Book Contents – Abstracts & Keywords

Abstracts and Keywords for each chapter of the book

Chapter 1: Introduction

Keywords: Sexual Identity; Sexual Practice; Gender Identity;

This chapter signposts the reader to the rest of the book explaining that it is intended to be a useful reference for the busy professional, rather than a weighty ‘library tome’ of interest only to the most ardent of academics. It also explains how it nonetheless should be of use to both clinicians (such as counsellors, psychotherapists, psychologists, psychiatrists, social workers, nurses, etc.,) and academics in traversing this complex area.

The chapter considers the differences between sexual practices and identities and outlines the pantheoretical stance towards sexuality and gender which requires that professionals are well versed in the basics of the field. It outlines the appropriate use of language in clinical spaces and also considers sexualisation in the clinical space as well as the potentials and challenges faced by professionals who are themselves from ‘minority’ communities.

The chapter explains that those identities and practices which may be considered to be more normative (although which are not necessarily more common) – such as cisgender, heterosexuality, and monogamy – may have issues intrinsic to them which are of note for the psychologist, psychiatrist, psychotherapist or other helping professional but which may be overlooked due to their normativity. Conversely those identities and practices which may be considered to be less normative (although which are not necessarily less common) may often be irrelevant to presenting issues. Similarly, the chapter briefly unpicks common concerns regarding morality and echoes Denman’s (2004) distinction between coercive and transgressive practices.

Chapter 2: Transgender (Trans) – Living a different gender to that assigned at birth

Keywords: Trans; Transgender; Transsexual; Transition; Gender dysphoria; Sex change; Genital surgery; SRS; GRS; Transphobia.

Trans (transsexual, transgender) people are those people who opt to live for a significant part of their life in a gender other than that assigned at birth. This chapter considers the issues involved in transition for trans people, as well as the surgical (breast, genitals, face, etc.) and endocrinological (Estrogens, Testosterone) treatments available to them. As well as these aspects, it pays particular attention to the relationships of trans people and the possible implications of transition to those relationships.

The chapter broadly considers both transsexual and transgender people, including  those trans people who wish to make a physiological change as well as those who do not. It considers family and relationship issues; drug use; sex work; suicidality and self harm as well as gender dysphoria more generally. It does not consider sexualised aspects of transition as these are considered in Chapter 11 – Cross-dressing which includes ‘transvestitism’; autogynephilia and autoandrophilia.

Chapter 3: Intersex / Diversity of Sexual Development (DSD)

Keywords: Intersex; DSD; Divergence of sex development; Disorder of sex development; Diversity of sex development; hermaphrodite; pseudo-hermaphrodite; genital reconstruction surgery

This chapter considers issues pertaining to people who have physiological characteristics commonly attributed to males and females as well as physiological diversity pertaining to sex development. These fall under the broad category of intersex or DSD, but would not all strictly meet the diagnostic criteria for intersex or DSD conditions. These include 5-alpha reductase deficiency; Androgen insensitivity syndrome (AIS); Congenital Adrenal Hyperplasia (CAH); Klinefelter syndrome (XXY karyotype); Turner syndrome; Mosaicism involving sex chromosomes; Aphallia; Clitoromegaly; Micropenis; Hypospadias; Ovo-testes (previously called ‘true hermaphroditism’); Gonadal dysgenesis; Cryptorchidism; Hirsutism; and Gynecomastia. The chapter gives a brief overview of each condition and examines  intersections with sexuality and gender identity. It also considers the psychological implications of any treatments available. In addition, it examines implications for reproduction and intimate relationships.

Chapter 4: Cisgender – Living in the gender assigned at birth

Keywords: Cisgender; Heterosexual; Heteronormativity; Masculinity; Femininity; Gender roles

This chapter considers the specific issues pertaining to the cisgender identity (living in the gender that one is assigned at birth). It pays particular attention to cultural norms and expectations around femininity and masculinity, and the problems that can be experienced if people feel pressure to adhere to these very rigidly, notably emotional difficulties and eating disorders for women and issues around violence and substance abuse for men.

