The Weight of the Grind(r)

I. The Underground Digital Bathhouse

A recent article on Vox raises questions about the mental health implications of gay “dating” apps such as Grindr, Scruff, and Jack’d. The article, written by a gay psychiatrist in Boston, opens with what reads like a caveat regarding the “huge strides” that have been made in the last decade to “bring gay relationships into the mainstream,” including the Supreme Court recognition of gay marriage as a constitutional right.

From here, author Dr. Jack Turban, pivots to discuss what he calls “the rise of the underground digital bathhouse” - the proliferation and growing use of apps like Grindr, which now has 3 million active daily users. These apps provide users with a streamlined process of identifying and connecting with sexual partners who are available, quite literally, at their fingertips. Users have the ability to sort potential partners by age, body type, sexual position, and many other physical and behavioral characteristics.

II. The Good, the Bad, and the Uncertain

In many important respects, this is a great thing. Risks associated with visibility are reduced, adding an element of safety, especially in places still rife with homophobia and transphobia. Sex is easier to arrange, and compatible partners are easier to identify. And, since a big part of sex is pleasure, more sex is a good! Indeed, when Dr. Turban conducted an informal survey of approximately 50 men on Grindr, this - sex feels good and Grindr makes it more accessible - was the most common reason cited for using the app.

The primary purpose behind this survey, however, was to provide Dr. Turban - and by extension other members of the medical, mental health, and research communities - with a window into the mental health consequences of using these apps. While Dr. Turban acknowledges that 50 participants is a small sample size, it still provides meaningful insight. And these clues, he concludes, paint a picture that “doesn’t look good.”

Dr. Turban draws a number of conclusions about the mental health effects of gay dating apps based on the data he compiles. These include:

  • The use of variable ratio reinforcement (rewards - in this context, sex and the potential of orgasm - that come at unpredictable intervals) make the apps both very easy to start using, and very hard to stop.

  • The majority of Grindr users feel regret after engaging with the app (this from a recent survey from Time Well Spent), and some end up feeling more anxious, depressed, and isolated.

  • The emphasis on sex first may impede efforts for users to form and sustain lasting romantic relationships.

  • The lack of research about mental health effects means that the most effective therapy treatments for harmful app use are underdeveloped

III. The Role of Therapy

Dr. Turban points out that one of the challenges of identifying harmful app use is figuring out what motivates the behavior. On the surface, of course, users are most often looking for casual sex. But there are lots of different things that we can get from casual sex. Dr. Turban asks: “Are you self-soothing anxiety? Do you think you can’t attain love, so you’re settling for hookups? Did your parents tell you being gay is wrong and you’re searching for acceptance?” He also asks if participants are struggling with compulsive sexual behaviors or with attraction and desire in monogamous relationships. All of these are possible reasons a person might feel pulled toward casual sex.

And they are questions that a therapist can help identify and discuss. As Dr. Turban asserts, “Therapy can help clarify these kinds of thoughts and feelings and lead to insights that bring about a healthy change.” Here at G&STC, we wholeheartedly agree!

Therapy can be a helpful environment to separate two things that Dr. Turban seems to conflate in this article. As he lays it out, it isn’t clear where the anxiety, depression, and isolation that users feel after engaging with the app find their source. It might be in broader social narratives about who uses dating apps, what this says about them, and how this relates to more “appropriate”, or possibly, permitted, behavior. Or, it might be a consequence of the experience the user has on the app itself. Each case, once clearly identified, will have a different approach in terms of developing strategies for understanding and managing the feelings that emerge.

On a positive note, the article acknowledges that people do use the app in ways that are fulfilling and positive. Dr. Turban mentions a user who met his fiance on Grindr, as well as the many others who use the app for sex without any of the challenges outlined above.

One thing that we’re sensitive to at G&STC is how societal narratives about sex can create feelings of shame and disgust around behaviors that are, in reality, fun and rewarding. Enjoying a lot of sex is an admirable manifestation of one’s desire and doesn’t always have a correlation to someone’s desire for long term romantic endeavors, a need to soothe anxiety, a need for acceptance, compulsive sexual behaviors or someone’s relationship orientation.

Blog authors all hold positions at the Gender & Sexuality Therapy Collective (G&STC). For more information about our therapists and services please contact us.

Maintaining Long Term Desire: Already Kinky

Most of the information out there about kink is aimed at vanilla couples. So why aren’t there more resources for couples who are already comfortably kinky?

To start, kink communities can be pretty insular. For a long time, communities kept underground due to the stigma attached to kinky, polyamorous, and authority-based relationships. The throes of beginner information has played a tremendous part in destigmatizing kink—and that’s a good thing. But we want to go beyond Kink 101., starting with a question: How do you maintain long-term satisfaction if you’re beginning to get bored, but you’re already kinky?

Consider exploring a new kink

If you’re a couple practicing kink long before anyone heard the problematic name “Christian Grey,” how do you keep the spark alive? Buy a new pair of handcuffs? Not going to work if ceiling restraints were installed years ago.

Sometimes we can get stuck in routines that then turn to ruts. Let’s say you’re super into verbal humiliation, have you explored physical aspects of kink? If you’re most used to physical kink, perhaps it’s time to explore the psychological aspect.

Maybe there’s a sexual interest you haven’t heard of, or something you’ve been interested in but haven’t shared with your partner(s) or pursued. To start, spend some time browsing through the plethora of groups on FetLife to see what peaks your interests. Then, communicate it to your partner(s), or browse together!

If there’s one thing kinky people are good at, it is creativity, so even the most experienced can be surprised and excited by what other people get into.

Keep life exciting in other ways

You’re kinky, but we are going to give some vanilla-sounding advice: consider other areas of the relationship that needs spicing up, or other forms of adventure. Sometimes kinksters can get so into their sex lives (and for good reason, they’re fabulous) that we forget about devoting time and to other forms of bonding.

When was the last time you and your partner traveled somewhere new together and refrained from social media? Went out to dinner just the two of you? Rather than focusing on the next play party, considering scheduling weekend trip.  Yes, bring your flogger and butt plug collection. Changing play locations can be a fun!

Check in with one another

When we become established in our sex lives, we can become stuck in routines in our relationships.

We may also incorrectly assume that we’re in touch with our partners’ desires and satisfaction level. Even if you consistently check in with your partner before and during scenes and practice aftercare, it can be helpful to sit down and see how the other is doing.

If you’re monogamous, are they continuing to want monogamy? Interested in opening up the relationship? Regardless of your relationship format, how are they feeling about your current level of intimacy? Do you have enough time together? Are there any new or recent fantasies they have?

Go back to the beginning

Do you remember why you first fell for one another?

For kinky couples, returning to the first few scenes you had together might elicit those memories. Perhaps you’ve mastered the single-tail whip, but when was the last time you enjoyed some simple spanking? Are there sex toys that you haven’t used in ages, now that you make more money and have moved on from small silicone anal beads to horse-tailed butt plugs?

Some couples return to the place they first had dinner, or where they were when someone said, “I love you.”

Yes, that might mean going back to the kink event you first met at, and breaking out the very first butt plug shared together.

Blog authors all hold positions at the Gender & Sexuality Therapy Collective (G&STC). For more information about our therapists and services please contact us.

The Dirtiest 5-letter Word: Shame

Shame is a prominent emotion, possibly the most prominent to come in to our office. Because shame thrives in silence and secrecy, many of our clients don't know or see it.

