2026 Symposium Abstracts

When Western Sex Therapy Crosses Borders: Clinical and Cultural Lessons from Training Romanian Psychosexual Therapists

Vanessa Snyder (USA) and Anda Mogos (Romania)

This paper examines the clinical, cultural, and ethical complexities encountered while training psychosexual therapists in Romania through a multi-year international collaboration. Western sex therapy models often presume individual autonomy, open sexual expression, and value-neutral clinical frameworks—assumptions that can conflict with collectivist social norms, post-communist historical narratives, and deeply rooted religious worldviews. Drawing from sustained clinical training, supervision, and dialogue with Romanian practitioners, this presentation explores how foundational psychosexual concepts required translation beyond language into culturally resonant meanings, therapeutic pacing, and relational posture. Particular attention is given to moments of tension surrounding shame, sexual agency, disclosure, and moral frameworks, highlighting how these dynamics surfaced in both training and clinical application. The paper further examines how therapist identity, power, and cultural location shape the transfer of clinical knowledge across contexts. Rather than positioning adaptation as dilution, this work argues that culturally responsive modification functions as a core clinical competency—one that enhances ethical practice, deepens therapeutic alliance, and fosters sustainable cross-cultural engagement. Implications for international training, supervision, and the future development of psychosexual therapy are discussed.

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Exploring the Effects of Chronic Wartime Stress on Sexuality and Relationships in Israel

Talli Yehuda Rosenbaum (Israel)

In the aftermath of October 7, 2023, Israeli society has been immersed in a state of ongoing collective trauma. While much has been written about the sexual impact of post-traumatic stress disorder (PTSD), the effects of acute and prolonged wartime stress on intimacy and sexuality remain less understood. This presentation explores how trauma in progress—rather than post-trauma—shapes sexual expression, attachment, and relational functioning. Combining personal reflection, clinical insight, and new research findings, the presentation examines the relational and sexual implications of acute stress, media exposure, identity shifts, and differential coping within couples. Special attention is given to the unique psychological and sexual challenges faced by soldiers and their partners. The session also presents practical clinical recommendations for therapists supporting individuals and couples navigating intimacy under ongoing threat and grief.

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Disappointment, confusion and anger in ultra orthodox Jewish marriages

Judi Keshet-Orr (United Kingdom)

Within the Orthodox Jewish community, marriages are often arranged through a shidduch process. This process takes into account the wishes, hopes, and expectations of parents, including levels of religious observance and the backgrounds of the respective families. While many such marriages are successful, many are not. This paper is largely based on clinical experience and anecdotal evidence in which couples have reported feeling unheard and unseen. These experiences can lead to frustration, psychosexual mismatching, and sexual dysfunction, as well as feelings of loss of agency and entrapment among young newlyweds. As a consequence, mental health concerns may emerge, influenced by confusion and disappointment in young adults who have often received insufficient relationship and sex education.

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Addressing Religious Trauma with Conventionally Religious Clients

Mark Yarhouse (United States)

Clinicians have encountered increasing numbers of clients who report psychological distress associated with harmful religious experiences. While religion and spirituality are well established in the literature as potential sources of meaning, resilience, and coping, they may also function as contexts in which trauma occurs. This paper presents conceptual background to the construct of religious trauma. We then offer case studies of religious trauma to help identify the practical considerations in conceptualization and treatment planning. We close with recommendations for clinical practice: distinguishing trauma from orientation, assessing for religiously mediated coercion and shame, supporting couples in renegotiating intimacy beyond sex, and avoiding theological or sexual normativity when working with conventionally religious clients navigating sequelae from religious trauma within their relationship.

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Culturally Responsive Interventions for Sexual Anxiety: Lessons from Working with Muslim Clients

Mariam Aziz (Egypt)

Sexual anxiety is a pervasive factor in many sexual difficulties, yet its treatment must be grounded in an understanding of the client’s cultural and religious context. Among Muslim clients, sexual anxiety often develops within complex intersections of restrictive sexual scripts, gender expectations, religious interpretations, and limited sexual education. These intersecting influences contribute to performance anxiety, guilt, and inhibition that can significantly impair sexual functioning and relational intimacy. This presentation introduces a culturally sensitive psychosexual therapy framework for understanding and addressing sexual anxiety among Muslim clients. The framework integrates psychoeducation, cognitive restructuring, mindfulness-based anxiety management, and relational interventions—delivered through a culturally responsive and ethically attuned lens. Key elements include: 1. Assessing sexual scripts and anxiety triggers using culturally relevant language and metaphors; 2. Employing permission-giving and sexual education that affirm clients’ religious and moral values; 3. Adapting traditional sensate focus and mindfulness techniques to align with faith-based constraints; and 4. Collaborating with clients’ spiritual beliefs to reduce anxiety without challenging core religious identities. The presentation will explore clinical applications through anonymized composite case material, highlighting therapist attitudes of curiosity, collaboration, and cultural humility as central to effective treatment. Rather than substituting techniques, the approach reorients the therapeutic process toward respecting clients’ belief systems while facilitating psychological and sexual growth. By bridging cultural competence and psychosexual methodology, this framework offers a model for therapists working across religious and cultural contexts to navigate sexual anxiety with sensitivity, creativity, and respect.

