Is your Sex and Intimacy OT Practice more Victoria's Secret or Rihanna’s SavageXFenty?
Before you read on, here's a self-assessment to stoke self reflection.
Take a look at Victoria's Secret's website and Rihanna’s SavagexFenty website.
Ask yourself: “If my sex and intimacy occupational therapy practice was either Victoria’s Secret or SavagexFenty, which one would it be?”
Here are some questions:
If you have patient handouts, who is visually represented in them?
What clients do you address sex and intimacy with and which ones do you hesitate to address it with?
Do you ask your clients what kind of sex they have or what it typically looks like?
Are you comfortable celebrating the expansive forms of sexuality and ways sexual activity can be engaged in? Does this acceptance translate when you’re working with your clients?
Last week, I wanted to buy a few new pieces of lingerie. Like an old habit, I typed Victoria’s Secret into my google search bar and went to the website…I didn’t last 7 seconds.
I quickly visually scanned the pictures and saw the bodies were all airbrushed, very tall, very thin. I noticed the more sexual the piece of clothing the more often it was on bodies that simply didn’t look like mine. Sure, I saw bigger (than the very thin) bodies, but bigger bodies that also somehow don’t seem to have belly rolls and back creases like my body does or they were in camisoles that cover their stomach. I didn’t see myself and didn’t want to buy from them.
Then I went to SavagexFenty. Different story.
While most of the people also did not look like me, it just felt better. I saw the beautiful variety of people being celebrated as sexy. I saw belly rolls front and center on people photographed in a way I felt was empowering - for example, their stomach wasn’t hidden under a flowy camisole. I saw lopsided boobs, scars, tattoos, wheelchairs. I liked seeing people with minimal chest modeling the bras. I’m full chested and it felt nice to not seeing big boobs always being centered in a sexual portrayal. So while I certainly didn’t see myself in every model - or even in most of them - I felt I wasn’t being sexualized or made to fit this narrow view of sexuality. Instead I felt empowered in my own uniqueness and sexuality.
Needless to say, I bought 3 pieces and felt fabulous in them once they arrived.
This got me wondering how our clients feel when we address sexuality with them or, probably more likely, how they feel when we don’t discuss sexuality with them.
Do they feel accepted as they are?
Do they feel represented in the questions we ask them or the images in the handouts we give them?
What if they feel they’re on performance to fit into a narrow box they feel we expect out of them?
What if they don’t feel safe with us to be authentic about who they are as a sexual person?
The OT profession in the United States is overwhelmingly white, straight, female, and not disabled. Our demographics aren't even close to representative of the actual demographics that make up our client population in the US. Additionally, occupational therapy was founded by white females and so the very lens of OT is informed by norms most familiar to white females.
All of this to say, we have to be intentional about providing OT interventions that are informed by our clients’ norms, preferences, and goals and NOT our assumptions and expectations.
I think looking at these two websites is an creative way for a clinician to assess their own sex and intimacy OT practices. We can ask the questions:
Who are we serving, who are we celebrating, who are we excluding, and what sexual activities or potential concerns are we excluding? And why?
Am I comfortable when I see certain people celebrated as sexual beings and uncomfortable when I see other people celebrated as a sexual person? What if these people are my clients?
Challenging these thoughts can look like this:
Perhaps you have the opinion that sex should be private and this makes you hesitant to address it with clients. You can ask yourself, “who thinks it’s private?” If it’s you who thinks sex should be private, then you can acknowledge it is your belief that is informing your clinical decision not to bring sex up.
Or maybe it’s an assumption that your clients think sex should be private? Do you assume sex is private for a client based on their age? Their political opinion? Their religion?
Also, just because your client may actually have the belief that sex is private, doesn’t mean this is a show stopper. The client also likely thinks toileting is private… but we discuss this with them without hesitation.
Self-reflection is the first step here, and I hope you’ll find the self-reflection prompts I provided in this newsletter helpful in that process. You can use this information to start thinking of actionable ways to change your practice to enhance the experience and provide your clients with sexual health intervention opportunities.