When shame is so prominent, we may see feelings of disconnection, feeling unlovable, harsh self judgement, a lack of empathy for oneself, addictions, and relationship patterns that harm connections and create disconnection. Because shame is so powerful, we see a lot of our clients seeking evidence to support that they are indeed unlovable, deserving of harsh judgement, disconnection and a lack of compassion.

Part of the work we do is witnessing and shining a spotlight on shame, and showing love, care, compassion, empathy and connection. Many therapists have different experiences with the word love, whether that be due to our histories, beliefs about the word love, or beliefs about love in the context of professional relationships. Ultimately, though, therapists often love and deeply care for their clients. In an environment of love, care and connection, we can untangle and understand the roots of shame. Basically, we call out shame.

The goal of working with shame in therapy isn't necessarily to banish shame forever (not sure if that's possible!), but to be able to talk about shame, notice when and why you're feeling shame, understand your shame's birthplace, develop the tools to challenge shame, not allow shame to dominant your life, your relationships, and your decisions, and lastly get to a place to possibly even laugh about shame. The ultimate goal is to dismantle shame.

Brene Brown has done a tremendous amount of work around shame (we highly recommend you check out her TED talks and books). She cites Linda Hartling's work around the Strategies of Disconnection, which Brown refers to as “shame shields”.

Here are the shame shields, which is how we protect ourselves from shame, but unfortunately through that process facilitate, nourish and grow shame:

Moving away: withdrawing, hiding, silencing ourselves, and keeping secrets

Moving toward: seeking to appease and please

Moving against: trying to gain power over others, acting aggressively, and using shame to fight shame

Brene also explores shame resilience and what can increase shame resilience, including: empathy; courage; compassion; connection; understanding shame; understanding triggers; contextualizing; normalizing; reaching out to share experiences (increasing connectivity); and honestly speaking about shame and expressing feelings and needs in relation to shame.

We want to ask you a few questions:

1) What shame shield(s) do you use and how do you respond to feeling shame?

2) When did you learn to use those shields?

3) What activates your shields?

4) How have those shields protected you?

5) How have those shields harmed you?

6) What would it look like if you were to talk about your shame?

7) What impact could reducing shame have on your life?

8) What would it look like if you approached shame?

We recognize this is not easy work, but we also know it's possible and that you don't have to do it alone. Brene Brown has said that “shame is a universal experience.” And connection is a universal need.

Side note: Prior to Linda Hartling and Brene Brown, German psychoanalyst Karen Horney brought feminism into psychoanalysis and challenged freudian understandings of gender by focusing on social and cultural factors (rather than innate factors). In 1945, Karen Horney developed a theory of personality and interpersonal relationships into three "neurotic trends." Horney believed that a basic anxiety develops in childhood is connected to a sense of helplessness, influenced by how well or not well a child's needs are met. This eventually turns into a “basic attitude toward self and others” that help us adapt and survive to a hostile world and life situations. The three neurotic trends are self-effacing type/moving towards (the compliant type), expansive solution/moving against (the aggressive type), and resigned solution/moving away (detached type).

Blog authors all hold positions at the Gender & Sexuality Therapy Collective (G&STC). For more information about our therapists and services please contact us.

Maintaining Long Term Desire: Introducing Kink

Sexual variety is key to satisfying partnerships, but doesn’t require multiple partners. For those in partnered relationships (monogamous or polyamorous), adding kink to your sex is an easy and safe (yes, safe!) way to energize your sex life. If you’re new to kink or simply curious, don’t worry! Kink doesn’t require a down payment on a dungeon. With just an open mind, you can turn the ordinary into an excitement that you may not have felt since the start of your relationship.

Why Kink Enhances Relationships
Kink allows us to explore parts of ourselves that we often must keep hidden in our day to day life. For instance, let’s say you have submissive fantasies (a partner spanking you, name-calling, or “forcing” you to lick their fee). During the day, you might operate from a more dominant position: you tell people what to do at work; perhaps you have children that need parenting. By adding kink into your relationship, you are enhancing not only sex, but your entire life.

You also get to see sides of your partner that may be foreign to you. Some partners take a more of a “submissive” role in their daily routine. They like it when you handle finances and travel planning. Yet in the bedroom, there may linger a secret side that wants to sit on your face and bark orders - hot, right?

Kink allows us to have sexual experiences that get our adrenaline going both mentally and physically. It allows us to act out scenarios in the bedroom that couldn’t exist in our everyday life (except for folks who live in a 24/7 dynamic). What about that fantasy of doctor/patient role-play? “Playing doctor”, performing an inappropriate medical examination? Hot!

When you’re New to Kink
As kink becomes more mainstream, more vanilla folks (non kinky people whose sex life is deemed “traditional”) have either recognized that they’re possibly more kinky, or have more interest in kink than they realized. Previously, kink often seemed like a dark and daunting sexually-awakened dungeon. For some it felt intimidating, and it might still feel that way. Small steps are often a great way to add kink to your sex life. An activity for those exploring is to create a spreadsheet with a column for “yes,” “maybe,” and “no.” The “maybe” represents what the kink community refers to as your “soft limits,” and the “no” your hard limits. (Some use “green,” “yellow,” and “red” when creating these lists.) Yes, or green, means things that you absolutely want to try. Maybe, or yellow, refers to what you’re curious about, but a little unsure of. And No, or red, is anything that’s off limits.

Whether it’s dirty talk, slapping, watersports…everyone’s limits are acceptable! Exchanging kinky spreadsheets (who knew Excel could be hot?) is an excellent way to share fantasies with your partner. And, if you need a guide, check out our recommended Yes/No/Maybe List

How to start
Once you’ve hashed out what turns you both on, it’s time to play.

Let’s start with bondage: does the more dominant partner want to tie up the submissive? Once you’ve decided, get to shopping. Now, while online retailers such as Babeland or the Kink Store sell top-notch products (and the employees at local adult shops tend to be extremely knowledgeable), you don’t have to break out the wallet yet. You can get kinky with what you have at home. A belt often works as great as handcuffs (and the act of removing a belt can be just as hot as handcuffs). Pro Tip: this works wonderfully with teacher/student or boss/secretary roleplay.

Likewise, if you’re curious about impact play, before you buy paddles or whips, try spanking with your hand, or a wooden kitchen spoon or spatula. Turning thoughts into reality before you go all-in with your money and products can help ease you into finding your kink.

For more guidance:

  • Watching youtube instruction videos (such as “guide to spanking”)
  • Reading kink or BDSM 101 books (such as The Ultimate Guide to Kink: BDSM, Role Play and the Erotic Edge by Tristan Taormino)
  • Consulting with a sex therapist or sex educator

Kink Is Healthy
A note about consent and mutual care: At first, especially if you’re exploring D/S (dominance and submission), kink can seem counterintuitive for some with progressive views about how to treat someone. In particular, a common concern is something along the lines of, “How can I be a feminist and also want to be slapped and called a slut in bed?”

Sexuality has been so repressed by society that taking control of your desires and fantasies is really as feminist as it gets, regardless of your gender. We live in a sex-negative patriarchal society in which religions and customs have affected the way we view sex. Those systems want us to view sex in a rigid, controlled way (only between a cisgender man and a cisgender woman, in the dark, in missionary position, for the sole purpose of procreation).

Even if you challenge parts of that narrative, others problematic aspects may live and thrive within your beliefs about your own sexuality and sexual desires.

Regardless of if you want kids or your gender or sexual orientation, very few of us would be satisfied if that’s the only way we had sex.

Claiming your sexuality and kinks is more than simply a rebellious act. It’s brave, and it’s your right. You deserve to have the sex life of your dreams. To do so is not only sexually fulfilling, but it can make your relationships stronger than ever.

