In recent years, the mental health field has made significant strides toward recognizing the complexity of human sexuality. Yet, as Silva Neves—an acclaimed psychosexual and relationship psychotherapist based in London—reminds us, there is still work to be done, particularly when it comes to supporting LGBTQ+ individuals in clinical settings. In a recent interview, Silva shared invaluable insights about the limitations of sex addiction models, the importance of cultural competency, and how trauma, shame, and heteronormativity often intersect in ways that harm queer clients.
For professionals seeking to better serve their clients, or individuals seeking affirming care, working with an LGBTQ Certified Sex Therapist can be transformative. These clinicians bring a much-needed understanding of sexual diversity, relational nuance, and the broader social forces that shape intimacy and behavior.
Reframing Compulsive Sexual Behavior: Beyond the “Addiction” Narrative
One of the most powerful insights Silva offers is the need to rethink compulsive sexual behavior. Rather than labeling these behaviors as “sex addiction” or “porn addiction,” he explains that current scientific evidence does not support such classifications as true addictive disorders. Unlike substance addictions, compulsive sexual behaviors do not typically involve chemical dependency or withdrawal symptoms. Instead, they often signal deeper psychological concerns.
Underlying causes often include trauma, depression, or internalized shame.
Labeling someone as addicted may actually increase their shame, reducing the effectiveness of therapy.
Evidence-based, compassionate care should focus on understanding the root causes, not suppressing the behaviors.
For LGBTQ+ clients especially, this reframing can be lifesaving. Pathologizing sexual behavior without understanding its context—whether that’s healing from trauma or expressing identity—can be not only ineffective but deeply damaging.
Why LGBTQ Clients Need Affirming, Culturally Competent Care
Silva makes it clear: LGBTQ+ individuals face unique therapeutic challenges due to persistent societal stigmatization. Sex is often one of the few available spaces where queer people can explore and affirm their identities. Yet, many therapeutic frameworks remain rooted in heteronormative assumptions.
Group sex, cruising, or polyamory may be normative, healthy practices within queer culture but are often pathologized by clinicians unfamiliar with these dynamics.
Therapists must distinguish between genuine distress and societal discomfort with non-traditional sexual expressions.
Affirming clinicians recognize sexual diversity as a strength, not a pathology.
This is where the role of an LGBTQ Certified Sex Therapist becomes critical. These professionals receive specialized training that prepares them to understand and support the unique sexual, relational, and cultural experiences of LGBTQ+ clients.
Religious Influence and Harm in the Therapy Room
A particularly important warning Silva offers is about the unacknowledged influence of religious morality in therapeutic work. Even well-meaning therapists may bring subconscious biases from their religious upbringing or belief systems into the clinical space.
Moralistic views on monogamy, abstinence, or heterosexuality can retraumatize queer clients.
Therapists must maintain ethical boundaries that keep personal beliefs separate from client care.
LGBTQ clients often carry religious trauma, making it crucial for therapy to be a space of healing, not judgment.
Training programs that certify therapists in LGBTQ-affirming sex therapy often address these issues directly. They help clinicians examine their own belief systems, develop cultural humility, and create inclusive, supportive environments for all clients.
Shame, Sexuality, and the Healing Process
Silva emphasizes that shame is one of the most common threads among clients who present with compulsive sexual behavior. This shame is often the result of societal judgment, familial rejection, or religious condemnation.
Therapy should help clients unpack and release shame, not reinforce it.
Shame reduction is especially crucial for queer clients, who often navigate multiple layers of stigma.
A person-centered, nonjudgmental approach is essential to long-term healing.
Certified sex therapists trained in LGBTQ care are particularly adept at recognizing these dynamics. Their training helps them identify when a client is carrying external judgments rather than experiencing internal distress about their sexuality or behavior.
Trauma-Informed Relationship Work
When working with couples, especially those impacted by trauma, Silva recommends prioritizing individual trauma therapy before engaging in relational work. This prevents retraumatization and lays a foundation for effective communication.
Unaddressed PTSD symptoms can sabotage relationship therapy.
Therapists should pace sessions based on each individual’s capacity, rather than pushing for resolution too soon.
Building emotional safety is a prerequisite to working on sexual or relational concerns.
An LGBTQ Certified Sex Therapist brings an added layer of sensitivity to this work, understanding how trauma intersects with identity, sexual expression, and societal marginalization.
Communication: The Lifeblood of Intimacy
Silva encourages couples to engage in ongoing conversations about sex, boundaries, and pleasure. Too often, sexual communication is treated as a one-time discussion rather than a continuous process.
Desires evolve. Trauma may shift intimacy needs.
Regular communication keeps relationships adaptive and connected.
Therapists can help couples build language around vulnerability, consent, and pleasure.
This is particularly important for LGBTQ+ couples, whose experiences may not be reflected in mainstream relationship models. An affirming sex therapist can provide tools and frameworks that resonate with queer experiences rather than impose heteronormative scripts.
Queer Spaces and the Healing Power of Visibility
One of Silva’s most poignant reflections is the importance of queer spaces—including sexual and erotic spaces—for identity, empowerment, and community.
Queer porn, clubs, and online communities often provide the validation and representation that mainstream media lacks.
These are not inherently “risky” or “unhealthy” spaces, but culturally significant avenues of connection.
Therapists should approach them with curiosity and respect, not judgment.
Understanding the significance of these spaces requires cultural competence that is central to LGBTQ certification programs. Clinicians who undergo this training learn to appreciate rather than pathologize queer sexual expression.
Why Choose an LGBTQ Certified Sex Therapist?
If you’re a therapist seeking to expand your practice, or a client looking for affirming care, working with or becoming an LGBTQ Certified Sex Therapist offers clear advantages:
Culturally sensitive, evidence-based care rooted in the latest research.
Awareness of how systemic oppression, trauma, and shame impact sexuality.
Recognition of diverse relationship styles, sexual identities, and expressions.
Avoidance of outdated models like sex addiction that pathologize healthy behaviors.
Ultimately, LGBTQ Certified Sex Therapists are leading the field toward a more inclusive, compassionate, and informed future—one where all expressions of sexuality can be embraced without shame.
A Paradigm Shift in Sexual Health
Silva Neves is a powerful voice for this much-needed shift. His work calls therapists, educators, and advocates to move beyond outdated labels and embrace a more nuanced understanding of sexuality. Through his advocacy, education, and writing—including his book Sexual Diversity—he reminds us that pleasure is not a problem to be fixed, but a birthright to be reclaimed.
For LGBTQ+ individuals seeking supportive therapy, or professionals looking to offer affirming care, the path forward begins with listening to voices like Silva’s—and committing to the kind of training and self-reflection that truly changes lives.
Want to become an in-demand sexual health professional? Learn more about becoming certified with SHA!
What can an LGBTQ Certified Sex Therapist offer?
An LGBTQ Certified Sex Therapist offers culturally competent, trauma-informed care tailored to the unique needs of queer clients. Rather than pathologizing sexual behavior, they challenge the outdated sex addiction model and focus on healing shame, trauma, and stigma. These therapists affirm sexual diversity, understand nontraditional relationships, and foster open communication, creating safer therapeutic spaces for LGBTQ+ individuals.
