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Writer's pictureEvelin Dacker MD

Sex Positive Life Lessons for Today

“There is no way to repress pleasure and expect liberation, satisfaction, or joy.” Adrienne Maree Brown

There existed a time before I was in my body. It was quiet. My body was not my own. It was a sacrifice I gave up for motherhood, social acceptance, and the security of partnership. It did not matter that silence kept me trapped, since tears made no sound.


The sounds of pleasure — laughter, screams, and moans — broke me into pieces. They came to me in waves; distant sounds in other hotel rooms, a movie that helped me escape, the laughter of new lovers. Left unto themselves, the pieces of me would continue to break, gradually becoming nothing more than sand slipping through my fingers. Luckily, I found the container to hold the broken pieces of self, reflect them back, and create a kaleidoscope of ever changing beauty. I began my journey back into my body, my life, and my community through the doorway of sexuality.


Sexuality has not only been a journey of embodied pleasure but also a deeper connection to source. The lessons I learned through a sex-positive perspective have been vital to navigating this past year. It may be strange to imagine that sex can somehow be related to our reality today — a time of social distancing, isolation, and upheaval. Yet, it is not the act of sex, but the integration of sexuality as a positive and healthy aspect of being alive helping us move forward during these difficult times.


In 2015, after an expensive four-year process, I completed a program and was certified in Functional Medicine. Functional medicine approaches the possible “root causes” of disease and illness. It aims to improve health and wellness by reconstructing a healthier gut biome through better nutrition, balancing hormonal interactions through stress management and supplements, minimizing inflammation through food choices, and supporting health as a lifestyle choice. I felt both excited and intellectually stimulated by a bigger toolbox of healing options. At the completion of my studies, I perused the books being sold at the annual conference: “The Mind-Gut Connection”, “The Blood Sugar Solution”, “The Missing Hormone”. Then it hit me, the missing piece to wellness and healing that was never addressed: pleasure.

Sex is fundamental for the ongoing longevity of our species; however, sexual energy serves many functions, not just reproductive. At its best, it provides a source of physical pleasure, release, and deep comfort. It brings us together, opens us up to love, provides physical joy, and helps us feel embodied. What a gift each of us carries within ourselves!


At its worst, sex can be shameful and terrorizing. Because sex can provide such deep connection, it can also instill trauma. Trauma held in our mind contributes to trauma in our body. Sex can be profoundly healing — a shared experience that holds us together. It can also act as a conduit for trauma that breaks us into pieces.


At the time, both were playing out in my personal life. My teenagers needed me less, my husband’s drink needed him more; thus, I began the expansive journey of self discovery on my own. It was a cataclysm of hormones, motherhood, boredom, and the desire to be something else, that landed me on my ass, complete with fishnets and knee socks, in roller derby. My first sex and body positive group of rebellious, excited women. Roller derby saved my soul.


Roller derby provided a place where I was able to let go of my professional image, take on the persona of Dr. Whack-her, and flirt with other skaters. I was surrounded by women who were tired of being mother’s, wives, professionals and caretakers. We wanted to be fierce and fast, while knocking each other down in play rather than in life. As a skater, I wasn’t very good. I spent most of my time falling but the fishnet bruises made me feel like a bad ass. Menopause loomed ahead. My spouse’s alcoholism, the mistress in our marriage, distanced me from the person I loved most. I was moving further and further away from my body. I was shutting down, no longer desiring of any physical intimacy. Dressing up in booty shorts and skating in circles allowed sexual energy to flow again. This led to careless flirting, mindless crushes, and to kissing women on the dance floor after parties. I didn’t want to lose myself and I wasn’t able to contain myself either.


The ramped up sexual energy of roller derby, the lack of integration of sexuality in wellness medicine, and my own midlife awakening, lead me to the study and understanding of sexual health.

