I’ve always believed that therapy is a space where we can talk about anything and everything. But through my experience, first as a client and then as a therapist, I came to realise that some parts of ourselves often remain unspoken. One of the biggest? Sexuality.

Sexuality is one of the core aspects of the human experience and yet it is one that’s most often clouded in shame and secrecy. Some people can’t even bring themselves to say the word sex, resorting often to phrases like ‘the birds and the bees’, ‘doing it’ or ‘fooling around’.

Whether it’s desire, shame, questions, identity or the complex ways our sexual selves can intertwine with the rest of our lives; sexuality is a space that can feel too taboo, too risky or too vulnerable to bring into the therapy room.

In her book Come As You Are, Emily Nagoski highlights just how deeply sexual shame is embedded in our culture, especially when it comes to women.

Did you know that medieval anatomists named women’s genitals pudendum, a word that literally means “to be ashamed” in Latin? Their reasoning? Since female genitals are tucked between the legs (unlike male genitals, which are visible), they must be something to hide, and therefore,
something to be ashamed of.

It’s a powerful reminder of how ideas of shame around sexuality and the body were built into language itself, and how much of that thinking still shapes our world today.

I remember, early in my career as a therapist, sitting across from a client who hesitated, their voice soft, unsure how to bring up what was on their mind. It was about their difficulties around sex. That moment has stayed with me. It prompted me to reflect on how affirming my own
therapeutic space is toward client sexuality.

Because too often, even in therapy, sexuality is treated like an old photo album left on a high shelf, full of memories, feelings, and stories we might not have had the chance (or permission) to look through. Dust gathers. Shame seeps in.

But why is this important?

Many people carry shame and unresolved pain around their sexuality, especially those with desires that fall outside of what is often considered acceptable or conventional, such as kinks and fetishes. This shame is not just about personal experiences, it is also deeply shaped by the larger messages we receive from the world around us. In many societies, sex is spoken of as something sacred yet also tied to dishonour; open conversations about sexuality are discouraged, and sex education is often neglected or dismissed.

This is especially important for queer individuals. Many queer folks face shame, stigma and trauma, not only around their identity but also, about their bodies and sexuality. An example of how extensive this stigma can be is by understanding the historical association of AIDS with queer communities, particularly gay and bisexual men. During the 1980s and 1990s, the AIDS epidemic was used to portray queer sexuality as dangerous, immoral, and diseased. Governments, Institutions and media used fear-based narratives that framed queer bodies and queer sex as a threat to public health.

Many LGBTQIA+ individuals still carry the echoes of this trauma, whether through internalized shame, fear of intimacy, or heightened anxiety around sexual health.

Sex positive therapy seeks to challenge these harmful norms and offer a space for healing. It’s about fostering a positive, respectful attitude toward sexual expression. As sex positive therapists, we hope to shift not only how clients experience their own sexuality, but also how the larger culture, including other health providers, institutions, media, and the government approach these conversations. At its heart, sex positivity is rooted in self-acceptance and compassion. It promotes consensual, respectful exploration of a person’s sexual self, all within a safe, affirming, non-judgmental
space.

And this matters deeply. Because research about the intricate interplay between sexual health and mental well-being continues to uncover a profound relationship that significantly influences our overall quality of life. The mind-body connection is a powerful one; when one aspect is
neglected or shamed, the other often suffers.

Healthy sexual expression is not just a physical act, it’s intricately tied to one’s mental and emotional states, to how we see ourselves and relate to others. A sex-positive therapeutic space offers a place to gently unpack these layers and move toward a more empowered and compassionate relationship with one’s sexuality.

Clients don’t always walk into therapy announcing their sexual struggles. Sometimes they start with anxiety, depression, relationship difficulties, and buried underneath is sexual shame or confusion.

If we, as therapists, create an atmosphere where these parts of the self feel unwelcome, we’re asking our clients to hide parts of themselves in the very space that’s meant for compassion, integration and healing.

But when we say, through our words, our presence, our training, All parts of you are welcome here, something amazing happens. Clients begin to write new, freer stories about who they are, of their whole selves.

So what is sex-positive therapy?

I’ve had clients who hesitated to talk about navigating non-monogamous relationships, struggled with sexual trauma and felt isolated in their healing, feared judgment around porn use, questioned their sexual orientation late in life. In each of these cases, it wasn’t a fancy therapeutic technique that made a difference; it was the experience of being fully seen and accepted, sexuality and all.
A sex positive therapist can help –

• Create a safe space and affirm diverse sexual experiences like the spectrum of sexuality to asexuality, kink & BDSM, non-monogamy and polyamory
• Support clients in working through shame and healing from sexual trauma
• Facilitate conversations around consent and communication
• Help enhance intimacy and overall sexual well being
• Address body-image issues as they relate to sexuality
• Building pleasure-centered lives
• De-pathologizing queer sexuality
• …& more

Being sex positive as a therapist isn’t about encouraging any one way of being sexual. It’s about embracing the full spectrum of sexual experiences, orientations, identities, and desires, without judgment.

It’s about seeing sexuality as a natural part of the human experience, just like grief, joy, or longing.

And here’s the thing: if we’re not explicitly affirming, we may be implicitly shaming.

As a therapist, I’ve seen how important it is to make space for this part of the human experience, openly, warmly, and without judgment.

That’s why being sex positive matters so deeply in the work we do.

At The bigSmall therapy, all our therapists are sex positive. We believe in creating a space where clients can bring their full, unfiltered selves, including the parts that society has tried to shame or silence. For us, being a sex positive therapist isn’t just helpful , it’s essential.

So if you’re carrying questions, shame, curiosity, or simply longing to explore this part of yourself in a safe space – know that you’re welcome here. All parts of you are welcome here.
Contact us contact@tbstherapy.in or WhatsApp – +91 8850203728

About the author –
Kremika is the co-founder and therapist at The bigSmall Therapy. When not at work, you’ll find her tucked in a corner with a book and hot cup of coffee