On the heels of the flibanserin decision, many of us are concerned, and rightly so. We’re concerned that now the new remark will be ‘I hear there’s a pill for that.’ We’re concerned that our family, and our friends, and our partners will try to convince us that we need to take it. But perhaps mostly for some of us, we’re concerned that our therapists are going to jump on board and insist we need it, as well.
Sprout Pharmaceuticals insists that this medication isn’t meant to target asexuals (and in practice, isn’t meant for many other people who might need it), and that they’re going to provide workshops or papers for therapists in order to explain the difference between HSDD and asexuality*. In all honesty, I don’t trust that Sprout is going to keep their word, or that their educational materials will be that well written. As a reaction to multiple fronts regarding the flibanserin decision, I’m putting together a series on dealing with and combatting acephobia from therapists. This first section will deal with my own personal experiences with acephobia in therapy, which occurred before flibanserin went back for approval to the FDA.
At the time that I first discovered what asexuality was, I had been with this therapist for approximately three months. At first, it was important, but it wasn’t a huge deal- I mentioned in therapy one day, ‘Oh, I’ve heard about this term demisexuality, I think it fits me and that’s great!’ And she agreed, initially: ‘Yeah! I’m glad you’ve found something that fits you.’ I don’t remember if I explained what demisexuality was, but I must have at the time. However, other than that brief aside, I didn’t bring it up much. For me, it wasn’t something I really needed to talk through. I found out what it was, this fit me, it was great, I was immediately assured that this was who and what I was. End of discussion.
I didn’t bring my asexuality up again for a couple of years; I had a partner at one point, and there were definitely some conflicts in the relationship, but it had nothing to do with my demisexuality, so who cared? At some point, though, I decided I wanted to find a community, to find out more about what other people had to say. And as a result of that decision, I decided that there needed to be a workshop on asexuality as it pertained to BDSM (somehow the idea to start a whole blog devoted to the topic didn’t even hit me until 9 months later). My kink life was something my therapist was definitely acquainted with- we talked about that way more than we had ever talked about my sexuality or my sex life. Up until that point, I had been more involved with the kink community than I was with the asexual community, anyway. Naturally, having trusted her thus far, I ran by some ideas for the workshop with her, and even did a test run on her. This was where we started to run into issues.
It started subtly at first, so subtly I almost didn’t realise it was happening. Small questions about what I meant when I talked about attraction, and that I just wasn’t realising what sexual attraction actually felt like for other people. That I was blowing things out of proportion, or not really understanding what I was supposed to be feeling (or more accurately, how I as a woman was supposed to be feeling). That she wanted to believe me, but as a professional she had all this training telling her that I was either sexually immature, or a victim of abuse.
This continued for weeks, and eventually culminated in an argument. It was under the guise of a ‘spirited debate’, but it was really an argument. I was actually talking about a novel I’ve been writing on and off. The main character is asexual, and I was back and forth on whether or not to have a romantic interest for her- on the one hand, I wanted some representation, and to show that asexuals can engage in healthy relationships that are sex free, but on the other hand I felt it would distract from the plot. I’m not actually sure how the argument got started, really, but I remember she said a few things that ended with, ‘How do you know this is your sexuality, and you’re not just broken?’ And I immediately replied, ‘Why do I have to be broken?’ And that’s when the argument really began.
We both said a lot of things, and to be perfectly honest, when I’m in an argument and I feel like I’m being put on the defensive, it’s hard for me to hear when someone might be making concessions or valid points. But that lasted for about a half an hour, and when I left, I was very seriously considering dumping her as a therapist. I was so hurt, and angry, and I felt betrayed. In truth, she’s lucky that I had a very solid sense of who I was and what my asexuality was, because if I had been questioning and come up against that argument and all that acephobia, it would have set me back years. I went home and ranted and raged and wondered if I should start the search for a new therapist.