Blog authors all hold positions at the Gender & Sexuality Therapy Collective (G&STC). For more information about our therapists and services please contact us.

IT’S COMPLICATED: Costs and Benefits of Coming Out

1. The science

A 2013 study done at the Centre for Studies on Human Stress at the Louis H. Lafontaine Hospital, which is affiliated with the University of Montreal, has concluded that lesbians, gay men, and people who are bisexual (LGBs), if out to others about their sexuality, show lower stress hormone levels and fewer symptoms of anxiety, depression, and burnout as compared to peers who are not out. More specifically, the researchers measured what is called allostatic load - encompassing the corrosion caused by cortisol, a stress hormone, across the body’s systems - among participants in the study. LGBs who were out to family and friends showed lower levels of psychiatric symptoms and lower morning cortisol levels, two of the many measures that make up the allostatic load assessment. (Interestingly, though not the focus of this post, gay and bisexual men had lower allostatic load levels than heterosexual men.)

2. Why doesn’t everyone just come out then?

So what keeps people who identify as LGB (in keeping things within the scope of the study here) from coming out sooner - or coming out at all? The lead author of the study, Robert-Paul Juster, wisely points out that “[c]oming out might only be beneficial for health when there are tolerant social policies that facilitate the disclosure process.” Juster makes the important point that institutional support can play a significant role in the decision to disclose this aspect of one’s identity. If one’s job security, custody rights, access to healthcare, and other institutionally-adjudicated features of one’s life are threatened by disclosure, the practical decision might entail remaining in the proverbial closet.

He goes on: “Societal intolerance during the disclosure process impairs one’s self-acceptance that generates increased distress and contributes to mental and physical health problems.” Juster makes an important distinction here between a more pragmatic assessment of the institutional realities one must consider when deciding when and how to come out and the lived experience of existing in relation to those realities and what affect this has on how one feels. In other words, living in a society where one’s job security, one’s custody rights, one’s access to healthcare might be at stake if one were to come out is a very real source of anxiety, depression, and other emotional and physical symptoms that have detrimental short- and long-term health consequences.

Additionally, one might carry feelings of shame, disappointment, fear, disgust and attendant (and supporting) thoughts inspired by environmental homophobia and/or transphobia. These thoughts and feelings, while inspired by external factors, are oriented inward and are self-reflexive in the sense that they animate how one thinks of oneself. This impacts whether one feels proud, confident, happy about oneself, or disappointed, disgusted, depressed. Whereas the anxiety and depression outlined in the previous paragraph has to do with the enemy “out there” - the hostile features of reality outside oneself - the lived experience we’re exploring here involves the enemy “inside” - the destructive voices, values, and perceptions that one holds about and within oneself.

3. The role of therapy

So what role can therapy play in all this? First and foremost, therapy creates a space where issues related to coming out can be shared and discussed without judgment, but instead with support, compassion, and affirmation. In many cases, the absence of opportunity to talk with another person is a powerful part of the problem facing folks considering coming out. Without any sort of outlet, one is forced to contain related thoughts and feelings alone, an exercise that is at best draining and often unsustainable.

Therapy also offers an opportunity to explore and challenge those destructive voices, values, and perceptions that exist inside - the enemy within. Explore in the sense that it can be helpful to identify where those ideas come from (and, perhaps more importantly, who they come from). And challenge in the sense that those ideas need not be accepted as truth, even if they have in the past. Undertaking this process with an LGBTQ affirming therapist ensures that the work is collaborative, supportive, and affirmative. In other words, a therapist can create a safer space to be vulnerable about how one thinks and feels about oneself and to think through the impact of those thoughts and feelings.

Finally, a therapist can provide perspective in relation to how and when one decides - or doesn’t - to come out. This conversation would encompass talking through the practical and emotional implications of coming out - to whom? what would be gained? what would be lost? The purpose would be to think through and prepare for the different outcomes that might come to be. It is important to note that the role of the therapist in this context would not be to encourage or discourage one for choosing to come out. The decision to do so is ultimately something that must be arbitrated on one’s own. But the therapist would provide support with respect to considering the consequences of various courses of action, both emotional and practical, and how one would cope.

At the Gender & Sexuality Collective, we work with many clients at different stages of deciding whether to come out. We’re thrilled to see the science back up what we’ve witnessed: that coming out can provide tremendous relief from stress. But we’re also sensitive to the powerful reasons people have for choosing not to do so. Ultimately, our goal is to ensure that whoever is making the decision feels affirmed and supported throughout the process!

Blog authors all hold positions at the Gender & Sexuality Therapy Collective (G&STC). For more information about our therapists and services please contact us.

BEHAVIOR VERSUS CONTEXT: Thoughts on the #metoo Movement

The #metoo movement has so far been a powerful cry for accountability from women, who every day experience the systemic and personal effects of misogyny - sexual predation, harassment, coercion, and violence. The incidents that have surfaced have ranged from the blatantly reprehensible - Harvey Weinstein, for example - to the more complicated and nuanced in terms of consent and responsibility - Aziz Ansari, for example. While it might be asserted that the former are worse (morally, socially, legally) than the latter, what isn’t different from one incident to the next is the need for accountability.

The above point about accountability is important in order to underscore our commitment to that fact, which we believe overarches any conversation about the movement’s features and ambiguities. The focus of this post, however, is on the language that gets used to describe the offenders and, more specifically their behaviors. To frame this discussion, it’s helpful to start by drawing a distinction between behaviors and their context. In broad strokes, certain behaviors are suitable to certain contexts and highly unsuitable to others. Shouting excitedly, for example, is considered largely appropriate if one is attending a professional soccer game, especially after a goal is scored. Shouting excitedly in a quiet restaurant, on the other hand, is almost always inappropriate. The point here is that there is nothing inherently appropriate or inappropriate about shouting excitedly when evaluated apart from context. It is the context, rather, that determines what we make of someone engaging in that behavior.

Shifting back to the #metoo movement, this distinction helps provide more precise language for talking about offenders of sexual violence and assault, and their actions. For example, it isn’t Louis C. K.’s desire to masturbate in front of women that is reprehensible nor his behavior in doing so. In a different context - one where all parties were capable of and freely consenting - that behavior could be sexy, fun and fulfilling. Instead, when we hold Louis C. K. accountable, we hold him accountable for his failure to evaluate (or perhaps to care about) the inappropriateness of the context - the lack of consent, the undiscussed and imbalanced power dynamics, the setting.

The danger of focusing on and moralizing about his behavior - it’s weird, it’s disgusting, it’s pathetic - is that we reinforce sex negative attitudes about certain sorts of sexual activity apart from their context. With these attitudes, sexual behaviors become bad or monstrous or gross regardless of how they happen and with whom. Instead, we should celebrate the many different ways that people connect with themselves and with each other sexually. These connections can encompass sexual proclivities - including (but certainly not limited to!) rough sex, public sex, role play, power play - that, while regrettably underrepresented (and misrepresented) in mainstream media, are not only tremendous fun, but also important and healthy forms of self-expression and self-care when done with intention, communication, and consent.

In this sense, the distinction between behavior and context is an integral aspect of a sex positive perspective, celebrating the many exciting and unusual sexual behaviors that people engage in with themselves and with others while evaluating whether the context for those behaviors is appropriate. Here at G&STC, we work with all our clients from a sex positive perspective, supporting them in finding fun, safe ways to achieve sexual satisfaction.

Blog authors all hold positions at the Gender & Sexuality Therapy Collective (G&STC). For more information about our therapists and services please contact us.

