There’s an exceptionally high, depressing number of heterosexual people who still operate under an exceptionally limited, depressing belief that “sex” = “this penis in that orifice, everybody cums like a porn star, then we all go home happy.” Occasionally, to change things up a bit, they might substitute finger(s) for penis, and even more occasionally a tongue. This might make for an okay but bland sex life in Relationshipland; at the very least, odds are good that definition of sex leads to a great deal of (maybe not so) secret dissatisfaction:

In June 2015, 1,055 women ages 18 to 94 from the nationally representative GfK KnowledgePanel® completed a confidential, Internet-based survey. While 18.4% of women reported that intercourse alone was sufficient for orgasm, 36.6% reported clitoral stimulation was necessary for orgasm during intercourse, and an additional 36% indicated that, while clitoral stimulation was not needed, their orgasms feel better if their clitoris is stimulated during intercourse. Women reported diverse preferences for genital touch location, pressure, shape, and pattern.

Herbenick D, Fu TJ, Arter J, Sanders SA, Dodge B. Women’s Experiences With Genital Touching, Sexual Pleasure, and Orgasm: Results From a U.S. Probability Sample of Women Ages 18 to 94. J Sex Marital Ther. 2018 Feb 17;44(2):201-212. doi: 10.1080/0092623X.2017.1346530. Epub 2017 Aug 9. PMID: 28678639.

Yet, many women still fake orgasm during intercourse, according to therapist Laurie Mintz, author of the new book “Becoming Cliterate.”

“The main reasons they give for faking is that they want to appear ‘normal’ and want to make their male partners feel good,” she said.

“This is one of the saddest and most common problems I deal with in my clinical practice,” added Anita Hoffer, a sexuality counselor and educator. “Women who either are uninformed or insecure and therefore easily intimidated by ignorant partners bear a great deal of shame and guilt at being unable to climax from intercourse alone. Many are greatly relieved when they learn that they are among the majority of women who engage in sexual intercourse.”

Intercourse isn’t everything for most women, says study – try ‘outercourse’” – Ian Kerner, CNN; Updated 10:32 AM EDT, Mon August 28, 2017

Porn really has a lot to answer for in having given the population a damagingly unrealistic image of what sex is and what it’s supposed to look like, but the real roots of our sexual destruction lie in the utter absence of truthful, honest, science-based sex education. Most of the clients who come into my office have never had any kind of formal Sex Ed beyond some terribly-awkward and embarrassing PE classes in high school about reproduction, and maybe some even more terribly-awkward and embarrassing instruction about avoiding sexually-transmitted infection (STIs). I’m *STILL* having to teach people that vulvas and vaginas are not the same things, that a woman’s urethra is a different opening from her vagina, that orgasm through penetration alone is something only 18% of women experience REGARDLESS of what the porn industry says.

All of this to say…

Imagine how much more interesting, and hopefully satisfying, “sex” might be for everyone if we broke away from the narrow definitions into something far, far more expansive and inclusive of a variety of sensations?

Anyone who knows me knows I’m a big fangirl of Emily Nagoski* and her work researching and presenting the sex education I wish we’d ALL had access to when we needed it. Her work has greatly influenced a movement in sex therapy away from the insular definition of sex as penis-in-vagina (PIV) intercourse and the focus on orgasm as the sole acceptable outcome of “sex”. The rallying cry of her first book, “Come as You Are” is, “PLEASURE IS THE MEASURE,” separating out the forced trajectory toward an outcome 72% of women don’t experience (as poor education and representation have led us and our equally-ill-informed partners to believe we should), and replacing it with the idea that it’s okay to focus on enjoying what DOES feel pleasurable instead. If that’s an orgasm, Great! But for a lot of folks, they want, and often need, something… different.

Defining sex solely as “PIV intercourse to orgasm then stop” is like going to a restaurant that has two items on the menu: an entree and a dessert. You might be able to vary the plating of the first, and the assumption is that the latter will (must?) be the inevitable ending for both participants. That’s a restaurant that’s likely to become boring in a Very Big Hurry, and then clients come to me wondering how, when, why they seem to have “lost the spark” in the bedroom.

