Speaking of Sex

   Good sex involves more than technical skills. Despite a lot of experience, many people
don’t feel very competent with one important component of sex: speaking up
about it. Sexual competence must
include the ability to be comfortable with sexuality, discussions of sex, and
especially, expressing sexual needs. It
is one of the great ironies of a sex-drenched culture that sex, if it is spoken
of at all, is too often described with a buffer of code words and cute metaphors.

 There are
many situations where this can be a problem. Couples (gay or straight) often have trouble speaking frankly about
their sexual needs or concerns in their relationship. Revealing serostatus to a date or sex partner
is a big concern for many gay men. And
others, even after seeking out a gay physician, are reluctant to talk about
their sexual practices honestly with them, which jeopardizes their health. I have had clients who prefer to get tested
and treated for STDs at an anonymous clinic rather than at the office of their
gay doctor. This is not for insurance
reasons but because they are embarrassed about their sexual behavior.

 Sex still
carries shame for many people. This is
true of professionals, as well. I have
had clients who completed inpatient substance abuse programs tell me that while
in treatment they never spoke of their sexual practices, most of which were critically
linked to their drug use. Why wasn’t
this discussed? In many cases it was
because the counselor was uncomfortable speaking about sexual practices. When I train other therapists we pay close
attention to their sexual competence: the ability to be comfortable speaking
about sexual concerns and make it safe for their clients to do so as well.

 How is your
sexual competence? Here are some tips
for speaking up about sex:

1. Respect
yourself. Gay men and women need to work
at self love even harder than society at large simply because we are
consistently bombarded with negative messages, both overt and covert. You have a right to your feelings, a right to
speak up and be heard, and a right to have your sexual limits honored.

2. Minimize
embarrassment or shame when speaking about your sexual needs, concerns, or
problems. You’re not the first to have
such feelings and not speaking up could have fatal consequences. That goes for discussions with your doctor,
as well. I know one man who didn’t want
to speak to his physician about his anal warts which consequently went
untreated and developed into rectal cancer.

3.  Speak your
truth, whether it’s your HIV status, the need to use condoms, or your concern
that your sex life might be a little out of control.  Don’t keep it to yourself.  Speak up and be willing to listen to the
feedback you receive.

 4. Make your healthcare provider an ally. Be certain that you can frankly discuss your
sexual practices and concerns in a safe, non-judgmental atmosphere. Even if you want to ask what you might think
is a naive question, speak up, Believe
me, they have heard it before.

 Sex should
be fun, but anxiety, anger, or other negative feelings resulting from unspoken
concerns can quickly destroy the mood. When
discussing something as important as sexual needs or sexual health, everything
should be on the table. Your life depends
on it.