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Written by: Dr. Denise Renye

A queer person sits in my office describing a familiar pattern. They have spent years feeling responsible for other people's emotions, over-functioning in relationships, and struggling to identify their own needs. They can trace the pattern back to childhood. They understand how family dynamics shaped it. They can articulate the role that marginalization, shame, and adaptation have played in their life.

Yet they continue to find themselves in relational terrain that feels eerily familiar. The old themes persist, but not always in the same form. What once operated as an unconscious pattern is gradually becoming something that can be recognized, reflected upon, and, over time, transformed. They recognize the warning signs earlier than they once did. They understand how earlier experiences of marginalization, concealment, or rejection shaped their expectations of relationships. And still, when intimacy becomes possible, they find themselves pulled toward familiar dynamics: over-functioning, self-abandonment, choosing emotionally unavailable partners, or remaining disconnected from their own needs. The problem is not a lack of insight. The problem is that understanding a pattern and living differently are not always the same thing.

The distinction becomes visible beyond relationships as well. Another person speaks about finally feeling accepted by friends, affirmed in their identity, and connected to queer community. On the surface, their life looks very different from the environment in which they grew up. Yet they continue to struggle with hypervigilance, insomnia, self-doubt, and a persistent sense that they are somehow too much or not enough. They intellectually know they are safe. Their body does not.

As therapists, many of us work with individuals and couples who possess tremendous insight. They understand attachment, trauma, family systems, and the ways larger cultural forces have shaped their lives. They can often articulate the origins of their patterns with remarkable clarity. Yet insight alone rarely transforms a nervous system. Understanding why a pattern exists is not the same as being free from it.

This distinction feels particularly important in work with queer clients. Many of the challenges our clients bring into therapy are not simply intrapsychic. They emerge at the intersection of personal history and larger social realities. Experiences of marginalization, invisibility, rejection, shame, and threat do not remain external. Over time, they become both internalized and embodied. They influence not only what people believe about themselves, but also how they move through relationships, experience intimacy, and understand their place in the world. What begins as adaptation can gradually become a way of relating to oneself, to others, and to the world.

For many queer and trans people, the body itself becomes a site where social, cultural, and political realities are lived in real time. Questions of identity and belonging are not merely intellectual concerns. They are lived through the body and negotiated within relationships. This is particularly evident in my work with trans clients, as well as with parents, partners, and clergy seeking to support them. The challenges that emerge are rarely only individual. They reflect the ways larger cultural conversations become lived realities, shaping not only how people see themselves but also what feels possible in their relationships and lives.

These adaptations often persist long after the original conditions have changed. A client may intellectually know they are safe while their body remains organized around vigilance. They may understand the origins of shame while continuing to live as though they are fundamentally flawed. They may recognize a relational pattern while finding themselves pulled into it again and again.

This is where I began to find myself asking a different question. If larger cultural, political, and relational realities become embodied and repeatedly enacted within individuals and relationships, what does it mean to work therapeutically at that level? And could this work itself be understood as a form of social justice?

As clinicians who are often deeply aware of the realities affecting our communities, many of us are engaged in conversations about how best to contribute. Some participate in activism, advocacy, education, community organizing, research, policy work, or leadership within professional organizations. These efforts matter enormously and have helped create meaningful change within queer communities.

At times, I have found myself wondering whether we underestimate the significance of psychotherapy because its effects are often intimate, relational, and difficult to measure. Unlike policy, activism, or public advocacy, its impact rarely announces itself. Yet psychotherapy frequently engages the very processes through which experiences of marginalization, shame, exclusion, and belonging become embodied, internalized, and reproduced within relationships.

This is one of the reasons I have come to see work focused on embodiment, sexuality, trauma, and relational dynamics as operating upstream. Long before harm becomes visible in institutions, communities, or relationships, it is often carried in bodies and nervous systems. Long before it is enacted between people, it is experienced within them. Adaptations that once served survival can eventually shape expectations, relationships, and ways of being in the world.

