Whether you are working as a sex therapist or in any capacity as a mental or medical healthcare provider, questions and topics around human sexuality likely arise during the routine course of providing patient care. 

Yet, in my experience, very few healthcare professionals receive adequate training in sexual health or how to provide sexuality education. 

Every person has a sexuality. Having a basic understanding of human sexuality is highly advantageous to providing quality healthcare. 

 What Is Sexuality Education?

In An Introduction to Sexuality Education: A Handbook For Mental Health Professionals by Karen Ryne and Ryan Dillon:

“Sexuality includes a person’s entire being and everything a community has to say about the intimate, relationship and cultural aspects of sexuality;

“Sex education and sexuality education provides knowledge and information;

 “Sex therapy provides and addresses sex and sexuality through a therapeutic lens. Sex therapists are mental health practitioners who specialize in therapy with clients concerning sex, sexuality and sexuality-related topics.”

While sex therapists are highly trained to provide sex therapy interventions, most other healthcare providers are asked to provide some level of sexuality education around topics of sexual anatomy and physiology, gender identity, sexual orientation, sexual concerns, or sexually transmitted diseases, for example. 

In addition, many patients who see a healthcare provider present with trauma-related concerns associated with sexuality, such as:

• Pregnancy and birth

• Sexual abuse of any kind

• Pornography

• Sex-negative religious education and shaming

• Coming out or prejudice and/or bullying due to LGBTQ+ related identities and experiences 

Being educated on sexuality topics and specific language to be utilized when interacting with patients during routine care can have a tremendously helpful outcome on the delivery of care and support of the patient. 

 Why Many Healthcare Providers Are Not Adequately Trained in Sexuality Education

Given the lack of comprehensive, sex-positive education available in our world today, many well-intentioned healthcare providers are not aware of their own biases and misinformation about sexuality. 

Further complicating this is the abundance of sex-negative or false sexuality education available through peer-to-peer interaction or pornography during adolescent years that the majority of Americans are limited to receiving. 

As healthcare providers, we are in a unique position of authority to provide information by which many of us have little actual training in the area of human sexuality. During the period of time I have been working as a sex therapist, the majority of clients come to our practice after they have received other mental healthcare services to which their specific goals around sexuality were not addressed or were inadvertently addressed in a way that was not helpful. 

Healthcare providers have varying degrees of comfort with sexuality-related topics, especially given their own background, religious upbringing, personal belief system, and/or trauma history. All professional ethics codes for mental healthcare providers include codes specifically aimed toward ameliorating projection of personal biases that would negatively impact care. 

Sex therapists, who specialize in treating sexuality concerns, are given specific training to stretch the boundaries of their own biases and overcome discomfort with topics so they are able to conduct themselves professionally and ethically while providing care. 

The specialized training required for American Association of Sexuality Educators, Counselors, and Therapists (AASECT) certification aimed at the provider understanding their own attitudes toward various aspects of human sexuality is the Sexual Attitude Reassessment (SAR).

I was afforded the opportunity to teach an undergraduate course on “Introduction to Human Sexuality” for several semesters. As a licensed mental health counselor and certified sex therapist, I found this experience highlighted again how vast the field of human sexuality is. Topics in the course included:

• Research methods in human sexuality

• Male and female sexual anatomy

• Physiology and sexual response

• Attraction and love

• Gender identity

• Roles and sex differences

• Relationships and communication

• Sexual behavior and fantasies

• Sexual orientation

• Conception

• Pregnancy and childbirth

• Contraception and abortion

• Sexuality through the lifespan (childhood, adolescence, adulthood)

• Sexual dysfunctions

• Sexually transmitted diseases

• Atypical sexual variations

• Sexual abuse

• Commercial sex

While no one can become an expert in all these areas, it is important that medical or mental health professionals are educated as needed when client topics present themselves. 

Most importantly, it is important to know yourself as a provider and the mental framework from which you are providing sex education.

 How Kimberly Keiser & Associates Approaches Sexual Healthcare Training 

While very few medical or mental healthcare providers will go on to specialize in human sexuality, as part of Kimberly Keiser & Associates’ commitment to providing quality sex therapy and sexuality education, it is useful to describe the types of training our team undertakes to provide quality sexual healthcare and sex therapy services.

All AASECT-certified sex therapists and sexuality educators undergo an extensive training program, which includes the SAR. While not all Kimberly Keiser team members strive for completing AASECT certification, elements of the SAR, among other forms of sexuality education, are a part of regular training and development of our team members. These trainings include:

• Didactic presentations

• Web-based training

• E-learning continuing education units (CEUs)

• Workshops

• Seminars

• Webinars

What Is the Sexual Attitude Reassessment (SAR)?

According to Patti Britton and Robert E. Dunlap in Designing and Leading a Successful SAR: A Guide for Sex Therapists, Sexuality Educators, and Sexologists, the SAR is:

“A training event for professionals seeking credentials or just learning about themselves or the field of sexology. SAR consists of materials and experiences that push the adult learner to confront his or her own values, attitudes, and beliefs (VABs) about a wide range of issues within the broad field of human sexuality. . . This process [is about] getting to know who you are – what you believe, feel, and think – and then enticing you to explore the vast world of human sexual experience.” 