Through the work of Nagoski and others, like Dr. Laurie Mintz and Dr. Lori Brotto, I’m teaching an expanded model of sexuality that breaks out of the narrow mode and expands the menu into four distinct types of experiences that can flow between being explicitly sexual, and the sensual (sensory) aspects of the moment: Desire, Arousal, Pleasure, Outcome


To desire is simply the act of wanting something. Everything from, “Y’know, I think I’d like to spend more time at the beach this summer” to “Right now I crave potato chips so badly I could chew my own arm off” falls under the heading of Desire. When most people think of Desire in the context of sex, what they mean, and unfortunately what they consciously or unconsciously expect, is Spontaneous Desire, which common sexual mythology portrays as the ability to get aroused (with all the assumed bodily reactions porn taught us to expect) instantaneously and without effort. What a VERY great many people ACTUALLY experience, however, is Responsive Desire, or a slower-building state that comes as a response to a set of often-invisible criteria that is often frustratingly fluid in nature. (To understand more about this aspect, look into Nagoski’s work on the impact of our individual CONTEXT at any given moment on our receptivity to sexual advances and overtures.)

If we look at Desire as the act of Wanting, then it’s possible to appreciate Desire in and of itself as an experience. Clients with healthy sexual connections sometimes describe how they look at their partner and experience that sense of Desire even knowing there is no time in the moment to act on it, and even if there is time, they may not feel particularly compelled to act. Simply experiencing, and perhaps even sharing, the sense of Desire, is part of that sexual relationship they enjoy. Desire as an emotional state does not require action, though a lot of us tend to forget that “Feelings are not facts”, and that “thoughts, feelings, and actions are three different things.” (When Desire becomes Compulsion, however, is an entirely different, cognitive-behavioural issue beyond the scope of this post.) Desire for Desire’s sake is an experience people can roll around and revel in all they want; it’s just a feeling.


Arousal is physical or emotional reaction to stimulus. Wind blows over your skin and all the little hairs stand up? That’s Arousal. Allergy season arrives and pollen counts have your body on histaminic alert? That’s Arousal. Watching the footie match on TSN have you on the edge of your seat ready to cheer or rage or pounce on a ref’s questionable call? That’s Arousal. Finding your heart quickens and your breath shortens every time your partner walks into the house? That’s Arousal. Many of our intense emotions arouse us, but we can also be Aroused by a wide variety of stimulation, and not all of those arousal states are sexual (just ask any allergy sufferer during hay fever season). Anger, fear: these absolutely Arouse us. Desire can also Arouse us.

Arousal, again, is a state that can and does exist irrespective of a sexual component. In the narrow-scope mythology, the assumption is that we do/must experience Spontaneous Desire leading to an Aroused state, meaning “ready to accept sexual activity”: women lubricate and their labia engorge with blood, men’s penises get erect. Neverminding the idea that our bodies can present these signals of sexual Arousal without actually feeling ANY kind of Desire, if these limited signals are not present, culturally we’ve all been led to believe this must signal a LACK of Arousal, and therefore also a LACK of Desire. There is zero room in that mythology for the notion that Arousal and Desire both function perfectly well, thank you very much, as individual emotional and cognitive experiences even if the bodies don’t follow the mythological script. I move in and out of Desire like I breathe. I move in and out of Arousal fairly commonly, but if I look only through the tiny lens of sexual mythology, my ability to access the singular expected definition of “sexual arousal” is hampered by a lot of things I can sometimes work around, and sometimes not. Again, context is everything here.


Pleasure and Outcome really go hand in hand in many ways. For some people, Pleasure *IS* the Outcome. Am I enjoying an experience that feels really, really good? That’s Pleasure. And don’t overthink things here; that’s really all there is to it. Nagoski describes Pleasure as something delightful and positive that occurs at the confluence of three factors: eagerness (the emotional engine that moves us toward or away from something), expectation (the cognitive linking of “what’s happening right now” to “what happens next”), and enjoyment (the “hedonic impact” of a stimulus) (Nagoski, Come as You Are, 2015). Aversion and avoidance would be a likely and common result of the negative aspects of these three factors coming together.

Are the experiences I have with my partner pleasing to me? What experiences bring me the most Pleasure?

The research measuring how [these] three [factors] function in human sexuality has barely begun. I include them here not because I have already seen definitive proof of how they affect sexual wellbeing but because when I teach about them, I see how helpful people find it to know that “desirable,” “pleasurable,” and “sexually relevant” are not always the same thing. Your brain can enjoy something without eagerness for more. It can expect a kind of stimulation that will lead to sex, and expecting may activate desire–movement toward–but it may also activate dread, depending on context. Your brain can even be eager for something without particularly enjoying it[.]