The therapy room is one of the places where these patterns become visible. A queer client begins to recognize that shame is not an inherent aspect of their identity but a response to environments that required concealment. A client discovers that what they have long called intuition is often hypervigilance. A couple begins to understand how earlier experiences of rejection, abandonment, or danger continue to shape the ways they protect, pursue, and connect with one another.

The work is not simply intellectual. The task is not merely to understand these patterns. It is to develop the capacity to experience something different: to remain present where there was once shutdown, to tolerate intimacy where there was once fear, to experience desire without shame, to set a boundary without guilt, and to stay connected to oneself while remaining connected to another.

These shifts may appear personal, but they rarely remain there. The ways we organize ourselves around shame, safety, belonging, and connection often influence how we engage with others. When a client becomes less governed by shame, fear, self-abandonment, or reenacted trauma, the effects extend beyond the individual. They influence how that person participates in intimate relationships, friendships, families, workplaces, faith communities, and broader social networks.

What changes is not only how someone feels, but how they engage. A person who develops greater self-trust may become more capable of setting boundaries, tolerating difference, expressing desire, or remaining connected during conflict. A couple that interrupts a cycle of mutual protection may create new possibilities for intimacy, communication, and repair. Over time, these shifts alter the relational environments people inhabit and help create.

This is part of what I mean by working upstream. The work is not simply about symptom reduction or individual well-being. It involves engaging the patterns through which shame, fear, exclusion, and disconnection are carried forward across relationships and communities. When those patterns begin to shift, something larger shifts with them.

This does not mean therapy replaces activism, advocacy, policy work, or community organizing. Nor does it mean that individual healing alone can resolve structural inequities. Rather, it suggests that these forms of change are interconnected. If activism and policy often seek to transform the conditions in which people live, psychotherapy frequently engages how those conditions become embodied, internalized, and enacted within relationships. Working upstream is not an alternative to social change. It is one way of participating in it.

ABOUT THE AUTHOR:

Dr. Denise Renye is a licensed clinical psychologist, AASECT Certified Sex Therapist, and IAYT Certified Yoga Therapist based in Marin County, California. She specializes in LGBTQ+ affirmative therapy, queer relationships, sexuality, embodiment, trauma, attachment, and complex relational dynamics, working with both individuals and couples. Her work integrates depth-oriented psychotherapy, somatic awareness, and psychedelic integration.

In addition to her clinical practice, she provides consultation and supervision for therapists and consults with organizations on relational dynamics, communication, and workplace complexity. Dr. Renye writes and teaches on topics related to intimacy, desire, attachment, and embodied relational healing.

Written by Kay Guyer, LPCC, ATR-BC

In 2012, a small group of thoughtful, committed citizens changed the world,1 and this time, it was Gaylesta members and those they organized who did it. 2012 was the year California’s landmark Senate Bill 1172 became law, banning licensed mental health providers from practicing conversion therapy on minors. SB 1172 was then used as a foundational model for 22 other U.S. states and many countries who passed their own laws banning conversion therapy.

Our story begins in 2008 when marriage equality was on the ballot as a proposition in California. Gaylesta joined with therapists around the state asking major psychological organizations to make public statements supporting marriage equality. While some organizations were willing, there was a lot of resistance from other organizations like the California Association of Marriage and Family Therapists (CAMFT). Former Gaylesta Board President Rebecca Silverstein recalled, “This is when we discovered that CAMFT had a significant amount of therapists (primarily in Southern California) who were conversion therapists and actively opposed marriage equality as well.”

Following a CAMFT state meeting, Dino DiDonato reflected on the surprising level of controversy surrounding conversion therapy, “You’d think therapists would be easily opposed to conversion therapy, but it became a public political issue, and people tended to back away.” Dino goes on, “CAMFT was reflecting what was taught in graduate programs at the time, which was not to be politically involved. For me, that was an impossible expectation…It was personal, and it was political for us.”

Former Gaylesta Co-President Deborah Cooper, along with several board members, met with the CAMFT board president, asking CAMFT to take a stand against conversion therapy. Given there were conversion therapists who were a part of CAMFT actively causing harm in our community, Deborah recalls, “We had to speak out.” Following this, there was a CAMFT board meeting where Galyesta members and conversion therapists each spoke to the CAMFT board. Advocacy committee member James Guay was instrumental in challenging CAMFT’s homophobic bias by developing a clear timeline of CAMFT’s discriminatory actions and serving as a strong voice for affirming mental health care.

