ABSTRACT
Sex therapy with lesbian couples begins with a deep commitment to honoring clients’ entire identities, using client language, and naming cultural discourses operating within the relationship. Intersectionality and pre-emptive radical inclusion are offered as theoretical frameworks for clinicians working with this population. We present two case studies-the first focuses on desire discrepancy in a couple which comprised two women from starkly different class backgrounds who hold different racial identities and who experience differing levels of social stigma and oppression as related to body size. Addressing thin privilege, interrupting fat phobia, and naming the pervasive effects of racist notions of desirability are at the fore in this case. The second case shows how to navigate grief when access to sex is lost and/or changed dramatically due to a medical condition, in this case severe Lichen Sclerosis. Ability and disability, physical pain, grief, and acceptance work are at the heart of this case. These case studies contain samples of therapeutic dialogue to illustrate how a therapist can address larger social forces within the intimate context of sex therapy.
