Ask A Sex Therapist Your most pressing questions about sex in all its mystery, answered ANA MARIA CAICEDO Arts & Culture Editor
AC: How do you help couples with varying sex drives find compromise? TM: I think it’s really about understanding that sexuality comes on a spectrum for everybody. You might like or dislike things a lot more or less than your partner in other areas as well, and you learn to navigate those things within the context of your relationship. We tend to think of sexuality as so different, but really, it’s a lot about compromises in a relationship. We do tend to think a person with a higher level of desire is right, or should have their sexual needs met because we tend to devalue the idea that someone might not be as sort-of sexually fueled within our societal context. But every person, based on their temperament, their genetics—a whole range of variables—will have different levels of sexual desire, of kinds of fantasy arousal that we help people navigate in the context of their relationship.
AC: In your practice, have you noticed problems that are more common for women to experience? Have you noticed problems that are more common for men to experience? If so, what are they? TM: Women are more likely to experience physiological pain conditions, I think just because of the physiological differences between [cis] men and [cis] women. [Cis] men are much more likely to present with erectile and ejaculatory difficulties. But you know, in thinking about this question, one thing I’ve definitely learned as a sex therapist is men and women are much more alike than different. I mean, we all want healthy and satisfying sex lives, we all experience anxiety around sexuality, we all experience insecurities, we all want to feel valued, loved, respected and desired.
AC: Is it harder for women to orgasm than it is for men? TM: Women are more likely to experience challenges with orgasm, that is true, but I would say that the main factor that contributes to orgasm difficulty for women during coupled sex is a lack of knowledge and focus on clitoral stimulation. There’s a really good book called Becoming Cliterate [by Laurie Mintz], and in that book she talks about the fact that only four percent of women would say that penetrative sex in and of itself is the most reliable road to orgasm, and that anywhere from 89 to 99 percent of women use no form of insertion when they masturbate. Yet the default sexual act is penetrative sex, often with no focus on 20
On a scale of 1 to 10, how would you rate your sex life? Do you feel at home in your own body and sexuality, or could things be better? This past decade, intersectional feminism has propelled typically marginalized discussions into the periphery of public consciousness, challenging the way many of us navigate our world and interactions. And yet, mainstream discussions of sex today still seem to start and end with safe sex education. We look to porn and television to show us what sex is supposed to look, feel, and be like. Inevitably, it’s hard to feel like you belong in our sexual climate. For this Valentines issue, the Courier asked Terri-Lynn MacKay, a clinical psychologist at the West Coast Centre For Sex Therapy, to help us demystify sex.
clitoral stimulation. I talk to my clients about that and tell them that, and it makes them feel really good in normalizing the fact that their experiences are common. I would also say that women are more complex in their sexual response. The historic model of sexual arousal for both men and women was based on [sexuality researchers] Masters and Johnson, where there were four different stages of [sexual response]: excitement, plateau, orgasm, resolution. But the newer model of female sexuality, based on [the research of psychiatrist] Rosemary Basson, looks at female sexuality as being more responsive than spontaneous. So female sexuality is based on a range of factors such as motivation, willingness, context, arousal, psychological factors, relationship factors, emotional and physical satisfaction. Not to say that a range of factors don’t also influence male sexuality, but testosterone plays a larger role for men than women. AC: It sounds almost like clitoral stimulation isn’t a part of what people generally have in mind when they think of sex, or it’s not a requirement. Why do you think that clitoral stimulation isn’t a part of the normalized definition or go-to thing when we think of sex, or I guess specifically, heterosexual sex? TM: I mean, within lesbian relationships, people are more likely to have orgasms than they are in heterosexual relationships. In terms of the question of why iwt’s not front and center, I think that’s just in large part due to a historical context of female sexuality not being valued. It wasn’t that long ago where female orgasm wasn’t even thought to be a real thing. Female sexuality has only really become front and center to sexuality in the past 20 years. And so, it’s going to take a while to catch up, because a lot of what you see in portrayals of sexuality, particularly in pornography—not that there’s anything negative about pornography—but you don’t see a lot of focus on female sexuality and clitoral stimulation within a standard pornographic theme. AC: I was wondering how you’ve seen sexual culture and it’s narratives around what sex and sexy is supposed to act, look, and feel like represented in your own practice in terms of the clients who come to see you?
TM: Well, I think the standard narrative for men is that you’re supposed to be able to get and maintain an erection and you’re supposed to be able to orgasm within a certain period of time. And if those things aren’t functioning exactly as is then there’s something emasculating about it, that you’re not a real man if those things can’t happen —as opposed to seeing men as textured and humanistic sexual beings. And for women as well, I think there’s a lot of narratives around sexuality. That’s why a lot of women fake orgasm, because they have