Tuesday, November 17, 2015

AASECT Position on Sexual Expression including Orientation and Identity

Sexual Expression including Orientation and Identity: 
Treatment and Education Foundations

It is the position of the American Association of Sexuality Educators, Counselors, and Therapists that we oppose any and all therapy models and interventions as well as any educational programs and curricula that seek to pathologize, dictate, or prescribe a person’s sexual orientation, identity, and/or consensual, sexual expression, whether or not it is conventional or atypical.  Regardless of how such clinical interventions or educational programs are labeled or named, AASECT recommends all helping and educating professionals to utilize best practices and culturally relevant resources for foundation and reference.

Furthermore:  AASECT affirms that sexuality is central to the human experience and sexual rights must be honored in order for sexual health and overall well-being to be obtained.  Informed by the best empirical research, AASECT recognizes human sexual experiences as diverse and supports the acceptance of sexual diversity while embracing consensual sexual expression within the framework of human rights and social justice.

AASECT accepts the evidence that human sexual experience includes a vast spectrum of sexual expression, orientation, and identities. These sexualities, between consenting adults when agreed upon, with permission, and assenting, are typically not psychopathological behaviors. Indeed, recent peer-reviewed research on these sexual experiences shows no correlation to pathology.

AASECT further asserts that all people seeking treatment and education about consensual sexual behavior, identity, or orientation deserve accurate information.  AASECT accepts that the empirical evidence is reasonably complete on reparative and conversion therapies that attempt to change sexual orientation or identity and shows that these techniques are experimental at best and overwhelmingly ineffective, with harmful consequences for clients widely documented.

AASECT takes the position that social justice plays an essential and foundational role in the organization’s mission.  Individuals have the right to be free as possible from undue constraints (e.g. discrimination, stigmatization, oppression and violence) along with the freedom to consensual sexual expression. Destigmatizing human sexual expression and experiences as well as creating and maintaining safe space for those who have been traditionally marginalized are essential practices for AASECT members who are predominately mental health practitioners and educators.  This overarching goal compels AASECT to disavow any therapeutic and educational effort that, even if unwittingly, violates or impinges on AASECT’s vision of human rights and social justice.

We are here to make sure that you don't think AASECT wrote the remainder of this post!  And don't forget to read our fine print:  Of course you may use parts of this  post to improve therapy for kinky folk anywhere in the world you serve them!  Attribution is nice!

On November 12, 2015, the AASECT Board of Directors unanimously adopted this position statement as recommended by its Public Relations, Media, and Advocacy Steering Committee.  I was one of a large group of interested people in AASECT who participated in this process.  The policy statement is obviously the official position of the entire organization.  The remarks immediately below are my interpretations, not official AASECT policy:

Alfred Kinsey (1894-1956).  His pioneering research on American Sexuality revealed its diversity was far greater than conventionally imagined then, and even now.

With this passage of this position, AASECT is officially on record as supporting BDSM, cross dressing, fetishism, erotic role play, polyamory and consensual non-monogamy as potentially sexually healthy lifestyle choices and behaviors.  This constitutes full implementation of Kinsey’s ideas about the broad range of sexually healthy behaviors.

This statement does not mean that sexual variability is always healthy, and it does not mean that it is usually without risks, but it does mean that educators and clinicians have the responsibility to remain neutral about these possibilities until given clinical data to question otherwise.   I would advise doing so even when sexual behavior is a specific axis of complaint in a client’s reasons for coming to treatment. 

This statement also bars devising treatments or educational programs specifically designed or marketed to stigmatize, marginalize or derogate unconventional but consensual sexual choices.  Society will continue to criminalize some forms of sexual conduct, and the clinical community must remain responsive to law, but the statement only applies to consensual activities.

The explicit target of this statement is reparative or conversion therapies, and it was crafted to include other therapies used for reparative purposes, regardless of how they are otherwise labelled or used.  A great example would be any measure of compulsive sexual behavior or ‘sex addiction’ that uses assessment measures that list such activities as polyamory, swinging, or BDSM to generate a score used to confer a diagnostic label.  While BDSM might be problem sexual behavior, any measure that automatically labelled it as such would be defective under the intent of this policy.   This targets the same bias that changes in the DSM – 5, published in May of 2013, partially implemented in the Paraphilias section.  There, a distinction was drawn between non-pathological variation, ‘paraphilias,’ and paraphilias that were non-consensual or the focus of client complaints; paraphilic disorders. Variant behavior is not pathological in and of itself.

