What if many of our clinical and educational frameworks are too small for the sex lives people are actually living?
Consensual non-monogamy (CNM) is no longer niche. At least 1 in 20 people in the U.S. are in a non-monogamous relationship—and some recent estimates suggest it may be as high as 1 in 4, depending on definitions and sampling. Interestingly, these numbers have held steady for over a decade and cut across age, education, income, religion, region, political affiliation, and race.
Where do differences appear? Gender and sexual orientation.
Rethinking the “Gold Standard”
Monogamy, long considered the default relational structure, involves sexual, romantic, and intimate exclusivity with one partner.
Consensual non-monogamy (CNM), on the other hand, is an umbrella term for relationship configurations where all people involved agree that multiple sexual or romantic connections are acceptable.
Research consistently shows that people in both monogamous and CNM relationships report similar levels of love, commitment, and relationship satisfaction. Yet stigma persists—many assume that CNM relationships are less stable, less satisfying, more jealous, or risky for sexual health.
But the science tells a very different—and much more interesting—story.
More Than “Open”: Relationship Constellations Explained
CNM isn’t one thing. It’s a spectrum:
Open relationships: sexual openness, romantic exclusivity.
Swinging: partnered erotic adventures.
Polyamory: forming multiple loving, romantic bonds.
Relationship anarchy: rejecting predefined norms and building personalized relational structures.
Many CNM structures are hierarchical (with a “primary” partner), while others are entirely non-hierarchical, something research is only beginning to fully explore.
CNM’s Not-So-Secret Superpower: Sexual Satisfaction
Across sexual orientations, CNM participants, especially swingers and polyamorists, reported higher sexual satisfaction than monogamous adults.
Why?
Need fulfillment: Higher-order psychological, emotional, sexual, and autonomy needs are often better met across multiple partners.
Novelty: More opportunity for self-discovery and new sexual experiences.
Diverse erotic experiences: Needs can be met by different partners in different ways.
But nuances matter. Open relationships, when examined separately, sometimes show less positive outcomes partially due to:
lower communication quality
more extrinsic motivation for entering CNM
less clarity around boundaries
The key takeaway: sexual satisfaction is multidimensional, and monogamy is not the universal benchmark.
Jealousy: The Plot Twist
Jealousy is the first concern many people have about CNM, and the one most often misunderstood.
Research shows:
Emotional jealousy (hurt, distress) is lower among open, swinging, and polyamorous individuals than among monogamous participants.
Cognitive jealousy (thinking/worrying about partners’ outside engagements) is higher—especially in open relationships.
Why?
Because CNM folks discuss, negotiate, and confront extradyadic involvement more directly. Thoughts about partner activity don’t necessarily provoke emotional distress.
For sexual health professionals, we must stop treating jealousy as one thing.
It can be emotional, cognitive, situational, or hypothetical, and often functions as a skill, not a pathology.
Satisfaction: It’s Complicated—and Queer
So how did this study compare to others?
Relationship Satisfaction
Heterosexual CNM individuals reported similar satisfaction to monogamous individuals.
LGBQ CNM participants reported slightly higher relationship satisfaction, especially in swinging and polyamory.
Sexual Satisfaction
Across all genders and orientations, CNM groups reported higher sexual satisfaction than monogamous individuals.
Among LGBQ participants, sexual satisfaction was highest in swinging and polyamory—not open relationships.
Jealousy
Emotional jealousy was significantly higher in monogamous groups.
Cognitive jealousy was lowest among monogamous individuals and highest among open relationships.
The message: Sexual orientation and relational structure intersect in important ways and we must not collapse queer experiences into hetero frameworks. And importantly, we need more research to understand how these patterns show up across different LGBQ identities, because the findings likely aren’t uniform for everyone.
Need Fulfillment & Communication: The Real Engines of CNM Thriving
Two major predictors of relationship satisfaction across relationship types:
Need Fulfillment: CNM often allows more needs—emotional, practical, psychological, sexual—to be met by different partners.
Communication: Effective communication (or lack of it) explains a large portion of relationship satisfaction across CNM forms.
Open relationships consistently showed less effective communication than swinging or polyamory groups.
Before assuming risk or instability, sexual health professionals should assess needs and communication patterns first.
Metamours: The Third Who Helps (Not Hurts)
A metamour is your partner’s partner.
And it turns out… metamours matter.
This contradicts the narrative that “the other person” is a threat. For many, additional partners create a stronger sense of community, support, or relational security.
Sexual health professionals should seek to understand metamour dynamics rather than just dyadic functioning.
Why Clinicians Must Move Beyond Dyads
Many CNM relationships simply aren’t built around primary partnerships.Yet most clinical models, assessment tools, and therapy frameworks assume dyadic pairs.
CNM adults frequently report that:
their relationships are pathologized
their providers communicate discomfort or moral judgment
some therapists refuse treatment due to relationship structure
To serve sexual and relational health effectively, we must expand our frameworks to recognize:
constellation-based relationship structures
multiple forms of attachment and support
diverse communication patterns and needs
the ways different aspects of identity (i.e. sexuality and gender) and CNM intersect
Relational diversity isn’t a niche issue; it’s a core part of modern sexual health.
Practical Tips for Sexual Health Professionals
Take an inclusive sexual and relational history
Reframe asking about relationships. Rather ask who your client is connected to, not just their “primary partner.”
Clarify jealousy
Is it:
emotional
cognitive
Situational
hypothetical
…or something else entirely?
Identify unmet needs.
Needs may be distributed across multiple partners; don’t assume one partner = one source.
Assess communication style
How do partners negotiate, set boundaries, or express concerns?
Avoid reinforcing mononormativity
Even the terms around CNM have been criticized as being mononormative by relating monogamy as the central, normed expectation. We must continue to ensure that all relationship constellations and configurations are included and normalized.
The Future of Sexual Health Is Multi-Partnered, Multi-Layered, and Multi-Dimensional
As relationships continue to evolve, so too must our clinical frameworks, research, and theories. CNM research isn’t a niche add-on; it’s a necessary lens for understanding modern sexual lives.
That’s where SHA shines. SHA’s sex-positive, non-judgmental, and evidence-based programs—particularly its renowned couples and sex therapy training—offer clinicians the knowledge, tools, and confidence to work effectively with clients of any relational structure. From cutting-edge coursework to expert-led certification pathways, SHA equips professionals to stay current, competent, and truly affirming in their practice.
The science is clear:
People can, and do, love, desire, and flourish in more than one relationship.
It’s time our clinical practices reflected that reality—and SHA is here to help you get there.
Written by Emma Sell-Goodhand, MPH
Emma is a doctoral student and Global One Health Fellow at North Carolina State University studying adolescent sexual health. She brings prior experience as a Technical Advisor at the World Health Organization.
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