“Why don’t I want sex the way I used to?”
It’s one of the most common questions that eventually finds its way into the therapy room.
I say “eventually” because many people don’t bring these concerns up right away. Sexual difficulties are common, yet most people experiencing them never discuss them with a healthcare professional. Instead, they spend months or years trying to make sense of things on their own.
What if nothing is wrong with your desire?
By the time we start talking about desire, people are often carrying a great deal of anxiety. They worry they have lost attraction to their partner. They wonder whether something is wrong with their body. They fear they are somehow broken because they don’t experience desire in the way they think they should.
Inspired by a recent sex therapy course with Dr. Morag Yule, I’ve been reflecting on how often misunderstandings about desire create unnecessary distress. So let’s talk about what contemporary sex therapy has taught us about sexual desire.
The good news is that many of these concerns begin to make more sense when we broaden our understanding of how sexual desire actually works.
The Story Most of Us Were Taught About Desire
Enter the linear model of sexual response. Enter the linear model of sexual response. It’s the story many of us absorb from movies, romance novels, popular culture, and even some forms of sex education.
The story goes something like this: first you feel desire, then you become aroused, then sexual activity happens, ends with a grand orgasm and tadaa!
A similar model is the Staircase Model of sexual arousal.
The Problem With the Linear Model
Things may work that way for some people, some of the time. However it makes some assumptions that don’t fit with reality for most people;
- it assumes that desire comes first, that it just shows up.
- it assumes that spontaneous desire is normal and that if desire isn’t there spontaneously, something is wrong.
- it assumes that all parties involved can orgasm easily
- it treats sex as a destination: intercourse, orgasm, finish
As a result folks not experiencing spontaneous desire feel broken. Partners interpret the absence of desire for them as rejection. There is also no room to ask what creates desire when it does happen. Based on this model clinicians end up giving advice like “this is a desire mismatch, some couples have to negotiate”. Couples end up feeling stuck.
Not All Desire Starts the Same Way
Sex educator and researcher Emily Nagoski has helped popularize the distinction between spontaneous desire and responsive desire.
Spontaneous desire is what many people imagine when they think about sexual desire—it seems to appear out of nowhere. Responsive desire, on the other hand, emerges in response to something: emotional closeness, affectionate touch, flirting, erotic stimulation, or simply creating space for intimacy.
Although responsive desire is often discussed in relation to women, people of all genders and sexual orientations can experience both spontaneous and responsive desire. Human sexuality is far more diverse than many of us were taught to expect.
As Nagoski writes, “If you have responsive desire, you are already normal.”
For many people, this idea can feel like a relief.
It means that not feeling “in the mood” before intimacy begins does not necessarily indicate a problem. Desire may show up after connection begins rather than before it.
This understanding is reflected in newer models of sexual response. Rather than viewing sexuality as a staircase with a fixed sequence of steps, contemporary sex therapists often think about desire as part of a more dynamic and interconnected process.
What Actually Creates Desire?
Rosemary Basson’s influential model of sexual response highlighted that people become interested in sexual intimacy for many reasons, including a desire for connection, closeness, pleasure, or emotional intimacy. Desire and arousal do not always arrive first. Sometimes they emerge along the way.
Basson’s cycle suggests that willingness to be open to a sexual connection is the beginning point, not spontaneous desire.
One of the most important insights from contemporary sex therapy is that sexual concerns rarely have a single cause.
A Bigger Picture of Sexual Wellbeing
When someone is struggling with desire, arousal, or sexual satisfaction, we look beyond the symptom itself. We become curious about the bigger picture.
- How is stress affecting you?
- Are there medical concerns, hormonal changes, pain, or medication side effects?
- What messages did you receive growing up about sex and sexuality?
- How connected do you feel to your partner?
- Are there unresolved hurts, communication challenges, or feelings of pressure surrounding intimacy?
Sex therapists often refer to this as a bio-psycho-social-relational approach. While the name is a mouthful, the idea is simple: our sexual experiences are shaped by our bodies, our emotions, our relationships, and the environments we live in.
Rather than following a straight line, sexual desire is often shaped by an ongoing interaction between desire, arousal, pleasure, emotional connection, satisfaction, meaning, and context. This reflects something many people already know from lived experience: our sexuality is complex, and it is deeply affected by what is happening in our lives.
Moving Beyond the “All-or-Nothing” Approach to Sex
One of the difficulties with the linear model is that it treats sex as a destination: intercourse, orgasm, finish.
More recent approaches, such as the Wheel Model described by Martha Fogel-Mersy and Kate Vencill, invite couples to think about intimacy more broadly.
Rather than placing intercourse at the centre, the wheel recognizes many forms of physical and emotional connection: affection, sensual touch, playfulness, eroticism, pleasure, closeness, and partnered sexual activities.
This shift can be especially helpful for couples navigating differences in desire, chronic pain, illness, recovery from surgery, aging, or life transitions. It creates room for connection without pressure and often allows desire to emerge more naturally.
When we approach sexuality this way, we can move away from asking, “What’s wrong with me?” and begin asking more helpful questions.
- What helps me feel connected?
- What helps me feel safe?
- What gets in the way of desire?
- What conditions allow intimacy to grow?
- What would I like to explore?
Perhaps the most important takeaway is this: a change in desire is not automatically evidence that something is wrong with you, your body, or your relationship.
Desire is influenced by context, stress, health, relationship dynamics, life circumstances, and the meanings we attach to intimacy. When we understand desire as something that can be cultivated—not simply something that appears spontaneously—we often find new possibilities for connection.
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If you have questions or concerns about your sexual wellbeing, you do not need to figure them out alone: get in touch! Therapy offers a supportive, non-judgmental space to explore these conversations openly. Whether you are navigating differences in desire, changes in your relationship, concerns about sexual functioning, or simply wanting a healthier relationship with your sexuality, these are conversations that belong in therapy.
Many people wait years before bringing up sexual concerns to their MD or therapist. You don’t have to. Sometimes understanding your experience through a new lens can be the first step toward feeling more connected—to yourself, to your partner, and to the kind of intimacy you want in your life.
Sexual health resources
Pleasure and Desire – Books:
Becoming Cliterate, Laurie Mintz
Come As You Are: The Surprising New Science That Will Transform Your Sex Life, Emily Nagoski
Come Together: The Science (and art!) of Creating Lasting Sexual Connection, Emily Nagoski
Desire: An Inclusive Guide to Navigating Libido Differences in Relationships, Lauren Fogel Mersy and Jennifer Vencill
Cisgender Men’s Sexuality – Books:
Not Always in the Mood – Sarah Hunter Murray
The New Male Sexuality: The Truth About Men, Sex and Pleasure – Bernie Zilbergeld
Coping with Erectile Dysfuntion: How to Regain Confidence and Enjoy Great Sex, Michael Metz and Barry McCarthy
Shows:
Netflix – Principles of Pleasure
The Big Sex Talk – CBC Gem
Sexual health-related Podcasts:
Dan Savage: Savage Lovecast
Emily Nagowski: Come As You Are
Do We Know Things
Dr Justin Lenmiller: Sex and Psychology
Additional Resources
Magnificent Sex: Lessons from Extraordinary Lovers
What Fresh Hell Is This? Perimenopause, Menopause, Other Indignities and You, Heather Corinna
Couple Sexuality After 60, Barry McCarthy and Emily McCarthy
Trans Sex, Lucy Fielding
The Stonewall Generation, Jane Fleishman
