Swiping with Agency: Beating Dating App Fatigue 

According to Shakespeare: “Love is a smoke and is made with the fume of sighs.” But when that love is sought via online dating, single daters may have to wade through a lot more than just smoke to smell the loving fume of sighs. According to a Pew Research Center study, 30% of American adults have used dating apps to find a partner. Out of that population, 12% of folks have found a long term partner or married their spouse through apps. While dating apps might alleviate social anxiety that some daters experience when attempting to meet a person IRL, there are unique concerns that contribute to what has been described as “burnout” and fatigue by clients who are relying on online dating apps or sites.

While many users find it easy to connect with potential matches based on shared interests or physical attraction, concerns about dishonesty, unwanted messages, and harassment are prevalent. Younger women are particularly vulnerable to these negative experiences. The Pew Study found that over 50% of women ages 18-34 feel as though dating apps are not a safe way to meet people, since they are more likely to receive messages with previously matched swipe rights after communicating that they were not interested. This unwanted non-consensual communication can be in the form of receiving explicit messages or being threatened.

Dishonesty & Dangers on Dating Apps

Single folks in therapy or coaching sessions express shock and fear at having their boundaries crossed and at times repeatedly violated by people they meet via dating apps.. Daters bemoan the common lying their matches enact by failing to communicate significant facts like: unlike what they wrote in their profile, they actually aren’t looking for a long term relationship after all, or they have not actually “moved out” of a home shared with a “previous” partner or spouse. According to a Forbes survey, one in five adults admitted to lying on their profiles in some capacity, which can contribute to a deepening pattern of anxious attachment by those daters who are lied to. The survey found that:

• 20% lie about age
• 14% about hobbies and interests
• 13% about employment or relationship status, and
• 12% about height.

Some therapy clients mourn the loss of their own basic trust in people, and report feeling burnt out after suddenly getting “ghosted” by a regular dating partner of a few months without any warning or explanation.

Dating App Burnout

Out of the portion of Gen Z responders who are on dating platforms, the Forbes survey found   that 79% of single daters were feeling signs of burnout. In addition, survey respondents reported spending on average over 50 minutes a day on these apps and cited a variety of reasons for engaging for long periods of time.  While some are actively screening candidates in search of a potential person looking for a long term relationship, others are simply seeking a social-emotional outlet and/or an ego-boost by continually swiping on their phone screens.

When coaching clients who are actively dating, I conduct a deeper dive of somatic inquiry and ask them whether they’re aware of what their body is experiencing and what emotions are bubbling up as they scroll for longer periods of time.

• Are they feeling tightness in their chest, a pit in their stomach or a clenching in their jaw?
• Has the app-scrolling habit become a mood regulation activity in and of itself in an attempt to tame feelings of loneliness, boredom, depression and/or anxiety?
• Are they disassociating or going into a fugue state while scrolling?

Some daters spend their precious time, energy and planning skills in swiping, responding, trying to be clever or humorous in their communications only to discover that the person on the other side is not only lying about things like their height, but are in fact not even the person they are representing themselves to be (also known as catfishing). Catfishing can lead single daters to become so burnt out with the entire dating app process that they cancel all their registrations and take a long break.

Along with catfishing, ghosting also heavily impacts people in the online dating world, as it has become such a commonplace practice for dating app daters. Getting ghosted whether it’s after weeks of messaging, going on a few dates, dating for several months and/or engaging in an ongoing sexual relationship causes many clients to lose faith they’ll ever find an honest partner . Additionally, breadcrumbing, or leading someone on with little effort and no intention of a real relationship, also has very negative mental health effects. A 2020 study by the NIH found that those who experienced breadcrumbing, or a combo of breadcrumbing and ghosting, reported higher levels of loneliness, helplessness, and lower life satisfaction. Dating platforms have become easy places to treat real people transactionally, leading to many single folks to feel hopeless.

How to Combat Dating Burnout & Date with Sex Esteem®

I encourage clients to consider carving out more of their free time in engaging in activities that provide self-care and nourishment like:

• a physical activity like going to the gym, social dancing or taking an art class
• Spending time with good friends
• attending a community or spiritual event
• volunteering to help others.

I also advise clients to limit swiping and messaging to 30 minutes a day, enough time to engage and move forward with potential dates.

Refrain from scrolling, swiping or texting on a dating app while in bed right before going to sleep, or immediately upon waking so it doesn’t lead to an obsessive activity associated with their bed. I recommend reserving the bed for activities such as sleep and/or sexual-erotic activity, both of which require deep relaxation and trust.  If one is continually scrolling in bed, your mind’s neural pathways begin to associate the bed with anxiety, distrust, and potentially even a feeling of being turned off.  This is obviously not helpful in sustaining or enlivening one’s embodied erotic energy.
Set your boundaries early and often with potential dates by telling them what kinds of messages you DON’T want to receive and what you WON’T be sending.

If you ARE interested in someone, meet them in public fairly soon after matching so you can see if indeed you are a match emotionally and with some chemistry.

Don’t solely rely on dating apps. Organize IRL gatherings with friends and ask each of them to bring someone from their network who you don’t know who might be a potential romantic interest to you.  ‘Meet cutes’ are not just a thing you see in movies, you can actually create fun social outings and expand your dating pool at the same time!

This is part 2 of my interview with Lisa A Phillips, author of the new book First Love: Guiding Teens through Relationships and Heartbreak. You can go to this blog post to see more of our conversation.