I wanted answers. How can mainstream medicine, the alternative health community, and our education system all ignore something this fundamental to our humanity? What makes sex so taboo to speak about in a positive, beautiful way? Why is sex shamed, controlled, silenced, and relegated to disease and illness?

“Sexual health is a state of physical, mental and social well-being in relation to sexuality. It requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence.” World Health Organization, 2006


Sexuality is fundamental to the human experience, regardless of where we exist on the sexual spectrum, and the role it plays in our body must be acknowledged in medicine and healing (all forms, but especially allopathic medicine). By focusing on the positive aspects of sex and sexuality, we shift our view from the lens of disease and dysfunction to joy and connection.


Sex can also tell us a story of a person’s relationship to their body. It told me mine:

  • I have self-pleasured since I can remember. I didn’t know what I was doing; it was a physically comforting sensation. I didn’t understand why I was shamed when I was caught. Judy Blume finally named it for me in her book, “Deenie”. I was 14.

  • I was taught to never trust the intentions of men. My mother, with a history of sexual abuse, tried to protect me from harm by installing fear. It worked.

  • I believed that I would be a virgin until I got married. For that reason, I shut off any desire living in my body until I was 20. I became very good at disconnecting.

  • Love and sex belonged together. It was a sacred act belonging to the temple of my body. I first fell in love with a bisexual man at 20, with two women and a man traveling together when I was 22 and with my future spouse at age 27.

  • My vagina rebelled soon after I met my future spouse. The burning pain with intercourse was unprecedented. I grit my teeth and endured this for three years until I learned in my residency training that birth control pills sometimes cause vulvodynia (pain in the vulva with intercourse). My spouse and I never used this as an opportunity to discover pleasure outside of penis in vagina sex. I suffered.

  • I gave birth to two children, one at home. I breastfed for a total of 4 years while working a full time job as a family physician and obstetrician. I was tired.

  • 20 years married to an alcoholic. Along the way I lost the desire, joy, and connection of sex.

  • “Mating In Captivity” by Esther Perel gave me hope to rediscover sexuality. I had an idea, opened up a door, walked into consensual nonmonogamy.

“Sex-Positive: An expansive, shame-free understanding that sex and sexuality are a fundamental life energy that provides pleasure, joy and connection to self (embodiment) and others (community). To be in alignment requires curiosity, communication, consent and cooperation. “ — my own personal definition

Sex positivity can transform many things. It not only gave me a narrative for my life, it gave me an insight to others. It became a philosophy that included the importance of consent, clear communication, embodiment and pleasure. Releasing shame and the cultural stories that work to control sexuality, we are better able to connect to our body. We can more fully understand our desires and boundaries. More importantly, by teaching consent, it brings us together with honest communication of who we are.

Gabriella Cordova, the founder of Sex-Positive World and Sex-Positive Portland (SPP), MeetUp groups formed in 2009, writes, “Sex positivity is a liberation movement. We take care of each other, practice the communication skills we learned and taught, practice informed consent when deciding what activities are appropriate to our risk level, and we observe confidentiality rules… We are successfully balancing safety and freedom, recognizing that one must forfeit some of one to have some of the other.”


I joined SPP in 2016, and later became the Executive Director in 2018. SPP was critical in my understanding of sexuality. It broke down its teaching in steps, starting with understanding boundaries, communicating consent, then moving into more touch based activities. SPP taught a harm reduction approach to sexual choices and helped people understand the spectrum of normal. Through my learning, I developed a model for sexual communication called STARS (Sexual health, Turn-ons, Avoids, Relationship intentions, Safer sex etiquette). Destigmatizing STIs through my teaching helped develop an understanding of risk tolerance. Recognizing the difficulty health care providers have discussing sex (and gender for that matter), I started teaching other health care providers about sex positivity. My focus in medicine moved from Functional to functioning: pleasure-affirming, self-actualizing, shame-reducing, consent-based, sex-positive medicine.