The chapter considers the implications of being cisgender for a person’s choices in life as well as for their intimate relationships, sexual practices, and family life and explore the constraints and freedoms afforded by the cisgender identity. It is made explicit that heterosexuality and gender are intertwined as many societal expectations relate to being a heterosexual man or women. Heterosexuality is covered in more depth in Chapter 10: Heterosexuality

Chapter 5: Further Genders

Keywords: Neutroid; Pangender; Androgynous; Gender fluid; Third gender; Other gender; Bigender; Trigender; Genderqueer; Genderfuck; Queer

This chapter considers the various gender forms aside from those of man and woman (sometimes called the gender dichotomy) such as genderqueer, neutroid and pangender, for example. It does not consider trans identities as such as these are covered in chapters 2 and 11. The chapter briefly situates such identities and practices within history and cultures. It outlines key terminology and how professionals may assist clients with navigating the social opprobrium that such identities and practices may attract. The chapter also aims to assist practitioners with considerations on how their work and wider practice setting may be adapted to assist these groups.

Chapter 6: Bondage and Discipline, Dominance and Submission, and Sadomasochism (BDSM) / Kink

Keywords: Bondage; Discipline; Dominance; Submission; Sadomasochism; BDSM; Kink; Safe Sane Consensual; Risk Aware Consensual Kink; Consent.

This chapter explores Bondage and Discipline, Dominance and Submission, and Sadomasochism (BDSM) / Kink and forms of erotic power exchange. It covers the various common ways of being sexually intimate within these identities and practices, the terms employed, and common paraphernalia used, alongside recent research about the experience of BDSM and the meanings that it has for those involved. The chapter examines the consensual nature of the practice and identity within the popular mantras of Safe, Sane and Consensual (SSC) or Risk Aware Consensual Kink (RACK). It also situates these practices and identities within the context of the historical pathologisation of BDSM and kink. The therapeutic aspects of BDSM experienced by some are considered in relation to how professionals may work alongside this.

Chapter 7: Asexuality

Keywords: Asexual; Non-sexual; Aromantic; Hypoactive sexual desire disorder; Ace;

This chapter explores the different types of asexuality and celibacy – specifically those people who do not experience sexual attraction or who do not wish to act upon it, sometimes just with others or sometimes alone also. The chapter includes those people who wish to be romantic, but not sexual. It pays particular attention to the marginalisation of these identities and practices within mainstream sexology and clinical practice and their difficult
associations with pathology. In particular the chapter briefly examines ‘sexual dysfunctions’ such as Hypoactive Sexual Desire Disorder (HSDD) and differentiates asexuality from these.

Chapter 8: Bisexuality

Keywords: Bisexual; Bi; Bi-invisibility; Double discrimination; Biphobia

This chapter explores bisexual (bi) people as well as those who have sexual relationships with both women and men, but who do not define as bisexual, and those for whom gender is not the primary source of their attraction to a person or persons. The chapter situates bisexuality within the wider cultural context of assuming sexuality to be dichotomous (people are either heterosexul or homosexual), and the invisibility and double discrimination that this results in for bisexual people. It also examines the high rates of depression and anxiety issues in this group related to biphobia and bisexual invisibility. The chapter covers intersections between bisexuality and other aspects of identity, outlining group norms within bisexual communities and considering the experiences of those who fall outside such explicit communities.

Chapter 9: Lesbian and Gay Sexuality

Keywords: Lesbian; Gay; Homonormativity; Homphobia; Coming out

This chapter explores gay and lesbian identities as well as those people who have sexual relationships with people of the same gender as themselves, but who do not define as gay or lesbian. It covers coming out, making sense of ones’ sexuality, and common sexual practices and relationship forms of lesbians and gay men, as well as issues relating to parenting and health/illness. The chapter also deals with the experiences of homophobia and heterosexism, both within public and clinical settings. and the attendant mental health concerns for some individuals. The chapter pays particular attention to he expression of sexuality and to intersections with other aspects of identity, as well as considering forms of homonormativity: the expectations that people will conform to a certain kind of lesbian or gay identity.

