Preface

To set the tone of this book, we wish to share a clinical vignette to demonstrate the power of a sex positive approach. To do so, coauthor and coeditor Dr. Angela Schubert asked permission from her client to share his personal perspective of what brought him to counseling and the poem that was birthed from the ashes of his personal sexual script—one that was informed by religion, disability, identity loss, and the internal conflict that occurred as each of those aspects challenged the very essence of his sexual being. We give you Henry, in his own words.

Henry’s Voice

One of the main reasons I finally went to therapy was because I felt I had no identity. I was no longer in high school, no longer defined by school pride or religion, or by the characters I had been inhabiting during high school as a means of survival. I felt like a gray blob: unnamed, uncharacterized, unworthy. I hoped I had identities in me; I certainly had questions about what identities I could claim and what claiming an identity meant. I started with what felt most pressing and uncomfortable: disability. I live with epidermolysis bullosa, a genetic skin condition that causes my skin to be as fragile as a butterfly’s wings. I have always lived as a disabled person, but only through therapy was I able to comfortably claim and identify as disabled. This poem tackles the intersectionality of disability and sex. It tells my story of how I grappled with sex as a disabled person raised in a Catholic school system that taught purity culture and denied the questions I had about my own human desire. A denial that ultimately pushed me to pornography as an alternative sex educator. Pornography is, of course, a shit teacher and only heightened my anxieties and worries that manifested over the years. Therapy has been tremendously helpful because it provides the space and safety to explore, unlearn, and craft identities. Self-love has been one of the constant areas of exploration for me to unlearn self-hatred, to challenge incorrect ideas, and, most importantly, to grow and craft and claim the identities I want to live.

My One Regret
Henry DeAngelis

I audibly choked
Swallowing the hopeless taste
Of purity culture.
“No, I don’t have any questions.”

My one regret.
My one moment I cannot forget.
The beginning of my emotional debt.

Fuck purity culture.
Fuck it until it restores to me
What should have always been mine:
A curious exploration of my body.
My sexuality.
My sexiness.

Oh yes.
Fuck purity culture.
Fuck it until it lets me ask those questions again.
Fuck it until it has a better answer than
“you shouldn’t be thinking about it.” (nasally)

Purity culture pushed me away.
Purity culture threatened to
Tell my parents
All my embarrassing questions
Threatened to shame me for wondering how sex worked with disability.
Shame me for wondering how I could be loved, when I was taught not to love myself;

Wondering how I could be desired, when I was taught disabled people were
Undesirables.

Wondering how my crip hands could unclasp a button or bra.

How my tied tongue could french kiss,
How my coarse hands could soothe,
And stumpy fingers pleasure, And fragile skin be touched.

Or even how to open the heavy door at the restaurant
Or have my date be seen as my date and not my nurse
Or have my date not pity me
And people not call my date a hero for going out with me

These are the questions purity culture pushed down my throat

to the very bottom of my stomach
From there it jumped up to my mind

And scolded me for wondering about my own human desire
And before it left
It whispered one final thing into my ear

Shame.

Shame for thinking about sex.
Shame for thinking about one day having children.
Shame for not being the asexual person purity culture believes I should be.

And with that purity’s damage was wrought
And it left me content with its knowledge
That I would forever shame myself
For my own human desire.

My one regret.
My one moment I can’t forget.
The beginning of my emotional debt.

As in that moment,
Purity.
Pushed.
Me. To.
Pornography.

Angela Schubert’s Voice

Henry was fearless in his pursuit to find his own truth and narrate his own story. His story and reliance on sexually explicit material, also known as pornography, for sex education is not unique to Henry. Considering the utter void of comprehensive sex education across all social fronts, it is no wonder sexually explicit materials have become the sex educator for all who are interested. This is not to say that sexually explicit material is to blame for existing and thriving as the default sex educator, but rather that the finger is pointed at the gap that allows sexually explicit material to be the default educator in people’s lives.

Henry chose counseling as a means to explore his own path as a sexual being with desires and needs, to challenge his own assumptions and biases, and to redefine his own sexual script. Henry took the path toward awareness, acceptance, and self-love, and I humbly held the lantern to shine a light on the path. My foundation as a counselor educator and sex therapist is rooted in the firm belief that everyone is deserving of their sexual story, and everyone is capable of narrating their own sexual script. Throughout this book, you will find the term “sexual script” repeated. A sexual script is the result of embedded cultural beliefs, social messaging, biology, personal experiences, and any formal/informal education about sexuality a person has received over their lifetime.

In the counseling session, counselors are gifted the opportunity to support a person as they come into their awareness of themselves and, sometimes, awareness of their sexual script. As mental health professionals, we are absolutely capable of facilitating therapeutic conversations to help clients better understand how their upbringing and personal experiences have crafted a view of their sexual selves. We are in the perfect place to illuminate the path as they begin to explore their sexuality, their sexual essence, and as a result, honor the parts of sexuality they wish to keep and release the parts that no longer work for them.

This book is an attempt to help mental health professionals and budding mental health students understand how to approach specific issues with clients yearning to explore their sexual story—without judgment and full of radical acceptance.

Why We Created This Book

Human sexuality counseling is an area rarely addressed directly in either the human sexuality literature or the professional counseling literature. Human sexuality textbooks generally consist of the fundamentals of sexuality, specifically the physiological aspects. The 2016 Council for Accreditation of Counseling and Related Educational Programs (CACREP) Standards now address the need for educating counseling students about human sexuality counseling, specifically in clinical rehabilitation counseling (CACREP, 2016, Section 5, Standard D.2.m.); marriage, couple, and family counseling (Section 5, Standard F.2.e.); and rehabilitation counseling (Section 5, Standard H.2.h.).

Furthermore, there is a belief by some that “information is enough.” According to this approach, all that needs to be covered in sex education classes in secondary schools are basic and introductory facts and data. That approach may then carry over through a counseling student’s undergraduate coursework too. By the time that the counseling student reaches graduate school, they too may have integrated into their own belief system that information is enough. Researchers have found, however, time and time again that training in sexuality-related pathology is too limited and that information alone is not enough in terms of which topics are addressed in counseling related to sexuality (Blount et al., 2017). It is, therefore, ethically imperative for counselor education curriculum to include an affirmative and expansive training in known pathologies wherein sexual arousal is attributed directly to typical and atypical (or nonmajority/nonrepronormative/nonheteronormative) fantasies, behaviors, or partners that cause danger, distress, or dysfunction (Blount et al., 2017).

Understanding and comprehensive application of effective treatment approaches associated with sexuality is absolutely necessary for the wellness of the counseling clients. Many people with sexuality-related concerns that are discovered in a medical setting are often referred to a mental health professional in conjunction with pharmacological interventions. For example, the American Urological Association (Burnett et al., 2018) guidelines for treating erectile difficulties recommend that urologists connect patients with a mental health professional to enhance communication about sexual concerns and to reduce performance anxiety. Furthermore, practicing urologists see an average of 70 patients per week, or 3,360 patients per year, and the types of cases they serve also include erectile dysfunction, pelvic floor, urinary tract concerns, penile rehabilitation following prostate cancer, reproduction, ejaculatory dysfunction, hypo-gonadism, penile implants, and sexually transmitted diseases—to name a few. Specifically, Burnett et al. (2018) explained that “psychotherapy and psychosexual counseling focus on helping patients and their partners improve communication about sexual concerns, reduce...