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ABDL: Comfort, Kink, or Coping?

Laurie Betito (Canada)

The Adult Baby/Diaper Lover (ABDL) phenomenon represents a unique intersection of fetishistic behavior, identity expression, and psychological coping mechanisms. Often stigmatized or dismissed in mainstream discourse, ABDL is a largely misunderstood subculture composed of adults who engage in behaviors associated with infancy or toddlerhood, such as wearing diapers, using baby bottles, or adopting infantile speech and mannerisms. This presentation aims to offer a comprehensive, nonjudgmental exploration of ABDL interests, with an emphasis on understanding the psychological, cultural, and clinical dimensions relevant to professionals in mental health, education, and human sexuality fields. The ABDL community encompasses a spectrum of motivations. For some, these behaviors are linked to sexual arousal (typically categorized as paraphilic infantilism or a diaper fetish); for others, the appeal is non-sexual and serves as a form of stress relief, emotional comfort, or identity fulfillment through age regression. This talk will examine the developmental and psychological theories proposed to explain ABDL interests, including potential links to early childhood experiences, attachment styles, trauma, and the role of fantasy in adult coping strategies. Additionally, the presentation will address the role of online communities in shaping and supporting ABDL identities, and explore how internet spaces provide both social connection and validation for individuals often marginalized or misunderstood. Ethical considerations, particularly around consent, public behavior, and the strict demarcation between adult roleplay and any inappropriate involvement of minors, will be emphasized throughout. Clinical implications will also be discussed, including how therapists and healthcare professionals can assess and support ABDL clients without pathologizing their interests. The distinction between atypical but benign sexual or identity expressions and clinically significant dysfunction will be clarified, drawing on DSM-5 and ICD-11 frameworks where applicable. Attendees will leave with a nuanced understanding of ABDL behavior, practical tools for working with this population in clinical or educational settings, and strategies to foster empathy, reduce stigma, and uphold ethical standards.

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Oral Sex in Marriage: Dyadic Patterns, Perceptual Alignment, and Culturally Attuned Therapeutic Strategies

Michael Sytsma (United States)

Oral sex has become increasingly normative in many Western societies over recent decades, with nationally representative U.S. surveys documenting rising lifetime prevalence among adults. Globally, however, practices remain highly variable due to cultural, religious, and historical influences, with lower prevalence and greater taboos reported in certain non-Western contexts. In clinical practice, desire discrepancies around oral sex frequently contribute to relational strain in couples seeking psychosexual therapy, particularly when one partner’s background involves more restrictive cultural, religious, or familial norms. This presentation presents findings from a large dyadic dataset (N = 501 U.S. married couples) examining self-reported frequency of performing oral sex, personal enjoyment of giving and receiving, perceptions of partners’ enjoyment, and relational correlates. Dyadic data analysis revealed many couples engage frequently and report mutual enjoyment of oral sex, while others report infrequent participation without corresponding decrements in sexual or marital satisfaction—underscoring that healthy sexuality is not monolithic. Better alignment between own and perceived spousal enjoyment is associated with modestly higher sexual satisfaction and more frequent oral sex performance, highlighting the relational value of accurate partner perceptions. Although based on U.S. data, these patterns hold global relevance for psychosexual therapists working in various cultures. The presentation translates findings into practice-ready strategies: normalizing variability (“not everyone does it”), decentering frequency as a universal benchmark, and using discrepancies as relational data rather than pathology. Applications are illustrated through systems, feminist, and narrative therapy lenses to foster empathy, clarify meaning, attend to consent, and support culturally sensitive sexual communication. The goal is to equip clinicians to hold cultural humility while addressing oral sex discrepancies in ways that respect autonomy, context, and mutual care.