Clocking Culture’s Role in Pleasure-Related Shame 

Michel Foucault (1982) put it perfectly when stating that “sex is not a fatality: it’s a possibility for creative life.” The interview, “Sex, Power, and the Politics of Identity,” was published in Advocate, Los Angeles, in August of 1984, but the importance of its message withstands the wears of time today. It remains all too common that cultural narratives around sex are riddled with pleasure-negativity. While exploring issues related to sexuality, it is important to note that internalizing these narratives deeply hinders the possibility for healthy sexual expression. Without minimizing the harms these attitudes perpetuate, we at the G&STC hope to weave in more compassionate perspectives about what it means to both engage with and enjoy the full range of sexual expression.  

It is our belief that human beings are capable of both holding the reality of their struggles while also acknowledging the parts of their experience that are not in struggle. With this in mind, a stuck point that often hinders folks’ ability to speak openly about sex and pleasure lies within the conflation of guilt and shame. Without understanding the difference, they begin thinking of themselves in a way that reinforces the harmful stereotypes we seek to combat.

One way to approach more useful conversations about this dilemma is to distinguish between guilt and shame.  As discussed in the post from December 4th, guilt refers to behavior, while shame refers to an internal experience of the self. Prominent shame researcher, Brenè Brown, further clarifies this point when positing that guilt means ‘I did something bad,’ while shame means ‘I am bad.’ By deepening an understanding of this distinction, we can begin to identify and externalize the narratives that propagate shame and inauthenticity.  

Navigating shame once it’s identified also requires us to understand that much of what we’ve been taught about sexuality is pleasure-phobic and oppressive. Human sexuality is rife with diverse forms of expression that, despite being consensual and pleasurable, are considered ‘bad’ because they are incongruent with dominant cultural norms. Sexual sadism and masochism, for example, are often thought of as behaviors associated with survivors of childhood sexual trauma. Disclaimer: there is no such correlation made in the research that would confirm this stereotype. On the contrary, not only can engaging in consensual amounts of pain be sexy to folks, it can also be cathartic and freeing. Conversely, feeling ashamed of these desires contributes to increased isolation, anxiety, self-negativity, and potential harm to partners.

At the G&STC, we aim to foster different conversations about pleasure-related shame, one that deepens our clients’ understanding of the harmful narratives they may be holding on to. It is through this process that we work towards a more authentic expression of sexuality, and build the foundation for a more self-affirming, pleasure-positive, and creative life.

Blog authors all hold positions at the Gender & Sexuality Therapy Collective (G&STC). For more information about our therapists and services please contact us.

Maintaining Long Term Desire

Sustaining and maintaining desire in long term partnerships can be difficult. Many long term partnerships, whether monogamous and non-monogamous, come to treatment with desire-based difficulties and a longing for the return of eroticism in their relationships. Ester Perel encourages us to explore how conflicts between our desires for security and reliability and novelty and change can impact our relationships. Perel, in “Mating in Captivity,” encourages us to consider how we might "introduce risk in safety, mystery to the familiar, and novelty to the enduring."

Eroticism thrives in separateness, longing and newness while love and care thrives in security, emotional intimacy and familiarity, which can be oppositional. Many partnerships come in to therapy feeling too “merged” or too “separated,” struggling to find both closeness and separateness, and seeking both relationship harmony and sexual excitement.

It’s important for each member of a partnership to think about and know your relationship to closeness and to separateness. Does being close make you want to run away and/or feel like a threat to your individuality? Does being apart trigger an overwhelming amount of anxiety and/or feel like a threat to the certainty of your relationship? Understanding your “attachment style” can better help you understand your relationship to closeness and separateness and then may provide some insight into the impact that could be having on relationship harmony and sexual excitement.

Some, historically and in the present, focus on the impact emotional intimacy has on the sexual lives of partners (i.e.- if you feel emotionally safe in the relationship then your sex life will prosper). However, too much intimacy may harm an exciting sex life. Being loved and being desired are different and may exist simultaneously, but can certainly also exist without the other.  

Here a few tips that we like to promote and that we’ve seen positively impact our client’s lives:

1. Finding a balance between having your lives together and having times apart. Having both shared and separate hobbies, passions or interests are important. Spending time apart and missing each other can have a positive impact on your sense of longing for the other. It’s important to have a self, your partner and then your shared space. Having this differentiation and individuation can look like having some hobbies, passions and interests that are different and/or socializing separately while in the same social space. Some people find watching their partner be charming with others or others desiring their partner to be a turn on and to generate desire.

2. Challenge your assumptions about what types of fantasies, desires and sex you can have with a partner. Respecting and caring for someone doesn’t mean that your sex can’t be wild, aggressive, degrading and/or rough. Seek and question assumptions you’ve held about sex, long term desire, sex with someone you love and sex in long term relationships. Challenge your assumptions about how sex is supposed to be initiated. “Spontaneous” sex, what many cite as how their sex was early on, is in many ways an illusion and was more planned and intentional than we admit. Planning and planning for sex can be erotic and doesn’t have to be mundane - brainstorm what that might look like for you.

3. Boring sex is not fun!! Explore ways to increase excitement and playfulness in your sexual lives and possibly modify a rigid repertoire. This could look like incorporating new toys, kinky/bdsm practices, role playing, sex parties, swinging, dirty talk, sexting, talking about your sexual fantasies, having sex in different locations (such as a car, your kitchen, the shower, etc), trying new positions, and/or attending a sex specific class together. While we don’t want any actual legal consequences, morality crisis, or to promote anything non-consensual, there is something exciting about illicit sex for a reason and exciting sex can exist in long term relationships.

4. We culturally place value on and find security in "knowing all there is to know" about our partners. However, our sense of predictability is an illusion and a fantasy, and a way to seek comfort. It also reduces curiosity we have for our partners over time as we think we know all there is to know and it doesn’t allow our partners to grow. In reality, there is a lot we don’t and can never really know about another person, and that’s okay! If we can accept this about our partners we can remain curios. If we trap our partners and our relationships in fixed narratives, it can be difficult to grow, express that growth, share newness and maintain excitement (and to do #2 and #3). People’s desires and fantasies can grow throughout their lives and that doesn’t have to be threatening - it can be exciting, invigorating and erotic!

5. Re-focus on eroticism and ask yourself what turns you on, what makes you feel pleasure, and what makes you feel desired.

6. Don't be afraid to think about and talk about the lack of sex - it's a common occurrence in long term relationships and ignoring it isn’t going to make it go away. When thinking and talking just remember that lulls in desire and caring about that lull can be an opportunity for change and expansion, to question the scripts of your relationship in ways that facilitate growth together, to share fantasies you’ve yet to share and to re-energize your sex life.

7. Be mindful of and challenge any narratives you've internalized in the context of the reduced sex and eroticism in your relationship. For example, have you created narratives about your own desirability or your partner’s?

8. Jumping from not having sex to having sex, regardless of if you intend on incorporating kink, can be intimidating. Try following sensate focus  exercises and start with intentionally touching and massaging, and specifically not having sex.

9. Schedule a session with a sex therapist as an individual or within your partnership to work with you to challenge beliefs about sex and sexuality, unpack sexual shame, explore and incorporate desires and take steps to incorporate the above steps.

Blog authors all hold positions at the Gender & Sexuality Therapy Collective (G&STC). For more information about our therapists and services please contact us.

Respecting the Structure

In many areas of the world, romantic relationships tend to be organized as monogamous, heterosexual cisgender dyads - two partners, one man and one woman, both unavailable for romantic or sexual experience outside the relationship. The development of this reality has been driven by economic, political, and religious forces. Like any rule, however, this one is not without its exceptions. As our name indicates, at the Gender & Sexuality Therapy Collective we work with clients who do not fit within the constraints of heterosexuality or the gender binary - we support and celebrate all sexual orientations and gender identities.