Talk about what you learned in your research for this book. We know that with younger generations that social media impacts teens. How does it impact the reluctance they may have around expressing emotional vulnerability in new relationships?

When I was a teen, my crush did not come home with me. He was in math class and I didn’t see him until the next math class. Now, kids have the crush in their pocket all the time to look, gaze upon in pictures, see what he’s doing, and who he’s dating. How do these kids do it? I always teach about Helen Fisher’s research on heartbreak. She conducted brain scans on people who just broke up, but were still in love with the person who rejected them. When Fisher flashed pictures of the ex, people would cry and scream and weep. They were thrust right back into the vividness of this breakup through images. Now, this is the daily reality after a breakup. On social media, you see image after image of your ex living their best life, which is exactly what thrust those people in the brain study into their feelings of distress. The “social media breakup” is an act of self saving, but young people feel like they’re not tough enough. The biggest piece of breakup advice? Unplug from this person as much as humanly possible.

The research shows that Gen Z and Alpha hold off on having sex during high school compared to the Boomer generation. In 1991 54% of high schoolers had stated that they had had sex, whereas by 2021 it had gone down to 30%. You’ve offered some theories about why you think younger people are more tentative towards emotional intimacy. Can we talk about why young people at times are avoiding “catching feelings”?

I think this trend is really fascinating and disturbing. Sure, we don’t have to worry as much about pregnancy, STIs, or dating abuse. However, there’s a lot of dangers around the things that we do to become adults: having sex, driving cars, trying alcohol, being in the workforce. All of these things make you less safe than when you’re at home alone in your room. Young people are entering their adult lives expecting this control, choosing exactly what to interact with. That leads to less openness toward our fellow human beings and deeper, more satisfying relationships. 

Additionally, the relationships that are happening are less defined than they were and when you and I were teens. There’s this whole spectrum of relationship experiences, from talking, to hooking up, to there’s something but we haven’t defined it yet. There’s an ethos of ambivalence that goes along with that. This can be positive; you don’t always have to go right into a relationship. But at the same time, situationships can be really tormenting for young people. They are worried about asking, “What are we?”, which can create a lot of “I’ll take what I can get” situations. 

What I preach in my book is: Choose what kind of relationship you want, but don’t tell yourself that it is not a relationship. Any human connection is a relationship. Being carefree about it is very different from being careless. Ambiguously defined relationships should not be an excuse to disrespect people. Walk through the world as a caring and ethical human being, especially with your sexual and romantic self. 

Today, there is a lot of important conversation around consent. How do you educate young people to discern the difference between flirting versus coercion?

Young people often talk about repeated pressure for someone’s attention as a very negative thing. I don’t know if I can give an easy answer to the line between persuasion and pressure, between erotic tension and manipulative seduction. When flirting is done well, it is very attuned. It’s about what you try and what the other person responds to. We forget that there’s another person on the side. Sometimes you need to not connect with them and you’ve made it very clear. That’s ok! But we also want to allow for a space of discovery and journey, of the fact that sometimes in sexuality and desire, yes and no are not clear. Creating spaces to find clarity and to figure out how to pursue is a very different thing than pressuring and ignoring the agency of the person on the other side. 

We are in a phase of correction, which is so important. By talking about consent, we are raising our young people to be really in touch with their desires and needs. But then we should also work on getting back some mystery in a way that is not violating, but enlivening.

You talk in the book about issues with mental health, which so many young people are going through and are more aware of. How are mental health and relationships tied together?

Every relationship story seems to entail one partner or both having some kind of breakdown or dealing with depression or being in crisis. At first, I started looking for stories that didn’t involve these things, but I realized that every teen love story is also a mental health story. This generation is distinctly troubled. The rates of depression and anxiety are not good, but their mental health literacy is also very high. When you feel someone in your life is not as loving to you as you are to them, you’re going to get the feels. You’re going to feel sad, unwell, and in pain. It is all part of human design. It does not mean you are broken; it often means you are whole.

First Love: Guiding Teens through Relationships and Heartbreak, is available to the public on February 4th, just in time for Valentine’s Day!

Earlier this month, I had the honor of interviewing Lisa Phillips, the author of Unrequited: The Thinking Woman’s Guide to Romantic Obsession and Public Radio: Behind The Voices. She’s written about relationships, mental health and teens for the New York Times, Washington Post, Psych today, Cosmopolitan, and many other outlets. She currently teaches journalism and the popular love and heartbreak seminar at the State University of New York at New Paltz. In her new book, First Love: Guiding Teens through Relationships and Heartbreak, chronicles the challenges today’s adolescents face as they navigate crushes, dating and breakups, and also the challenges that adults face as they strive to provide guidance and support. It’s told from the perspective of a professor, a mother, and an award winning journalist. This is a condensed version of our interview, which will soon be on our youtube page. The second half of this interview will be posted in another blog in the coming weeks.

In one of the earlier chapters, you talk about your own experience as a mother. When your daughter first kind of crushed on somebody, she used the language, “I’m so gone”. You described your feelings as a parent, as a mother, as also feeling like your daughter was so gone from you as an attachment figure. What should be concerning when teens are so “gone” from their own core sense of self in relationships? 