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Understanding Early Sexual Feelings and Digital Sexual Development in Youth Who Experience Minor Attraction

Caleb Jacobson (Germany)

Research on the early development of sexual feelings in adolescents who experience attraction toward younger children remains extremely limited, despite its relevance for developmental psychology, sexual health research, and preventive mental health care. Existing literature has largely focused on adult populations, leaving a significant gap in understanding how such attractions first emerge, how young people make meaning of them, and how contemporary digital environments may influence psychosexual development during adolescence. This study examined these processes using an anonymous cross-sectional survey of adolescents aged 13 to 17 who reported experiences of minor attraction. Survey domains included age of onset, patterns of attraction, emotional responses to emerging sexual feelings, exposure to pornography, peer-to-peer digital sexual behaviors, and perceived access to support or treatment. Results indicate that digital sexual experiences play a meaningful role in shaping sexual self-understanding among many participants. Distress related to attraction was common, and a subset of respondents reported experiences of pressure or coercion within digital contexts. Participants also described significant barriers to seeking support, including fears of stigma and limited access to appropriate care. These findings highlight the importance of situating minor attraction within a developmental and digital framework. Implications for early intervention, clinical practice, and ethical engagement with adolescents navigating these experiences will be discussed.

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Nine Types of Desire: Clinical and Empirical Perspectives on Use of the Enneagram in Psychosexual Therapy

Sam E. Greenberg (United States) and Lyndsey Fraser (United States)

Psychosexual therapy, while effective with many clients, can be unresponsive to the diverse ways clients experience and express desire. Emerging research suggests that nine distinct patterns of sexual desire and expression exist, consistent across demographic categories and associated with each of the nine Enneagram personality types. The Enneagram of personality, a map of motivations and personality structures, can provide a framework for sex therapists to create individualized therapeutic approaches for clients. In addition, clinical observations from over a decade of practice indicate that integrating the Enneagram into sex therapy is associated with accelerated therapeutic progress, deepened intimacy, and increased compassion among clients and partners. This paper reviews the empirical and clinical evidence for use of the Enneagram within psychosexual therapy and provides a roadmap for implementing Enneagram-informed sex therapy with diverse clients.

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On the Evaluation of sex acts in Shi'a Islamic Theology and Jurisprudence

Donja Hodaie (Germany)

The evaluation of sexual acts is an important topic in Islamic theology, with many scholars offering their viewpoints based on their understanding of Islamic sources. Islamic religious beliefs and teachings significantly shape Muslim perspectives and attitudes toward issues related to sexual acts, sexual orientation, and identity. The belief that engaging in or abstaining from certain sexual acts is a moral disorder and forbidden in Islam is deeply ingrained in the minds of many Muslims. The fear of divine punishment, exclusion, or stigmatization from their religious community or social circles can be particularly relevant in sex therapy with Muslim patients, as these concerns may lead to personal identity crises and considerable psychological stress. To foster cultural sensitivity in psychosexual therapy and improve psycho-sexual care, it is essential to understand the theological background of these potential conflicts. This paper aims to provide the theological context for psychological challenges related to premarital sex, same-sex acts, consensual and coerced sex, both inside and outside of marriage. As the evaluation of these sexual acts can vary depending on the theological branch and the Islamic school of law, this paper will focus specifically on the Shia Ja’fari school of law, followed by many Shi'a Muslims worldwide. In accordance with the Iranian constitution, the Iranian government adheres to the Twelver Shia tradition and the Ja'afari school of law. Therefore, this paper will examine the legal responses to the aforementioned sexual acts in Iranian law as an example of lived reality, followed by an analysis of the theological justifications for those laws.

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Uncertainty, Autonomy, and the Regulation of Chemsex: A Cultural Psycholegal Perspective

Bryson Kelpe (Germany)

Chemsex coined by David Stuart is not merely a clinical phenomenon—this intentional use of psychoactive substances to enhance or prolong sexual experience is quite often positioned in psycholegal discourse as a problem sexual behaviour in need of societal control, particularly through restrictive treatments and legal prohibitions and abstinence-based treatment protocols. This paper examines chemsex through a psycholegal cultural lens, drawing on Juan J. García Blesa’s analysis of legal culture, the author’s clinical work with marginalized communities across Europe and the United States, and contemporary literature. Even the most multicultural-aware and culturally sensitive clinicians practice under policy and legislative frameworks (professional guidelines and licensure board regulations) that frequently originate from, and reinforce, cultural patterns of uncertainty avoidance and enduring tensions between individualism and communalism. Using dimensions such as uncertainty avoidance and individualism–collectivism, this paper explores how legal and moral orientations toward risk, control, and responsibility shape clinical treatment. The historical emphasis on abstinence-based recovery rooted in uncertainty avoidance is contrasted with more recent harm reduction and controlled-use approaches (“flight control”), situating this shift within broader cultural movements away from authoritarian governance and toward individual autonomy. Recovery literature from experts like David Fawcett also reflect this transition in clinical orientation. Particularly attention is given to involuntary and coercive treatment mechanisms, including compulsory psychiatric admission and court-mandated detoxification. Although commonly justified through narratives of collective safety or public order, these interventions are frequently experienced by patients as disempowering, stigmatising, and culturally misaligned. Such practices risk undermining therapeutic alliance, sexual agency, and ethical psychosexual care. This paper concludes by calling for greater critical reflection on how therapists can maintain cultural humility and patient-centred practice in contexts where the law demands control, and how clinicians might navigate the productive discomfort of cultural ambiguity when therapeutic values and legal imperatives collide.