We also work with clients who represent another type of exception to this rule: participation in consensually non-monogamous relationships, an umbrella category that covers polyamory, open relationships, swing relationships, and many other romantic and sexual relationship configurations. For the purposes of this blogpost, lets refer to these various relationship configurations as “different relationship structures.” In this sense, each relationship has a different structure - polyamory, monogamy, swinging, open - a sort of framework on which many other features of the relationship rest. The structure creates expectations and boundaries around how the partners in the relationship engage with each other and with other people - in other words, what is appropriate and what is not.

The purpose of establishing this concept is to address a clinical concern that - in our experience - many clients in consensually non-monogamous (CNM) relationships express. In some cases, this concern is a consequence of lived experiences and previous therapy attempts; in other cases, it is a fear about the possibility of having those same experiences that discourages couples in CNM relationships from seeking therapy altogether. The concern is that the structure of the relationship will be questioned, blamed, pathologized, undermined in a way that shifts focus away from relationship dynamics within the existing structure that are presenting challenges. Instead of exploring what is working and what isn’t within the structure, this clinical misstep scapegoats the structure itself, finding it responsible for any difficulties that exist.

The point here is not that clients never come in to discuss and work on the structure of their relationships - they certainly do! They might want support navigating how to open a relationship, to close it, or adjust particular expectations that comprise their specific structure. (And indeed, in these cases, the clinician ideally helps the clients have these conversations without coming down on one side or another, without lobbying for a particular answer or approach.) Instead, the point is that clinicians must be able to differentiate when clients are interested in working on the structure of their relationship and when they are interested in addressing challenging dynamics within that structure. In the latter case, if a therapist calls the structure into question (or blames or undermines it), they risk alienating - or worse, harming - clients who already face prejudice, judgement, and hostility outside of sessions for the ways they organize their sexual and romantic relationships.

Alternatively, by showing an understanding of and respect for the structure, whatever form it may take, therapists affirm the validity of any consensual romantic and sexual relationship configuration. Romantic and sexual relationships encompass so much more than monogamous, heterosexual cisgender dyads - at the Gender & Sexuality Therapy Collective, we validate and celebrate the diversity of different relationship structures while helping our clients strengthen the dynamics of these relationships in ways that make them feel more connected, cared for, and fulfilled.

Blog authors all hold positions at the Gender & Sexuality Therapy Collective (G&STC). For more information about our therapists and services please contact us.

G&STC Book Review: In the Darkroom

Published last year, in 2016, In the Darkroom is Susan Faludi’s account of reconnecting with her father in 2004 after she (Susan’s father) had undergone “sex reassignment surgery” (what we now more correctly call gender confirmation surgery). Stefanie, formerly Steven, has been an elusive figure all of Faludi’s life, and the animus of the book is her (Faludi’s) effort to more fully understand her father, as parent and person. The book digs into Stefanie’s past, growing up Jewish in Nazi-era Hungary and surviving the Holocaust, drawing parallels between the politics of that period and the present day. At the same time, Faludi - who has made a career of writing about the politics of gender in America - reflects on her own reactions and assumptions about her father’s transition.

When Faludi first meets her father at the airport in Budapest, “she (Stefanie) was wearing a red cabled sweater, gray flannel skirt, white heels, and a pair of pearl stud earrings. She had taken her white pocketbook off her shoulder and hung it from a hook on the cart. My first thought, and it shames, was: no woman would do that.” The book offers many episodes in this same vein, moments where Faludi recognizes her own - or others’, including her father - entrenched ideas about what it means to be a woman and how women behave. At one point, she asks (and at the same time admonishes) herself: “Since when had I become an essentialist?”

From a clinical perspective, Faludi’s book highlights how quickly our minds move to mobilize assumptions we carry about things like gender, even in those who have spent a lifetime unpacking, challenging, and rejecting these very assumptions - and when such assumptions escape, either into conscious thought or into spoken word, how often they inspire feelings of shame. With respect to the former, the point is not to rid ourselves entirely of these assumptions, for as it stands, there is no effective way to excise or erase certain aspects of our unconscious with the precision such an operation would require. Instead, the clinical work is to focus on slowing down, to acknowledge that these assumptions exist within us, but that they do not control or encompass us.

With respect to the latter, it is important to appreciate how the potential for shame can add pressure and anxiety to how we navigate situations where sensitivity is required (in some cases, leading to a full-fledged rejection of this need for sensitivity). While we make every effort to understand and respect others in the ways they want, the expectation cannot be that we will never err. Instead, we must feel comfortable (or perhaps more precisely, able to tolerate our discomfort) when this happens owning and learning from our mistake.

At the Gender & Sexuality Therapy Collective, we work hard to do both of these things - to slow down and catch our assumptions and to take ownership when we err - both with ourselves and with our clients. 

Blog authors all hold positions at the Gender & Sexuality Therapy Collective (G&STC). For more information about our therapists and services please contact us.

How to Manage Kink Shame

Whether you’re just curious or already ingrained in the kink scene, you may be experiencing shame around your sexual interests and desires. Given how sex negative American culture can be, it’s no wonder that many experience it. The good news is that it doesn’t have to be this way. Shame can be a difficult emotion to experience, and it does a very good job at getting in the way between you and your authentic self. While shame is often used interchangeably with guilt, guilt refers specifically to negative emotions about something bad that we did, while shame refers to feeling bad about who we are. If your kink involves consenting adults—you’re good to go! Now: let’s get to the root of dismantling kink shame.  

Know that Kink is not “Abnormal”

If you’re reading this, it means that you’re aware that you are or may be kinky—which puts you a step above many others. Addressing and putting a name on something helps take away the power shame has over you. While it may feel shameful at first to think of yourself as a kinky person, repression is what what tends to increase problems, where people bury and ignore their healthy sexual desires.

A study in the Journal of Sexual Medicine surveyed over 1,500 people and found that very few sexual fantasies are actually atypical. For instance, 64.6 percent of women-identified participants and 53.3 percent of men-identified participants shared fantasies related to kink. In fact, all sexual fantasies of dominance and submission were found to be common, meaning more than 50 percent of respondents shared them. While 50 Shades of Grey perpetuated some untrue myths about BDSM (for example: being asked to sign a contract is not expected; no research supports that kinky tendencies arise from childhood trauma, as is the case with Christian Grey), there’s no denying the series not only normalized kink, but also brought BDSM into the mainstream. So, rest assured, you are not alone in your kink!

Understand the Source of Shame

The U.S. is steeped in sex-negative culture. Even if you avoided an abstinence-only sex education in school, you likely grew up with some impression that sex is shameful or “dirty”. Many of us were taught that sex was solely for procreation—not pleasure, and only for monogamous and committed relationships. Many adults think that sex means intercourse done in the missionary position, with all the lights out, and that anything else  perverted or risqué. If that’s how they want to have sex-fine- but everyone has the right to choose the sex that is best for them.

For many people, sex this means kinky sex. When you unpack the source of your shame, which is often rooted in deeply ingrained myths about sex learned as a child and adolescent, you can better understand and therefore free yourself from it. As sex-negativity is insidious and often deeply-ingrained, it’s often helpful to work with a sex-positive and pleasure-positive therapist to unpack sexual shame and learn coping techniques for managing sexual shame.

Life is too short to let shame hold you back from being yourself and having the type of sex and pleasure you want to have!

