Pleasure in a Post-Roe World

For millions of people in the United States, their bodies no longer belong to them. In 26 states, lawmakers are deciding to outlaw abortion, in many cases without the exception of rape, incest, or life of the pregnant person. This new reality means that for many, where you live will determine whether a pregnancy in your body will have more rights than you do for life, liberty and the pursuit of happiness.

Unintended pregnancies happen. Medically complicated pregnancies that put the life of the pregnant person in danger happen. Maternal mortality rates are higher in the United States than in most developed nations, making pregnancy a dangerous experience for many— physically and politically.

Abortion is a safe and common procedure that one in four people with a uterus will have by age 45. People who have abortions come from all walks of life- from your family dentist, to your postal worker, barista, school teacher, neighbor, mother, friend. It’s a necessary procedure that many people will need in their lifetime. And for many, obtaining this safe, effective procedure will now become impossible, extremely burdensome, or criminally illegal. Sperm can now cause a traumatic experience- being pregnant and forced to carry to term against one’s will. How do we reconcile with this new reality?

As a therapist, reproductive rights activist, and person with a uterus, I’ve been wondering how sex therapy will change with these new legal realities. How can I continue to support penis-in-vagina (PIV) intercourse when it comes at such a risk to the person with the vagina? Further, research shows that for people with vaginas, most don’t find it to be pleasurable anyway. It’s a role expectation, something they’ve learned is “sex” and superior to non-penetrative forms of sexual activity.

Mostly- it’s people with penises who want the PIV. And they will never become pregnant as a result.

So as a sex-positive, pleasure-focused therapist, how do I advocate for a sex act that is now so politically charged and literally dangerous?

I think it comes down to comprehensive sex education, contraception, and informed consent. “Oops” means something completely different in 2022 than it did in 2021. And that’s just the beginning.

Pleasure is a holistic experience, and can include anything from gentle caressing to oral stimulation, fantasy, relaxation, connection and even joy. Perhaps it’s time to redefine pleasure, including sexual pleasure, to be less focused on PIV and more focused on safer, more empowering forms of play.

Ultimately, I will meet my clients where they are, and will support them to make the best decision for themselves. Whether that means PIV, abstaining, pregnancy, or abortion.

Pleasure is our birthright. It’s time to get more creative with how we experience it.