As I discussed in my previous post about an upcoming TV show, social justice is an important part of my mission and my work as a sex therapist. So what does social justice mean, and how exactly do I apply it in my sex therapy practice? First, let’s take a look at a definition of what social justice is. I found a good quote from Matthew Robinson, a Poli Sci professor, that pretty much sums up my own views on this issue:

Social justice is defined as “… promoting a just society by challenging injustice and valuing diversity.” It exists when “all people share a common humanity and therefore have a right to equitable treatment, support for their human rights, and a fair allocation of community resources.” In conditions of social justice, people are “not be discriminated against, nor their welfare and well-being constrained or prejudiced on the basis of gender, sexuality, religion, political affiliations, age, race, belief, disability, location, social class, socioeconomic circumstances, or other characteristic of background or group membership” 

The key elements of this that resonate for me in my practice are: a) challenging injustice, b) valuing diversity, c) welfare nor well-being constrained or prejudiced based on gender, sexuality, etc…. As a practicing psychotherapist, I am sometimes concerned that social justice is not always appropriately observed in consulting rooms and I often speak out about this in my writings and lectures. Often, social injustice is perpetrated unwittingly through unnecessary pathologizing of non-normative, yet non-pathological manners of sexual expression and behaviors.  I believe the good folks who do this mean well, they just don’t have enough training, education, and lived experience in these areas to know any better. Examples of this kind of social injustice include any kind of attempt to cure homosexuality, transgenderism, or kinky fetishes for instance. I’m not saying that a clinician should push these things onto a confused client either. Just that they need to honor the person’s individual process and allow them to make their own decisions without the harmful usage of assumed pathology on the part of the clinician. Thankfully such quack treatments such as conversion therapy have been largely discredited. In fact, reparative (or conversion) therapy is illegal in New Jersey.

However, there are two other key areas that I think cause a lot of problems for clinicians and as a result, break forth unwitting examples of social injustice. These two areas are sex addiction and women’s sexual freedom. Let’s start with sex addiction first. One of the first things to know about sex addiction is that it is a controversial and highly charged topic in sexological circles, and indeed, was rejected for inclusion in last year’s DSM 5. I don’t think that anyone really believes that sexually compulsive behavior doesn’t exist. We’ve all heard or know of shopaholics, workaholics, gambling addicts, so why not sexaholics? Makes sense. I work with a number of sexually compulsive folks, so I know it is a harsh reality in some peoples’ lives. The problem is that many sex addiction professionals approach their work from a sex-negative stance. For more on this click on this article about the difference between sex positivity and sex negativity.

I don’t see anyone treating shopaholics from the standpoint that shopping is bad or that workaholics are being told that they should stop working. But there’s a very strong conservative bent in the sex addiction field that views any sex outside of a loving, committed relationship as bad, or that any sex, even in a loving relationship, should be about sweet pillow talk, eye gazing and other forms of romance novel “intimacy”. So, unfortunately anyone who deviates from that template is deemed to be pathological. I would never refer clients to clinicians who work from this perspective. Bringing in the social justice component, telling someone who has a high sex drive that they are a sex addict is a form of social injustice, calling someone who desires sexual variety a sex addict is social injustice, and telling someone who has a non-normative sexual appetite that he/she is a sex addict, just because other people don’t like it, is yes, also social injustice. In this way, social injustice is perpetrated in numerous mental health offices throughout the country every day. Now, I’m not talking about liars, cheaters, acts of infidelity, or any other such nonconsensual behavior. I’m talking about the social injustice of pathologizing human sexuality.

Another issue that is top of mind for me is women’s sexuality. I’m talking about the double standard in our society between men and women when it comes to sex. Women who have lot of sex and like it, they are called sluts. Slut shaming. (Men get shamed too, but it’s usually in the context of a committed relationship– see sex addiction above). I see this issue of slut shaming come up a lot in my work with sex workers. Most sex workers are women, and because there is no way in hell that women like sex, it must be assumed that these women are somehow oppressed or coerced to do what they do. Sure, there are unfortunate folks who fall into some kind of human trafficking scheme and I don’t want to minimize that. Although I have to say I have never run into such a person and I have worked with numerous sex workers, so I’m not really sure how accurate the alarmist headlines really are. Note: I’m not talking about street prostitution here, in which the women are often engaged in survival behavior, and are often addled with various addictions, but rather indoor sex work, which accounts for a majority of it and is legal in most 1st world countries, including Canada.

In my experience, sex workers do sex work because they LOVE sex. Yes, they enjoy what they do. And they are most concerned about law enforcement than about sexual exploitation.  I think it’s a mistake that people make to assume that strong, confident feminist women view sex in some sort of negative light. They often confuse feminism with the Andrea Dworkins and Catharine MacKinnons of the world. However, there is a large contingent of pro-sex feminists who advocate female empowerment through sexuality, and the clash between these two rival factions is now known as the “Feminist Sex Wars.” Sex-positive feminism is a big movement with numerous conferences, both nationally and internationally, in which they will discuss such key issues as the decriminalization of prostitution and feminist pornography. Yes, feminist pornography. I’ll say it– those who think that all, or even most women, have a problem with pornography or prostitution in which all parties participate consensually and through self-agency, live in a sheltered cave.

A recent study in the prestigious Journal of Sex Research found that many women in the pornography industry actually have higher self-esteem, a better quality of life, and are more spiritual than their non-porn cohorts. The researchers concluded that the “damaged goods” theory about sex workers was BS. Don’t just believe me, read the journal article here.

Recently, the Australian government ran a research project, interviewing about 200 indoor prostitutes. This is what they found according to Ronald Weitzer, a George Washington U professor:

A study by the Australian government reported that half of the 82 call girls and 101 brothel workers interviewed felt their work “was a major source of satisfaction” in their lives; two-thirds of the brothel workers and seven out of ten call girls said they would “definitely choose this work” if they had to do over again; and 86 percent in the brothels and 79 percent of call girls said that “my daily life is always varied and interesting.”

I could go on and on, but anyway, I think this article has gone too long and has run it’s course. The point is that anyone who assumes that any woman engaging in sex work is somehow damaged is practicing social injustice.  Taking away a woman’s kids because she does sex work is social injustice. For that matter, I’ll go the next step and say that in my opinion, based on longitudinal outcomes, the criminalization of most sex work is in itself a social injustice.

One last point… no discussion of social justice and psychotherapy can be complete without at least a mention of fees. The availability of mental health services to marginalized and disenfranchised populations is a major issue in what is mostly a broken mental health system here in the US. Even Freud, back in the day, set up free clinics in Austria to help poor people, outside of his practice with wealthy, bored, and sexually frustrated Viennese women. While, as a highly trained specialist with an office in midtown Manhattan, my rates are competitive with my peers, I make a point of making at least a few spots available in my schedule at highly reduced fees for the most marginalized sexual minorities, such as teens or young adults who have been outcast from their homes due to their sexuality and young trans folks who are in various phases of their transition. I think it’s the socially just thing to do.