Connect with Like-Minded Individuals

From friends to lovers, there are other people out there who share your kink. Connecting with other kinky people is not only a great way to meet potential partners, but also build communities that understand and accept you. Of course, not all your friends will be kinky or a part of the scene. Likewise, you probably won’t want to be friends with every kinky person you meet, but having friends and partner(s) who accept you for who you are is crucial.

One wonderful, easy way to connect with others is FetLife on social media. There, you can join a group specifically created for your kink and discuss it with others.  The site also usually lists as kink meet-ups or kink-friendly parties where you can meet up with others in person. Additionally there are kink/BDSM events listed on and kink specific apps such as

If you live in a bigger city like San Francisco or New York City, rest assured there is a vibrant, accepting, and welcoming kink scene waiting for you. If you live in a small city, suburb or rural communities, know that kinky people are everywhere and the internet can connect us beyond our geographical communities.

Practice Self Care

Developing a community of friends who accept and understand you is part of self-care, as is working with a sex-positive therapist to work through kink shame.  Other forms of self-care and stress management are meditation, exercise, sleeping enough,  and healthy eating. Not practicing self-care can reduce your patience or ability to manage internal and external stressors such as sexuality-based shame. It’s hard to feel good about anything, let alone your sexuality, if the rest of you isn’t well-cared for!

Blog authors all hold positions at the Gender & Sexuality Therapy Collective (G&STC). For more information about our therapists and services please contact us.

Transgender Day of Remembrance (TDOR)

On Trans Day of Remembrance we honor the memory of those whose lives were lost due to anti-trans violence.  

"The Transgender Day of Remembrance seeks to highlight the losses we face due to anti-transgender bigotry and violence. I am no stranger to the need to fight for our rights, and the right to simply exist is first and foremost. With so many seeking to erase transgender people -- sometimes in the most brutal ways possible -- it is vitally important that those we lose are remembered, and that we continue to fight for justice." - Transgender Day of Remembrance founder Gwendolyn Ann Smith

Check out this article for more information about TDOR include how to participate, the list of names (that is often read during vigils), events, and other resources.


How To Tell Your Partner About Your Kink

Whether it’s a new lover or a long-term relationship, sharing one’s kink can be a daunting task. What if your partner isn’t interested into your kink?? What if they judge you? The list of concerns can go on and on. However, communication, which means vocalizing your sexual needs, is a crucial step to experiencing them! 

So first, kinks are a normal and healthy part of sexuality! One survey suggests that 75 percent of people have at least one, the most common being BDSM. We can make fun of and critique Fifty Shades of Grey all day long, but there’s no denying the film’s impact in bringing kink into mainstream media, giving it some well-deserved recognition. However, because kink and sex can still be taboo and filled with shame, it’s possible that your kinks are more widely practiced than you may know. It’s possible your partner has kinks, shares yours, is familiar or was already interested in trying!

So, how do you even start to engage with your kink? First, ask yourself: are you comfortable with what turns you on? If you’re nervous that your partner is going to judge you for wanting to try a role-playing scenario, such as a doctor/patient scene, or a form of bondage, check in with yourself first. If you’re comfortable with the fact that you want to be called dirty names in the bedroom, it’s more likely that you’ll express that desire in a calm and relaxed tone. On the other hand, if you’re still struggling internally,  it might be helpful to process your feelings with a kink competent and affirming therapist before sharing your kink with a partner. If you have internalized sexual shame acting as an obstacle to having fun and feeling good with your kinks, it may be helpful and important to work through emotions and the beliefs you’ve internalized. If your sexual needs involve exploring something with another consenting adult, take a deep breath knowing (or possibly reminding yourself) that there’s nothing wrong with you. 

Once you’ve explored and better understand your internal obstacles to sharing your kink - be it a desire to dominate and consensually inflict pain on a partner, or perhaps to be humiliated and called names -it may be time to share that with your partner(s)! Remember: difficulties often  begin when we try to repress desires, rather than express them healthily

So: how do you bring it up? Mentioning mainstream media is always an easy conversation starter. Whether that be Fifty Shades of Grey, the many magazines you can find with a sex and sexuality section, an article or a film can be a great icebreaker. Perhaps email your partner(s) a link to an article about BDSM asking what they think about it. 

While some people prefer to discuss sexual interests prior to getting into bed, arousal can be a powerful tool. One of the easiest ways to tell your partner about your kink is through dirty talk. Let’s say that you really want to spank your partner: during a makeout session, consider vocalizing how attracted you are to them and your desire to spank them, and ask if you can spank them. This presents your kink in an intimate setting, and, by phrasing it as a question, you’re practicing consent. And consent is an important part to any sexual relationship, from kinky to vanilla. You certainly don’t have to bring up your kink over dinner or coffee, but if that setting feels good to you, go for it!. Always do what feels best for your relationship. 

If disclosing a kink in the bedroom feels right, but you like the idea of a visual aid to do the talking for you, ask your partner if they’d like to watch some porn with you and pick a film that showcases your kink. Watching pornography together can be an incredibly intimate experience. 

Prefer games over watching porn? Ask your partner to write down their kinks, what they desire, their soft limits (what they are pretty sure they don’t want to do, but may be somewhat curious about) and hard limits (sexual acts they know are not for them). You can both complete this exercise and then exchange papers. For a guide, check out this yes/no/maybe list. 

Another wonderful way to tell your partner about your kink is by asking them about their desires. Focus less on testing your partner for their response, and more on introducing the topic of sex, inviting conversations about desire, and partaking in those conversations.Whether it’s on the couch after a night of Netflix, while out to dinner, or in bed, just ask them what turns them on. Not only is this an excellent way to learn about their needs and desires but it will open the doors of communication for you to talk about yours. When everyone is talking about what they desire, this conversation can feel more comfortable. From disclosing kinks to asking someone how their day was, communication is a pillar of relationships. Along with first becoming comfortable with your kink yourself, , make sure you have a solid communication foundation to ensure such subjects are approachable. 

Once you’re feeling sure of yourself, sharing kinks tends to be much less scary than we might assume. Additionally, some people find sharing their kinks easier over time. The more you practice openness the more comfortable it feels, especially when once you’ve experience acceptance. 

Remember, you don’t have to jump in headfirst. For instance, if group sex turns you on, but you’re only sleeping with one partner at the moment, before sexually opening up your relationship, you can test the waters through dirty talk about group scenarios, or by watching group sex porn together. Taking baby steps, especially if it’s a new experience, can help you healthily gauge where you’re at. 

It’s highly possible that if your partner is open-minded, caring, and understanding, they’ll be excited to hear you talk about your desire. Even if they don’t share them, there are always ways to safely and responsibly have a rewarding and fulfilling sex life, through various relationship formats, visiting professionals such as a dominatrix, compromise, or seeking support in the context of psychotherapy with a sex therapist. 

Additionally, it’s important to know and be honest with yourself with how important your kink is to you and your satisfaction with your sex life. Worst case scenario, this isn’t the most compatible sexual partner for you, and that’s okay! People are allowed to have differing sexual desires and just because someone doesn’t share your kink doesn’t mean there is anything wrong with you or anything to be ashamed of. Your sexual pleasure is important, and you deserve to fulfill it!

Blog authors all hold positions at the Gender & Sexuality Therapy Collective (G&STC). For more information about our therapists and services please contact us.

No More Shame: Addressing Stigma As a Barrier to Therapy

For many of our clients, taking the first step toward seeking therapy is often the hardest step they’ll  take toward recovery and self-empowerment. Despite increasing awareness for and access to mental health treatment across the United States, there is still a ton of stigma and shame surrounding seeking help from a licensed professional.