It’s developmentally appropriate, they’re supposed to be having these feelings. They’re developing sexually and emotionally and they essentially are supposed to be on a journey of finding new attachment figures to replace us with. Not as their new mother or father, obviously, but as their peer, main attachment figure. This is what we do as human beings. It is how the species perpetuates itself. It is how we all have the promise of living healthy relationship lives. This is part of what keeps us healthy. Parents may think: This can’t be healthy, because everything is about the other person and the enmeshment of the relationship, and that, of course, can be cause for concern. If you can, engage your child about this. Sometimes even they feel like less of themselves and that can be a very hard thing to interfere with. But, it is absolutely something that, if you have some language for it, can be a real awakening for a young person. Ask: Do you feel like more of yourself? Do you feel like less of yourself? They might not necessarily say, Hey, Mom, you just made me see the truth of this situation. This dude is gone. It may not happen that way, but you know how young people are. They hear you, even if they don’t always let on that they hear you. So this is one of the ways that parents can offer ideas and language to help them assess how gone they are and if it’s healthy. If it’s not ask your child what might they want to be thinking about to change that?

What would you say to parents about how to prepare themselves? Not talking about having conversations around sex, but how to prepare kids for understanding what will happen to them when they initially fall in love?

Young people will be exposed to representations of romance, desire, and love from a very early age. I mean, this is in Disney movies, right? So you can actually start those discussions really early. And I definitely did with my daughter. We had an ongoing joke about Snow White and the foolish things she did. Why is she opening the door for strangers? Just overall, whenever we saw a representation of love on screen, we would engage about it. What I talk to my students about a lot is that this is a force that can be very disorienting and very intense, and it can lead to wonderful things. As Helen Fisher says, it’s a great addiction when it’s going well and a horrible addiction when it’s going badly, but it ties us to something that is so fundamental to being human. If we didn’t have these feelings, we would not open the door to lasting, loving, romantic relationships. It can be very redeeming for young people to hear that it’s not just because I can’t control myself that I feel this way. It is a part of the life force of being a human being.

What did you find when interviewing parents about what emotions got raised as they witnessed their kids emerging romantic lives?

A friend of mine read an early version of this book and her comment was, “we’re all still recovering from being teens”.  Parents get very stirred up by watching their kids enter the teen years, because it brings up a lot. It’s like they get to have all the firsts again. They hopefully get to do it better than we did, right? It stirs up regret, longing for different lives, nostalgia, all kinds of things I think we all go through. Fathers tend to get depressed watching their sons date, but they also have a rise in self esteem. That was like a wacky finding from that study, and it’s almost like what their sons are doing out in the word world sexually, is some reflection on the fathers, where the mothers tend to have these feelings of, you know, regret and longing, should I change my life and things like that. 

I think that what I have heard from parents is a lot of “I don’t want my child to turn out like I did, or to go through what I did”. If they had experienced sexual assault, dating abuse, domestic abuse, or anything traumatic, they felt very concerned about what could happen to their child. Sometimes that really opens them up in a really beautiful and inspiring way, then sometimes it shuts them down where there are things they literally couldn’t see because they were still in their own stuff. One of the big messages in my book is for parents to take that time to really tune into what they’re going through and not impose it on their child. Their child, at this juncture, really needs to be seen and heard for what they are going through at the moment. 

Children are often very curious about their parents’ past romantic lives. It’s not like you can never bring that up. They’re really powerful, lasting cautionary tales that teens will quote to me. The timing of this disclosure is really important. If your child is in strife about a breakup, for example, this is not the time to go into your worst breakup when you were 15. Timing is everything. So it’s just really about when you bring these things into the conversation that’s really important. Also, to just know you’re going to need care for yourself if it really stirs up a lot. You want to try to find that balance between acknowledging some of the reasons for the ways you react and the policies you set and giving your children their own reality in this journey. It opens up a space for parents to start to connect on a deeper level about what they were going through intergenerationally, and not just like one person’s past and one person’s present.

How do we prepare kids to think about what they are interested in having in a sexual encounter?

One of the things that parents get really concerned about is relationship policy, like, what do I do? I think there are some interesting conundrums that come up because we have to figure out what kind of space is okay in our homes for our children to explore their sexuality? At what age is the closed bedroom door okay? At what age is the sleepover okay, if it’s ever going to be okay? I think when I got to those questions in my own life, I was really fascinated by things that I felt okay about and things I didn’t. A young woman I interviewed for the book told me that she would ask her parents to go out to dinner when she’s just having a date. She’d basically say, like, Mom and Dad, could you please go out to dinner? I’m going to have this person over. She said they knew that this was basically: will you give me privacy to have sex? And I thought to myself, “Oh my God, this is so great, but I can’t do that”. I just can’t do it! I can’t be that open. I felt really confused about that, and I struggled to express it in our family policy. And then I finally kind of figured out a language, which is that I really wanted my daughter to be aware of pleasure and equality. We have talked about it in a limited way, and she often was like, “No, Mom, no, I know about that, conversation over”, but at least we got it out there, right? So we both know it matters to us. 

But then we need to be open about giving kids space to truly explore, which, especially for girls in heterosexual relationships, means talking about the fact that the boy orgasm is automatic while the girl orgasm is an art form. And our art takes time. It takes privacy, it takes being relaxed. I sort of struggled with feeling a little bit like a hypocrite for this, until I finally said, You know what, I want you to know that I really value the privacy around this. I think I figured out a kind of unspoken way to talk about it that wasn’t quite as explicit. My husband and I just started to leave more open spaces and made sure she knew they were open spaces.

First Love: Guiding Teens through Relationships and Heartbreak, is available to the public on February 4th, just in time for Valentine’s Day! 

