Experienced sex therapist Ken Howard talks about specialising in LGBTQ therapy
Ken Howard LCSW, 56, is a sex therapist and founder of GayTherapyLA based in Los Angeles, California. Dedicating his life to helping others, Howard spoke about the intricacies of being a sex therapist specifically for gay men, and what he has experienced over his almost 30-year career that started during the height of the HIV/AIDS epidemic.
What is sex therapy?
Sex therapy training aims to serve the public by equipping graduate level, trained therapists to be more clinically competent in sexual and relationship issues. We look into the sexual components and disorders in cisgender men, cisgender women, trans people, and any kind of thing where sex therapy has a lot of overlap with medical specialities. Just like an eating disorder would have a lot of overlap with treatment by an MD (Doctor of Medicine), sex therapy might have a lot of overlap with an urologist, gynaecologist, endocrinologist, etc. It often involves a multidisciplinary approach where the therapist is handling the psychological and the interpersonal aspect, and the physician is handling the medical side.
What drew you into becoming a sex therapist specifically for gay men and the LGBTQIA+ community?
Becoming a certified sex therapist was a natural extension of my being a therapist, a gay men’s specialist, and my mental health training going back to the early days of the HIV epidemic. With my background in HIV and sexual issues, particularly around safer sex and harm reduction, I had a lot of clients that were gay men who would come to me and say they want somebody who’s a specialist and is able to understand the issues more than others. There are a lot of gay male therapists in Los Angeles, but sometimes they are dealing with their own internalized homophobia.
Having 29 years of experience as gay men’s specialist, this was a venture for the home stretch. I have about 10 years or so before retiring, and I wanted to become a certified sex therapist as a kind of swan song. With sex therapy, I can’t just sit back and watch gay men with sexual concerns languish without the specialised help they need. I thought if I can stand up and do something about this, I’m going to, because I believe these guys need support. I mean, all people do.
What are some specific issues that are dealt with in gay men sex therapy that may be difficult to cover in regular sex therapy?
The first word that comes to mind is specificity. Specialists can really get down to the depth of understanding something like the contributing causes of erectile dysfunction or how to deal with the discomfort of being penetrated as the bottom partner in gay man anal sex.
We challenge the social stigma that the only legitimate sex is heterosexual; vaginal penetration that puts emphasis on the male’s pleasure, and the myth that there is perfect erectile functioning to the point of orgasm for the purposes of procreation. There is this religious-based, socially conservative idealisation of what sex should be. And yet, when we’re informed, we really start to challenge this idealism and prejudices. Even gay sex goes beyond anal sex and blow jobs. It’s nuanced; It’s the blending of the emotional, sexual, physical and social.
According to a report from Gay Star News, 56% of gay and bisexual men experience some form of erectile dysfunction, whereas only 46% of straight had this issue. Black men are also more likely than any other race to experience erectile dysfunction. Do these results surprise you?
Not really, in general all sex therapy topics are generally underfunded in terms of publicly funded research. There have been prejudices about getting data for LGBTQ and women’s representation, particularly back in the days of new AIDS drugs, as they were approved by the FDA with data only on men. People of colour were also notoriously underrepresented in HIV drug and clinical trials. So, we must start with that.
But when we talk about that statistic, we need to remember gay and Black men are social minorities, one a sexual minority, the other a racial ethnic minority. I think the role of minority stress plays a part in erectile dysfunction. For gay men, its usually the religious pressures of being told they shouldn’t be having gay sex in the first place. As for Black men and the racial issue, it’s usually due to the objectification of being stereotypical sexual objects.
What would you tell someone who has never considered LGBT sex therapy what the benefits of seeking this option are?
Trust. Don’t wait until it’s 100% comfortable to get the help that you need, go in there despite the fact you’re a little nervous to talk.
One of the things I really find rewarding is when a guy comes to me and hesitates before and says “Gosh, I don’t know if I should talk about this.” Earlier this week a client said, “my boyfriend likes me to pee on him… can I say that?” And I’m just like, yes! Clients should just trust that the therapist is there to help them.
Ken Howard LCSW, CST can be reached for consultations via ken@gaytherapyla.com or gaytherapyla.com