Are you disconnected from your passion for physical connection? Sexual desire can arise spontaneously, but this is often not the experience for women in long-term relationships, as well as for people across genders for many reasons. I work with clients who miss having interest in sexual intimacy or who have not yet found their desire for sexual intimacy. Identifying pathways to desire offers you opportunities to choose more pleasure in your life.

I also work with partners who find that the discrepancy between their levels of desire creates tension, frustration, guilt, obligation, and resentment. These emotions result in a further divide between partners, and the path to a meaningful and mutually fulfilling intimate relationship can be elusive. Partners who learn from each other about their unique sexuality rather than making assumptions based on their own sexuality can learn to develop a closer emotional connection and a more intimate relationship.

Our sexuality is shaped by our experiences, our environments, and our body chemistry, all of which are ever-changing. We can choose to have an intentional and empowered role in our sexual development, with consideration for the factors that have influenced the creation of our sexual selves. We may be more or less connected to our sexuality due to messages we learned as children and adolescents, sexual experiences in our youth, sexual trauma, and intimate relationships throughout adulthood.

Our level of sexual interest and enjoyment may change at stages of life including new relationships, long-term relationships, challenges with fertility, parenting children, stages of career development, health issues and life stressors, hormonal and body changes with aging and menopause, as well as transitional periods such as children leaving home and partners retiring.

We are affected by our sense of sexuality, the meaning we attribute to being a sexual person, our ability to experience sexual desire and pleasure, and our capacity for emotional intimacy through sexual experiences. I encourage my clients to honor where they are in their process of sexual evolution, to have self-compassion for the challenges life has presented, and to accept all aspects of themselves as sexual beings.

Individuals who experience persistent pelvic pain or pain during sex need to work with a treatment team to address the related health issues. If you experience pelvic pain and have not yet found a gynecologist, pelvic floor physical therapist, or dermatologist who specializes in treating these issues, I can offer recommendations.

My role on your team of providers is to help you work with pain, manage stress and anxiety, maintain a sense of hope, develop self-compassion, and stay connected to your courage and resilience. I can also work with you to identify and work through the areas of your life that may be impacted as you have been living with chronic pain, such as self-image, quality of life, and dynamics in your intimate relationship.

The messages we are given about sexual performance can lead to anxiety when we think we cannot meet these expectations. Often performance anxiety is the primary culprit for future performance issues, thus we experience a self-fulfilling prophecy of less-than-ideal sexual experiences due to our fear of disappointing partners as well as self-criticism.

I work with clients to address the anxiety and shift to an empowered perspective in regard to sexual expression to address struggles with anxiety about sex, erectile dysfunction, early ejaculation, and anorgasmia.

When we have experienced unwanted sexual experiences, whether or not we have given our consent, we may feel differently about sex in the future. We may have learned that sex is a commodity, our bodies belong to others, our feelings are irrelevant, and sex is harmful. We may have learned to drink, dissociate, or appease through performing to take care of ourselves through unwanted sex. We might be uncomfortable or highly anxious about sex even with partners who are loving and respectful because we have been harmed in the past.

Healing from traumatic experiences can allow us to again feel safe to be present, relaxed, and embodied. We can rebuild trust in our bodies and discover our voice in expressing our desires and boundaries.

Therapy sessions can include EMDR, somatic work, and guidance in identifying and communicating boundaries to others.

We are fortunate to live in an environment that is becoming more affirming of LGBQ identities and same-gender relationships. However, inequities due to minority status still exist and affect individuals, including internalized negative beliefs. Owning our sense of sexuality is especially important when we are exposed to judgmental messages about our sexual orientation. Each specific sexual identity brings many unique complexities as well.

Individuals may find the therapy space helpful in exploring issues such as accepting their sexual orientation, finding community, coming out to family and friends, and relationship issues specific to same-gender partners, as well as a space for challenges that individuals and partners face regardless of sexual orientation.

I work with transgender clients to explore gender identity issues, address challenges in relationships and other areas of life, and support any medical steps associated with transition. Very few models of healthy sexuality exist in our culture, and even less is available for those who are transgender, gender non-binary, or gender variant. Sexual issues often shift over the course of life for transgender individuals as they do for cisgender individuals.

Common areas to explore in therapy include the effects of gender dysphoria on sexual desire, exploring sexual desire discrepancy with a partner, developing a sense of sexuality and congruent sexual expression, and navigating the effects of transition on existing romantic and sexual relationships.

Are you beginning to add light sensory play to your vanilla sex or exploring power dynamics with a partner? Sessions can provide a place to learn and reflect on how to integrate new experiences in a safe and erotic way.

Perhaps you have identified as a kinky person throughout your life and are looking for an affirming therapist who holds this aspect along with all of your intersecting identities.

Relationships are often the most complex aspect of our lives. Creating and maintaining romantic and/or sexual relationships with multiple partners is especially complex due to the feelings and needs of each person in these relationships. When working with clients in relationships with multiple partners, I encourage individuals to be aware of their feelings, effectively communicate with respect to all involved, and develop attunement to partners' feelings.