Gaylesta also asked the Board of Behavioral Sciences (BBS) to prohibit conversion therapy as a licensing board. Rebecca recalled the BBS’s response, “They said they can't keep their practitioners from practicing conversion therapy because they follow the law, and it’s not the law.” During a Gaylesta advocacy meeting, Rebecca recalls Dino’s reply was, “Well, let’s change the law!”

Gaylesta organized with major organizations on the conversion therapy ban, including the National Center for Lesbian Rights, who played a key role in drafting SB 1172.2 Gaylesta contacted two senators before finding California State Senator Ted Lieu, who was willing to put SB 1172 before the state legislature. As a survivor of conversion therapy himself, advocacy committee member James Guay testified before the legislature in support of SB 1172. Gaylesta members then went to work gathering over 30,000 online signatures. The signatures were delivered by advocacy committee members Jim Walker and Guy Albert, along with other colleagues, to California Governor Jerry Brown in support of him signing the bill. Governor Brown signed SB 1172 making it the first law banning conversion therapy on September 30, 2012.

Guy Albert acknowledged, “It was really the first bill to be passed to ban conversation therapy in the world, a big moment in the world and in Gaylesta activism.”

“It spread like wildfire,” Deborah Cooper went on, “When one person stands up, others stand up, and other states passed it.”

Following the passing of conversion therapy bans on state levels, Gaylesta members explored how to make it a national effort. Jim Walker looked to the U.K. where the 2015 Consensus Coalition organized healthcare and therapy practices to create a Memorandum of Understanding against conversion therapy. This sparked the idea to create the United States Joint Statement Against Conversion Efforts (USJS). Jim Walker and Guy Albert did an incredible amount of lobbying with groups in Washington D.C. and built relationships with dozens of organizations while being financially supported by Gaylesta. Jim and Guy’s efforts from 2015-2023 resulted in 28 national professional mental health and medical organizations signing on to the USJS, including the American Academy of Pediatrics, the American Medical Association, the American Psychiatric Association, and the American Psychological Association. The USJS currently has 29 signatory professional associations and is still managed by Guy Albert and with Gaylesta’s ongoing financial support to assure the website remains available to the public.

Believing that lasting change often requires working from within institutions, James joined the CAMFT State Board, where he advocated for stronger social justice engagement and helped advance more affirming policies and public statements in support of LGBTQ communities. Gaylesta’s grassroots organizing within CAMFT, as well as collaborations with other organizations like the Board of Psychology, resulted in CAMFT issuing an official statement against conversion therapy in 2016.3 Jim explains, “In our efforts to get the state CAMFT leaders to issue a statement against conversion efforts, we acted as CAMFT members and CAMFT chapter leaders to unify allies in various CAMFT chapters across the state. CAMFT chapter after chapter began issuing statements against conversion efforts before the state organization. Finally, from chapter after chapter speaking officially against conversion efforts, the pressure was on the state organization to issue a statement against SOCE [Sexual Orientation Change Efforts]. Grassroots change such as that can create more foundational change than top-down change. By joining with allies–especially at a grassroots level–you can accomplish so much more.”

Significant progress has come with significant challenges. A 2022 challenge to Colorado’s conversion therapy ban came before the U.S. Supreme Court in 2025. In preparation for this case, Guy coordinated with lawyers from Washington D.C. to write an amicus brief for the USJS to present to the U.S. Supreme Court. In March 2026, the U.S. Supreme Court ruled that Colorado's conversion therapy ban likely violated First Amendment free speech protections and sent the case back to lower federal courts to reconsider the law.4 In May 2026, the Colorado legislature passed a rewritten version of the law that prohibits therapists from imposing any predetermined outcome related to a minor’s sexual orientation or gender identity, whether affirming or non-affirming.5 The Supreme Court’s ruling opens the door for additional challenges to states’ conversion therapy bans for minors and raises questions about where we go from here to protect queer and trans youth.