In the end, I went back the next week. I decided to let her know that she seriously hurt me, and see what happened. If she apologised and seemed like she was more willing to listen, I would reconsider. If she didn’t, though… This is where I’ll let you know that I’m very lucky that my therapist was actually a pretty decent person. I didn’t have to tell her I was hurt for her to know. She had spent time in the proceeding week researching asexuality and reading AVEN, and came back to our next session with a slightly more thorough understanding of what it was I had been trying to say. We both clarified some things, with the advantage of distance and time giving us cooler heads, and when I left that day I was reassured in my choice of therapist. When I finally left her service a year later, before I moved back home, she was one of my most ardent supporters, and even went so far as to broach the topic of asexuality and give resources to other patients.
Admittedly, I had a very lucky break. My therapist was the kind of person who was willing to acknowledge when they were wrong, and admit that they might not know everything that’s best for their patients right away- that, in fact, their patients can teach them. Still, the whole experience taught me some fundamental things, and I’m going to share them with the rest of you now.
- Whether you’re questioning your sexuality, or know where you’re coming from, you need to come armed with resources. Sometimes, we as people can’t always explain ourselves well, no matter how hard we try. That’s where having a third party as a resource is helpful. That party says everything you may not have the words or presence of mind to say, and offers some validation that you most certainly are not the only person to be thinking or feeling this way. Even if your therapist doesn’t read them in front of your eyes, they really should make an effort to read them in general, and maybe even talk them over with you.
- If your therapist is making you uncomfortable or hurting you in any regard, you should say something. I know it can be scary, especially depending on what you’re going to therapy for, but bottom line is that you’re paying them. They are trained professionals who are providing a service that you are monetarily compensating them for, and therefore you have a right to speak up and say when you feel they aren’t doing it well. Even if you’re not paying for your therapy, they have an ethical and professional obligation to put your wellbeing above their own biases. Therapy is for you, your therapist is there for your benefit.
- Building off of what I just said: this is therapy for you, your experiences should come first. If your therapist (in general, but especially about your sexuality) isn’t willing to take your experiences and what you say to heart, they aren’t any good for you and your growth as a person.
- It is always okay to leave your therapist if they no longer work for you. Some therapists and people can overcome acephobia and bigotry with some information and time, but some of them can’t. It’s perfectly alright to not want to babysit someone through this experience, especially if their prejudices are aimed at you. This was the seventh therapist I’ve had in my life, and they were the only one I’ve had since I began identifying as asexual. There are a myriad of reasons to consider switching therapists, and negation of your sexuality is certainly one of them.
Your therapist is someone you should feel safe with, bottom line. Therapy can be scary, especially when starting out with someone new. It feels like this person is going to judge you, or say your entire life is worthless, or that you’re broken. A good therapist will never do this. A therapist is someone you should be able to confide your deepest, darkest secrets to, and they should be able to react with compassion, and react appropriately. That doesn’t mean that as patients, we can’t sometimes get caught up in our own heads, or have incorrect ideas. I know that whenever she told me something I didn’t want to hear about my OCD, I would immediately bristle. But it helped that I could trust my therapist: I didn’t have to blindly trust her, and she didn’t demand it at any point in our relationship. She earned that trust by being someone who continually gave me good advice, and who showed that she was a person with her own flaws that she was willing to address. Talking about sexuality, especially one that is ‘new’ and maybe you yourself aren’t even really sure of, is always going to be frightening. Opening up so much of yourself to anyone is always going to be frightening. The right therapist, however, is going to be the one who is willing to grow with you, and that’s the person you should find to help you when you need it most.
*In a statement to Newsweek, Sprout says the research on flibanserin already accounted for the distinction between asexuality and HSDD: “Asexual individuals are not distressed, and therefore would not be a candidate for treatment with Addyi. Sprout is committed to educating healthcare providers about Addyi to help facilitate informed, educational conversations with their patients. With the five question screener, called the Decreased Sexual Desire Screener (DSDS), doctors can effectively rule out women who would not be considered for medical intervention.” (from the article For Asexual Community, Flibanserin Is a Bitter Pill to Swallow, Newsweek, 8/20/15)