Let’s Get Physical || By TJ Dubovich, MA, MFTC
When it comes to understanding our bodies from a sexual perspective, I find many clients don’t even know where to begin. This isn’t a critique on them but a concern as to why this exists and what we can do as practitioners to equip our clients with deeper somatic congruence and knowledge of their bodies and erotic self.
It appears in westernized American culture we are challenged to feel completely present within our bodies (with all the external stimuli and distraction, how could we?) during sexual experiences, as mentioned in my previous blog. However, beyond that, we have a lack in information and clarity of sex processes, issues, or ailments to give us strong roadmaps to full sexual ownership of self. If we are not taught correct and inclusive information about our genitals, hormones, sexual abilities as we age, etc – no wonder we find ourselves having uncertain, or even dissociative, sexual experiences. My hope for this writing is to provide information and myth-busting to a small portion of a vast world in sexual health awareness, as I know this information has been transformative in my own.
So. Let’s Get Physical.
Did you know that for approximately every 1 out of 1500 births someone is born with some type of intersex condition? You may be wondering, what does that term even mean? “Intersex is a general term used for a variety of conditions in which a person is born with a reproductive or sexual anatomy that doesn’t seem to fit the typical definitions of female or male” (ISNA, 2026). Although the spectrum includes folks with varying external genital differences, it is more nuanced than just what can be seen. There are a variety of internal variations within the intersex spectrum and folks can live a portion, or even most, of their lives not even knowing they are. The larger context of sharing this point is that even with our external genitalia, there are vast differences in presentation and function. To know this is to normalize this and thus expand our understanding of how our bodies “should” look.
For the purpose of this article, I’m going to divide the next bit into 2 sections. One for AMAB folks (Assigned Male At Birth) and one for AFAB (Assigned Female At Birth). These terms are utilized because some folks (like those who are non-binary or transgender) may not identify with the gender of the sex they were born.
Assigned Male at Birth
Did you know that for every decade an individual with a penis is alive, there is a 10% increase in erectile dysfunction? It’s much more common than one may realize. For example, a 50yr old AMAB person can experience issues with getting or maintaining erections 50% of the time (NIDDK, 2026). Also, ED can be caused by a variety of issues so it can be beneficial to check with a primary care physician or urologist if there is concern – as it can be linked to cardiovascular health, diabetes (Yetman, 2025). If there are no medical issues, working with a sex therapist can explore if there is any underlying trauma, anxiety, or self-esteem issues that are contributing to ED. The mental connection to the penis can be complex and it’s completely normal to take time to process what may be distracting from staying present in pleasurable moments.
AMAB folks are born with prostates. “The prostate is a walnut-sized gland below the bladder, above the penis, and in front of the rectum. Its primary function is to create prostate fluid, which is a component of semen” (Zachary et. al, 2024). However, it also can be stimulated to induce intense orgasms. This typically can be done by some sort of internal anal massage/rectal play but also externally by stimulation of the perinium (the area between the scrotum and anus). Anal play can be associated with queer men, which is true, however AMAB folks of any sexual orientation can explore prostate play with themselves or their partner. Societal scripts on what is appropriate heteronormative sexual play can limit all genders.
Assigned Female at Birth
Did you know that what was originally considered PCOS (polycystic ovarian syndrome) has finally been classified more accurately as PMOS (polyendocrine metabolic ovarian syndrome)? A complex condition that affects 1 in 8 people, it can cause “fluctuations in hormones that can affect weight, metabolic and mental health, the reproductive system and the skin” (Ungar, 2026) The advancement in understanding this condition is notable, as historically, AFAB medical conditions have not been as thoroughly researched as male counterparts. It also provides AFAB folks with more agency around understanding their sexual health, which is a key ingredient to ownership of pleasure.