Guy Albert shares his hopes for the future, “One of the dreams I have for Gaylesta is that it becomes an organization that is not just limited to the greater bay area. There’s a lot of advocacy that needs to happen on a national level. I am hoping that having a national organization, it would be able to reach other professional associations, promote more lgbtq+ oriented training, and have a single body that would lobby nationally.”

Reflecting on organizing knowledge gained, Jim Walker states, “Don’t let anything stop you from being advocates.” He acknowledged there were things he didn’t initially know how to do, but there’s a way in which advocacy efforts can come together quickly because of emotional support for a cause. “If you have an idea to advocate for something, run it up a flag pole and see if it flies.”

Many thanks are extended to interviewees Guy Albert, Deborah Cooper, Dino DiDonato, Rebecca Silverstein, and Jim Walker, as well as the many others who have put their efforts to the task of advancing rights in our community.

1 The popular quote in social change circles, “Never doubt that a small group of thoughtful, committed citizens can change the world; indeed it’s the only thing that ever has.” is attributed to American anthropologist Margaret Mead.

2 National Center for LGBTQ Rights. (2026). National Center for LGBTQ Rights. California Senate Bill 1172 - National Center for LGBTQ Rights

3 California Association of Marriage and Family Therapists. (2016, March 19). CAMFT Statement on Conversion Therapy (SOCE). Press Releases | CAMFT Statement on Conversion Therapy (SOCE)

4 Jouvenal, J. (2026, March 31). Supreme Court revives challenge to Colorado conversion therapy ban. The Washington Post. https://www.washingtonpost.com/politics/2026/03/31/supreme-court-conversion-therapy-colorado-ban/

5 Thompson, S. (2026, May 11). Colorado lawmakers pass rewritten conversion therapy ban after Supreme Court ruling. Pink News. https://www.thepinknews.com/2026/05/11/colorado-conversion-therapy-ban-supreme-court-jared-polis/

About the author:

Kay Guyer, LPCC, ATR-BC, is an art therapist supporting queer and trans youth and adults in Berkeley. They hold a bachelor's degree in Peace Studies and master's degree in Art Therapy Counseling, bringing together their commitment to social justice and belief in art as a vehicle for personal and collective liberation. Beyond their clinical work, Kay is passionate about creating spaces for community care and collaboration.

www.kayguyer.com

Written by Bridget Bertrand, LMFT

Today, I invite you into creativity. I hope you will join me. Before you keep reading, go grab some paper, pencils, pens, or any art supplies you have nearby.

When I start a creative practice, I have no idea where it will go. When I am dancing, there is no choreography. With pencil, watercolor, and marker, I go with the flow. Maybe, it’s all those years in dance class when I was young, with choreography and precision being the goal; now I would rather be free to move wherever, and however I want. I am letting my body, mind, and spirit be in flow.

There is something powerful happening in the brain when we create this way. Expressive creative practice can quiet the overactive, analytical parts of the mind and engage sensory and emotional networks, helping us regulate our nervous system. Research suggests that creative practices can lower stress hormones, increase dopamine, and support integration between the left and right hemispheres—essentially helping us feel more whole.

For years, I have been using watercolor and other materials to process and check in with myself in the morning. I have been writing more about this process, and I notice my thinking is somewhat slower—in a positive way. My thoughts and feelings typically come very quickly as someone with ADHD. Being a therapist and a facilitator has helped me slow down and reflect deeply on these experiences. This is a good time to take three of your biggest breaths of the day. I hope these words help you regulate. Take that paper and make a squiggle, a box to fill in with thoughts you want to let go of. Draw a shape that inspires you to return to the intention you are calling in. 

My meditation practice has deepened my inner slowness. I consider creative practices to be a form of meditation. In fact, when we are immersed in art-making or creative practice, we often enter a “flow state,” where the brain shifts away from rumination and into present-moment awareness. This state is associated with increased well-being and reduced anxiety.

Recently, a few comments about my work have stayed with me and are helping me craft and re-craft the messages of my offerings.