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From Cultural Competence to Cultural Humility: Indigenous Hawaiian Wisdom in Psychosexual Therapy

Chris Wilhoite (United States)

Cultural sensitivity, competency, and humility are crucial for ethical, comprehensive, and effective psychosexual therapy. This paper, viewed through a Hawaiian framework, aims to broaden psychosexual therapists’ understanding of relational, psychological, spiritual values, belief systems, and the interconnectedness of sexuality, identity, spirituality, land, tradition, and community (Pukui, Haertig, & Lee, 1972/1979; Rezentes, 1996). Collaterally, this paper aims to extend the definition and practice of cultural sensitivity and cultural competency to include cultural humility. It emphasizes the importance of self-reflection and partnering with indigenous healers (Hook et al., 2013; Watkins et al., 2022). Included is the exploration of cultural humility’s impact on therapeutic outcomes and impact on the Indigenous community’s values and attitudes toward mental and sexual health (Oneha et al., 2023; Watkins et al., 2022). Also included are Native Hawaiian views on sexuality, identity, spirituality, ʻāina (land), and relational networks, and their influence on healthy sexuality and well-being (Pukui et al., 1972/1979; Rezentes, 1996). By increasing understanding of Hawaiian and Western philosophies and their parallel efficacy, therapists can foster enhanced therapeutic alliances, promote safety, and empower Hawaiian and Indigenous clients leading to the advancement of psychosexual therapy as a profession (Oneha et al., 2023; Shore, 2015). Drawing on Mary Kawena Pukui and associates’ work at the Queen Liliuokalani Children’s Center, this paper demonstrates how psychosexual therapy can move beyond pathology to culturally sensitivity, competency, and humility (Pukui et al., 1972/1979). This includes the understanding of cultural humilities imperative of ongoing self-reflection about power, colonization and impact, and the dangers of misusing or appropriating Indigenous practices (Hook et al., 2013; Shore, 2015). Evidence supporting a change from cultural sensitivity and competency to include cultural humility in psychosexual therapy beyond common definitions of cultural competency will be explored. (Hook et al., 2013; Watkins et al., 2022). Healing practices in Native Hawaiian and other Indigenous contexts often parallel Western modalities(Oneha et al., 2023; Walters et al., 2011). This paper addresses the need and benefit of psychosexual therapist ability to recognize Indigenous practices as real, valid forms of healing central to Native Hawaiian and other Indigenous clients (Hurdle, 2002; Oneha et al., 2023). It highlights the value of collaboration and working with cultural practitioners and healers as partners in care, sharing authority in ways that honor community knowledge (Hurdle, 2002; Shore, 2015; Walters et al., 2011). Several Hawaiian cultural practices will be explored.

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Black Women and Sexual Liberation: Breaking the ‘Strong Black Woman’ Narrative. An American Perspective

LaTanya E. Jones

For centuries, the intersections of race, gender, and sexuality have shaped how Black women’s erotic lives are perceived, regulated, and expressed. This presentation examines how American historical stereotypes and contemporary expectations, most notably the Strong Black Woman (SBW) narrative (Abrams et al., 2019), have influenced Black women’s sexual agency, pleasure, and liberation (West, 1995; Collins, 2000). From the hypersexualized Jezebel to the nurturing yet desexualized Mammy, and through the moral constraints of respectability politics to the modern SBW archetype, these controlling narratives continue to affect how American Black women relate to strength, vulnerability, and desire (hooks, 1989; Roach, 2024). Drawing upon social work, psychosexual therapy, and feminist theory, presenters LaTonya N. Oliver and LaTanya E. Jones explore the psychological and relational costs of internalizing these narratives. While the SBW schema is rooted in survival and resilience, it often results in emotional suppression, sexual disconnection, and shame surrounding pleasure and need (Abrams et al., 2019; Liao et al., 2020). Respectability politics reinforces a double bind: sexual expression invites social judgment, while restraint reinforces invisibility, illustrating the ongoing tension between cultural expectations and personal authenticity (Morris, 2016). Moving toward restoration, the presenters center therapeutic and community-based strategies for reclaiming sexual agency. Through critical dialogue and case reflection, they demonstrate how sex therapy, trauma-informed care, and pleasure activism can help Black women unlearn inherited scripts of self-sacrifice and embrace sexuality as a site of healing, joy, and liberation (Lorde, 1984; Lipscomb & Ashley, 2021; Jones, 2023). Integrating the works of Audre Lorde, Black feminist scholars, and contemporary cultural movements, this session affirms that reclaiming eroticism is both a personal and political act. Participants will gain insight into how clinicians, educators, and advocates can dismantle internalized oppression, challenge respectability politics, and support Black women in redefining strength to include softness, pleasure, and erotic autonomy.