Another common but vastly misunderstood condition is dyspareunia, otherwise known as pain during intercourse. This affects up to 20% of AFAB folks as a chronic issue (ASHA, 2026). Dyspareunia can be caused by a variety of issues such as endometriosis, pelvic floor issues, fibroids, a retroverted uterus, and hormonal fluctuations – just to name a few. (ASHA, 2026). Many AFAB folks are socialized to accept that “pain just comes with sex sometimes” but this does not need to be true. One way to explore this by yourself is to see if pain exists only with a partner or also with masturbation/toys, as that can be one factor to the underlying cause of the pain. To further this point, if individuals explore what does feel good for them – alone or with partners, it can lead to more understanding when something is off. Pelvic floor PTs and gynecologists can also be helpful in pinpointing what may be causing the pain.
Related to dyspareunia, AFAB folks can have varying experiences of orgasm & intensity. In a study completed of over 24,000 U.S. adults, it found that AFAB folks orgasmed around 46-58% of the time during sexual intercourse, in comparison to AMAB folks orgasming 70-85% (Gesselman et. al, 2024). That finding may not be surprising but why this orgasm gap exists might be. Folks with vulvas/vaginas tend to orgasm from clitoral stimulation. Depending on many factors including ones’ anatomy (if ones’ clitoris is more than 2.5cm from their vaginal opening, it’s much more difficult to orgasm from penetration alone), psychological state, or type of touch can lead to a plethora of pleasure experiences.
With this information, I hope one can start to explore their own body with more intention, as I know we are not taught or supported to do this. There is so much to learn about ourselves from our erotic template so take tune in and see what you find.
Afterword: If you are a clinician reading this and finding yourself feeling uncomfortable, please educate yourself or refer your clients to a certified sex therapists, coaches or educators. This step could serve our community to become more stable and secure in our sexual selves.
Resources:
- AASECT: American Association of Sexuality Educations, Counselors and Therapists (https://www.aasect.org/)
- Sexual Health Alliance (https://sexualhealthalliance.com/)
- Integrative Sex Therapy Institute (https://www.integrativesextherapyinstitute.com/)
- Planned Parenthood (https://www.plannedparenthood.org/learn)
If you are someone seeking counseling or currently in therapy, please know you can always advocate for this information. Ask questions for yourself, vet potential clinicians on their knowledge and if it’s not a good fit, trust yourself to find someone who is.
Resources:
- AASECT: American Association of Sexuality Educations, Counselors and Therapists Referral Directory (https://www.aasect.org/referral-directory)
- Podcasts: Savage Love, Sex ed with DB, Sex and Psychology Podcast, Sex with Emily, In Bed with Alexa: Have Better Sex
- Books: Every Body by Julia Rothman, Come As You Are by Emily Nagoski, Bonk by Mary Roach
References:
American Sexual Health Association (2026, Feb 3rd). Dyspareunia – Why Sex Hurts. https://www.ashasexualhealth.org/dyspareunia-sex-hurts/
Gesselman, A. N., Bennett-Brown, M., Dubé, S., Kaufman, E. M., Campbell, J. T., & Garcia, J. R. (2024). The lifelong orgasm gap: Exploring age’s impact on orgasm rates. Sexual Medicine, 12(3). https://doi.org/10.1093/sexmed/qfae042
Ungar, L. (2026, May 18). The condition known as PCOS is now called PMOS. what to know about the name change and treatment. PBS. https://www.pbs.org/newshour/health/the-condition-known-as-pcos-is-now-called-pmos-what-to-know-about-the-name-change-and-treatment
U.S. Department of Health and Human Services. (2026). Definition & Facts for erectile dysfunction – NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/definition-facts
What is intersex?. Intersex Society of North America. (2026) https://isna.org/faq/what_is_intersex/
Yetman, D. (2025, April 10). How common is Ed? statistics, diagnostic criteria, risk factors. Healthline. https://www.healthline.com/health/how-common-is-ed
Zachary, Z., Engle, G., & Strong, R. (2024, October 30). Male G-spot: How to find it, stimulate it, best positions & more. Men’s Health. https://www.menshealth.com/sex-women/a19541010/how-to-find-the-male-g-spot/