Likewise, it would be an unethical and defective business practice to advertise that one changes sexual orientation, variant behavior, or sexual desire per se, even though one might ethically contract with an individual patient who complained that variant orientation or behavior was a problem.  Such advertising is doubly defective, in that it is not only stigmatizing of behaviors or identities that deserve protection as sexual human rights, but it is scientifically defective given that reparative and conversion therapies have repeatedly been found ineffective in rigorous scientific evaluation.  Thus it is also a violation of this statement to undertake a therapy to change orientation, desire or behavior without explicitly contracting up front with the client that such an attempt involves therapeutic techniques which are experimental and unproven for such purposes.

Note, however, that this is a position statement.  It does not specify how AASECT might deal with the problems of dual certification if an individual practitioner affiliates with an organization which has members that do any of these unprofessional things.  A Member might complain to AASECT Ethics Advisory Committee (EAC) about another Member who was perceived as violating the position statement, and the EAC might issue an advisory opinion to the Membership about such behavior.  In serious cases that could not be resolved by negotiation, the Board might choose to discipline a member who was found to be violating our Code of Ethics or practice standards.  This is an advocacy statement, not a disciplinary policy.

Anyone who encounters advertising, practitioners, or organizations that claim to be working in the fields of sexual health and education that seem to be violating this policy should contact them and request that they stop.  If they persist, The National Coalition for Sexual Freedom, the Woodhull Foundation, and/or the major LGBTQ organizations should be contacted.  All have reparative therapy policies in place, and actions they can take.  A few states have passed legislation specifically barring gay reparative therapies, and the list is growing.  Licensing and certifying bodies in those jurisdictions will be resources in stopping these practices. Similar legislation does not commonly protect consensual non-monogamy or BDSM practices.

Members and the public are correct to feel that such a position changes the practice landscape.  The statement begs for extra care in making sure that kinks are the main problem that clients want to become the focus of treatment.  It pushes us to check to see if problems of occupational and life functioning stem primarily from the kink itself, or are primarily the consequences of identity problems associated with assuming a stigmatized social status.  It acknowledges that diagnostic labels function both ways; sometimes allowing access to treatment and as a source of reassuring meanings, yet also conferring shame, promoting dependency, and marginalizing some clients.

It is hoped that AASECT will challenge our partner sexual health organizations in the North American Federation of Sexuality Organizations (NAFSO) and The World Association of Sexual Health (WAS) to adopt this or similar language, and to bar sexuality organizations that decline to do so.  For this is an excellent, and much needed step in advocacy efforts to promote quality sexual health care for kinky clients, but it is far from the last step necessary to secure these ends.

Thank you AASECT!

© Russell J Stambaugh, May 2015, Ann Arbor MI, All rights reserved, but permission is granted for sexual health advocacy purposes.



  1. Russell I would like to post a link to this from my blog...well said.

  2. And I'm going to post the link on our FB page. Good job, Russell. I do wish gender identity and expression had been included, but ....it's a hell of a lot more than the other sexology orgs, this is a pretty big step.

    1. Gender expression was specifically included and removed in precursors to the final document. This is in part because gender is explicitly referenced in the AASECT Vision of Sexual Health, a relevant passage of which is included below:

      "Sexual Variability and Rights: AASECT recognizes the many varieties of sexuality including, but not limited to, the full range of sexual orientations, gender, transgender, and intersex positions, as well as erotic preferences and lifestyles. AASECT opposes the application of labels such as "normal" and "abnormal" to these variations in the healthy sexual expression of adults, and AASECT believes that all sexual and cultural minorities should enjoy sexual freedom, equal civil rights, and parity of social opportunities and privileges"

      No one should assume AASECT's position statement doesn't cover transgender, queer, and fluid sexual expression. It is silent about gender expression in minors and persons society might view as unable to consent, which is a very hot topic in the trans community right now. This is another of those next steps I implied need to be addressed..

  3. Mine was but a small part. I am optimistic that other sexuality organizations will come along in due time, or perhaps in past-due time. We have people working on it even as I write this...

  4. Russell, thank you helping this come together. You hold the torch that lights the way. Challenging those who want simple solutions to complex human expression. I am so proud to know you.

  5. Hello Russell. This is great work. May we use it as a resource in training pre-registration psychotherapists in their awareness of gender and sexual diversities and the ethical requirement of non-pathologising respect for clients of sexual and gender minority?

