Why Should Social Workers Care About Sex Positivity?

By SJ Dodd

In Sex-Positive Social Work, SJ Dodd shows how to translate social work’s strengths- and 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.

~Laina Bay-Cheng, University at Buffalo

Social workers engage with sex and sexuality in all kinds of practice settings and with a variety of client populations. However, conversations about healthy sexuality and sexual well-being are all but absent from social work literature, education, and practice. In today’s CSWE virtual exhibit post, SJ Dodd, author of Sex-Positive Social Work, discusses why this book is needed and why social workers should embrace issues of sexuality in their practice.

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Sex is everywhere. On television, in movies, on social media, in advertising, even in politics. Sex and sexuality are central to our lives. Social workers come across them in almost every practice setting and in 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.

Despite this reality, proactive conversations about healthy sexuality and sexual well-being are missing from social work literature, education, and practice. This “conspiracy of silence” first identified by Harvey L. Gochros almost half a century ago is still very much with us. My students often tell me they avoid topics of sexuality whenever possible, and their supervisors often admit the same.

Twenty years ago, after I discovered that there was no course course on sexuality available during my masters in social work program, I started teaching a course called Human Sexuality to social workers. I had taken Human Sexuality as part of my graduate degree in education, and so it seemed odd to me that there was not even an elective offered in the social work curriculum. During my doctorate 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, inquisitive students. My colleague and I both learned a tremendous amount—and twenty years later, we both still teach Human Sexuality, though we’ve now moved on to different faculties and are at different schools.

Social work centers the values of our profession as it explores sexuality and gender from a nonjudgmental, self-determination-focused perspective.

When I got to Silberman School of Social Work at Hunter College in 2000, I was met with the same situation—no class in human sexuality. Luckily, this time there was one in the catalog, which the administration allowed me to resurrect. We have offered the Human Sexuality elective regularly ever since, and this academic year we are adding extra sections to support ever-growing interest in the content.

In my two decades of teaching sexuality, I have relied almost exclusively on textbooks written by psychologists, 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 bio- and psycho-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.

Because of these core values, contemporary social work must also be sex-positive. Sex positivity encourages agency in sexual decision-making and embraces consensual sexual activity as healthy—something to be enjoyed without stigma or shame. It embraces sexuality as a human right. Despite sexuality’s prominence in social work practice settings, many social work professionals have internalized sociocultural taboos around discussing sexuality, and 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: focused on risks and possible harms, like STIs and unwanted pregnancies. A strengths perspective does not focus on the client’s deficits or limitations but on their strengths, skills, aptitudes, and resources. It does not pathologize consensual sexual activities like 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.

Too often, substandard sex education and the cultural taboos around sex leave people unsure of their sexual selves, fraught with shame and guilt rather than excitement and joy.

I encourage social workers to embrace rather than avoid issues of sexuality within their practice, incorporating the sexual dimension into the biopsychosocial assessment and engaging conversations about sexuality regularly with clients, as appropriate. This sex-positive approach encourages sexual fulfillment, attention to desire, intimacy, arousal, and overall sexual wellbeing without judgment or assumptions. Too often, substandard sex education and the cultural taboos around sex leave people unsure of their sexual selves, fraught 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.

Sexual wellbeing is critical to overall wellbeing. Social workers must have the tools to approach sex and sexuality proactively and positively with clients. The foundations are to develop your own comfort; avoid assumptions; consider cultural context; set the environment (including physical space and inclusive intake forms); take a sexual history; and understand physiology, differences in arousal, variations in sexual identity, and ethical considerations like erotic transference, as well as experiences of gender identity, intimacy, communication, relationships, sex in older adulthood, BDSM and kink, and consensually nonmonogamous and polyamorous relationships. This is by no means a complete list.

Sex positivity affirms the centrality of sexual wellbeing to overall wellbeing, 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 your clients’ lives as critical context, whether it is related to the presenting problem or not. Our goal here 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 it 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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