The Silent Crisis: Men’s Health

Men’s medical self-care has long been a topic avoided by men. However, it’s a critical issue that deserves to be amplified. On average, men live 5 years shorter than women, and often experience poorer health outcomes and die earlier from preventable causes. A study published in Psychology of Men & Masculinity names 11 distinct masculine norms in society that men view as “ideal” — winning, emotional control, risk-taking, violence, playboy, self-reliance, dominance, primacy of work, heterosexual self-presentation, power over women and pursuit of status. Partly due to these pressures on men to adhere to these “masculine” ideals, men’s health actually suffers. As therapists, it is crucial to open up conversations about medical symptoms and conditions with men who are in psychotherapy.  

The Toxic Mask of Masculinity and Its Impact on Mental and Sexual Health

Since societal pressure on men to present as strong, independent, and emotionally stoic it discourages men from seeking the proper medical help, even when they’re struggling with physical or mental health issues. As a result, many men delay seeking medical attention, leading to more severe health problems. Men die earlier than women, despite having more socioeconomic resources. According to a study by the American Sociological Association, men with strong masculinity beliefs are half as likely as men with more moderate masculinity beliefs to receive preventative care. 

Even when men with high masculinity beliefs are educated on the importance of preventative care, the likelihood of them seeking out care actually decreases as their occupational status, wealth, and income increases. In another study done at Indiana University among Black men in Chicago, researchers found that masculinity, but not socioeconomic status, was positively associated with excellent self-reported health, leading them to choose NOT to seek out preventative medical care. 

How does this stoicism get seen in a sex therapist’s practice?  Men tend to suffer in silence and avoid intimacy with their partners (if married or partnered) for months in order to prevent being viewed by their partners as broken or lacking in so-called masculinity.  They also feel deep shame if they can’t “perform” sexually, which is indicative of how they understand what sex is supposed to be; that is a performance.   Their erectile and/or ejaculatory challenges or disorders also impact their mental health, decreasing the ability they may have had before to express emotional intimacy and may have the domino effect of their partners feeling like they are no longer attractive to their male partners.  It is usually when a man is given an ultimatum by their partner who threatens to break up or divorce them unless they go to sex therapy or if the man is unpartnered, he finally accepts that he needs help that he agrees to seek out sex therapy. 

The Role of Therapists in Men’s Mental and Sexual Health

In 2021, nearly 80% of deaths by suicide are men. Additionally, the NIH reported that 60% of men who died by suicide had accessed mental health care in the past year. Although many men do not seek out preventative mental health services, when they do, many clinicians may not accurately assess their mental health and sexual health diagnoses. It is shown that depression in men often presents differently than in women, leading many clinicians to misdiagnose when men are actually struggling. And, since the majority of general clinicians and couples counselors aren’t trained and/or comfortable asking about their clients’ sexual health and function, erectile or ejaculatory disorders are missed as well.  In a 2019 study(1) of 79 mental health professionals, only a third of the participating psychiatrists and psychotherapists stated they addressed sexual health in patients as part of their daily routine. 25% of the physicians suspected sexual health problems in 60–100% of their patients but did not ask their patients about whether they had sexuality concerns.

Based on the 11 masculine norms for men stated earlier in this blog, research by the NIH has shown that the masculine norms of Self-Reliance, Playboy (i.e., desire to have multiple sexual partners), and Violence, had heightened risk of Depression symptoms.  These traits may differ greatly for women, leading certain therapists to not be able to note key warning signs for men. Aggressiveness, substance abuse, and risky sexual behavior can be telltale signs of Depression in men but may not be directly screened for by therapists.

More research is needed to understand the ties between negative health outcomes and masculinity. Organizations like Movember, the Canadian Men’s Mental Health Foundation, and HeadsUp Guys all have great toolkits for therapists to battle the biases we all carry to help men with their mental health. Non-profits like The Sexual Medicine Society of Sexual Medicine Foundation and the Urology Care Foundation are good sites to get accurate sexual medicine information. 

While the month of November has ended and with it, men’s mental health awareness month, all medical and mental health professionals need to become more confident and better informed around mental health and sexuality related disorders to better serve their male clients all year round.

November is Men’s Health Month, an important time for men to think about their physical, mental, and sexual well being. The Movember organization works to bring awareness and create programs to battle against the stigma of men’s physical and mental health. On average, cis-gender men in the United States die 5 years earlier than their cis-gender female counterparts. According to Harvard Health, there are multiple reasons for this:

• Men generally work more dangerous jobs
• die by suicide at higher rates than women,
• are less socially connected and
• generally avoiding doctors more often.

Hannah Farrimond, a sociology researcher based in the UK, describes this avoidance of medical help as a way for men to feel more masculine and in control. In her study, she describes that her subjects felt as though not seeking out help from anyone else was their way of acting responsibly and maintaining their masculinity. By taking matters into their own hands instead of relying on a medical professional, they feel stronger and more capable.

It is often very difficult for men to put down the facade of feeling strong and masculine when thinking about their physical health, but things really compound when we talk about men’s mental and sexual health. In an extensive 2018 literature review of 49 published studies in The Journal of Sexual Medicine the nexus between erectile dysfunction (ED) and Depression in men was discussed. The findings suggested that men with ED are significantly more likely to experience depressive symptoms than those without ED. While the review found this link, it remains unclear which is the cause and which is the effect. From a behavioral model perspective the authors state that “patients with depression tend to engage in negative thought and are less confident, which results in performance anxiety that further reduces erectile function”. On the other hand, the “biological model postulates that depression affects the hypothalamic pituitary adrenocortical (HPA) axis, leading to excess catecholamine production, which in turn, leads to poor cavernosal muscle relaxation and ED”. In clinical practice, therapists find that when men’s sexual prowess and mental strength are being questioned, many report feeling emasculated due to societal pressures instilled in them from early ages. They commonly begin to avoid all intimate touch or even verbal expression that might be interpreted as a sexual initiation by a partner. 

