The Evolution of Sex Therapy

I found this article I wrote a while ago and thought it might be useful for people interested in sex therapy.

A Timeline of Modern Sex Therapy

Sex therapy, the treatment of sexual problems, has positively evolved since Kinsey and Masters and Johnson, the pioneers of modern sex therapy (Weeks, Gambescia, & Hertelin, 2015). Technological advancements have helped many people effectively deal with sexual issues while debate and controversy has expanded our understanding of human sexuality, helping many more in education and therapy. Let’s take a look at a partial timeline of sex therapy, noting the positive evolution of the field due to technology and challenges to previous understanding.

1948: Alfred Kinsey published Sexual Behavior in the Human Male, sparking interest in both the public and in researchers about human sexuality. Five years later, he published Sexual Behavior in the Human Female. The focus of the burgeoning field of sex therapy is on sexual behavior at this time since it is a taboo topic in Western society (Ridley, 2015).

1954: William Masters begins his research on sex, joined by Virginia Masters in 1957. They attempt to understand the human sexual response with an emphasis on physiology and behavior, sparking the field of sex therapy (Hyde & Delamater, 2011).

1960: The Pill is invented to help women decide if they wish to pursue sexual activity for pleasure by preventing pregnancy. This technological advancement is credited as a major part of the Sexual Revolution, sparking curiosity in the Western culture as to their enjoyment and satisfaction with sex (Leiblum, 2007).

1967: The American Association of Sex Educators, Counselors, and Therapists is founded by Patricia Schiller. This organization became the credentialing body for sex therapists, helping to promote higher standards and effective practice in the field (Haeberle, n.d.).

1970: Masters and Johnson publish Human Sexual Inadequacy, the first modern book on treating sexual problems (Hyde & Delamater, 2011).

1973: The Diagnostic and Statistics Manual (DSM) of Mental Disorders removes homosexuality as an illness, promoting equality and informing sex therapy practice (Ridley, 2015).

1974: Helen Singer Kaplan publishes The New Sex Therapy, building upon Master’s and Johnson’s behavioral model by adding an emphasis on desire, sexual satisfaction, and couples’ dynamics (Weeks, Gambescia, & Hertlein, 2015).

1982: Ladas, Whipple, and Perry publish The G Spot – and Other Recent Discoveries about Human Sexuality. Female researchers begin to emphasize the differences between male and female sexuality, where previously it was viewed from one dominant lens (male) (Leiblum, 2007).

1987: The DSM-III-R is published, which removes nymphomania and Don Juanism as illnesses, and makes a reference to sex addiction, igniting a fervent debate over the nature of compulsive, impulsive, hyperactive, or out of control consensual sexual behavior. This discussion spurns research and attempts at articulating how to understand and treat this behavior (AASECT, 2017).

1989: Gerald Weeks describes a theoretical underpinning of sex therapy using his Intersystems Approach, which uses a systemic lens, signalling a change in approach from a behavioral focus to a more holistic perspective (Weeks, Gambescia, & Hertlein, 2015).

1998: Viagra is approved by the FDA, the first effective oral medication to treat erectile dysfunction. This medical intervention shifted focus to a more medicalized treatment of sexual disorders, which has had both positive impacts and significant discussion of the role biology and medicine play in sex therapy and understanding human sexuality (Leiblum, 2007).

1998: The American Psychiatric Association releases a statement opposing conversion therapy (attempts to change sexual orientation from homosexual to heterosexual). The nature of how we define illness and the boundaries of therapy continues to evolve (Hyde & Delamater, 2011).

2002: Rosemary Basson presents the female sexual response cycle, distinguishing the female complexity of sexuality with the more linear model for men, helping sex therapists understand how to better assist females seeking sex therapy (Leiblum, 2007).

2007: Facebook and the iPhone spearhead social media networking, which changes how people relate to each other. Sexual contact also changes with hook-up apps, while niche sexual interests form online communities. Pornography is also exploding in popularity at this time, and our society’s ability to adapt to these technologies creates debate while clinicians adapt to new issues in therapy (“porn addiction,” infidelity and technology, and exploring fetishes and alternative forms of sexuality) (Weeks, Gambescia, & Hertlein, 2015).

2013: The DSM-5 is published and debate rages on about the nature of diagnosing sexual problems, enriching the field with an important conversation about the nature of sex therapy (Ridley, 2015). Some argue that sexual problems are reflections of a sex negative culture while others attempt to pathologize to meet the needs of insurance companies (Donaghue, 2015).

            The current state of sex therapy is that it remains in its relative infancy of development. Debate rages on regarding the importance of the medical model in sex therapy, the differences between male and female sexuality, how to define sexual problems/ disorders, the best ways to understand the factors involved in sexuality, and how to understand sexuality when it presents differently than most (Weeks, Gambescia, & Hertlein, 2015). These conversations and debates are important so that we can push ourselves to find better models, theories, and interventions to help clients. Sex therapy is for the curious, for those who want to explore issues without having definitive answers (Ridley, 2015). If we all embrace this culture of curiosity and not shying away from debate, we can keep moving forward in our understanding of human sexuality and our important goal of helping more people. Sex therapy, as I understand it currently, necessitates consistently learning and integrating new findings.

References

AASECT. (2017). AASECT’s 50th anniversary timeline. Retrieved from https://www.aasect.org/timeline

Donaghue, C. (2015). Sex Outside the Lines. Dallas, TX: BenBella Books.

Haeberle, E. J. (n.d.). Chronology of sex research. Retrieved from https://sexologyexpert.online/articles-and-lectures/

Hyde, J. S. & Delamater, J. D. (2011) Understanding Human Sexuality (11th ed.). New York:

            McGraw-Hill.

Leiblum, S. R. (2007). Sex therapy today: Current issues and future perspectives. In S. R.

Leiblum (Ed.). Principles and Practice of Sex Therapy (4th ed.). New York, NY, US: The

Guilford Press.

Ridley, J. (2015). What every sex therapist needs to know. In K. M. Hertlein, G. R. Weeks, & N.

Gambescia (Eds.). Systemic sex therapy (2nd ed.). (pp. 3-16). New York, NY, US:

Routledge/Taylor & Francis Group.

Weeks, G. R., Gambescia, N., & Hertlein, K. M. (2015). Sex therapy: A panoramic view. In K.

M. Hertlein, G. R. Weeks, & N. Gambescia (Eds.). Systemic sex therapy (2nd ed.). (pp.

276-298). New York, NY, US: Routledge/Taylor & Francis Group.

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