One friend asked, “Do you ever make art for art’s sake?” I think the question was also asking whether I create art to sell or because I see something I want to make—in my mind’s eye or in the world. The answer is almost always a complete nope. I can count the number of pieces I’ve made to represent a specific object, like flowers or a vista. I do have some consistent shapes in my work: hearts, rainbows, waves, clouds, and infinity symbols.

I deeply love questions about the things I create. I see my friends trying to understand what is happening in these messy, unpredictable, expressive arts practices. I also show my clients how messy and abstract this kind of creativity can be.  When I engage in a dance practice to a favorite song, I return to my off-Broadway theatre roots. Those shows were not linear, but like the abstract paintings I create most days. 

I remember clearly a wildly talented painter in a person-centered expressive arts training saying—and I paraphrase— “the movement scares me like the painting scares you.” After a decade of being out of the closet (yes, I am a late-in-life queer) and doing art weekly, neither painting nor moving scares me anymore. Painting feels like second nature, just like dance and movement. Putting them into the world does not scare me anymore, either. So, I invite you to make a creation, pick up that old craft discarded and gathering dust bunnies. 

You might be thinking, “I want to create something that looks like something in my mind.” That is completely fine. All I offer is that you create a space of compassion for yourself as you create.

If you are a dancer and want to paint your next movement piece, I encourage you to try it. Do all the things that help you get into your body and away from screens. Your nervous system will thank you. These times we are in call us to slow down, create for ourselves, share with our beloveds, and gather in community as we create. 

A second question that has stayed with me over the years from one of my clients: “Adults do that?” When I shared what expressive arts can look like in therapy sessions, I said, “Yes.” Do adults love committing to art in session? Do they dive in like kids? Not always. But they can play. Adults can play too.  We need to play in all forms, so I hope this short blog has inspired you.

I have said this for a decade: this stuff works. Art heals. When we create, we are not just making something—we are reorganizing our internal world, building new neural pathways, and giving form to what might otherwise stay stuck inside. Let’s live a little more in the moment—in color, in paint, in music, and in collage. Any Gaylesta member can book a free 30-minute creative session with me. My passion is sharing how creativity can support us now more than ever. 

About the author:

I am Bridget Bertrand (any pronouns), a queer parent with training in expressive arts practice, mindfulness, and embodied social justice. I grew up in the U.S. South, attended undergraduate there, and earned a degree in Theater Arts with a minor in Education. After graduation, Imoved to New York City, where I taught theater in four of the five boroughs and did acting along the way.

After years of parent meetings that felt a lot like therapy, I turned to a career in psychology while raising a child. I am thrilled to offer expressive arts and mindfulness sessions WORLDWIDE. It is an honor to walk along with clients, and I hope to inspire folks to find their own unique path toward healing. I have completed 150 hours of coursework centered on social justice and mindfulness at the Embody Lab and with the folks at MINDFL. All these courses are rooted in somatic healing. I am committed to creating mutual aid relationships with members of my community. Additionally, I am a Board Member at Large for Gaylesta and am on the Social and Membership committees.

Visit my website

Written by Lisette Lahana, LCSW

Healthy communication matters in every relationship, but LGBTQIA+ partners often have an extra layer of lived experience shaping how we talk and connect. Identity, minority stress, dysphoria, neurodivergence, safety concerns, and cultural or family expectations weave into the way queer and trans people show up in love relationships. Strengthening communication in LGBTQIA+ relationships begins with warmth, safety, and a willingness to understand each other’s stories. The following are LGBTQIA communication tools to help your relationships toward resilience.

Begin With Safety

Conversations tend to go better when both partners feel grounded emotionally, and physically. Sometimes this means choosing a calmer moment to bring up something tender. Other times it looks like a gentle check-in: “Is now a good time to talk?” When having these conversations you may use fidgets, weighted blankets, or other sensory tools that help you settle.

Creating this sense of safety is not about being perfect. It is about giving yourselves the best chance to stay connected while navigating something vulnerable. If you like more structure, the Gottman Institute offers research-backed ideas, self-help books and workbooks that many people in relationships find helpful.

