Sex Therapy With Erotically Marginalized Clients
One of the things I’ve witnessed at the SHA events I’ve attended is how often this organization introduces people—who are often already professionals—to ideas that they have never before encountered. Truthfully, some of this information should be required learning before someone can become a licensed marriage and family therapist, but it’s not. SHA fills a void (especially with their certification programs) to introduce their students and attendees to information that will better help them assist their clients in a sex-positive and safe way. However, these programs and events may not be accessible to everyone, and you can’t always replay a webinar when you need some guidance.
Enter Sex Therapy with Erotically Marginalized Clients, a book and framework by three therapists who understand the need to expand upon basic therapy training and licensing as well as SHA does. In their book, Damon Constantinides, Shannon Sennott, and Davis Chandler define “erotically marginalized” people as anyone who has experienced oppression due to their sexual identities, orientations, or behaviors. This is a broad category that includes but is not limited to the LGBTQ+ community and folks who are kinky or polyamorous folks. Through their practices and personal experiences as erotically marginalized (EM) people, the authors realized sex therapy frequently falls short for erotically marginalized clients, in part because the goal of therapy so often seems to end at coming out and integrating with a society that very likely includes at least some sort of erotic marginalization. The result of this realization is this book based on nine principles of clinical support for sex therapists, whether the clinician is erotically marginalized or not.
The 9 Principles of Sex Therapy for the Erotically Marginalized
The principles are as follows:
Maintain transparency and name systemic and individual oppressions
Challenge binary thinking and its constrictions
Support willingness to experience the anxiety of uncertainty
Practice a relational and dialogic approach to sex therapy
Emphasize clients’ own words, knowledge, and narratives
Locate oneself and respond to clients meta communication
Support participation of family and communities
Practice active allyship
Build a community of colleagues
This Book’s Approach
These principles are divided into three sections in this book: foundations (1-3), practice (4-6), and systematic principles (7-9). Readers will learn the basics of erotic marginalization and a framework designed specifically to help EM clients, learn how to specifically adapt therapy for those clients, and discover how to challenge systemic marginalization while finding support for themselves as they read the book. This is a wonderfully comprehensive approach.
The information imparted in the book’s beginning will carry through to the end. For example, the authors understand that it is not enough to recognize how their clients might be marginalized but to examine their own privileges and power—including within the sex therapy room. To achieve and affirm this throughout the book, Constantinides, Sennott, and Chandler (and clinicians whose submitted case studies are incorporated) frequently mention their own locations of self from gender to orientation to race to education, among others. Each chapter builds on those that came before.
Readers can easily see how this work rests upon a social justice framework that respects diversity and works toward inclusion. The authors explicitly state that they are influenced by trans feminism and queer theory and that they use narrative approaches within the therapy room, all of which they introduce the reader to. Gender and sexual identities that are so often stigmatized are always affirmed within these pages. The authors also specifically center the voices of people of color, which they do by including case studies from colleagues of color. Neither of these ideas was new to me, but it was so lovely to see them included together and to see how the authors practice what they preach with the very way they wrote this book.
The in-depth case studies that conclude each principle chapter are especially noteworthy. They explain how the authors or their colleagues have incorporated these principles into practice and inspire readers to do the same. I imagine that many other readers will agree with me that these examples help to cement both the chapter’s principle and information from the previous chapters, and readers may be surprised to discover how long these case studies are! They are a critical aspect of their book after the explanation of each of the principles.
Aside from the case studies, there is a detailed glossary that is far more useful and personable than your typical glossary. There are also several appendices that include an example referral letter, ‘Self-Determined Gender Psychosocial Form’, and a professional ethics statement—all of which readers could adopt for their practices. The digital version further provides access to several tools mentioned in the book. These resources make this book far more than a theoretical read. After finishing it, you will be able to immediately put something into practice, of that I am sure.
Who This Book Is For
For some, Sex Therapy with Erotically Marginalized Clients might just seem too progressive because it embodies the provocative dialog and radical collaboration that are embraced by SHA. There’s no beating around the bush here. This mention of gender and sexual nonconforming people in this book–and the ready acceptance of them all–will be controversial to some people. But they are not the target audience and they will not be the therapists who help EM clients.
This framework will be the most useful to those who want to improve how they work with EM clients specifically but aren’t sure how to do that without forcing their clients to educate them. Clinicians who aren’t erotically marginalized themselves might fall into this group, and the book can help them forge a path and serve as a reference.
For others, this book will be a fantastic springboard into the social and therapeutic concepts suggested by the authors to better help EM clients. They may want to pause to research ideas mentioned in the book before returning to reading because they need to know more than what is provided (the included glossary is helpful, however). Some readers may be receptive but will need to seek knowledge and expand their comfort zones before they can even start this book and appreciate what’s inside these pages. For them, the book might remain on their shelves until they want to help a specific EM client or have become more comfortable with the ideas presented.
Of course, the book is dense and may not be a “read-straight-through” type of book for some. It’s the type of book that can easily become home to a number of bookmarks or Post-It notes so you can return to it time and again. Sex Therapy with Erotically Marginalized Clients truly is a wonderful and unique resource. I am tempted to say it’s ahead of its time, but in reality, I think it’s about damn time someone wrote a book like this!
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