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Therapy Withlesbian Couples ‘iflflfifi . 98 c Handbook ofLGBT-Affirmative Couple and FamilyTherapy GOYUDB-II. sex How (2006). Sanfte Couples: gay and lesbian Couples am teach heterasexuals how t0 improve relattonshzps. Retrleved from http://www.gottman.com/49850/Gay--Lesbian-Researchhtm] Gottman, 1., Levenson, R. W., Gross, I., Frederickson, B. L.‚ McCoy‚ Y.‚ Rosenthal, L.‚ Yoshimoto, D 7 (2003). Correlates of and lesbian gay Couples’ relationship satisfaction and relationship dissolution.i Sex With Journal ofHor/nosexuality, 45(1), 23-43. Therapy Lesbian Couples Hertlern, K.M.‚ Weeks, G.R.‚ 8( Gambescia, N. (Eds). (2009). Systemic sex therapy. NewYork, NY: Hertleln. K. G. 8: Routledge. MARLA COBIN and MICHELE ANGELLO M.‚ Weeks, R., Sendak, S.K. (2009). A clinicianä guide t0 systemic sex therapy. New York, NY: Routledge. Iasenza, S. Some (2005). unconscious sources of low sexual desire in gay male and heterosexual peer mar- riages. Contemporary Sexuality, 39(7)‚ 3-7. S.A. Kingsberg, (2006). Talcing a sexual history. Obstetrics Gynecolagy Clinics ofNorth America. 33, 535-547. S. Lerblum, (Ed.). (2006). Principles and practice ofsex therapy (4th ed.). New York, NY: Guilford P['e3s_ 8: Le|blurn‚_S., Rosen, R. (Eds).). (2000). Principles und practfce ofsex therapy (3rd ed.). New York, NY: Gmlford Press. Sex between women has a precarious place in history. Even today, there are plenty of “experts” L.‚ 8: who deem that sexbetween women is unnatural.It is notdifficult to find reorien- Long, Burnevtt, I. A.‚ ihomas, R. V. (2006). Sexuality counseling: An integrative approach. New York, therapists doing NY: Memll. tation therapy. Wornen in same-sex relationships need therapy as much as anyone else. Whereas LoP1ccolo‚ I.,8€l-Ieiman, I.R.(1978). Sexual assessment andhistory interview. In I.LoPiccolo 8:L.LoPiccolo it can be difficult to find a therapist who is well versed in working with lesbians, it is even more (Eds), Handbook ofsex therapy (pp. 110-123). New York, NY: Plenum Press. to find a who is at with lesbian more E- 8KVan challenging therapist adept working Couples. Significantly 043111901311: l—‚ Lankveld, I.I.(2004). Hypoactive sexual desire disorder: An underestimated condi- U011 diflicult than this is finding a therapist who i5 trained, experienced, and competent to d0 sex m men. B]UInternational, 95, 291-296. doi:10.1111/j.l464-4l0X.2005.05285.x Purcell, D. with lesbian it is for this reason that there is a of W, Wolitski, R-1., HOfE C-C. P3130115, I.T.‚ Woods, W.1., 8: HaIkitis‚ P.N. (2005). Preclictors of therapy Couples. Perhaps paucity ernpirical the use of viagra, testosterone, and antidepressants among HIV-seropositive gay and bisexual men. research and little written about sex therapy with lesbian Couples. lt is time for this area of the AIDS, 19(Suppl. l), 57-66. sexuality therapy field to develop so that women in same-sex relationships having sexual dif- Rxtter, K.‚ & A. Terndrup, (2002). Handbook ofafiirmative psychotherapy with lesbian: andgay men. New ficulties can more find the that need and deserve. York, NY: Gwlford Press. easily help they The dearth of reliable information with this community makes it arduous for nascent thera- ifistrada, D. L.‚ 8: G. (2008). Sexual orientation and counselor Rl-lftefärä»e lfefguson, Piggs, competency: to in this area. far‚ the pioneer in this field is Margaret Nichols, lmpact of traunng on enhanclng awareness, knowledge, and skills. Journal ofLGBT lssues in pists develop competency By Caunselmg 2, 209-225. who has been writing about the subject since the 1980s. In 1987, the book Lesbian Psychologies: D. E.‚ 8€Schafft". S. was SChafE. I. (1987). Qbject relarionsfamib/ therapy. Linham,MD: Iason Aronson, Inc. Exploration: and Challenges, edited by the Boston Lesbian Psychologies Collective, pub- L. (2002). Shaplro. .8:R055. Applrcatlons ofnarrative theory and therapy to the practiceof family medicine. lished. Two of this groundbreaking book's chapters were written byNichols (198721, 198713). Her Pamrljz Medrcme. 34(2), 96-100. to G. chapter, “Lesbian Sexuality: lssues and Developing Theory,” highlights what she found be Tunnel], (2006). An aflirmational approach to treating gay male Couples. Group, 30(2), 133-152, common sexual problems among lesbian Couples. Morerecently, Leiblum(2007) wrote the Chap- ter “Therapy With Sexual Minorities" for the popular sex therapy book she edited, Principles and PracticeofSex Therapy. MarnyHall (1998,2004) has written several articles andbook Chap- ters about lesbian bed death and developed a four-stage modelfor working with lesbian Couples. There are several others who have written works that include information on this subject. Many ofthese authors are cited throughout this chapter anddeserve credit for contributing t0 this area ofliterature that is so lacking. It should be noted that in this chapter weuse the Word lesbian when, in fact, weacknowledge that many Couples made up of two women d0 not identify as such. Often women in same-sex relationships identify as bisexual, queer, or otherwise. As therapists, we ask Clients how they identify both as individuals and as a couple in order to ensure that we