I often joke that when people ask me what I do I have to check in with my energy level before I give the full answer. Sometimes, to save myself the energy, I’ll just say that I’m an acupuncturist (also true). It’s honestly not because I’m afraid of anyone’s reaction, but because sometimes I’m just not up the the discussion. “Sexa-what?? What’s that?” Is the most typical response. Depending on the questioner’s background and visceral response to anything with the root word “sex,” they might assume I do tantra or erotic work (I don’t). Given more information, they might also assume I’m do pelvic floor physical therapy work. Nope, not that either. Well, what then?
The true beginnings of what we now call sexological bodywork started with a man named Joseph Kramer during the AIDs epidemic in San Francisco, circa 1990. Kramer noticed a need for intimacy development for and amongst the gay community who were suffering from lack of physical touch after their diagnoses. He began to teach them embodiment skills to be more present with their sexuality. Fast forward many years, and sexological bodywork has now blossomed into a sex positive community of open-minded people stepping up to assist the public with any issue that relates to sexuality. Perhaps you might feel that you have difficulty relating to your partner. A sexological bodyworker will use this opportunity to assist you in being more present with your own sexuality, perhaps offering sessions that teach both people to be present with each other. The difference, and gray area, came when touch was being offered. In a society so laser-focused on sex hypervigilance, where do we draw the line between sex work and sex education? The answer, simply, lies in the practitioner’s boundaries and ethics. Certified sexological bodyworkers follow strict ethical guidelines that dictate the wearing of gloves and staying clothed while present with a client.
Tantra, the ancient art of intimacy, has its benefits for those looking to deepen their experience in sexuality. Breathwork, partner massage and the depths of the masculine and feminine, in exploration within both the self and with a partner, can be beautiful things. The spiritual tilt that comes with the tantra experience also offers an amazing community of soulful people. While many tantra practitioners offer one-on-one work, there’s no designating body that requires lack of sexual contact between practitioner and client. This is where boundaries can get fuzzy, and while deception can lurk in any space or under any title, there are many tantra practitioners who might not have as dandy a reputation as one might hope. If you’re thinking of going the tantra route, more power to you! Make sure that your practitioner has a solid reputation in the community, research their credentials if possible, and ask where or under whom they’ve studied. Ask about their boundary and consent skills - do they have a protocol they personally follow? Be clear about what you expect from a session, and get clear on what kind of session or interaction they typically offer. As with any of these interactions, clarity is key, especially when one does not practice under a certifying body.
Sex therapy is typically performed by a licensed therapist who’s gone and done an additional certification to further their skills in discussing sexuality and intimacy issues. You won’t find touch in these sessions, at least not in the US, Australia or most of Europe. Talk therapy is the basis of this modality, and whether the therapist decides to incorporate trauma therapy skills is dependent on their personal background. You’ll find that these sessions are mostly based on lifestyle changes and interpersonal communication skills. Finding a sex therapist in particular might be challenging. Many LMFTs or psychotherapists have comparable skillsets, depending on the type of additional training they have. The key here is to ask the therapist in question which modalities they prefer to utilize. For example: do they lean toward trauma resolution therapies such as EMDR or Somatic Experiencing? The type of therapy you’re looking for might be dependent on whether you’re interested in addressing issues that feel like a trauma response, or if you’re desiring more of a behavioral talk therapy approach.
Finally, people often ask me if what I do is on par with Pelvic Floor Physical Therapy. Pelvic floor PTs are western doctors of physical therapy first and foremost. All of them learn what I call the western medicine “mechanics” of the body. (Examples: If you correct your positioning here, it’ll effect your posture there. If a muscle is tight here, it may be pulling on that tendon, ligament or joint connection there). From here, some PTs choose to attend a continuing education school, in addition to their original schooling, which teaches them how to work specifically with the physiological aspects of the pelvic floor. Now this is a super wonderful thing - we’ve now got western medical providers with scope to do internal pelvic floor work. The upside is that there is now help for those who need it in the most physical sense. The downside is that not all practitioners are trauma informed or clued into the subtle or emotional body of a patient. Now don’t read me wrong - there are some truly amazing pelvic floor physical therapists who have developed a felt sense the body’s needs in such a sensitive area. But just like any type of practitioner, getting clarity about what you expect from your session is key. If you choose to see a PT, ask them how long they usually take to do any internal work. If you are nervous about being touched, be clear about your needs for a gentle approach or clear verbal communication before your session begins. As for the difference between sexological bodywork and PT, unless they’re trained otherwise, don’t outright expect embodiment coaching from a physical therapist. Their job is typically mechanical in nature. And this in and of itself could be very beneficial if a body mechanic is what you’re looking for. If you’re in the game to address some more subtle emotional issues, a sexological bodyworker or embodied pelvic care provider is likely a more aligned choice.
And me? Well, I’m a sexological bodyworker. However, the basis of my medical training is in acupuncture, which is why you’ll see me writing a lot from a traditional Chinese medicine perspective, talking about organ systems and Taoist philosophy. Acupuncture is also heavily about the physical - that western mechanical view of the body is not without merit, by the way. If your pelvic floor needs releasing (don’t worry, it’s not as scary as it sounds, and we never put needles in the genitals), then you better believe that’s what we’ll be doing, in addition to balancing the rest of the body, reproductive system, and emotional state.
The perspective focus of a provider’s education is what formulates the type of attention and work you’ll receive in the long run. There are so many different ways to work within the scope of sexuality and pelvic floor health. The important thing to note is at what level you feel you’re ready to approach your problems. Are you only prepared for the physical at this point? Are you more interested in your relationship patterns? Are you willing to expand your spiritual side? Are you ready to explore your emotional depths? What level of growth and healing are you looking for? There is no shame in desiring any one path over another. Be true to you and what you’re able to handle right now. Baby steps are okay. Big leaps are okay. Knowing and owning what works for you at this point in your life is what matters most.