According to a recent study produced by Mental Health America, almost 44 million adults across the United States are currently living with a mental illness. That said, almost 56 percent of those individuals said they did not receive any treatment in the past year. Below, we explore a few myths that are still perpetuated around seeking mental health treatment, and de-bunk these stigmatizing assumptions around therapy.

Myth 1:  “Psychological Illness is different or less important than addressing other health problems”

A person’s environment, upbringing and life circumstances are often linked to mental health and a person’s struggle to manage and cope with life’s circumstances. Additionally, studies also show that there’s a genetic and biological root to many psychological and behavior disorders.. Even so many people may refuse to seek out therapy based on the assumption that it’s not as important as treating other underlying health issues, such as heart disease, diabetes or injuries. The perpetual stigma of mental illness doesn't address the real and underlying causes of emotional issues.. Therefore it perpetuates suffering, making it difficult to make positive decisions for our lives or enjoy our lives. Lastly mental health may be somatized and at the cause of some physical health problems. If this is the case the regimen for somatized symptoms is through mental health treatment.

Myth 2: “Seeking therapy means I’m weak”

It takes a lot of courage to admit or accept your suffering stems from mental illness, an emotional issue, emotional instability, or psychological disorder. Seeking professional help doesn’t mean you’re “losing the battle” — in fact, it means that you’re building up the strength to manage your mental health head-on. That’s bravery. New clients who seek therapy often display remarkable resilience through the process by maintaining jobs, raising families, even starting new relationships despite their struggles with  anxiety, depression and trauma. Therapists are here to  support and cultivate that strength, not get you to admit to any weakness. Additionally, many behaviors that are possibly harmful to you today could be rooted in survival and resilience, and we believe in respect and compassion for those behaviors.

Myth 3: “If I’m ‘crazy’ now, I’ll always be crazy.”

First of all — “crazy” is a stigmatizing and largely meaningless word in the realm of mental health treatment and therapy. Psychological disorders and crises manifest themselves in a variety of different ways. Some people desire or require  long term treatment in varying degrees of intensity. Does that make someone “crazy” though? No. And with therapy, some people may never have a recurrence after seeking out professional care. Additionally, many people seek treatment or choose to remain in treatment for deeper insight, increased communication skills, to continue to make decisions that create a happy and fulfilling life, and find value in both the relationship and support a therapist provides.

Myth 4: “If I go to therapy, I’ll have to spend years dwelling on my childhood and other unimportant parts of my life.”

That all depends on the type of therapy you seek out. Cognitive therapy, for example, focuses on modifying your current behavior and thinking, not your past.. The only way to figure out what kind of treatment is best for you is to talk to a therapist, and possibly explore several options of interventions. A good therapist will listen, help assess if you’re a good fit together, adjust your treatment according to your needs, while staying in their scope of practice. Additionally, while some types of therapy do explore our histories, our past creates who we are today. If current problems are rooted in or began in your past, it could be useful to address them and understand them in the context of and to change your present. This may help uncover hurtful patterns and beliefs that you live with today unquestioned that currently cause you harm.

Myth 5: “If people find out I am in therapy, they will treat me differently — or even reject me.”

Fortunately, therapy is an entirely confidential process. If you don’t want friends, family or your loved ones to know you’re going to therapy, simply don’t tell them. For those whom mental health issues and treatment carry a huge stigma, but that’s changing fast as more and more people are open about their struggles.  The truth is that some people, whether from ignorance, prejudice or their own self-doubt, may treat you differently, or turn you down if you tell them what you’re going through. The trick is knowing whom to tell and when to tell them — and a therapist can help you navigate that. We don’t want our clients to feel shame about coming to therapy. A therapist can work with you to address your fears and how to communicate that you’re in therapy when you’re ready to share that. Taking steps to help yourself live a more happy and fulfilling life is nothing to be ashamed of.

Moving Beyond the Myths

In order to help defeat public and self-stigma around seeking therapy and mental health treatment, we suggest trying out these three approaches in your everyday life: protest, education and contact.

First, we encourage our staff and clients to speak out against inaccurate portrayals of psychotherapy, whether that’s in popular media, day-to-day conversations or other more informal sources. We also encourage people to seek out accurate information about psychotherapy if they’re unsure about seeking treatment — whether that’s through reading books, watching videos or reading up on scientific literature or blog posts online. We also encourage our patients to reach out to the people who have already been in counseling to help assuage their fears and dispel additional judgements or anxieties.

Studies show those who have contact with people who have experienced a mental illness or personal crisis tend to stigmatize therapy less. At the end of the day, normalization, advocacy and self-empowerment can go a long way in defeating the shame many people feel toward reaching out.

Blog authors all hold positions at the Gender & Sexuality Therapy Collective (G&STC). For more information about our therapists and services please contact us.

When, Where and Why: Telling Your Sexual Partners You Have a Long-Term STI

There’s a lot of misinformation and stigma out there around sexually-transmitted infections like herpes (HSV-1 and HSV-2), human papillomavirus (HPV) and HIV. Often, when clients come in with one of these so-called “big three” incurable STI diagnoses, it presents a major crisis in their lives: How will they tell their partners? What will this do to their relationships? Will they ever feel loved again?

Fortunately, with plenty of condoms, talks around educated consent and recent advancements in medical treatment for all three STIs, it’s very possible for people to maintain safe and fulfilling sex lives no matter their status. For instance, people with HSV-2 can re-assure their partners by taking anti-viral treatments to suppress the infection and reduce their chance of passing on the virus to a partner by 50 percent. There’s also the HPV vaccine, which people of all genders can receive up to 26 years of age. And by now, everyone should be aware that people on HIV treatment with a fully-suppressed viral load are virtually unable to pass on the virus to their sexual partners.

That said, even in this new age of prevention, it’s still a good (and often times legally-required) move to tell potential partners of your status before you hook up. Additionally, we believe conversations about sexuality, what you like, what you don't like, and STI status are important for everyone regardless of your gender, sexuality, and STI status.

Below, we outline five common approaches people living with long-term STIs can use when disclosing and how to deal with the ups and downs of dating with a more “complicated” sexual health history:

1. The “Three-Date Rule”

Do you like to hook up on the first date? Hooking up on a first date is totally possible for folks living with long term STIs like herpes, HPV or HIV. And things might get a little bit more complicated when navigating consent around an impromptu sexual intimacy or experiences. Many people living with chronic conditions like to wait a few dates before disclosing their status — allowing the person to really get to know them, to increase trust and understanding and forge a personal connection before sharing their status. The time buffer also allows some time for you to suss out whether or not you want to disclose this information, their education and understanding around STIs, and if the person you’re interested in will react positively or negatively to the news. A longer lead-up also gives you time to talk to people like your friends, family, therapist and other support structures before disclosure, so they can be there for you if the discussion turns sour.

2. Write it Out

Don’t like wasting time or energy when it comes to pursuing relationships? Then throw out the three day rule. Some folks with long-term STIs say a well-crafted text message or email simply explaining your status is one of the easier ways to disclose. You don’t have to make it a big production. A quick “Just so you know, I’m positive” and then how you like to practice safer sex, allows your potential partner to make an informed decision without using stigmatizing language or making them feel like it’s a bigger deal than it is. Once again, with all the recent advancements in sexual health treatment, being in a serodiscordant (a.k.a. positive-negative) relationship really is possible without much risk. If they write back concerned about what you just told them, you can always send along links or information educating them about any potential risks. Plus, if the person has a stigmatizing or rejecting response, you’ll have time to experience and process your response, have some time to deal with the news alone and/or seek support and confide in trusted friends.