  6. Hello Russel. Great work!
    May I share this as a resource in training of pre-registration psychotherapists to help open awareness of gender and sexual diversities and the ethical requirement of non-pathologising respect of sexual and gender minorities?
    Pamela Gawler-Wright, BeeLeaf Institute for Contemporary Psychotherapy and Pink Therapy Clinical Associate,
    UK Council for Psychotherapy workgroup on Diversity and Equality in Education, Training and Practice

  7. I really appreciate AASECT's statement, and there is a lot to be admired in it. I almost posted it on the NCSF Facebook page, but then I realized I would have to explain that it includes BDSM and non-monogamy. Then I realized – I'm not sure what AASECT intends to include as acceptable forms of consensual sexual expression.

    I’m glad to see from your explanation, Russell, that this statement is intended to be inclusive of BDSM and non-monogamy. I hope it’s also inclusive of fetishes and cross-dressing.

    My only issue with this statement is in the ambiguity of not naming the sexual practices. NCSF has staked everything on actually naming the things that are stigmatized. It’s caused issues for us as an organization, especially when it comes to getting funding. Also some professionals decline to be listed on our Kink Aware Professionals list because of an association with a BDSM advocacy organization.

    Yet we have long felt that someone has to name the specific practices in order to destigmatize them. We do believe the past 20 years have born out that theory. We wouldn't have 50 Shades of Grey today if the acts themselves hadn't been destigmatized to the point of acceptance by the mainstream.

    Perhaps future iterations of this statement on sexual expression could name the sexual experiences that aren’t considered pathological.

    Susan Wright

    1. It is my belief that AASECT passed this broadly intending to be inclusive, and that the failure to mention any specific kink was not intended to convey judgement about unnamed mutually consensual practices.

  8. This was a process that took us more than a year to complete and several different teams of authors. In the end, the final group of authors were a very diverse group of AASECT members representing a broad variety of view points. There was unanimous agreement on the final document before it was put to the AASECT Board of Directors for approval. Russell played a key role in getting this done. I believe that every single person who helped to author this document can feel proud of making a contribution to the field.

    Neil Cannon, Ph.D., LMFT
    Chairman, AASECT Ethics Advisory Committee

  9. I was a member of the committee that crafted this position statement and I stand by every word. My purpose for this note is to address colleagues who are using this statement to condemn the use of any variant of an "addiction" construct to help people who are experiencing significant distress and adverse consequences due to recurrent, hard to control sexual fantasies, urges, and behaviors.  

    I understand that much of this outrage is a reaction to times when the "sex addiction" label has been misused to brand people as broken simply for engaging in statistically atypical or traditionally marginalized consensual sexual behavior. Critics complain that the construct can obscure the toxicity of acculturated sexual shame on issues of identity, orientation and consensual sexual expression that are incongruent with the nonsexual aspects of a person's life.

    However, I'm deeply concerned that some people want to invalidate any attempt to apply the addiction paradigm to matters of sexuality.  Opponents mischaracterize the concept of sex addiction as nothing more than an oppressive tool of sexologically untutored enforcers of hetero/mono/vanilla-normative values.  I reject this notion and assert that there is no inherent incompatibility between the proper application of the concept of sex addiction and the central tenets of this position statement.

    Yes, people have been harmed by the inappropriate use of the sex addiction label for simply engaging in traditionally marginalized sexual behavior.  However, it is equally true that people have also been harmed by inappropriate withholding of the sex addiction label for truly compulsive use of sexual fantasies, urges and behaviors.  The fact is that it is a paradigm with the power to transform -- and even save -- lives when it is properly applied. 

    Those who attempt to use this position statement to justify a wholesale rejection of the concept of sex addiction risk harming people who garner strength and hope from the application of its principles to their lives.  Women and men who define themselves as recovering sex addicts are not helped by being told that their self-identity is contrary to human dignity.

    There is no universal answer to the question of how best to assist a person who does not feel capable of self-regulating sexual expression in a manner that is consistent with the other activities, values and relationships that she or he considers necessary to a balanced and fulfilling life.  Using this position statement to wholly negate all addiction-based theories of disordered sexual self-control dismisses a person's right and agency to choose or reject available models of assistance, both of which are at the heart of the right of self-determination. 

    Not only are sex addiction models of care never going away, they are growing in diversity and depth.  This is a complex topic with few easy answers.  It's time to bridge differences, learn from each other and cease wasting time and energy trying to fight a rear-guard action against a methodology that has clearly brought sexual health, personal empowerment and strengthened relationships to many people who would not trade these stirring achievements for any alternative the most ardent promoter of this position statement could possibly advocate.

    Bill Herring, LCSW, CSAT
    Atlanta, USA