Sex-Positive Social Work, by SJ Dodd (introduction)

INTRODUCTION

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ex is everywhere—on television, in movies, on social media, in advertising, and even in politics. Sex and sexuality are central to our lives. Social workers come across them in almost every practice setting and almost every client population. We routinely engage with clients experiencing sexual- and gender-identity issues, reproductive concerns, sexual abuse, sexual violence, troubled relationships, and sexually transmitted infections.

Yet active conversations about healthy sexuality and sexual well-being are missing from social work literature, education, and practice.1 The “conspiracy of silence” identified by Jean Gochros almost half a century ago is still very much with us.2 My students often tell me they avoid topics of sexuality whenever possible, and their supervisors often admit the same. Part of the problem is too little information, knowledge, and experience with sex education in social work education. That’s why I wrote this book. SexPositive Social Work is meant to address this silence, challenge social workers to embrace rather than avoid questions about sexuality in practice, and articulate a sex-positive frame for social work.

Twenty years ago, I started teaching a course called Human Sexuality to social workers, after I discovered that there was no such course available

INTRODUCTION

during my master’s in social work program. I had taken Human Sexuality as part of my graduate work in education, so it seemed odd to me that there was not even an elective course on the subject offered in the social work curriculum. During my doctorate program at the University of Southern California, I joined forces with a colleague from the Campus Student Counseling Center to develop a three-credit elective. The response to our first course was overwhelming: full enrollment and fully engaged and inquisitive students. We both learned a tremendous amount, and now twenty years later, we both still teach Human Sexuality, though we’ve moved on to different faculties and are at different schools.

When I got to the Silberman School of Social Work, Hunter College, City University of New York, in New York City in 2000, I was met with the same situation—no class on human sexuality. Luckily, this time there was one in the cata logue, which the administration supported me in resurrecting. We have offered the Human Sexuality elective regularly ever since, and this academic year (2020) we have added extra sections to support the ever-growing interest in the content.

Along my journey teaching human sexuality, I’ve always been amazed by the willingness of my students to share their experiences, vulnerabilities, and fears about sexuality in practice and through their own experience. And I am always equally disappointed by how little attention is paid to sexuality—especially positive sexuality—within the social work curriculum and literature.

In my two decades of teaching sexuality, I have relied almost exclusively on textbooks written by psychologist, psychiatrists, and physicians.

But the social work lens is different. That is precisely why we all chose social work. It addresses the holistic person-in-environment. It pays attention to the biological, psychological, and social. And it champions social justice. Social work centers the values of our profession as it explores sexuality and gender from a nonjudgmental, self-determination-focused perspective.

So I wrote this book. I wrote it to fill a gap in the literature and the curriculum—giving us a social work lens on sexuality and gender and shifting from a deficit focus to a positive, strengths-based one across the whole

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curriculum. I also hope it challenges you to look at some of your own assumptions about your clients’ relationships, gender, and sexuality and to begin to test those assumptions by engaging the subject in practice.

The goal of this book is to survey key topics around sexuality for social workers from a strengths-based, sex-positive perspective. A sex-positive perspective encourages agency in sexual decision making and embraces consensual sexual activity as healthy, something to be enjoyed without stigma or shame.3 It embraces sexuality as a human right. Despite sexuality’s prominence in social work practice settings, many social work professionals have internalized sociocultural taboos about discussing sexuality, so they tend to avoid the topic in practice. While social workers have embraced the notion of working from a strengths-based perspective, sexuality is still predominantly approached from the opposite direction— focusing on risks and possible harms. A strengths perspective does not focus on the client’s deficits or limitations but instead on their strengths, skills, aptitudes, and resources.4 It does not pathologize consensual sexual activities like paraphilias or fetishes unless they cause distress. And it does not assume that someone’s sexual- or gender-minority status is the key to their presenting problem.

The purpose of this book, therefore, is to offer a sex-positive approach to sexuality for social workers with illustrative case examples. It is designed to encourage you, as social work practitioners, to embrace rather than avoid issues of sexuality within your practice, incorporating the sexual dimension into the biopsychosocial assessment and engaging in conversations about sexuality regularly with clients as appropriate. The book encourages sexual fulfillment, attention to desire, intimacy, arousal, and overall sexual well-being without judgment or assumptions. Too often, substandard sex education and the cultural taboos related to sex leave people unsure of their sexual selves, filled with shame and guilt rather than excitement and joy.

They do not understand their own likes and dislikes and are unable to ask about those of their partners.

This book provides you with the tools to develop a vocabulary for sexpositive conversations with your clients so they can engage with their sexual selves and explore who they are as sexual beings. It is also an opportunity

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for them to unlearn sex-negative messaging and replace it with affirming, nonjudgmental internal dialogue.

Sexual well-being is critical to overall well-being. This book will give social workers the tools to approach sex and sexuality actively and positively with clients. It is designed to embolden you to engage in discussions of sexuality with clients, and it is written to provide an opportunity for self-reflection and professional growth. The book includes foundationallevel content on a range of topics related to sexuality: developing your own comfort; avoiding assumptions; considering cultural context; setting the environment (physical space and inclusive intake forms); taking a sexual history; understanding physiology; differences in arousal; variations in sexual identity; experiences of gender identity; intimacy; communication; understanding relationships (attachment theory and relational theory); sex in older adulthood (expectations, physical issues and enhancements, residential settings, and sexually transmitted infections and diseases); BDSM (bondage and discipline, dominance and submission, and sadism and masochism) and kink; consensually nonmonogamous and polyamorous relationships; and ethical considerations, including erotic transference. It is by no means complete. In some cases I can raise only some of the most basic issues of a subject. And just as in class, in some cases the book raises more questions than it answers. But it will provoke conversations, encourage you to think, and introduce topics you may explore more fully.

