Introduction to the Special Issue: Sex Positive Art Therapy

When I was a teenager in the early 1990s, the chorus to Salt-N-Pepa’s hit song Let’s Talk About Sex concluded, “Let’s talk about all the good things/And the bad things that may be.” It always seemed to be on the radio except for Sunday nights when the local top forty music station broke from its regular playlists to air Lovelines (www.lovelineshow.com). This call-in program for expert advice on all matters related to sex offered a counterpoint to my public high school sex education with a focus on puberty and anatomy, reproduction and birth, and safer sex practices to avoid pregnancy and sexually transmitted infections (STIs). What Lovelines and more recent similar pop culture offerings, such as Savage Love (https://savage.love/savagelove) and Netflix’s Sex Education, offered is not only a range and non-heteronormative perspective to sexuality but an inclusion of joy. While in university, I enrolled in a year-long psychology course on human sexuality that coached us as peer sex educators in residence halls, classrooms, fraternity and sorority houses, and in the community. So, when I started working as an art therapist and professor, I transitioned what I knew, with subsequent learning, into my new role.

I took for granted that my comfort talking about sex with clients was uncommon; a reflection of social taboos in professional settings. Fortunately, contemporary practitioners and educators have access to reliable resources from organizations, such as American Association of Sexuality Educators, Counselors, and Therapists (https://www.aasect.org) and National Coalition for Sexual Health (https://nationalcoalitionforsexualhealth.org). Still, there continues to be a dearth of information specifically by and for art therapists. The rare exceptions were an annual panel on sex positive approaches at the American Art Therapy Association conference (Clark et al., 2017, 2018; Kirby et al., 2019) and Metzl’s (2016, 2020) descriptions of clinical work and recommendations for graduate training (Metzl, 2013). This special issue, which combines seasoned practitioners and new professionals, provides frameworks and practical applications that offer intentional ways to promote healthy sexuality through sex positive attitudes and approaches in art therapy.

Sex is an innate human behavior but much of the research and interventions in these areas tend to focus on reducing threats to public health (unintended pregnancy and STIs) or individual and relational health (sexual disorders). These narrow foci limit the more expansive areas described as the Circles of Sexuality (Dailey, 1981): sensuality (experiencing pleasure), intimacy (emotional closeness), identity (gender expression, roles, sexual orientation), behavior (procreation and recreation; solo and partner[s]), and sexualization (seduction, coercion). In parallel with these ideas, Nancy Lautenbach’s cover art, Nature Knows Sex, collages her own photographs that offer a compelling visual and inspired message in a colorful, stimulating, and empowering image of holistic women’s sexuality.

When notions of sex are restricted or omitted, art therapists obscure the various health benefits of sexual expression—short-term (pleasure, stress relief, intimacy), intermediate term (pregnancy, mood regulation, anatomical functioning), and long-term (heart health, quality of life, satisfaction; Gianotten et al., 2021). Three articles provide means by which art therapists can be proactive with clients. Michaela Kirby introduces sex positive concepts to describe a set of competences for art therapists. She offers reflective and engaging exercises rooted in her own teaching for readers to increase their proficiency. Daniel Blausey provides the results of a survey study as to how art therapists engage in sexuality dialogues with clients to emphasize both art therapist preparation and client benefits. Zachary D. Van Den Berg and Mikey Anderson offer a specific framework when working with LGBTQ+ clients based on their adaptation of queer worldmaking in art therapy centered on ethos of care, radically inclusive studios, and critical connections with(in) art and community. These authors offer a secure foundation for art therapists to further their own education, reflect on their own attitudes, and prepare to work in sex positive manners.

Within health and mental health therapies, sex positive approaches emphasize a supportive and non-judgmental stance, uphold the diverse and cultural elements of human sexuality, and respect individual determinations of sexual pleasure based on accurate sex education in respectful, consensual relationships (Cruz et al., 2017). In addition, therapists need to be attentive to how they facilitate sex positive interactions in trauma-informed ways (Fava & Fortenberry, 2021). Two case studies directly illustrate these concepts. Shirin Mazdeyasna provides an intimate and thoughtful description of individual short-term art therapy with a client navigating her sexuality amidst the intersections of Muslim and Iranian identities. Haley Hasen describes how an open studio approach offered to sex workers provided a space for affirmation, autonomy, and empowerment. Both authors pay careful attention to trauma-informed and intersectional attention to their clients as part of a concerted sex positive approach.

To call attention to human rights and social justice, the World Association for Sexual Health (2014) Declaration of Sexual Rights demands respect and protection for all humans to engage in consensual sexual activity, access to sex education and related healthcare, and pursue a satisfying sexual life (Kismödi et al., 2017). Tamara Galinsky describes how dioramas of one’s sexual self can yield to explorations of sexual empowerment, body acceptance, gender identity, trauma integration, and further development. Jordan Ferranto offers how she incorporated vulva education through soft sculpture and zines in a process that originated in her own art making that she gradually extended to clients. Each of these encounters demonstrates how intentionally selecting materials and metaphors can support sex positive advocacy.

The various contributions offer encouragement and direction for readers, whether the presented ideas are new or helpful reminders. In their closing commentary, Sarah Watson and Michael Giordano, who are both certified sex therapists and served as specialist reviewers, reflect on their own journeys from being informed to becoming appropriately credentialed and offer a challenge to readers. Overall, this special issue documents, models, and inspires art therapists to talk about sex in its fullest.

Disclosure Statement

No potential conflict of interest was reported by the author.