Talk About Identity

Identity deeply shapes how we learn to communicate. Partners may have very different coming-out journeys, levels of family acceptance, relationships to gender, or experiences with dysphoria or racism. These differences can affect everything, from how comfortable someone feels expressing emotion to how quickly they shut down during conflict.

You might recognize patterns from childhood. Maybe you watched a parent, often a mother in some cultural contexts, quiet her own needs to keep the peace. Without meaning to, you might find yourself doing the same in your adult relationships. On the other hand, some cis men, trans men, and nonbinary trans masc folks carry internal pressure around masculinity and work hard to avoid communication styles that feel harmful or toxic.

Learning and talking about where your communication habits come from helps your partner understand you with more compassion. It also creates space to grow together.

Validate Each Other

For many LGBTQIA+ people, having feelings or identities dismissed has been a painful and repeated experience. This makes feeling validated within a relationship particularly powerful. When your partner truly listens and reflects that they understand, it can feel settling, like letting go of an exhale you did not know you were holding.

Validation does not mean agreeing with everything. It means offering emotional presence. Simply sitting with a partner and saying, “I believe you” or “I hear you” can be helpful.

A few additional examples:

“Your feelings make sense given what you have been through.”

“Thank you for trusting me with this.”

“I can see why that was hurtful.”

These small moments soften conversations and make it easier for partners to stay open to one another. Try starting with validation before adding hard feedback. It can help the other person feel safe enough to hear you.

Repair Quickly and Gently

There is conflict in most relationships. What matters most is how you come back together after something has gone wrong or off kilter. Repair can be especially meaningful for LGBTQIA+ partners who carry the weight of discrimination, family rejection, or the fear of being misunderstood.

Repairs do not need to be dramatic or perfect. The heart of repair is simple: turn toward your partner with care and begin a conversation.

You might say:

“Let me try that again. I really want to understand you better.”

“I hear how that hurt you.”

“Can we slow down and try to reset?”

“I care about us, and I want to reconnect.”

Repair is most effective when it happens early, before there is too much distance. These efforts at repair build trust and help your relationship stay resilient, even during stressful times.

Use Rituals

Rituals can bring a sense of steadiness and comfort to our LGBTQIA+ relationships. They do not have to be big or time-consuming; they just need to be intentional and consistent. Rituals communicate, “We are choosing to nurture our connection.”

A weekly check-in, a shared gratitude practice, or a sensory-friendly bonding ritual can give you a predictable place to return to each other. Maybe Sunday mornings become a time talk about what went well that week and what could help you feel more connected going forward.

Rituals can also be playful or creative. Cooking a meal together, choosing a queer pizza and movie night, making art or a night of DJing for each other. Reading gratitude lists to each other can strengthen mutual appreciation.

The best rituals are the ones that feel like you and represent your relationship. Let your personalities, sensory needs, cultures, and humor guide what you build together.

If You Are Feeling Stuck, Consider Therapy

Queer and trans love deserves tools that truly support it.

If you and your partner want help strengthening your communication, working through conflict or deepening your connection, the therapists at Gaylesta.org offer affirming relationship therapy for LGBTQIA+ relationships.

About the author:

Lisette Lahana, LCSW has been licensed for over 25 years and is a queer white, Latine therapist in California. She runs an online and Oakland-based private practice group, Authentic Alliance, serving LGBTQIA+ clients including offering relationship therapy and individual therapy for all ages. Lisette specializes in trauma therapy, work with transgender and non binary clients, their families, as well as mood disorders, such as bipolar disorder. She is a WPATH Certified Member and Mentor as well as an EMDR therapist.

Written by Dr. Denise Renye

In working with queer couples, the range of presenting concerns is broad and often complex. Desire discrepancy is one recurring entry point, and one that is often approached in ways that can miss what is actually organizing it. What often appears as a mismatch in desire is more frequently shaped by regulation needs, relational patterning, and the conditions under which desire can emerge.