In class, my students challenge me by presenting a wide range of experience levels—from comprehensive to almost nonex istent. Some of my students have significant experience working as sex educators or in sex stores or running groups for teens in schools. Some have taken a number of courses on sexuality and gender in high school and college. However, others come to class knowing almost nothing about sexuality and with no experience in discussing sex. Some grew up in strictly religious households where sex was not discussed (especially with girls). Some came from places within the Ca ribbean, the Middle East, or Latin America, where cultural taboos about sex prevailed. My readers are an equally diverse audience. Some of you will be left wanting to explore topics more fully.

Others will find the information a little uncomfortable to digest and may 4

INTRODUCTION

move through the book slowly, taking time to process the information.

Whatever your par tic u lar level of familiarity and comfort, I hope you will find things in this book to challenge your assumptions, give you new ways to think about a topic, or additional skills to engage clients more fully in relation to sexuality.

Each chapter is designed to provide an overview of foundational content about the specific topic as well as references and resources for you to explore more deeply if you desire. In many ways the book mirrors my classroom process by first providing clear and straightforward descriptions of key concepts using theoretical frameworks and then emphasizing the application of that knowledge through case illustrations and specific examples. At the end of each chapter, a summary provides an overview of the key issues raised. Discussion questions are also provided to stimulate further dialogue and promote self-reflection. Resources offer suggestions for further investigation into particular topics. Student learning outcomes identified in the Council on Social Work Education’s “2015 Educational Policy and Accreditation Standards” are highlighted at the beginning of every chapter. Some are cited only in particular chapters. For example, competency 1—to “demonstrate ethical and professional behavior”—is featured in chapter 10, which addresses sexuality and ethics. Others are universal themes, like competency 2—to “engage diversity and difference in practice”—which crops up in every chapter.

This book can help you build a framework from which to discuss sexuality in your practice. Sex positivity affirms the centrality of sexual well-being to overall well-being, including increased life satisfaction and improved relationship quality. I encourage you to fully attend to the sexual dimension of your clients, acknowledging its importance in their lives as critical context whether it is related to the presenting problem or not. The goal is to integrate a central notion of sex positivity even in situations where there has been trauma or experiences typically aligned with a deficits model (e.g., sexually transmitted infections). The sexual dimension should be an integral part of all social work practice, regardless of setting or practice method, and should be included in the initial assessment and ongoing evaluation of all clients. Ignoring the sexual dimension of our clients’ lives diminishes our understanding of who they are as people.

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Gender and sexuality are constantly evolving, as is the language we use to discuss them. Thus, some of the expressions, terms, and definitions used in this book may become outdated while the book is at the printer. Please give me the benefit of the doubt that my goal was to be inclusive and affirming. I hope you find Sex-Positive Social Work an informative and engaging addition to your social work library.

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“In Sex-Positive Social Work, SJ Dodd shows how to translate social work’s strengthsand justice-based commitments into practice related to sexuality. Such knowledge and skills are vital to social workers’ ability to promote the sexual rights, well-being, and dignity of all clients.�

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“Sex-Positive Social Work is a brilliant, comprehensive, and well-constructed text useIXO IRU VRFLDO ZRUNHUV LQ WKH FODVVURRP RU SUDFWLFLQJ LQ WKH ɞHOG 0RYLQJ WKURXJK relevant foundational and contextual information on sex, sexuality, and practice, the WH[W LV D ZHOFRPH DGGLWLRQ WR WKH ɞHOG ,W LV IUDPHG ZLWK DSSOLFDEOH FDVH LOOXVWUDWLRQV and resources to assist social workers in becoming more sex-positive in their practice.�

M I C H A E L D E N TAT O , editor of Social Work Practice with the LGBTQ Community: The Intersection of History, Health, Mental Health, and Policy Factors

“In Sex-Positive Social Work, Dodd begins the conversation about healthy sexuality and sexual well-being that is missing from social work literature. She uses wonderful, clear, and realistic case vignettes to illustrate her arguments. Every practitioner should read and incorporate this text into their practice.�

G E R A L D P. M A L L O N , editor of Social Work Practice with Lesbian, Gay, Bisexual, and Transgender People

“Finally! A sex-positive text about sexuality for social work instructors and students WKDW HQFRXUDJHV SOHDVXUH IXOɞOOPHQW DQG WKH IXOO HPEUDFH RI HQJDJLQJ SHRSOH around sexual well-being. The content is expansive and robust enough to deepen one’s capacity for conversations about sex and sexuality with clients, in supervision, or the classroom.�

S T E P H A N I E WA H A B , Portland State University

“Dodd presents a strengths-based, health-positive approach to human sexuality. This should be a required text for all graduate-level social work students.�

D O N I W H I T S E T T, University of Southern California

SJ DODD

is associate professor at the Silberman School of Social Work at Hunter College and the CUNY Graduate Center. She is also founding director of the Silberman Center for Sexuality and Gender. She is coauthor of Practice-Based Research: A Guide for Reluctant Researchers ( ŇŚŇŞŇ?ŇŚ ).

Cover design: Elliott S. Cairns Cover image: Private collection / Bridgeman Images ISBN: 978-0-231-18810-4

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