Societal expectations for men to be tough, competitive, emotionally stoic, and the primary breadwinners can result in men neglecting preventative health measures, especially when it comes to mental and sexual health. While the tie between depression and ED is apparent, our society still makes working through these issues even more difficult. Therapists should understand how to have clear, honest, and compassionate discussions with their male clients surrounding sexual wellness. Since studies and sexual therapy clinical observations support the biopsychosocial-sexual connection between ED and Depression, therapists need to get more training and sense of comfort in asking their male clients about their sexual health and functioning in addition to screening for their mental health.  General therapists might need to learn more about how each client’s or couple’s challenges are frequently complex and varies from case to case  It’s important that clinicians treat ED as a multifactorial condition frequently requiring a multidisciplinary team approach which might include:

• urologists
• sex therapists
• pelvic floor physical therapists
• oncologists.

While there are PDE5 inhibitors (like Cialis and Viagra) and other medical interventions that treat symptoms of ED, medical providers often forget the importance of the psychosocial-sexual-spiritual component of sexual wellness. Researchers at the European Society of Sexual Medicine published a 2021 report stating that there is “increasing evidence that psychological treatments of ED can improve medical treatments, the patient’s adherence to treatment, and the quality of the sexual relationship”. Since many general therapists aren’t trained in sexual health issues and specifically male sexual disorders, it might be more intimidating to ask detailed questions regarding ED symptoms including; timing, frequency, how full an erection is, and the history of the disorder.  If general therapists gain more sexual health information while also becoming more comfort in asking these questions, they can support their male clients through the stigmatized barriers that society has put up around sexual expression, while inviting them to seek out medical care and treatment for the biological aspects of their symptoms leading to an emotionally healthier and a more fulfilling sex life.  They may also provide the support they need in going to a urologist or a cardiologist since many research studies has shown that early signs of ED can be red flag warnings to future cardiovascular disease. 

In order for therapists’ male clients to feel empowered emotionally, physically, and sexually, clinicians must be ready to get more educated on how to assess for sexuality related issues and disorders that may feel taboo to bring up or had previously not been part of their own training and education. Encouraging male clients in psychotherapy to express more of their sexual health and psychological challenges is key to men gaining the medical and emotional treatment needed. By expanding their training and becoming biopsychosocial-sexual and spiritually clinicians, psychotherapists can model for their male clients to overcome the stigmas society has engrained in them.  Therapists can offer them guidance and support to seek out appropriate medical professionals which will not only help them to improve their mental health but will get targeted treatment for sexuality and sexual-health related disorders which can also prevent potentially serious medical problems down the line.

Why do heterosexual women climax less often than their lesbian and bi peers?

According to a 2024 study published in the Journal of Social Psychological and Personality Science, 65% of heterosexual women, compared to 95% of men, report experiencing orgasm when having sex, which reveals a significant contrast in orgasm rates between heterosexual women and men. However, this gap diminishes substantially when considering lesbian women, among whom 86% usually or always experience orgasm during sex. Additionally, the orgasm gap almost completely disappears when women engage in masturbation or self-pleasuring involving clitoral stimulation. Therapists working with clients need to feel more comfortable in speaking wtih their clients about their sexual behaviors and fantasies in order to support diverse definitions of pleasurable sexual experiences and to encourage more agency around speaking about each of their sexual and erotic needs. As we celebrate Pride, it’s time therapists and clients become more curious about the underlying factors contributing to the orgasm gap between queer and heterosexual women. This curiosity to ask more directly about clients’ sexual challenges and interests allows for increased erotic intelligence both in the professional and layperson population. It can also hopefully facilitate female-identifying clients to feel more sexual confidence to explore their needs when it comes to reaching orgasm.

The Orgasm Gap

The concept of the ‘orgasm gap’ stems from previous research highlighting the statistic that heterosexual and gay men experience orgasms more frequently than women during partnered sexual encounters. Additionally, this term can also speak to the difference in reported orgasm rates between lesbian and heterosexual women.

According to Grace Wetzel, one of the study’s authors, “there is nothing inherently biological” about why an ‘orgasm gap’ exists. In other words, the majority of women have the physical ability to climax during sex, yet, heterosexual women don’t report having orgasms in partnered encounters nearly as frequently as men.

According to the 2024 study by Kate Dickman et al., orgasm frequencies vary not based on gender but based on sexual orientation. The study shows a notable 21% disparity in orgasm rates between straight and lesbian women, whereas the gap between straight and gay men is only 6%. Continuously, bisexual women also report low rates of orgasm that more closely resemble the rates of straight women. However, one of the study’s most intriguing findings, was that 64% of bisexual women experience orgasm when their partner is a woman compared to 7% when their partner is a man. Therefore this study suggests that the difference in orgasm rates may be due to the gender or the partner during sex and/or what kinds of sexual activities in which they participate.