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Race, Trauma, and the Erotic: A Black Therapist’s Framework for Working with Interracial Couples

Robert Hudson (United Kingdom)

Interracial couples bring together not only different personal histories but also the cumulative weight of cultural, racial, and intergenerational narratives that shape how intimacy, desire, and erotic experience are lived and understood. These narratives influence power, safety, embodiment, and sexual expression, often outside of conscious awareness. Drawing on clinical experience as a Black male psychosexual and relationship therapist, this presentation examines how racialized trauma is stored in the body and how these embodied patterns shape emotional regulation, attachment, and erotic connection within interracial relationships. The session explores how racial power dynamics, internalized stereotypes, microaggressions, and culturally shaped erotic scripts interact with trauma responses to create patterns such as sexual anxiety, avoidance, erotic shutdown, overaccommodation, or the eroticization of racial power. Particular attention is given to how racialized threat responses and shame cycles emerge somatically and disrupt intimacy, and how these processes are often misread or missed entirely in therapeutic work. Participants are introduced to a clinical framework for understanding the “racial–erotic system,” including how to identify trauma-driven interactional loops, how racial narratives intersect with sexual functioning and desire, and how partners can co-create erotic safety. The session also addresses the challenges therapists face when race becomes activated in the therapy room, including the impact of the therapist’s own racial identity and clients’ projections. Practical, trauma-informed, and culturally attuned interventions are offered, including techniques for opening conversations about race in psychosexual work, repairing racial misattunements, attending to embodied responses, and restructuring erotic patterns grounded in safety rather than racialized power. By integrating theory, case vignettes, and embodied clinical practice, this presentation aims to expand therapists’ confidence, competence, and sensitivity when working with interracial couples in racially and erotically charged contexts.

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Impact of Labiaplasty in Young Adults: Sexual Function, Body Image and Psychosocial Effects, case study

Wafaa Eltantawy (United Kingdom)

Labiaplasty, one of the most frequently performed genital cosmetic procedures, has seen a marked rise among young adults over the past decade. While commonly presented as a means of improving comfort or genital aesthetics, the psychological, sexual, and social implications of this procedure remain complex and multifactorial. Understanding its broader impact on sexual function and well-being is essential for ethical and patient-centred practice. To explore the current evidence on the outcomes of labiaplasty in young women, with a particular focus on sexual function, genital self-image, body satisfaction, and psychosocial well-being. Also to illustrate the impact of labioplasty in my case A narrative review of recent studies (2018–2024) examining the physical and psychosocial outcomes of labiaplasty was conducted. Emphasis was placed on validated measures such as the Female Sexual Function Index (FSFI), Genital Self-Image Scale (FGSIS), and standardised body image and mood assessments. Evidence suggests that labiaplasty is associated with significant improvements in genital appearance satisfaction, self-confidence, and sexual function domains, including desire, arousal, and satisfaction. Many patients report reduced embarrassment and improved relational intimacy. However, methodological limitations are notable—most studies are small-scale, retrospective, and lack long-term follow-up. A minority of patients experience negative outcomes as in my case such as psychological impact ,altered genital sensitivity, unmet aesthetic expectations, or persistent body image distress. The role of sociocultural influences—especially pornography, social media, and peer comparison—is increasingly recognised in shaping motivation for surgery. Labiaplasty can have positive effects on sexual satisfaction and body image in carefully selected young women, but the evidence base remains limited and ethically complex. Comprehensive preoperative counselling, psychological screening, and multidisciplinary collaboration (including psychosexual therapy) are crucial to ensuring informed consent and realistic expectations. Further longitudinal research is needed to clarify long-term sexual and psychosocial outcomes.

