It’s (Not) All In Your Head: Mental Health And Sex

It’s (Not) All In Your Head: Mental Health And Sex

by Kim Adamski

Mental illness is a widespread concern. In the United States, it’s estimated that 1 in 5 adults live with a mental illness; the rate among LGBTQ+ folks is twice that. The numbers are likely even higher for folks living with subclinical mental distress. It’s not hard to see why mental health issues are so common: we live in a fast-paced, productivity-focused world where we are constantly exposed to negative news, cruel behavior on social media, and loneliness. It’s tough out there!

Poor mental health has a serious impact on sexual wellness. This metaphor from Emily Nagoski, Ph.D. perfectly illustrates the effect of mental distress on sexuality. According to Nagoski, our sexual desire is affected by two components: the accelerator and the brakes. Accelerators are the things that put you in the mood for sex, like foreplay, candles, or sexy music. Your brakes, on the other hand, are things that take you out of the mood. Stressors put the sexual brakes on big time! For example, if you are worrying about your personal safety in your everyday life, that’s going to make it much harder to get in the mood for sex.

When we are in distress, our sexual function and satisfaction suffer. Our sex lives are put on the back burner to deal with more pressing issues. Mental health issues are associated with decreased desire and lower sexual satisfaction; in addition, the medications commonly used to treat mental illness carry sexual side effects, like inability to orgasm or maintain an erection. For some people, their now-dissatisfying sex life becomes yet another weight on their mental state.

Among LGBTQ+ folks, long-term discrimination can add another layer on top of all this. Anti-queer, religious upbringings and social stigmas about LGBTQ+ sexuality have a profound affect on sexual wellness. When we are exposed over and over to social narratives that portray queerness in a negative light, we unconsciously internalize them. Mainstream cultural disgust about anal sex is one such example. If you’re repeatedly told explicitly or implicitly that there is something wrong with anal, that will plant that idea in your psyche, and it’s incredibly difficult to unlearn. The resulting feelings of shame can interfere with being present in the moment during sex, exploring sexual pleasure, or seeking healthy, intimate relationships.

For many LGBTQ+ folks, this stress has been heavily impacted by the current political climate. Not only is anti-LGBTQ+ legislation demoralizing and frightening—adding to the dogpile of other stressors in everyday life—it’s criminalizing positive queer sexuality. For example, attempts to restrict gender-affirming care will likely lead to increased rates of gender dysphoria and negative self-image, both of which are associated with decreased sexual satisfaction. Bans on LGBTQ+ sexual identity topics in schools lead to low-quality sex education, leaving queer students with few resources to help them stay safe and healthy in sexual relationships. Politicizing gender and sexuality is a public health crisis when it comes to sexual wellness.

While I can’t change our entire society singlehandedly, I do have a few recommendations for coping. First and foremost, address the stressors in your life. Happily, some stressors can be removed easily. If you can’t stop worrying about the chores that need to be done, finish them before you plan to have sex. Other stressors are a bit harder to change, like experiencing homophobia and transphobia in everyday life. In this case, you’ll need to develop coping mechanisms. A good therapist can help you with this; you can also come up with your own remedies, like avoiding stressful social media posts.

Next, work on consciously unlearning negative sexual narratives. It can be really difficult at first to rewire the way we think about sex, but with practice, we can gradually improve our sexual self-image and satisfaction. Say you’re a woman who grew up with messaging that sex has to involve penetration, and now you are in a relationship with another woman. As a result, you may have feelings that the sex you are having with your partner is not “real” sex. Once you are able to identify these feelings, you can reframe them positively. Maybe the sex you’re having is super creative, or perhaps you feel empowered to ask for what you want without the expectations set up by our heteronormative world!

Mental wellness upkeep is, admittedly, a lot of work and a lifelong endeavor. It can feel overwhelming at times. At the same time, it’s important to your overall well-being and closely tied with sexual wellness. Despite all that’s going on, coupled with the stress that comes with being human, you deserve a pleasurable and satisfying sex life. Use the tools available to you to make it happen!