Social Scripts and How They Affect Orgasms 

Given that the traditional scripts about sex involve “foreplay,” vaginal intercourse, and the man’s orgasm, clitorial stimulation is often overlooked in media, conversation, and education about sex. Research indicates that breaking away from these predefined scripts can result in increased sexual satisfaction and orgasm rates. Additionally, when women experience fewer orgasms, they may begin to devalue them during sexual encounters. This study underscores the inadequate focus on clitoral pleasure when cis women engage in sexual activity with men, especially considering that many women do not achieve orgasm through penetration alone. How can women effectively communicate their needs, and how can men and partners ensure their female counterparts experience equal pleasure? What changes occur when traditional sexual scripts are discarded?

What We Can Learn from Queer Couples

In 2003, The Gottman Institute conducted a groundbreaking 12-year longitudinal study on gay and lesbian couples, one of the first of its kind. The study revealed that during conflicts, gay and lesbian couples exhibit more positivity, are better at comforting each other, and demonstrate greater kindness compared to heterosexual couples.

Additionally, queer couples were found to use fewer emotionally manipulative and hostile tactics, which researchers interpreted as indicative of greater fairness and power-sharing dynamics within these relationships. The research also showed that the Gottman Method Couples Therapy was twice as effective and required half as many sessions for gay and lesbian couples compared to heterosexual couples. Based on both research studies, queer couples serve as exemplary models for effective communication, innovation, exploration, and mutual satisfaction in sexual encounters.

While queer couples enjoy advantages like increased orgasm rates and more equitable power dynamics, they also encounter distinctive challenges. Queer individuals may face higher rates of prejudice, contend with greater internalized shame, and may find self-acceptance more difficult. However, there are many lessons we can extract from queer relationships to benefit our own intimate relationships in general.

Lessons to increase pleasure:

1. Center female pleasure during sexual encounters, which involves expanding beyond penetrative sex alone.
2. Take some time by yourself to learn what you like and don’t like.
3. Explore the use of toys and engage in sexual activities that focus on clitoral stimulation, ensuring comfort and consent throughout the experimentation process.
4. Gently massage the surrounding area of the clitoris as an alternative to direct stimulation, recognizing that direct contact may feel overwhelming or painful for some individuals.
5. Be mindful of erogenous zones such as thighs, neck, nipples, and breasts during sexual activity, paying attention to their stimulation both leading up to climax and throughout the experience.
6. Incorporate lubrication to enhance smoothness and comfort during stimulation, facilitating a more pleasurable experience.
7. Communicate your needs to your partner and listen to what your partner needs in and out of the bedroom

Key terms for cis-gender females to learn as part of a Sex Esteem® tool-kit when it comes to penetrative sexual pain.

According to a nationally representative study of American adults, about 30% of cis-females have experienced pain during vaginal penetrative sex. When sex therapy cis-female clients come to treatment for individual or couples treatment, one of the issues they’re asked about is whether and how often they have had pain during vaginal penetrative sex. Painful sex not only impacts the cis-woman experiencing it but her partner(s) as well, especially if the pain has occurred over months or years. This is why painful sex should also be treated in couples sex therapy when a client is involved in a committed partnership or marriage.

There are several diagnostic terms that are used by medical professionals, therefore as part of developing one’s Sex Esteem® confidence it’s important to learn some key terms when discussing sexual pleasure with partners and treatment needs with medical professionals. 

Here is a primer on best principles in seeking help,  the most common terms, assessment techniques, and explanations for women to learn if they are experiencing sexual pain.  

Sex Esteem® Principles around Seeking Medical Care for Sexual Pain

Many cis-women have suffered with GPPD for years without getting a proper diagnosis from their medical professsionals. One reason may be due to the fact that of the 43% of American women aged 18 to 85 who report experiencing some form of sexual complaint, only 12% self-report to a provider.  In fact,  a woman might use understated terms like ‘discomfort’ or ‘uncomfortable’ when describing the sensations they’re experiencing during vaginal penetrative sex to their gynecologist instead of the word ‘pain’. 

Part of the Sex Esteem® Principles is to empower clients to become their own best advocates when it comes to reporting pain to medical providers. A sex therapist will coach clients to use a numbered scale system out of 10, when describing the level of pain, to discourage them from minimizing the level of pain by using mild adjectives. A sex therapist should also teach women to use the proper terminology to identify and tell their ob/gyns the location of the pain and by coaching them with these key questions that should be asked by their doctors:

• If their vestibule (vaginal opening) is a clock that their provider is facing when examining them, what o’clock is the pain usually felt upon penetration? 3 o’clock,6 o’clock, etc? 
• Is the sensation they feel more like burning, cutting or tearing and is it on the inner labia or both inner and outer labia? What level of pain is it on a scale of 10? 
• During penetration, does the sensation feel like searing pain or an aching thudding pressure against their vaginal walls? 
• Do they feel a sharp pinch when a dildo or penis bumps up against their cervix during penetration?
• Before making an appointment with a new gynecologist, we will practice asking a medical provider if they utilize a Q-tip assessment of the vestibule as part of their exams. 

The second challenge for cis-females seeking medical care for vaginal pain is that the majority of ob/gyns unfortunately have not had any or much training and clinical experience in female sexual disorders during their medical school education or their residencies. A recent survey reported that out  of 236 American medical school students, 58.5% reported receiving instruction in female sexual disorders (FSD) compared with 78.4%  who received training in male sexual disorders (MSD) in their preclinical curriculum. It’s clear that medical schools have to do more to increase the amount and depth of training around FSD. 