It is well established that in mental healthcare education, up-and-coming mental healthcare providers are trained on cultural competence, diversity, and managing their own countertransference to produce maximum effectiveness and practice ethically. However, little attention is usually paid during training at any point specifically in the realm of human sexuality. 

In addition, research has shown that mental healthcare providers are largely uncomfortable or even unwilling at times to discuss sexual issues with patients. 

Britton and Dunlap (2017) also note that the goal of a SAR is:

“Bringing that person towards greater tolerance, understanding, compassion, and acceptance of all forms of sexual expression. It is also a crucible in which you discover who and what you tolerate and do not, whom you can serve and cannot; SAR becomes a mirror in which you see your true self and reflect on what you have to offer those you serve, whether or not you consciously choose to serve that population.” 

The SAR utilizes media, live speakers, experiential activities, and small group discussions to process.

In addition to didactic training, much of sexuality education incorporates the observation of sexually explicit media. Sexual imagery is utilized to represent various forms of human sexuality, sex acts, or sexual anatomy accurately or in a way that is true to life. 

Sex therapy includes the use of sex-positive sexual imagery and sexually explicit media to normalize and educate the great variety of human sexuality that exists. For many healthcare providers who have been taught that viewing sexual imagery in general is not appropriate, this type of education aims to push up against critical countertransference dynamics that would interfere with patients’ care if unaddressed. 

A Brief History of One Type of Sexuality Education: Sexually Explicit Media

Since the 1940s, during the beginning of the formation of the field of sex therapy as we know it today, the observation of sexual behavior through laboratory research or video was utilized by Alfred Kinsey. 

Dr. William Masters and Virginia Johnson continued sex research through the documentation of filming research subjects engaging in sexual activity during the 1950s. This research paved the way for the first models of sexual arousal and response, models that are still utilized today. 

In the 1960s and 1970s, Dr. Edward Tyler at Indiana University first utilized Kinsey’s films to engage medical students in talking about their experiences of watching the films. Soon after, Reverend Ted McIlvenna, past president of The Institute for the Advanced Study of Human Sexuality, developed the method of examining sexual attitudes and promoting awareness of those through the use of sexual imagery — subsequently, the first SAR. Today, the regular use of sexually explicit media and sexual imagery to educate professionals is an accepted practice. 

I can thank Dr. John Money in the 1970s for the development and use of his “direct confrontation technique,” by which he presented sexually explicit media to medical students to educate and promote awareness, for the fact that I was able to take an “Introduction to Human Sexuality” course as an undergraduate student at the University of South Dakota in 1996. During this class, my instructor, Dr. Cindy Struckman-Johnson, utilized a vast array of sexually explicit media to educate and provide the structure to process and create with peers a deeper understanding of human sexuality. 

Continuing through the 1970s, the University of Minnesota’s Program in Human Sexuality and the University of Pittsburgh’s School of Medicine also utilized sexually explicit media to educate medical students and explore with them about their attitudes about sex through small group processing sessions. In 1976, Dick Price produced the first films on sensate focus, an effective sex therapy technique for couples developed by Masters and Johnson. This made available the use of sexually explicit media for sex therapists to utilize as treatment interventions with their patients. 

Bringing educational sexually explicit media to the general public began in the 1990s by Stephen Kapelow, who produced the Better Sex Video Series, a sex-positive sex education production. 

Finally, in 2006, Dr. Bill Stayton updated the sensate-focus videos through the Health Science Advisory Board to create The Guide to Sexual Pleasure Series, which was produced by Dr. Mark Schoen.   

Sexuality Education Today

While much of the sexual imagery that people are most often made aware of comes through the form of pornography, which can perpetuate sex-negative stereotypes, fantasy-based sexuality, and fears, there is sex-positive and educational sexual imagery available. 

Thanks to the groundbreaking work of these courageous scientists and professionals, sexuality education is available to professionals and the general public in many forms, including sexually explicit media. 

Sex-positive education conducted in the context of a supportive, safe, and healthy discussion can have life-changing impacts to those in search of answers and healing. For many of our clients, sexuality education, including sex-positive sexual imagery, is the first opportunity they have ever had to observe and learn about healthy sex. 

At Kimberly Keiser & Associates, our company mission is not only to promote sexual health, freedom, and inclusivity, but also to support the development of healthy, sustainable, and loving relationships. 

As a team, we train utilizing a variety of forms of sex-positive educational mediums. It is our goal to utilize the many forms of sexuality education available today not only with our clients, but also with other healthcare professionals to achieve our mission.

Learn More About Sexuality Education for Healthcare Professionals

Kimberly Keiser & Associates is pleased to announce that we are offering a new clinical group supervision for AASECT sex therapy certification and clinical consultation services.

Our founder, Kimberly Keiser, will complete her AASECT sex therapist supervisor certification in early 2021 and is starting sex therapy supervision groups, which will be open to any therapist in the U.S. 

We will also have clinical case consultation services available to licensed professionals seeking specialized consultation in the topics of human sexuality and sex therapy. 

If you are interested in being a part of these new sexuality education services, please contact our team to learn more!