Chapter 10: Heterosexuality

Keywords: Heterosexual; Heteronormative; Marriage; Masculinity; Femininity; Penis in vagina sex;

This chapter examines heterosexual identities and practices, paying particular attention to the implications of being heterosexual in a culture that assumes heteronormativity, and the freedoms and limitations inherent in this. Particularly there is a focus on the pressures that people can face if they try to conform rigidly to a rather narrow definition of what it means to be heterosexual (only certain kinds of relationships, sexual practices, etc.)

The chapter relates to Chapter 4: Cisgender because it particularly considers the expectations upon heterosexual men and women regarding sexual practices and roles in relationships, families and everyday life. Common sexual and relationship practices are outlined, and the implications of shifting societal assumptions examined.

Chapter 11: Cross-dressing

Keywords: Trans; Transgender; Transvestite; Cross-dressing; Gender dysphoria; Fetishism; Dual role; Transphobia; Autogynephilia; Autoandrophilia.

This chapter examines the eroticisation of gender variance, including cross dressing transvestitism, drag, autogynephila and autoandrophilia. It covers the various common ways of being sexually intimate within these practices and identities, the terms employed and some common paraphernalia used. It examines both masculine and feminine expression and the cultural situation of these, as well as historical – and current – pathologisation. The chapter considers intersections with other aspects of identity, and overlaps with other sexual identities and practices. It pays particular attention to the role of the clinician in avoiding the reinforcement of negative stereotypes. It does not cover uneroticised gender variance as this is covered in Chapter 2: Transgender.

Chapter 12: Further Sexualities

Keywords: Slash; Adult baby; AB/DL; Furry; Cosplay; Fandom; Fetish; Rubber

This chapter explores professional work with people who have sexualities and identities which are either less common than those detailed in the other chapters, or are less commonly discussed if rather commonly practised. It touches upon some fetishes and the reading and writing of erotic fiction, as well as furryism, infantilism and voyeurism/exhibitionism, utilising these as illustrative examples, rather than chapters in their own right due to the dearth of scientific literature or accepted clinical guidelines on these topics. The chapter covers the various common ways of being sexually intimate within these practices and identities, the terms employed and some common paraphernalia used. It examines overlaps with BDSM and other sexualities and the pathologisation and marginalisation of minority sexualities in both the queer and heteronormative worlds. It also examines the role of the internet in support formation for minority sexualities.

Chapter 13: Monogamy

Keywords: Monogamy; Marriage; Heteronormativity; Infidelity

This chapter explores having a single highly intimate relationship at one time (monogamy), paying particular attention to its relation to cultural norms, including religious beliefs, assumptions around heterosexuality and heteronormativity, and the limitations and benefits associated with these. The chapter considers marriage as it is situated within mainstream culture and the freedoms and limitations imposed upon people who have this relationship structure. It explores infidelity as part of the wider picture of monogamy and non-monogamy and how this may be addressed in a clinical setting when working with individuals or couples.

Chapter 14: Non-monogamy

Keywords: Non-monogamy; Infidelity; Open relationships; Swinging; Polyamory;

This chapter explores having multiple highly intimate relationships simultaneously, including polyamory, open relationships and swinging. It explores the potentials of these and the constraints upon them, paying particular attention to the pressures on people whose relationship structures lie outside mononormativity. The chapter outlines common ways of conducting non-monogamous relationships, and the experiences of non-monogamous people. It considers the use of contracts in negotiated non-monogamous relationships, issues of disclosure, and the legal situation regarding open non-monogamy.


The glossary defines many of the terms used in the book which professionals may hear in the consulting room also. It defines many safe terms in a brief and to-the-point manner. It also contains a ‘Shadow Glossary’ of unsafe terms which may nonetheless be in common usage such that busy professionals can avoid at least a few of the pitfalls inherent in working within this ever changing and linguistically complex field.

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