Pelvic Floor Muscle Dysfunction (PFMD) & Physical Therapists

The pelvic floor often refers to the muscles, tissues, nerves, and ligaments that are a bowl-like structure that supports one’s pelvic organs used for digestion, urination, and sexual activity. Research has shown that 25% of women experience one or more pelvic floor disorders in their lifetime. Pelvic floor muscle dysfunction (PFMD) is often classified into two main types:

Hypertonic: the muscles in the pelvic floor have tightened at rest and/or shortened, which causes spasms or pain.   

Hypotonic: the muscles are lengthened at rest, which weakens them. It is hard to contract your muscles with this condition.

Most cis-women who seek out sex therapy after years experiencing pain during sex require a multi-disciplinary biopsychosocial approach that includes a pelvic floor physical therapist to teach them how to strengthen hypotonic muscles and to provide pressure point massage to release hypertonic muscles.  

Most Common Sexual Pain Disorders and Proper Diagnostic Terms

1. Sexual Pain Disorder: Genito-Pelvic Pain/Penetration Disorder (GPPPD)

The Diagnostic and Statistical Manual of Mental Disorders (DSM5) categorizes Genito-Pelvic Pain/Penetration Disorder (GPPPD) is a sexual pain disorder, occurring in the vagina, the vulva, the opening and/ or inside the belly either during vaginal penetration, or spontaneously. 

1. Vulvodynia: chronic pain in the entire vulva, or in multiple areas in the vulvar region.
2. Vestibulodynia: pain in one’s vestibule, which is the tissue, at the opening of the vagina, within one’s vulva. 
3. Neuroproliferative Vestibulodynia (NPV): Women often have too many nerve endings in their vestibular tissue.
4. Vaginismus This term was removed from the DSM 5 since most women who have fear, anxiety and accompanying involuntary vaginal muscle spasms usually also have a co-occurring pain disorder so this term was incorporated into the updated GPPPD diagnosis described above.  However there are many women who have fear and spasms who have NOT experienced pain and the spasms are due to a phobic or trauma related response.  These may be women with a sexual trauma history and/or have grown up in a strict religious upbringing.  

Sex therapists conduct a thorough sexual history when working with clients to find out how long a woman has experienced Vulvodynia and Vestibulodynia or NPV, where exactly it is felt, under what conditions and how they have dealt with it when it comes to their sexual relationships. They also work with the woman with her partner or husband in order to teach them alternative techniques to increase both partners’ sexual pleasure and avoid continued painful experiences. As we know from both clinical care and research, partners exploring other types of sexual play and oral or anal penetration may experience high rates of pleasure and orgasm while a woman is getting treatment for her GPPPD. 

They’ll ask if the condition is Primary (meaning they have had pain their whole life) or

Secondary or acquired (pain developed later in life). They’ll also ask under which conditions the pain occurs; is it when the area is touched or during insertion of a tampon, finger or penis/dildo (provoked) or quite spontaneously while walking around or sitting (unprovoked)?

Sex Esteem® Steps to Advocate For Yourself if You are Experiencing Pain or Spasms:

1. Read up on how a sexual health professional conducts an exam on a recently created ISSWSH self-help handout or at Prosayla. 
2. Find an ob/gyn who is educated in diagnosing and treating sexual pain using a biopsychosocial framework through ISSWSH. 
3. Write down a highly detailed description of the pain and conditions you’re experiencing along with how long each symptom has been experienced before your scheduled ob/gyn appointment. 
4. Request a very specific exam of the pelvis, vulva, and vagina including the Q-tip test for mapping and diagnosing pain in the vulva.  (NOTE: if your provider does not offer this type of diagnostic test it may be a sign that they are not trained in sexual pain disorders). 
5. Work with an experienced sex therapist individually and/or with your partner (if in a longstanding relationship) to re-learn how to engage in pleasurable sex while re-establishing new neural pathways in your brain in approaching sex. 
6. If needed, get referrals for a pelvic floor physical therapist from your trusted ob/gyn or sex therapist or through the International Pelvic Pain Society. 
7. And remember, one shouldn’t continue to have penetrative sex if it hurts. 

Goodbye to cuffing season and hello to horny season

As folks transition out of winter and have re-set their clocks forward, it is critical to better understand how single people can approach consensual flirting this spring fever season. Given the turnover from what singles describe as cuffing season to horny season, appreciating the nuanced shades of what exactly do these terms; flirting, wanted vs. unwanted attention, signaling actually mean? Defining and disentangling misinformed beliefs about giving and receiving attention is essential to understanding flirty and/or mating cues whether on date #1, and any subsequent date and/or sexual encounter. 

Unwanted Sexual Attention vs Flirting

A 2015 study of 52 opposite-sex pairs of college students found that only 36% of men and 18% of women accurately identified when the opposite gender was actually flirting. This study suggests that males “over-estimate female interest so as not to miss an opportunity to mate, thereby rendering their judgment more accurate when females are actually flirting, but impairing judgment when they are not flirting.” This study then found that third-party observers of these interactions did not predict flirting any better. The third-party observers detected flirting when it happened only 38% of the time. Given the coupled context of flirting, which typically requires that one individual be more active while the other partner take on a more following or receiving role, the predominance of gender role beliefs in predicting behaviors may reflect the perception that a certain role must be taken on for the flirtation dance to move ahead.

