‘There’s no such thing as normal’: 13 essential lessons about sex – from 20 years of Sexual Healing | Sex

People find it so hard to talk about sex, so if someone takes the time to sit down and write a question, then send it to the Guardian for me to answer, I always regard that as a great privilege. In the 20 years of writing the column, I have been reminded how many people are still out there, living their lives in quiet desperation about something that’s really troubling them sexually. Often the solution is more education; they just need to learn something, or be helped to be more open about a problem.

So many people grow up without the message that sex is healthy and important for a person’s quality of life, and they feel guilty every time they have sex, or think a sexual thought. They haven’t been able to enjoy sexuality and discover who they really are. Sometimes, it’s not the sexuality that is causing someone’s problem, it’s societal notions – prioritising monogamy, for instance – that makes life difficult. One of the things I would have liked to have addressed more was sexuality when people have serious disabilities or illness. Many people think they can’t continue to be sexual beings, and often that idea is pushed by people around them – that, to me, is tragic.

As the column went on, I did start to notice that readers seemed to have a greater understanding of sexual issues. There has been a welcome change in acceptance of people’s gender identity, and so that would sometimes come into the questions more frequently too. The social environment has changed, including the rise of dating apps and people hooking up casually, but essentially, the basic issues have remained pretty similar.

As the Sexual Healing column comes to a close, I wanted to take this opportunity to thank you for all your questions over the past 20 years. Here are some of the things they have taught me.

Illustration: Hannah Robinson/The Guardian

The most common question hasn’t changed

Low desire continues to be something people struggle with, especially when there is a mismatch between partners. This situation is very problematic if someone wants to continue having sex but their partner is no longer interested. Other sexual issues come and go, but that one has been a constant.

People separate sex from relationships

I have noticed issues around intimacy. I’ve had a lot of questions that were phrased in such a way that I realised many people separate sexuality from relationships. They’re comfortable seeking and having casual sex, but when they try to make a switch to something more long term, that tended to be when they would write to me, because they don’t quite know how to do that. But sexuality is not a constant throughout people’s lives. It changes and develops, and people go through all kinds of different stages. Just because you’re experiencing issues with intimacy when you’re 20 and prefer casual sex, where you’re not really revealing anything about yourself or learning anything about your partner, it doesn’t mean that in your 30s you’re not going to be ready for something different.

Try to be truly honest about your own needs and accept it, rather than have expectations of what you should like

Understanding your own sexuality is key

So often, people compare themselves with others, or they’re looking on the internet, or seeing idealised notions of sexuality and relationships from movies and so on. Sometimes we get a lot of messages about sexuality when we’re growing up; other times there are none. It means that people can start their sexual life confused and find it difficult to navigate. There’s this sense of, “I should be feeling this,” or, “I should be doing this, but it doesn’t really turn me on.” Try to be truly honest about your own needs and accept them, rather than have expectations of what you should like. Once you’ve figured that out, the next step is to be able to make that clear to a partner – and also be able to receive the information about your partner’s needs. Who are they truly, sexually?

There’s no such thing as normal

I don’t use the word “normal” when talking about sexuality because it suggests that there’s a certain standard. I will sometimes use the word “normative”, often when someone wants a bit of reassurance. When somebody asks: “Is it normal to do this?”, I’ll say: “Well, it’s common.” But I’m not going to describe anything as normal, because there’s such a broad range.

The female orgasm is still a mystery to some people

I’m still getting questions that show me people continue to think that the only “correct” type of female orgasm is one that’s purely vaginal and doesn’t involve the clitoris. For people to still think that, or to have that as the ideal, is extraordinary, but there it is. They just haven’t had the education to understand otherwise.

There’s only so far I can go

In clinical work, I’m able to spend time to get a thorough background and understanding of what has led to the issues a person, or couple, is having. I don’t just focus on the sexuality, because everything is connected. With the column, I only ever had fragments of something that the writer was dealing with, and maybe it involved a partner, but I had no information about them, so it was one-sided. I would try to faithfully reply to that person from their perspective, while knowing that there’s always a broader view. Sometimes there was clearly a medical aspect. Very often, I’d get a sense that the person who was writing to me could really benefit from some supplementary hormone treatment. Even if I knew the answer, I couldn’t give advice – I’d have to say: go to a GP.

Sex doesn’t have to stop when you reach a certain age

It has been wonderful that in the past few years I’ve had more questions from people in their 70s, 80s, even 90s, who are very accepting of the fact that they’re still sexual beings. Earlier on, I didn’t really see that. I knew, and many people knew, that people can be sexual until the day they die, but society is ageist.

The internet has changed sex

When I started the column, the digital world wasn’t really something anyone wrote in about. Now, I do have concern about young people’s access to sexual imagery. It means that they don’t necessarily have a realistic notion of sexuality and this can influence their later connections and understanding of their own sexual self. Apps have meant that for many people sex has become more available. For some this is great, but others struggle. Younger people may not learn about intimacy early on, because they get into a pattern of casual hook-ups.

BDSM comes out of the closet

Something that I noticed happening was I started getting a lot more questions from people in the BDSM community, and this was really good. That has happened over the past 10 years. I think people are just more comfortable with being more open in those communities. It was very hidden 20 years ago.

We’re more accepting of kink …

Younger people, especially, are more open to the idea that one shouldn’t “kink shame” others for whatever they are into. I was always glad to help people with those questions. But I think, equally, there are a huge number of people out there who would never write to me with their problem. There’s still a lot of fear and embarrassment about sex that isn’t considered normative. As a society, we’re not moving towards “anything goes”. What does that even mean? There are still parameters and things that have to be considered – boundaries, legality, consent issues that abound – and it all requires education and understanding.

… and of polyamorous relationships

Recently, I’ve had more questions from people wanting answers to problems that emerge in relationships with more than one person – not just the sexual issues, but more often the difficulties negotiating those relationships. Whether they are long term or casual, there are a lot of pitfalls if such relationships aren’t well negotiated and well understood, and if people are not communicating effectively. It would be good if it was more widely discussed.

There are a huge number of issues that affect sexuality

Neurodiversity is still not well understood, in terms of how it relates to issues that some people have with their sexuality. If you can’t focus or you become very distracted, that can really influence your ability to enjoy sex. That’s just one example, but there are myriad reasons why people might have low desire, for instance, and it’s not just a relationship issue. It could be depression, or the effect of bereavement, or a side-effect of medication. Maybe somebody is having erectile difficulty and doesn’t understand that they have early diabetes. There are many ways in which the whole aspect of a person affects one’s sexual self.

People are selfish when it comes to sex – and that can be good

I think that people should be selfish to a degree, because if they don’t understand how their own body works they can’t impart that to a partner and help a partner to please them. People need to learn to give and receive pleasure, and sometimes people are not selfish enough: they find it difficult to receive, which often goes back to a deeply ingrained sense of guilt about enjoying sex. There is also pleasure for the giver as well as the receiver – there’s a negotiation that has to occur. So unless people are able to truly receive pleasure, then they’re not going to have a satisfying sex life.

As told to Emine Saner