We Need to Talk 

For something as delightful as having sex, people sure do worry a lot about it. It seems to me that we have a hard time managing our expectations about sex and, to quote a therapist friend of mine, we tend to "compare our insides to other people's outsides." In other words, it can seem like everybody but us has it together sexually. Given the years I've been doing this work, you can trust me when I say we all go through periods of self-doubt and dissatisfaction about sex.

Having good conversations about sex is a great way to feel better about it. But it's rare that we feel comfortable doing that. In the decades I've been teaching and counseling about it, the questions I've been asked number in the several thousands. Generally speaking, we just don't know very much about sex, which makes it pretty hard to talk about it. It isn't only the average person who has difficulty, either. Therapists, physicians and other healthcare providers aren't immune to the tongue-tied, foot-in-mouth, problems of talking about sex. (Take some comfort in knowing even the pros struggle.) Fortunately there are exceptions, and some of us do obtain post-licensure training in sexuality. Interestingly, midwives often have considerable skill in this department.

If you're concerned about a sexual health matter, your provider is, nevertheless, a great starting place. If the problem has to do with how your body is functioning, asking a medical person about it should be your first move. When patients ask me sexual function questions, I usually have them talk to their providers first to make sure everything is OK health-wise. If the issues are more in the enjoyment realm, talk to your lover.

Accept that it will be awkward at first if you haven't had many conversations about sex. Agree with your partner to assume each other's best intentions. Do yourselves a favor and don't pick right after having the kind of sex you don't love as the time to bring it up. Go for a walk, maybe head to the beach or the forest, and just start talking. Start with what you do love about sex with this mate. Be kind, but be honest. Offer suggestions, not just problems. Sentences that start with "I love it when ..." are a lot easier to hear than something framed negatively. It is very hot to hear your partner tell you all the things they love about having sex with you. The potential rewards are great and the risks small.

What would you ask for if you thought your ideas would be met with grace and interest? Setting that stage is worth the effort. Spend the time and effort to create a climate of openness and wonder about the sexual side of your relationship. It will pay off in abundance. If you're not sure where to start, I've got a great worksheet of sexual ideas I'm happy to email you (or you can download it here. You could also make a list together of all the sexual things you've heard of or thought about. Include some you are interested in, but also include some you know you aren't interested in. The best way to brainstorm is to not eliminate anything until the full list is complete. Then go through and tell each other whether the items on that list are in your "yes, absolutely," your "it depends" or your "nope, not interested" categories. Once you've identified some common yes items, set aside time to try them out. You don't have to apologize for the no's, either. There are plenty of enthusiastic yes's to be had, so don't spend energy worrying about those activities you crossed off. The "it depends" column will be a great place to really talk about what moves you and what doesn't.

Here's one common example. Let's say you enjoy giving your partner pleasure in some particular way, but if that same behavior happens in some other way — some other position, for example — it triggers something unpleasant. Start with what does work, and explain but don't apologize. If looking up at the ceiling reminds you of something unpleasant, change rooms or change positions, but don't stop having sex unless you want to.

If you can't talk to your lover for whatever reason, a sex therapist (a licensed mental health provider marriage and family therapist, licensed clinical social worker, or psychologist who has advanced training in sexuality) can help. If you need more information about the things on your list, or about sexual health, there are some excellent and reputable resources out there. I'm happy to answer your questions here, anonymously, of course. San Francisco Sex Information can be reached by phone (415) 989-SFSI. It's a well-respected, queer- and kink-friendly, basic-to-advanced resource worth knowing about (and supporting).

Got a question, sexually speaking?

Maybe, you know, for a friend? Email it to [email protected]. You're probably not the only one who's wondering.

Dr. Melinda Myers is a Humboldt State University psychology lecturer, the owner of Good Relations in Eureka, and a clinical psychologist practicing in Arcata. Information presented here is not intended to provide specific treatment advice. Consult www.ncamhp.org to find a licensed clinician who can help with individual concerns.