My work in sexuality, showed how acceptance, communication and pleasure are such powerful healing modalities. Extending the concepts beyond “sex”, can help us reimagine a future that built on conscious relationships and intimacy based on trust . Adrienne Maree Brown, in her groundbreaking book “Pleasure Activism”, writes, “Our radical imagination is a tool for decolonization, for reclaiming our right to shape our lived reality.”


The sex-positive movement provides lessons helpful to navigating 2020. Understanding boundaries, consent, clear communication, desires, risk tolerance and intentions are critical to our creation of social cohorts. Learning to accept people’s differences, moving away from judgement and shame, can help us create a new “normal” as we rebuild our society. Accepting pleasure as a guiding principle, we create a healthy society based on abundance and love rather than socially accepted scarcity principles that keep us trapped in ongoing battle with one another.


There is a lot of anxiety over that which is uncontrollable, unknowable, and unpredictable. Rather than further fractured our economic, political, and health care system, finding a way to bond us is critical now. Anger over institutionalized injustice, the declining belief in science and mistrust of news, burn like the fires in the West. What is real is fake news. What is fake is becoming our not so alternative reality. We feel the Autumn chill, and can sense the possible social unrest and smell the smoking fires. It is confusing, frightening and overwhelming and at the same time, hopeful. Imagine what our future can be like if we came together with joy and compassion.


Sex Positive Principles to Help Us Create a New Normal:

  1. Accepting sex as healthy and sexuality as a gift, we utilize pleasure as a conduit for loving and healing ourselves. Pleasure as a principle allows better self-care, reduces shame and improves relationships to others. Removing shame from our pleasure bodies helps us access abundance to move forward in uncertain times.

  2. Sexuality, the life energy that created us, is integral to being human and is complex. Sexuality is not just what we are doing with other people, many people are asexual, but what is alive in ourselves. By regarding each other with curiosity and openness we can let go of our biases and judgement. We learn to not “yuck someone’s yum” and make room at the table for each of our unique qualities.

  3. Boundaries are fundamental to healthy relationships. By creating a container for our no, allows yes to be an authentic choice. Boundaries keep us in integrity and learning to communicate them is essential to liberating relationships free of coercion.

  4. Agreements are easier to co-create when we are honest about our intentions with one another. Through boundary setting and affirmative consent, we work towards meeting each other’s needs and desires. This is critical now during times of physical distancing, social unrest, and political uncertainty. Creating and honoring agreements keeps us in integrity and builds trust.

  5. Safety is an illusion. Rather we work toward “safer”. Understanding risks, harm reduction, and intentions, we can all be in agreement with one another.

  6. Destigmatizing infectious disease opens the door for honest communication. Understanding risk tolerance, the individual choice between risk aversion and risk taking, helps us align with one another to reduce transmission. We see infections as a normal part of being social animals, and therefore we take responsibility to test, disclose and use precautions to reduce getting each other sick.

  7. Alternative relationships and sexual styles can be models for sustainable social structures. Navigating outside of the socially acceptable cis-gender, monogamous, reproductive based relationship style, allows us to work towards inter-dependence, sovereignty and away from systemic oppression.

All the events in 2020 have stressed our society in ways that we could not have been prepared for. By recognizing our need for one another, for not only physical pleasure but emotional support, we can utilize the lessons of sex-positivity to help us create healthy connections during such uncertain times.


A sex-positive approach teaches us that understanding our desires and communicating our needs is good. Elevating the pleasure and joy of a healthy connection with others improves our quality of life. Lessons of curiosity, communication, consent and cooperation are vital for us in moving forward. Recognizing sex as pleasure, pleasure as healthy, and health as the integration of body, mind and spirit, we move away from suffering. Being human is hard. It is easy to get stuck in the belief that struggle is our birthright and dis-ease is natural. Joy and pleasure are a path of bliss to transcend the thinking mind of suffering. We need this now more than ever.

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