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Beyond Cultural Competency: Toward a Culturally Adaptive Model for Psychosexual and Relationship Therapy in Mixed-Race and Interfaith Contexts

Natalie Green (United Kingdom)

Demographic shifts across the United Kingdom and globally point to notable growth in mixed-race partnerships, blended families, and multifaith households. In England and Wales, the 2021 Census recorded nearly 3% of the population identifying as mixed or multiple ethnicities, alongside a clear increase in households in which partners are from different ethnic groups and members report different religions. Comparable data from the United States indicate that one in six newlyweds marries across racial lines, and over a quarter of married individuals are in interfaith unions. Despite these trends, psychosexual and relationship therapy models seldom acknowledge the cultural, racial, and spiritual intersections shaping intimacy in these couples. Existing frameworks of cultural competence in mental health provide valuable foundations, but they often stop at therapist awareness and knowledge. These frameworks struggle to translate effectively to psychosexual practice, where dynamics of faith, race, and family loyalty actively shape sexual scripts, relational power, and identity negotiation. Recent reviews of intercultural and interfaith couples highlight inconsistent research findings, gaps in assessment tools, and a lack of practical guidance for therapists, particularly in Western settings. This paper argues that the field must move beyond “competence” toward cultural adaptability—a responsive, dynamic stance that equips therapists to engage with hybrid identities, faith-based sexual ethics, and the sociopolitical stressors couples navigate. Drawing on clinical experience and emerging scholarship, it proposes a framework for culturally adaptive psychosexual practice that integrates systemic assessment, renegotiation of sexual scripts, and culturally grounded interventions. By positioning mixed-race and interfaith couples not as anomalies but as reflections of a shifting social reality, this paper challenges Eurocentric and secular biases in psychosexual therapy. It calls for a reorientation of training priorities and clinical practice to meet the realities of an increasingly plural relational world.

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The Cost of Silence: Academic Freedom and Clinical Integrity in Sex Therapy

Caleb Jacobson, Shoshana Bulow

Panel Discussion

In recent years, mental health and sex therapy have increasingly become fields marked by caution rather than curiosity. Clinicians, educators, and researchers report growing hesitation to ask questions, pursue lines of inquiry, or discuss controversial clinical phenomena for fear of professional censure, reputational harm, or social “cancelation.” While ethical sensitivity and cultural awareness are essential to responsible practice, the erosion of academic freedom poses a serious threat to scientific integrity, clinical effectiveness, and patient care. This panel explores the role of academic freedom in psychosexual therapy and examines the consequences of censorship—both overt and self-imposed—within clinical training, research, and professional discourse. Panelists will consider how fear-based silence undermines evidence-based practice, restricts clinical competence, and ultimately limits therapists’ ability to respond to complex and marginalized presentations. Particular attention will be given to the distinction between ethical accountability and ideological conformity, and to the ways in which intellectual pluralism has historically advanced, rather than endangered, the field. Drawing on perspectives from clinical practice, research, ethics, and professional leadership, the discussion will address why open inquiry is not a luxury but a clinical necessity. The panel will also explore practical strategies for fostering environments where rigorous debate, thoughtful disagreement, and responsible scholarship can occur without fear of professional retaliation. Ultimately, this conversation calls for a deliberate reversal of the current chilling effect and a recommitment to the principles of academic freedom as foundational to ethical, effective, and humane psychosexual therapy.

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Anti-Oppressive Psychosexual Psychotherapy: Next Steps

Julie Sale

Poster

Anti-oppressive psychotherapy is recognized as the sixth force in psychotherapeutic theory and practice, building on the fourth force of multiculturalism and the fifth force of social justice. This approach identifies and critically examines the ways oppression, power, and privilege operate within therapeutic relationships. It moves beyond a narrow focus on inclusivity and diversity or an exclusive emphasis on marginalized client populations, instead articulating universal guiding principles that promote safety for both therapists and clients across all minoritized identities. In her book chapter, Towards an Anti-Oppressive Psychosexual Psychotherapy Practice, Julie synthesizes concepts from intersectionality, minority stress theory, and trauma-informed practice with established anti-oppressive frameworks in general psychotherapy. From this integration, she proposes four core principles intended to support ethical, culturally responsive, and socially attuned psychosexual therapy: self-awareness, critical examination of dominant sex and gender scripts, linking minoritization to trauma, and maintaining adaptable clinical approaches. Together, these principles aim to enhance therapist reflexivity, challenge normative sexual and relational assumptions, acknowledge trauma associated with marginalization, and promote flexible, client-centered interventions. Building on this earlier articulation of anti-oppressive principles in psychosexual therapy, this paper examines the current state of the field and outlines future directions for establishing safe, inclusive, and transformative psychosexual therapy practices on a global scale.

