Although sex therapy is a research-based discipline, it is influenced by social context in the questions it asks, the conclusions it draws, and the treatment programs it develops. As the recognized experts on sexuality, sex therapists and researchers have a reciprocal role in shaping the prevailing stereotype of normal and achievable sexual functioning. Modern sex therapy is based on the paradigm of behavioral deficits as evidence of sexual dysfunction, which led to the notion that sexual competence is the cornerstone of a good sexual relationship. This translates into the model of “great sex” that sex therapists promote in their public discourse. Current assumptions underpinning clinical practice are that great sex should be passionate, meaningful, regular, and adventurous, and this should be achievable by all normal-functioning well-adjusted individuals. Although recognition of individual differences is assumed to be an implicit part of the theory and practice of sex therapy, the modern construct of normal sexual functioning supported by sex therapy blurs individual differences and promotes sameness. Individuals with low sexual desire, rapid ejaculatory response, low or non-existent orgasmic capacity, lack of interest in sexual variety, preference for routine and brief sexual encounters, or who do not attach any great importance or meaning to sex, are likely to be regarded as suffering from a psychological problem or sexual dysfunction. Sex therapy does not offer treatment programs based on the notion that these individuals may be functioning to the best of their sexual ability, and the public promotion of great sex as the achievable norm adds to the distress of those who cannot, despite their best effort, reach these goals. Sex therapists neeed to acknowledge the influence of social context on their own beliefs and practices as sex experts, and to develop more inclusive models of normal sexuality and “good enough” sexual relationships.
Conflict of Interest: None disclosed
Financial Support/Funding: None disclosed
Recorded: Sydney, Australia, April 2007
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