Abstract
Objectives
Individuals with non-mainstream sexual preferences can report barriers in accessing healthcare, in particularly mental healthcare. This study investigated beliefs affecting uptake of mental health talking therapies in individuals with sexually diverse preferences including kink, fetish and BDSM (Bondage and Discipline, Dominance and Submission and Sadomasochism), preferences formerly described as paraphilic.
Methods
Qualitative research is presented from an inductive thematic analysis of five semi-structured interviews with adults who describe themselves as kinky. Participants were recruited through the snowball sampling method via intermediaries. Semi-structured interviews explored barriers that individuals experience in accessing healthcare, in particular mental health care and talking therapies, drawing upon personal experiences and beliefs about healthcare. Respondents reported barriers and facilitators to accessing psychotherapeutic support.
Results
Participants reported self-censorship as a risk-management strategy to avoid encountering (i) social stigma, (ii) medicalization and (iii) conflation of true BDSM with abuse or self-harm. Interviewees required therapists to be better informed, and for services to be more inclusive and proactive. Participants regarded the kink community as therapeutically minded, harboring a population motivated and appropriately skilled to engage with counseling and psychotherapy services. Findings recommend changes to therapist training and public service provision to enable practitioners to work more effectively and ethically with sexually diverse clients.
Conclusions
Individuals with non-mainstream sexual preferences did not believe mental health services were adequately accessible. They required services to be actively inclusive and affirmative of their sexual lifestyle, and mental health professionals to be adequately educated and aware of sexual diversities including non-mainstream sexual practices, non-monogamy and gender diversity. Participants required that they would engage enthusiastically and effectively with mental health interventions including psychotherapy if stigma, pathologization of preferences and misidentification of behaviours as harmful or violent were addressed.
Individuals with non-mainstream sexual preferences can report barriers in accessing healthcare, in particularly mental healthcare. This study investigated beliefs affecting uptake of mental health talking therapies in individuals with sexually diverse preferences including kink, fetish and BDSM (Bondage and Discipline, Dominance and Submission and Sadomasochism), preferences formerly described as paraphilic.
Methods
Qualitative research is presented from an inductive thematic analysis of five semi-structured interviews with adults who describe themselves as kinky. Participants were recruited through the snowball sampling method via intermediaries. Semi-structured interviews explored barriers that individuals experience in accessing healthcare, in particular mental health care and talking therapies, drawing upon personal experiences and beliefs about healthcare. Respondents reported barriers and facilitators to accessing psychotherapeutic support.
Results
Participants reported self-censorship as a risk-management strategy to avoid encountering (i) social stigma, (ii) medicalization and (iii) conflation of true BDSM with abuse or self-harm. Interviewees required therapists to be better informed, and for services to be more inclusive and proactive. Participants regarded the kink community as therapeutically minded, harboring a population motivated and appropriately skilled to engage with counseling and psychotherapy services. Findings recommend changes to therapist training and public service provision to enable practitioners to work more effectively and ethically with sexually diverse clients.
Conclusions
Individuals with non-mainstream sexual preferences did not believe mental health services were adequately accessible. They required services to be actively inclusive and affirmative of their sexual lifestyle, and mental health professionals to be adequately educated and aware of sexual diversities including non-mainstream sexual practices, non-monogamy and gender diversity. Participants required that they would engage enthusiastically and effectively with mental health interventions including psychotherapy if stigma, pathologization of preferences and misidentification of behaviours as harmful or violent were addressed.
| Original language | English |
|---|---|
| Journal | Journal of Sexual Medicine |
| DOIs | |
| Publication status | Published - 1 Nov 2022 |