roll around on for extra fun.

Aroma makes us more receptive to sensuality: when women are

involved, fragrant flowers, lightly scented candles, and lavender
potpourris usually create instant relaxation; when men are involved,
heavier, more masculine scents (such as musk or sandalwood incense)
enhance the mood.

Fruit and water are two of the best treats to keep by your bed stand:
water to hydrate before, during and after sex (very good for you!);
and fresh fruit to give you energy boosts (natural sugars) and to link
deliciousness with sex. You can use any sweet or savory food as an
opportunity to slow your pace in bed too (imagine slowly sharing a
sweet strawberry while making love).

Music can enhance eroticism – a hard rock beat, mellow jazz notes,
etc. It won’t work for everyone (some people find it too distracting)
but for those who love to move to a beat, music adds extra
dimensions of pleasure.

Sex Toys

As a sex therapist, I consider adult aids (also known as sex toys) a practical
way to enhance sensuality and improve orgasmic ability. Three popular toys
are

1. Vibrators and dildos: women use sex toys more than men, and their
favorite ones are the type which most reliably give them orgasms, i.e.,
vibrators and dildos (non-motorized insertables). These days, vibrators
come in dozens of different forms, from small vibrating eggs to huge
lifelike systems, and dildos come in every size and shape imaginable. Some
vibrators are designed for vaginal insertion; others deliver all stimulation to
the clit and outside lips. Improve the sexual experience for your woman by
learning which toys work best for her.

2. Cock rings are devices which restrict blood flow at the base of the penis
(such as a rubber ring or a vibrating condom). The tension at the base of the
penis traps blood in the organ, making it more sensitive and more engorged.
Slide one on your partner and see if he’s happy with the results.

3. Anal insertables: whether it’s a penis-shaped toy, a vibrator or a probe, if

you enjoy anal eroticism, an anal toy can enhance fun and increase your
(and your partner’s) capacities for anal pleasure.

How to Extend Intimacy

If you want to extend lovemaking over a period of hours, take a 21st century
approach to more spiritually integrated intimacy and spend more time on
sensuality than sex. Don’t be afraid to slow it down – anticipation enhances
both arousal and climax.

Three ways to slow it down:

1. Extended Kissing: slow down to lose yourself in long deep kisses. Any
time you feel things are moving too fast, making-out will help you refocus
your energies without breaking the mood.

2. Soul-Gazing: stare into each other’s eyes and communicate without

words. A key precept of Tantric sex and the best way to build partnered
intimacy. As much as possible, look into each other’s eyes during sex acts
to acknowledge each other and make the all-important visual connections.
If your vision is compromised, compensate for the eye-lock with a special
touch or position you can hold with your partner to mutually express
passion through stillness.

3. Use All Five Senses: sex isn’t just about your lips and genitals, it is a
full-body buffet of delights. Slow down to listen to the sounds your partners
make; touch them all over; taste their skin with your lips and tongue; look
at them all over without shame; inhale their natural odors.
May all your lovers love you back and may all your sex be great!
 About the Author

GLORIA G. BRAME, Ph.D. in Human Sexuality, is an author, blogger,

sex historian, board-certified sexologist, and sex therapist in private
practice. Brame is the world’s leading authority on fetishes and BDSM, and
is a much-quoted expert on mainstream sexual issues, including
performance disorders and orgasmic function. In addition to The Truth
About Sex, Volume I: Sex and the Self and Volume II: Sex for Grown-Ups,
she is the author of perennial bestsellers Different Loving: The World of
Sexual Dominance and Submission and Come Hither: A Commonsense
Guide to Kinky Sex. A full professor of Human Sexuality at the Institute for
Advanced Study of Human Sexuality, Brame also sits on the board of the
Woodhull Sexual Freedom Alliance. Most recently, Brame was named
among the “10 Best Sex and Dating Experts,” by DatingAdvice.com.
Google Gloria Brame or follow @DrGloriaBrame on Twitter.