3. The Kitchen Table Talk

It’s probably not the best idea to disclose you have something like HPV when you’re already undressed and getting into some heavy petting with a partner. Discussing sexual health histories involves a lot of disclosure and trust. Even if you have good intentions, or maybe you are pushing back this conversation out of fear, if you disclose at the last minute possible it may result in someone feeling like you were not trustworthy. Hence “The Kitchen Table Talk” which we recommend be done sober, fully-clothed and as honestly as possible. Explain to them what’s going on, how long you’ve been dealing with the STI, and how you plan to keep everyone safe in a potential sexual relationship. Do your homework and be ready to answer any questions they may have. Whipping out a few handy statistics like “an estimated 80 percent of sexually-active people will get HPV at some point in their lives” or “one in six people ages 14-49 in the U.S. have a genital HSV-2 infection” might also be helpful. Remember that by knowing and openly-discussing your sexual health status, you’re already a safer partner than the millions of undiagnosed and unaware people out there.

4. Testing Together

Considering the high prevalence of STIs already circulating around the population, testing together can also be a good way to approach a disclosure conversation. Partners can make screening appointments together at places like Planned Parenthood, LGBT centers and sexual health clinics. Some places even allow you to schedule counseling sessions to help you and your partner(s) work through the results together and make informed choices around safer sex and prevention. For instance, if you come back HIV-positive and your partner is negative, the clinic can prescribe them PrEP that same day to help them stay that way. It’s also a great way to build trust and support within a relationship, and can help transform the topic of disclosure from a one-way to a two-way conversation. Plus, testing together helps you stay safe as well, making it a fair exchange for every party involved.

5. Dating App Disclosure

This one’s not for the faint of heart and could potentially open you up to some stigmatizing and difficult conversations with strangers. That said, putting something like “HSV-2+, deal with it” in your Grindr profile ensures that any potential matches know exactly what they’re getting into when they swipe right. The potential for feeling rejected three dates in because of your STI status is virtually eliminated. Being completely up-front and honest about your status also allows other people with long-term STIs to seek you out and initiate conversations, potentially allowing you to meet both someone who understands where you’re coming from and isn’t afraid of being exposed to anything new. The dating app disclosure approach can ultimately opening up the conversation about sexual health for all the world to see, putting a face to HPV, herpes, HIV or whatever you’re dealing with, and de-stigmatizing the secrecy and shame that perpetuates the spread of these STIs in the first place.

However you decide to disclose, know that doing so is a crucial factor in the consent process. We believe in taking steps toward honesty and openness in any relationships, no matter the potential consequences.

Blog authors all hold positions at the Gender & Sexuality Therapy Collective (G&STC). For more information about our therapists and services please contact us.


G&STC's Director addresses "7 Microaggressions Trans People Face in Health and Mental Healthcare Settings"

G&STC's Director, Jesse Kahn, was recently interviewed about "7 Microaggressions Trans People Face in Health and Mental Healthcare Settings" on, a new resource for LGBTQ+ folks looking for competent providers.

In the article, Kahn explores various migroaggressions about gender that uphold heteronormativity and cisnormativity in our everyday lives and which infiltrate our conversations, including in medical and medical healthcare settings. 

Blog authors all hold positions at the Gender & Sexuality Therapy Collective (G&STC). For more information about our therapists and services please contact us.

First Ever Transgender Surgery Training Program in the United States

While the president recently directed the United States military not to move forward with a plan that would have allowed for the recruitment of transgender personnel and banned the Department of Defense from providing medical treatment for existing transgender members of the armed forces, we are thrilled (and relieved) to be able to share some exciting local news related to transgender services and support. In 2016, the Mount Sinai Health System opened the Center for Transgender Medicine and Surgery. The Center takes a multidisciplinary approach, incorporating primary care, transition care, and behavioral health in an affordable and accessible program. Since its launch, the Center has operated on approximately 350 patients at a rate of nearly four patients per week.

At the same time, medical school curriculum provides little - only about five hours - in the way of education around trans and GNC (gender nonconforming) health and wellness issues. To ameliorate this inequity, the Mount Sinai Health System, under the banner of the Center for Transgender Medicine and Surgery, also created - in July 2017 - two full-year fellowships to train surgeons and psychiatrists to serve the trans and GNC community more sensitively and comprehensively. Over the course of the fellowship, surgical participants assist and perform surgery, teach residents and medical students, and conduct transgender-related research.

It is important to acknowledge that, with respect to the trans and GNC community, medical procedures are not always the primary focus of their experiences. That said, it is exciting to hear about a major medical institution devoting significant resources to better serve this population. This is a development that we here at G&STC wholeheartedly stand behind, and we hope it inspires similar developments at other institutions here in New York City and across the country!

To learn more about the work that G&STC does with the trans and GNC community, check out our recent blog post that outlines ten tips for finding a trans-affirming provider. And get in touch to ask questions, express concerns, and/or schedule a free phone consultation!

Blog authors all hold positions at the Gender & Sexuality Therapy Collective (G&STC). For more information about our therapists and services please contact us.

G&STC's Director "debunks 5 myths about gender"

G&STC's Director, Jesse Kahn, was recently interviewed about 5 myths about gender on, a new resource for LGBTQ+ folks looking for competent providers. In the article, Kahn explores various myths about gender such as about cisnormativity, rigid trans narratives, and micro-aggressions as a way to open up the conversation, start educating other providers, and challenge incorrect assumptions. Check it out here

Blog authors all hold positions at the Gender & Sexuality Therapy Collective (G&STC). For more information about our therapists and services please contact us.

When to start relationship therapy?

Relationship therapy is one of the kindest gifts you can give to your relationship. Relationships require care and nurturing, and seeking therapy with your partner(s) can be an incredibly helpful way to ensure the longevity and happiness of your relationship. Many partnerships wait until their relationship is "no longer working" or filled with resentment, hostility, contempt and conflict. 

What many therapists have known is that partners should seek therapy way before they think they "need" to. Pre-martial therapy is becoming more popular and hopefully the way we culturally think about individual and relationship therapy is shifting. 

Additionally, relationship therapy can be more effective and enjoyable when when your relationship is not in crisis and possibly dealing with a symptom such as infidelity.  Getting into treatment earlier can increase the ease of changing dynamics and patterns, and can reduce the amount of conflict and hurt that we process in treatment.

At G&STC, we believe relationship therapy can be effective within the first 2-4 years of relationship and even earlier if you see fit. We decided on that number based on when many of our relationship therapy clients report the origins of realizing there were some bumps in their relationship. By not coming to therapy until 5-6+ years into their relationship those small bumps turned into major obstacles and conflicts. Often, either one, two or more partners felt "it was too early to be needing therapy." This outlook on therapy shows that we look at relationship therapy with judgement, something only to seek when in crisis or major conflict and, unfortunately, not one of the many ways to nurture a relationship. At G&STC, we hope that relationship therapy can be viewed less as a solution to a crisis or major conflict, and more like one of the many activities relationships can do to ensure the health and connectedness of relationships much like sex and going on dates.

Check out the recently published CNN article that explores some frequently asked questions about relationship therapy, such as when to start and what to expect.

Additionally, check out the G&STC Director's previous blog about foundations to effective communication.

Note: The CNN article says "couples therapy," but at G&STC we are affirming of consensually non-monogamous relationships and believe "relationship therapy" is more accurate and affirming.

Blog authors all hold positions at the Gender & Sexuality Therapy Collective (G&STC). For more information about our therapists and services please contact us.