Sex
A sex therapist on anxiety, self-pleasure, and arousal non-concordance
An interview with Casey Tanner, MA, LCPC.
As a sex therapist, you’ve mentioned that a popular question you receive is: “Am I normal?” Can you share why you think that question is so popular, and your approach to responding?
I believe this question comes from the years (sometimes decades) of messages we all have received that something is wrong with us. Capitalism survives on this very point— by convincing us of a deficit in ourselves or our lives. And the sad irony is that these messages are so conflicting that we often feel we can’t win, especially as it relates to sexuality. “Is my sex drive too high? Not high enough?”; “Am I not lubricating enough? Am I too wet?”; “Is my relationship codependent? Is it too distant?” “Am I too vanilla? Or too kinky?” We always seem to be caught in between extremes.
As a sex therapist, I respond with both accurate, evidence-based information and emotional sensitivity. On the surface, folks want to know what the “normal range” is, and we do have some data on that. However, I find that the real question isn’t about lubrication or sex drive at all. It’s that child inside of us asking “Am I okay? Am I lovable?”, and the data can’t answer that. The journey towards releasing shame and believing in one’s own goodness is an inside job, but therapy and affirming relationships can help.
How do you approach the topic of safe sex, from a physical and mental perspective?
I’m so glad you asked about the mental component! It’s often neglected in favor of behavioral practices, but the research says that we have to start with mindset. For example, if someone feels shame about asking for birth control or doesn’t have a safe person to go to for help, it doesn’t matter how many pamphlets we put out about preventing unwanted pregnancy. If someone feels too ashamed about an STI to share their status with a partner, it doesn’t matter how much we teach about safe sex practices. Thus, removing shame, de-stigmatizing, and creating access to body and pleasure-positive resources is a crucial first step.
This is also true for the topic of “consent”, which I fear has become so much of a buzzword that people feel all the pressure to engage in consensual sex with very few concrete resources on what this actually looks like. As much as looking for a “yes” or “no” is a good place to start, everyone deserves a course that gets into the nitty gritty.
As far as behaviors and practices, I believe accurate and up-to-date information is a human right that unfortunately many people still do not have access to. I love that brands like Sustain are serving up real info alongside their products. Unfortunately many people still use Google, Wikipedia, and porn for sex education. This isn’t on them, it’s on the states and systems that don’t require accurate sex education. This is why on top of offering paid services, I consistently aim to post free resources on social media.
What is a common misconception about queer sex that you’ve noticed?
I can’t tell you how many times people assume that 1. queer people don’t have “real” sex or 2. queer people need toys to have “real” sex. We live in a culture that is OBSESSED with penises. And not just penises - hard penises. So when folks try to fathom how people without penises, or without hard penises, attempt to have sex, their minds explode!
This is why I love working with the queer community; we are a group of people who have been socialized to believe the kind of sex we can have isn’t “real”, so we have done a lot of work to get creative and challenge social norms to have great sex. And guess what? The research says that when two people with vulvas have sex, more orgasms abound than with straight and cisgender couples! This is because there is a level of communication and body positivity that is hard to find in people who haven’t actively worked to undo normative messaging. So when people call penis-vagina intercourse “real” sex, I say, “Keep your real sex; I’ll take the unreal sex that I get to have.” Sorry, not sorry.
How do you approach the topic of self-pleasure? Do you have advice for folks who are navigating the road to personal sexual fulfillment?
When I work with folks looking to increase self-pleasure, whether alone or in partnered sex, I begin by taking some focus off of the genitals and putting more focus on the brain and breath. Most sexual concerns have one root - anxiety. Performance anxiety, anxiety resulting from trauma, social anxiety, body image anxiety, dysphoria, etc. I take the stance that our anxiety has something to teach us— about the past, about our needs, about healing that needs to be done - so we start there. Throughout this process of healing, I interweave accurate sexual health information and make any necessary referrals to doctors, gynecologists, urologists, and/or pelvic floor physical therapists. It’s important to rule out any medical/biological concerns.
So to those beginning the road to personal sexual fulfillment, I’d say go slow and manage your expectations. Let go of perfectionist fantasies of multiple orgasms in the first day, weeks, or months. Know that anxiety will come, and that there is something to learn there. Focus less on performance, and more on what it feels like just to be in your own body.
You’ve written about sexual desire using a concept that you call “Arousal Non-Concordance.” Can you share more about what that is and how we can apply it to our own desires?
Yes! Most of us were taught that if we want to know whether or not someone (including ourselves) is turned on, we should look for wet vulvas and hard penises. By the same token, if there isn’t a hard penis or wet vulva, that person must be unaroused. There is so much danger in these limited beliefs, though, and we see the consequences especially when it comes to navigating consent. Think about the assault survivor who is invalidated because their vulva became lubricated during a rape, or because their penis became erect during molestation. These uncontrollable physical responses have been used against survivors socially and in court to discredit their very real non-consensual experiences. What our bodies do is NOT always congruent to what we want, how we feel, and what our words are saying - this is arousal non-concordance.
The main take-away from arousal non-concordance research is to listen to your brain and your partner’s words over any signs of arousal. This goes both ways. If your partner is not erect, wet, etc., it does NOT mean they aren’t turned on or don’t desire you. We tend to see our partners’ genitals as some type of mirror that says something about our own sexiness, however this just isn’t what the research says. I hope we can continue to help ourselves take these moments less personally, and to attune ourselves to our partner’s voice, rather than their genital responses.
What resources would you recommend for folks who are exploring queer sex for the first time?
If at all possible, find a queer sex therapist— someone trained not only in queer-affirming therapy, but also in sexual health. These folks can be rare (and sometimes expensive), and luckily online resources abound. Spectrum Boutique is a sex-positive toy store for all bodies that also contains no-nonsense Q&A. For folks who identify as women, Autostraddle has great resources about not only sex, but also connecting to other queers in your city. Planned Parenthood is great and super affirming (they may be known for their clinics, but they have a massive sex education initiative). Scarleteen also has fantastic online resources and downloads — check out their “Yes, No, Maybe” list to get started on figuring out what parts of queer sex you might enjoy most!
I’m obviously biased, but I also recommend curating your instagram feed with 10-20 excellent sex therapists, coaches or educators. @pusssywitch, @itswalela, and @ihartericka are some of my favorites.
Can you share a moment that has surprised and/or delighted you while working as a queer sex therapist?
Most people don’t know this about me, but I was raised incredibly conservative and originally went to school to be a pastor— wild, right? Thus, I love working with couples who have experienced religious trauma and are working to expand their sexual repertoire, let go of shameful messaging, and revel in their sexuality. With these folks, there is usually a moment in the work where the shift is palpable, and it usually comes with the partners sexualizing one another (possibly for the first time). For example, maybe they were using words like “intercourse” or describing their bodies with anatomically correct, sterile language. Now, they’re saying words like “pussy”, “hard”, “wet”, “dripping”, etc. The room gets warmer, cheeks get flushed, and I know this couple is getting laid after therapy. I had one couple like this who went from terrified to speak about sex to writing each other erotica. It’s truly amazing how resilient our sexualities can be with the right resources and an affirming presence.
