Two further things which people sometimes come into sex therapy about, but which are not exactly about the act of sex, are sexual and gender identity. Our sexual identity is usually based around who we are sexually attracted to (and sometimes the kinds of things we’d like to do with them). Our gender identity is about what we feel our gender is.
Mostly if somebody is heterosexual (only ever attracted to the ‘other gender’) they don’t worry much about their sexual identity. Similarly if you have a female-looking body and feel like a woman, or a male-looking body and feel like a man, you might never wonder about your ‘gender identity’. However, a lot of us, at some point or another, have sexual feelings about someone of the same gender, or feel that we don’t completely match with the ideas society has about what it means to be a woman or a man. If those feelings are difficult at all then it can be useful to talk about them in therapy.
Of course we now live in a time when it is acceptable to be in a same-gender relationship or attracted to someone of the same-gender. And most people have some knowledge that not everyone who is born looking ‘male’ or ‘female’ wants to stay that way their whole life. However, there is still a lot of ‘homophobia’, ‘biphobia’, and ‘transphobia’ around, which means that people who are attracted to people of the same gender, to the same and other genders, or who are trans*, may still experience bullying, being excluded from their family or community, being the victim of abuse, and all kinds of other problems which can cause great stress and unhappiness. If you wish to find out more about this, go to Stonewall, BiUK (www.biuk.org) or Press for change.
If you are thinking about your sexual identity you might want to consider ideas such as whether you want to identify as gay or lesbian, or as bisexual, or perhaps you are happy to see yourself as heterosexual but open to sometimes having same-gender attraction, or perhaps you don’t want to label your identity at all. Similarly some people like to step out of being called ‘man’ or ‘woman’ (they sometimes use words like ‘genderqueer’, non-binary gender, or ‘androgynous’), others might be happy that they are a masculine woman, a tomboy, or a feminine man. Some may want to wear the clothes of the ‘other’ gender sometimes as a ‘transvestite’ or in ‘drag’. Others may want to change their body to fit their gender, and they often use the words ‘transsexual’ or ‘transgender’.
In any of these cases you might well want a therapist who has some expertise and experience in these areas. That is something you could ask about when you are finding a therapist or in the assessment. There are also lists of LGB&T (lesbian, gay, bisexual and trans*)-friendly therapists links.