Let’s talk (more) about sex: Experts lament lack of sex therapists, resources in Iowa

Talking about sex is hard.

Perhaps that's why there are so few doing it professionally in Iowa.

In fact, Denise Stapley is the only sex therapist in the state certified by the American Association of Sexuality Educators, Counselors and Therapists (AASECT), and she rarely accepts new patients.

'I don't want to be the only one in Iowa,” Stapley said. 'I turn people away all the time ... There's more need than I can manage in my practice.”

There are a small handful of therapists in the area Stapley trusts to refer excess clients to, but no one else is certified. Anyone who claims they are without the proof of training or education, that's what 'freaks her out,” she said. 'That's where I get nervous, because being a sex therapist I take very seriously.”

That being said, when people call her saying they're interested in the field and looking to become certified, she has a 'party in her office,” she said.

'There's a desperate need in our area to have trained clinicians that really know what they're doing and can offer a safe environment,” she said.

That's exactly why Rhonda Estling, a marriage and family therapist at the Cedar Rapids Relationship Center, is currently in pursuit of her own AASECT (American Association of Sexuality Educators, Counselors and Therapists) certification.

Estling earned her master's degree in marriage and family therapy from Mount Mercy University and formed the Relationship Center with her business partner, Jennifer Gage, last year. For the past six months, she's been working toward her certification and plans to have it within the next year and a half.

For Stapley, however, it took quite a bit longer.

She started in 2000 after earning a master's degree in mental health from the University of Northern Iowa in 1996. In 2006, she received her certification.

'It was a long road to get here, but it's worth it,” she said.

In order to maintain that certification, she must renew it every three years, which means continued education. But even that 'never feels like enough,” she said.

To become certified in the first place, applicants must hold an advanced degree that includes psychotherapy training from an accredited university, be licensed in the state to practice, complete a minimum of 90 hours of sexuality education coursework, 60 hours of 'psychosexual disorders” training, 300 hours of AASECT supervised clinical treatment of patients with sexual concerns and complete the Sexual Attitude Reassessment (SAR), which requires them to explore their own feelings, attitudes and beliefs regarding sexuality and sexual behavior.

'Not all therapists are comfortable talking about sex,” Estling said. 'We try to be open but some judgment is just there.”

'Anyone who tells you they don't have biases or won't judge you is a load of crap,” Stapley said. 'We all have biases. That doesn't mean you can't be a great therapist, but it means you have to be aware of those biases and if you're able to challenge them.”

'You can't do this work if you're not aware of your yikes factor,” agreed Anthony Rodriguez, founder of the Men's Center in Iowa City and a certified sex addiction therapist.

Part of doing therapy is being able to 'stay in the same space with your client,” listening with curiosity and compassion, he explained. Otherwise your bias 'will be broadcast” in your reaction.

'Those underlying judgments can cause a lot of shame,” Estling said.

Many people feel shame regarding sex for a variety of reasons. One of the biggest, though, is a lifetime of messages casting negative light on the act of sex or sexuality in general.

'Everywhere you look there's something that's sexualized,” Stapley said. 'It's all over the place, but we're never given the tools to learn how to talk about it like rational adults.”

Many schools teach abstinence-only programs that leave out important facts, for example, she said.

'We're taught that sex is dirty, that it's bad, and yet, you should save it for the one you love,” Stapley said. 'So it gets kind of twisted.”

That, or people simply won't talk about it because it's too uncomfortable. So it becomes 'steeped in shame and judgment,” Estling said.

'It's so secretive, so hush-hush,” she said. 'We need a place where we can feel safe to talk about it.”

'Sexuality is such an integral part of who we are. It's part of our identity,” Stapley said. 'If we don't talk about it, nothing is going to change. It will continue to be cloaked in shame. We just need to be able to talk about it, not shut it down and be afraid of it.”

Those safe spaces are lacking, especially in Iowa, experts say. Resources are limited, they're not accessible or visible, they say.

Rodriguez said some of his clients drive one to two hours to see him, since so few in the state specialize in these issues.

'It feels really disjointed,” Stapley said of resources for sexual health. 'There's a huge need, not only for more providers, but also for some way to connect our community.”

A handful of resources for sex health in the corridor:

' American Association of Sexuality Educators, Counselors and Therapists: www.aasect.org

' Denise Stapley, AASECT certified sex therapist: www.denisestapleytherapy.com

' Tony Rodriguez, clinical director of the Men's Center: www.themenscenter.net

' Rhonda Estling, sex therapist in training at the Cedar Rapids Relationship Center: www.crrelationshipcenter.com

' PFLAG & Transformations Cedar Rapids, a support group for gay, lesbian, bisexual, queer, transgender and questioning people: www.pflagcr.com

' Advocates for Youth, an educational resource for sexual health for youth (national): www.advocatesforyouth.org