Gendered Interpretation of Flirting Signals 

Since many dating clients report that they have trouble picking up on flirting cues, how can help clients differentiate between unwanted advances and actual flirting? Even more so, how can a person agree to flirting without agreeing to anything when people can not even identify when or if they are flirting? A 2023 study examined gender differences in the aftermath of unwanted advances. They found that 71% of women in the study reported experiencing unwanted advances earlier in life compared to men, and additionally have more negative experiences and worries about rejecting unwanted advances. Given this, how do women’s flirtation cues get misinterpreted by men? 

A 2024 study on how men perceive women’s sexual interest found that when women’s global cues(i.e. clothing or appearance) and specific cues (i.e. facial expression) were conflicting (not aligned with one another) about sexual interest towards men, men often misinterpreted the women’s intentions to mean she was interested. Furthermore, according to this study,  researchers found that if a man was sexually aroused or if he usually looked upon women as sexual objects, he would be more likely to misinterpret a woman’s cues thinking she was interested when she wasn’t. 

How to Manage Expectations in the Dating Sphere

When single therapy clients discuss their anxiety around getting back to dating apps after taking a pause or starting to date after a breakup or divorce, they are feeling unsure of how to show interest so that they can go at their own pace.  Many of them find their date is more sexually assertive and at times aggressive when they’re not ready for that level. They ask for help through coaching on how to set their date’s expectations non-verbally and/or verbally. At other times, dating clients express frustration in session when they believe they are explicitly expressing themselves in a flirty manner on a date and interpret their date’s responsiveness as mutual interest only to find that they have been ghosted a few days later.  

The Influence of Gender Re-Flirting Behaviors

A 2021 study exploring what influenced non-verbal flirting which included heterosexual, bisexual, lesbian and gay participants from a college community in western Canada found gender, rather than sexual orientation, to be the primary predictor of flirting techniques. What researchers found was that “men who globally identify as masculine will be particularly likely to select masculine-typed flirting behaviors which fulfill this traditional role. Gender-role beliefs, however-which have to do with relations between men and women-did not predict flirting behaviors. Thus, for men, the individual’s identification with the traditional norms of their gender, rather than their beliefs about gendered relations, are more important to flirting behavior.”  

Interestingly, “for participants who identified as women, sexual orientation did not emerge as a predictor of flirting behaviors.” Their results support the findings of previous research, “in that they indicated no difference in flirting styles between heterosexual and sexual minority women.” However, what researchers found in this study is that what did impact women more critically in flirting behavior were their beliefs about men’s and women’s roles rather than their self-concepts of femininity or the adherence to a traditional feminine identity.

However, it is also important to note that the sample of people who identified as non-binary participants was minimal. Therefore the analysis of flirting in individuals who identify as non-binary is limited. Similarly, the measures used to determine flirting were also based on studies and measures designed for heterosexual samples, and thus, it is hard to truly say whether these scales accurately portray flirting patterns of gender-expansive and queer populations. As gender becomes more fluid it is hard to say how applicable any of these measuring scales truly are as ideas around gender expand. Nonetheless, these results do shine a light on the presence of traditional gender role behavior when it comes to flirting. 

It is important to note that most of the other studies were also done with entirely, or mostly, cis-gender white heterosexual participants, which may make the results less generalizable to queer-identifying, gender-expansive, and people of color . However, these results call for more clear communication skills and boundary-setting techniques in dating and new relationships. 

Signal Sending, Receiving, and Consensual Communication

It is essential to note that if you’re sending signals that aren’t being mirrored back or reciprocated, that should be taken as a sign that the flirtation is not mutual and to back off. If you interpret that someone is mirroring back your flirtation, check in on your interpretation by asking them if they’d like a hug. You can tell them you’re really attracted to them, and wait to see if they respond in kind. If you think they are leaning in and sharing personal space with you and smiling and connecting with your eyes a lot, and you’re into them, ask them if you can kiss them. It’s a first step that many people skip over but is essential to beginning consensual communication early on in a romantic or sexual relationship. 

You can also flirt by telling a date you are thinking about what it would be like to kiss them and see if the person responds that they too are curious about what your lips would feel like. Talking about doing a sensual or sexual thing can be a sexy type of flirtation and is a way of feeling out verbally whether your interpretation of non-verbal signals is accurate.  The 2nd partner might not want to kiss at that very moment, so an option they have is to say in a flirty inviting way: I’m not ready at this time but definitely ask me next time we’re out, or at the end of the night. It can be fun, and light, and yet express the notion that sexual interest might not be mutual at one point but could be revisited at a later point. This is a more nuanced way of keeping an erotic seduction vibe while maintaining consensual language embedded in the dating experience.

Techniques to Embrace a Fun Flirty Spring

1. Practice eye gazing with short pauses looking away as a form of showing interest in a person you’re interested in at a social gathering or on a date. 
2. If you’re finding yourself attracted to a person, let them know by moving towards them and perhaps asking to touch their shoulder or forearm as you’re telling a story. If you find you’re less interested in them, move back in your seat, do not touch them, and cross your arms to show less openness in your body language. 
3. If you feel someone is showing you more attention than you’re comfortable with, break eye gaze more frequently, take more distance from them, and maybe end the date a little earlier. 
4. When someone touches you and you’re uncomfortable, you can either move further away or verbally let them know you’re sensitive to touch and would prefer not to be touched at this time. If you are interested in the person, you can let them know that you take a while to warm up to someone and that you are interested in them.  
5. If you are feeling unsafe or pressured by a date partner, you can end the date by either saying you have been feeling under the weather and need to get home earlier than you expected or that you have an early start at work the next day.