utilize appropriate lan- guage throughout the therapeutic relationship. Social lssues Lesbians remaina marginalized group, facing continual ridicule, judgment, and sometimes vio- lence. Homophobia and heterosexism continue t0 permeate society. Green (2004) outlines four challenges that may lead t0 problems between Same-Sex Couples. They are societal homophobia and heterosexism, the “lack of [a] normative and legal template for same-sex couplehood," lower levels of family and social Support, and the possibility ofboth partners conforming to “tradi- tional gender roles” (Green, 2004, p. xv). It is imperative to acknowledge both vulnerability and resiliency within the couple. Many women in relationsllips with women have bccn cut ollfrom thcir family oforigin bccause ofthc 99 c 101 u - _ Sex Therapy With Lesbian Couples I00 Handbook of LGBT_Atfirmatlve Couple and Famlly Therapy ' ' ' ' desire than one’s to acce theu’ * -- than one's with orgasm, experiencing greater familys unwillingness pt onentanon. This concePt 0 f bexng d’lsowned can mmally lower desire partner, Problems with lead t0 . ' ' and about sex. Far fewer lesbians reported problems an "n5 against the workr, dYnamlc m which the couP1ePartner‘s lnsu1ate the1r relanon.- partner,difficulty lubricating, anxiety . ' lesbians lubricate more and but fectlon w1th_ - - as well as The reason for this may be that 3111p den), anything per e h th . mmdset evolves lubrication reaching orgasm. avoid into a more than do heterosexual women,or it may be that lesbians realistic view, and the couple Parltläer: caelll‘ encounEventurllyer 1 cuultopla:ty ac nowledging that and have less painful penetration v . to withlubrication difficulties and d0 not empha- they have differencesa a8 d0 anCou 1 .If th - andthus d0 nothave cope unacknowledged’ this dis- vaginal penetration more than d0 connect can lead to fusion ' The data did show that lesbians achieve orgasm reliably betweell 21S couplfesfvfielfefltryefltcfisY e remallnCoup e partners mi ht ex size nonclitoral orgasms. ‘ g permnce emotlonal ‘ ‘ sexual relationships (Nichols 8cSchernoff, 2007). dwtance from each other=unresolved cOHfhct’ some t e of d f“flctlon w1th 011e or women involved in heterosexual ‘ ‘ yp 75 This term - . ‘ ' what in the 1980s was coined lesbian bed death. both Partners‚or triangulatmnm WhlCh a th1rd party is involved In order t0 obv1ate blame {mm Many authors have talked about the in literature about lesbian relationships of sex being frequent dur- couple (Green=BetünSei’: 3FZacks, 1996). On the contrarY,the same authors refers to a common theme _ acknowledged-- . off More recently, this concept has been that this Concept Offusion amon actuall be c0'151‘der‘!d the first few and then tapering significantly. glesb1an. Couples may y aposltlve attnbute ing years The because Ofthe cou . ' ' ' of the research spawning the term questioned. concept man}, ples exhlbued mtense closeness that manifested m mnmacy’ mutual criticized and the empirical validity “ that mainstream defines sex as including and ‘ The authors went on to s criticized for several reasons. The first is theory engagement, empowerment a)’, Our findings indicate thatl esb‘m“ is sexual are - - . a of Many lesbian Couples have more frequent Couples exceptionally close and more t‘ fi d w1th the1r relatlonshlps than gay male and genital contact with goal reaching orgasm. include contact and/er than do some heterosexual heterosexual l not orgasm coupless, (Grünet a1‘ 1996l PS2; contact that may simply genital -- . for mainstream theory as heterosexist is that it asserts Blumsteinand Schwartz (1983 as a contrib„ couples. The second reason criticizing indicator of sexual health (Goldstein et al., 2007; Nichols 8:Schernoff, utingfach” in the highdissolutign 1122:5261:letslln;ilajcllcefaftliffilllllllllllfitloflhofs 1P. not ertmfixrriageseory for the dissolu. that frequency ofsex is an ' that it is much mmof that Nichols “ v the heteronormative undertones of this term-namely, relationship (198%JSuggested 1s that womeI1 Couple prematurely, which 2007). Finally, beyond or low leads t0 „later _„ “ ' with women to have issues with sexual infrequency a famn offof I for women g sexual deslre (p. 101) She says that On ly fall‘Ing m love produces more common partnered sexual ' ' levels. desire’sowefall in love aE3111. w1th a new partnera and the limerance ofth‘1s new relatlon-- clesire-it is on many „ . problematic 30-40% of revives our Sexual“ ' ' ' is a common of women in general, with possibly ship flagging y (Nichols, 19S7b=p. 107) She suggestst hat 1t1s Important for Low sexual desire complaint _ —. deem this as is a source of debate (Basson, lesbian Cou [es t0 d _ __developed (Nlcholsl 1987m women reporting low desire. When to dysfunction . or low of sex dis— Becauselzhere iselalrflällhergllä er“lhliädlflreklsm to w1th _ "Ihere are several possible reasons for the sexual repression frequency I? lBSblaIl Couples 2007). One is that ’ ‘ - to lesbian seeking sex therapy. ___==______.__.__1(See Chapter 3’ this volume)» bis we WäHE:giäwtbtedm o moregznerallt tlgerapy lrrlPact played by lesbians that often contribute Couples’ _ be less to sex.
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