All three are context dependent: if your expecting, eagerness, and enjoyment substrates are busy coping with stress or attachment issues […] then sexually relevant stimuli may not be perceived as sexy at all.

Nagoski, Come as You Are, 2015

The individual definitions of what feels Pleasurable will change tremendously from moment to moment as well as over the life span based on more contextual factors than I can list here. But trying to keep things in the realm of sexual/sensual pleasure, we’re looking for things that feel good in and of themselves, whether they signal a movement towards the default script of sexual activity or not. For me, massage (therapeutic or sensual) is an intrinsically Pleasurable bodily experience that is in a lot of cases DEFINITELY not sexual, even when a Lover provides the contact. Same with having my hair washed or brushed. A walk through woodlands in the fresh, warm spring sunshine is an intensely Pleasurable, sensual experience, even when I’m expecting chronic pain issue to mean it will also hurt.

All of which brings us to the last but definitely not least of the four menu options…


If we’re following the mythology script of heteronormative sex, there are only two outcomes to intercourse: orgasm, or disappointment.

Yeah. Think about that for a moment. Especially if you’re in the VAST MAJORITY of women who do NOT experience orgasm through penetration alone, your options are really, therefore, disappointment and disappointment. Possibly with a precursor of “faking it” (especially for women), and maybe an aftermath of “frustration”. If those were my only experiences of the narrowest-possible definitions of sex, is it any damned wonder that the sexual spark falls off in the bedroom after a while??

If the only acceptable outcome is orgasm, we’re shutting ourselves off from a vast array of sensory experiences–physical, emotional, mental–that can also be seen as Pleasurable, even Desirable outcomes. We miss out on the idea that Pleasure for Pleasure’s sake is, in and of itself, a perfectly okay thing to seek within the scope of our sexual/sensual encounters. We don’t have to completely remove orgasm from the Outcomes, but maybe we can expand on this menu section by allowing that other experiences will be just as important sometimes. Allowing for sensual Pleasure, for example, to be a valid and Desired Outcome instead of orgasm takes a lot of pressure off people who can’t relax for PIV intercourse, who don’t orgasm that way, who experience vaginal dryness or erectile difficulty. It creates a vast array of sensually Pleasurable Outcomes for connection and stimulation that potentially have nothing at all to do with “sex” but may still be tremendously enjoyable and intimate.


Put simply:

I can and do Desire a lot of things that do not Arouse me; most of them are Pleasurable; a great many things I Desire have nothing to do with sex. Desire does not have a straight line to any particular Outcome; sometimes a feeling is just feeling.

I can be Aroused by things I do not Desire and do not Pleasure me. Sometimes what is Aroused is an emotional reaction, sometimes an intellectual curiosity, nothing whatsoever to do with sexuality. Arousal also does not have a straight line to any particular Outcome; sometimes a feeling is still just feeling.

I can and definitely do enjoy Pleasure, probably a bit more than I should. Things that bring me Pleasure I do not always Desire, and they may not Arouse me. The vast majority of what I find Pleasurable is non-sexual, but there are some very definitely sensual Pleasures that I will give myself over to at just about any available moment. Certain states of sensual Pleasure are more likely to invite the slide over into overt sexuality, but not always.

Sex, meaning the act of penetration, is sometimes an Outcome in its own right, regardless of the potential for orgasm. For some, orgasm remains the only acceptable Outcome. Others prefer the Outcome to be an intimate connection, relaxation, relief, or even catharsis. There are as many ways of achieving different Outcomes as there are Outcomes in the first place, and a lot of them are not explicitly sexual.

You can order from any one, two, three, or all four sections of this menu in myriad combinations of sexual, sensual, AND “none of the above” experiences until the band goes home and they turn off the lights. With this kind of approach and an open mind, it’s going to be awfully difficult to stay bored and sparkless in the bedroom.

The more I teach this expansive four-part model of sex, the more I find what Nagoski found almost a decade ago: people generally respond very well to understanding there is so much more to sex than just PIV intercourse, and that Desire, Arousal, Pleasure, and Outcome are NOT the same things, however narrowly we are STILL being taught they intersect. The freedom to expand the sexual/sensual menu allows people who WANT to enjoy not only their partner’s body but their own a much broader scope of experience. “The Mighty ‘O'” will always be a fun option for many people, but wouldn’t it be great if there was more than one Happy Ending to the script??

[* — In coming weeks you can expect I’m going to have gushing and gleeful Things To Say about her new book, Come Together.]