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Literature Review of The Prevalence of African-American Women in Psychosexual Research Data

Karen Banks

Poster

This literature review is an examination of the prevalence of African-American/Black women as study participants in the psychosexual research field. Historically, African-American people in the United States have been underrepresented in the research and abused as test subjects in scientific and medical research. If new theories, treatment protocols, and “best practices” are derived from research then applied across cultures, then it becomes crucial for marginalized and abused populations to be represented in the research, specifically taking into consideration systemic and medical racism, historical and current oppression, and any socioeconomic disparities. Some of the research questions this literature review aims to address include: are black women included in psychosexual research proportionally to their existence in the population and what methods are researchers using to attract black women as research participants? The methodology for this literature review was a randomized search and review of up to 100 research papers published in peer-reviewed, scholarly, psychosexual journals including: Journal of Psychosexual Health, The Journal of Sex Research, Journal of Counseling Sexology & Sexual Wellness, Archives of Sexual Behavior, Psychology of Sexual Orientation and Gender Diversity, and The Journal of Sexual Medicine. This author examined research papers from 2010-2020 that included women-identifying subjects in the United States and provided demographics such as race, age, marital status, and socioeconomic data on research subjects. The number of study participants and their demographics was compared to census data during the same time frame. Findings from all the research reviews are summarized and presented in this article. Finally, this article will raise for consideration the implications of non-culturally informed research data in the field of psychosexual health and the potential ways to address any disparities in research collection.

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The Necessity of Sex Therapy for Adolescent ADHDers

Tommy Underhill

Poster

The use of sex by adolescents with ADHD to improve social standing is a documented but under-discussed issue in clinical psychology, social work, and adolescent development. Adolescents with ADHD—especially those with impulsivity, low self-esteem, or social rejection histories—may engage in risky or premature sexual behavior as a compensatory strategy to gain peer approval, emotional connection, or social status. This presentation challenges the conventional, pathology-driven understanding of Attention-Deficit/Hyperactivity Disorder (ADHD) by proposing a cultural framework for interpreting ADHD identity—particularly in adolescents. Drawing from clinical research and client narratives, it explores how the lived experiences of ADHD individuals form a coherent, culturally-distinct set of values, communication patterns, and behavioral norms that diverge from neurotypical expectations. The presentation emphasizes how viewing ADHD through this cultural lens reveals unique vulnerabilities in sexual development, gender identity, and relational functioning. It highlights the ethical consequences of minimizing sexuality in therapy and underscores the need for culturally competent, sexuality-informed mental health care. Through a synthesis of developmental psychology, sex therapy literature, and neurodiversity-informed ethics, the presentation argues for a paradigm shift: recognizing ADHD not merely as a clinical diagnosis, but as a cultural identity that demands tailored, respectful, and affirming therapeutic engagement.

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Bridging Faith, Culture, and Access: A Multidisciplinary Arabic-Language Online Intervention for Vaginismus

Mariam Aziz

Poster

Vaginismus remains one of the most prevalent yet under-recognized and under-treated sexual difficulties among women in Muslim-majority societies, where limited sexual health education, modesty norms, and shame-based scripts hinder help-seeking and treatment accessibility. This presentation introduces the development and implementation of Quareb’s Overcoming Vaginismus Program—a comprehensive Arabic-language, self-paced online course designed to guide women through evidence-based psychosexual therapy while honoring cultural and faith-based sensitivities. Grounded in the biopsychosocial model, the program adopts a multidisciplinary approach, integrating contributions from an OBGYN and a pelvic floor physiotherapist while being led by a Certified Psychosexual Therapist™. Through this collaboration, participants receive coherent, clinically sound guidance addressing the psychological, relational, anatomical, and physiological dimensions of vaginismus. The program combines psychoeducation, cognitive-behavioral strategies, mindfulness, and gradual exposure within a culturally congruent framework. Delivered through pre-recorded videos, reflection exercises, and guided worksheets, the course progresses from foundational understanding of the body and relational dynamics to individualized and partnered sensate focus exercises. Each component—from addressing hymen myths and sexual guilt to cultivating trust, body awareness, and relaxation—was linguistically and conceptually adapted for Arabic-speaking audiences to ensure clinical safety, modesty, and religious congruence. Designed for accessibility, the program’s cost is a fraction of ongoing in-person therapy, expanding care to women who would otherwise be excluded from psychosexual treatment due to financial, geographic, or cultural barriers. Early participant feedback indicates improvement in women’s understanding of and relationship to their bodies alongside reductions in sexual anxiety and vaginismus symptoms, and increased comfort during intercourse. This innovative and multidisciplinary model demonstrates how psychosexual therapy principles can be effectively translated into culturally sensitive, accessible and affordable online modalities—bridging global best practices with local values and widening access for underserved populations.

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Reconstructing Intimacy When Painful Sex Occurs in a relationship: a male support group perspective

Ronnnie Burke

Poster

Many women experience painful intercourse at some point in their lives, and this condition can profoundly impact their partners and the overall intimacy within the relationship. When painful sex occurs, couples often find themselves needing to renegotiate their connection, especially in terms of the withdrawer and pursuer dynamics that commonly arise in intimate relationships. While much attention has been given to supporting women who suffer from genital pain, there is minimal information and support available for their partners, despite the significant emotional and relational challenges they face. At the Sex Therapy Clinic at Reut Rehabilitation Hospital in Tel Aviv, Israel, two sex therapists led a pioneering support group specifically designed for men whose partners experience painful sexual intercourse. This was the first male partners’ group of its kind in Israel. The support group not only provided a safe space for men to express their emotions and share experiences but also served as a valuable source of data on the dynamics between withdrawers and pursuers in these relationships. This lecture will explore these withdrawer-pursuer dynamics as reflected in the group’s findings and emphasize the powerful role of therapeutic cards, which I personally designed, to enhance sexual communication. These cards act as a valuable tool to help men overcome barriers to emotional expression and facilitate conversations about sexuality that are often difficult to initiate. Men are frequently socialized from a young age to hide or suppress their emotions, which may contribute to their role as withdrawers in the relationship. However, this dynamic is complex and multifaceted. The support group offers a unique environment where these roles can be explored, challenged, and sometimes transformed. Ultimately, this work underscores the critical need for more inclusive and targeted support for partners dealing with painful intercourse, or sexless relationships and demonstrates the effectiveness of support for men and the powerful effect of innovative tools such as therapeutic cards in fostering sexual communication and intimacy.

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Sex Therapy with Neuro-spicy Couples

Lena Fenton

Poster

Clinicians working in sex and relationship-focused (SF) therapy must be thoroughly trained in understanding how sensory features impact sensuality, sexuality, and eroticism for autistic individuals and couples. Sensory sensitivities are highly prevalent in autistic populations and can significantly influence experiences of intimacy, connection and sexual functioning (Minshew & Hobson, 2008). These sensitivities may manifest as heightened or diminished responses to touch, sound, light, or other sensory inputs, which can affect both solo and partnered sexual experiences. Therefore, it is essential for therapists to implement an approach to sexual functioning and dysfunctions that can both assess and accommodate these differences. Studies suggest that approximately 1% to 3% of the general population has a diagnosis of autism, highlighting the importance of inclusive and informed therapeutic practices (Skuse, 2020). In my own experience there appears to be an increase in couples with mixed neurotypes that present with emotional and intimacy issues. By integrating knowledge of sensory processing differences and neurodiversity into their practice, sex therapists can provide more effective, empathetic, and individualized care for autistic clients and their partners. This presentation will examine several key areas of impact, beginning with the senses of sight, touch, and olfactory experience. It will then address the double empathy problem, proprioception, and synaesthesia. I will illustrate how these factors influence connection, intimacy, and eroticism. I strongly believe that it is vital that psychosexual therapy trainees are educated about these issues and equipped to avoid common pitfalls in therapeutic settings, as described in the recent book, even by counsellors who have received some form of training in autism (Attwood, T. & Aston, M., 2025).

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Shadow, Symbol, and Sexuality: Integrating Sex Therapy and Art Therapy Through Depth Psychology

Michelle L. Dean (United States)

Clinical Demonstration

This didactic, experiential, and interpersonal workshop introduces an emerging, integrative approach that unites sex therapy and art therapy through a depth psychology framework, offering clinicians innovative ways to address the symbolic, somatic, and relational dimensions of human sexuality. While sex therapy traditionally emphasizes cognitive and behavioral interventions, and art therapy centers on nonverbal expression and emotional processing, their combined application remains vastly underexplored. Grounded in Jungian principles, including the shadow, symbolic imagery, and the transcendent function, this workshop explores how creative processes can illuminate unconscious material that shapes sexual identity, desire, intimacy, and embodied experience. The didactic portion will orient participants to depth psychological concepts relevant to sexuality, including how disowned or repressed aspects of the psyche manifest in erotic life, embodiment, and relational patterns. Participants will examine clinical literature demonstrating the benefits of integrating symbolic expression with sexual health interventions, particularly when working with couples, trauma survivors, LGBTQIA+ individuals, and clients experiencing somatic disconnection. The experiential component invites participants to engage in guided art-making designed to access implicit sexual narratives and embodied awareness. Through symbolic drawing and gentle somatic-attuned mark-making, participants will explore how creative processes surface hidden beliefs, fears, and desires related to sexuality, while also cultivating curiosity and psychological safety. The interpersonal segment will involve structured small-group or dyadic dialogue (adapted for cultural comfort and consent), supporting participants in reflecting on the emergent imagery and its clinical applications. Emphasis will be placed on how these methods deepen therapeutic attunement, relational repair, and understanding of non-verbal communication in couples work. Together, these components provide a comprehensive introduction to a depth-oriented, creative, and culturally responsive model that enhances therapeutic work with diverse sexual concerns. Participants will leave with practical interventions, theoretical grounding, and future directions for research and global clinical practice.

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