Responsive desire is still often misinterpreted as diminished libido. In queer couples, this can be compounded by the absence of clear cultural scripts for how desire is “supposed” to function. Many people we work with expect desire to precede arousal. When it does not, they assume something is wrong. But for many people, desire emerges in response to conditions: feeling emotionally connected, physically at ease, and not under pressure. When clinicians orient too quickly toward increasing frequency, it can unintentionally reinforce the idea that desire should be spontaneous and consistently available. This often deepens shame and further disrupts the conditions that allow desire to emerge in the first place.

A common intervention in couples work is to focus on communication. While important, this often occurs without sufficient attention to whether either partner is regulated enough to engage. In many couples, particularly those organized around pursuit and withdrawal, conversations about sex are happening in states of dysregulation. One partner may be activated and moving toward contact as a way to restore connection or reduce anxiety. The other may be moving toward shutdown, protecting against overwhelm, pressure, or a loss of internal contact. In practice, this often looks like one partner leaning forward, trying to initiate a conversation about sex, while the other becomes quieter, less present, or subtly withdrawn. From this state, even well-structured communication tools tend to have limited impact. Desire does not respond to pressure. It responds to conditions. And those conditions are mediated by the nervous system.

In queer couples, pursuit and withdrawal can take on particular forms, especially in the absence of heteronormative roles that might otherwise organize the dynamic. One partner may move toward sex as a way of regulating distress or seeking reassurance. The other may experience that movement as demand, leading to further withdrawal. Over time, sex becomes organized around this pattern. It is no longer primarily an expression of mutual desire, but a site of regulation, negotiation, and, often, misattunement. Clinicians may inadvertently reinforce this dynamic by encouraging compromise without attending to the underlying regulatory mismatch.

One of the central clinical tasks is to hold both partners without quickly assigning dysfunction. The partner seeking more sex is often not “too much.” They may be attempting to regulate anxiety through closeness, or they may simply experience desire as a more central pathway to connection. The partner seeking less sex is not necessarily avoidant or low libido. They may be protecting against overwhelm, pressure, or disconnection from their own body, particularly if intimacy begins to move them outside their window of tolerance, where the body shifts toward activation or shutdown. In other cases, they may feel less oriented toward sexual connection, require different conditions for desire to emerge, or already feel more internally resourced without needing sex to regulate or connect in the same way. At times, one partner may feel more at home in their body or more available to pleasure, while the other is navigating tension, inhibition, or the lingering effects of trauma that shape how safety and contact are experienced. These differences do not inherently signal dysfunction, but they do shape how desire is experienced and expressed within the relationship. When either position is pathologized, the system tends to become more rigid. A non-pathologizing stance allows for a different kind of inquiry: What function is sex serving for each partner? What conditions support or inhibit desire? What happens in each partner’s body as intimacy becomes possible?

Queer couples are often navigating additional layers that shape how desire and regulation unfold. These can include histories of marginalization, internalized shame, and the absence of consistent relational templates, as well as the complexity of forming identity and attachment outside dominant cultural narratives. For some, these experiences are not only social but also somatic, shaping how safety, exposure, and connection are felt in the body, particularly in the presence of intimacy. In smaller or overlapping communities, relational patterns may repeat within shared social networks, making differentiation more difficult and increasing the pull toward what is familiar, even when it is not sustaining. These factors do not determine outcomes, but they do shape the relational field in which desire emerges.

Over time, I have come to understand these dynamics less as problems to solve and more as patterns to track. When desire discrepancy is approached primarily as a problem of frequency, interventions tend to remain at the surface. When it is understood as an expression of regulation, attachment, and relational patterning, the work begins to shift. The focus moves away from increasing desire directly and toward understanding and supporting the conditions in which desire can emerge. This often requires slowing down, tracking the nervous system, and working at the level where misattunement occurs. In this way, desire becomes less something to fix and more something to understand, support, and, over time, reorganize.

About the author:

Dr. Denise Renye is a licensed clinical psychologist, AASECT Certified Sex Therapist, and IAYT Certified Yoga Therapist based in Marin County, California. She specializes in LGBTQ+ affirmative therapy, queer relationships, sexuality, embodiment, trauma-informed care, and complex relational dynamics, working with both individuals and couples. In addition to her clinical practice, she provides consultation and supervision for therapists seeking deeper training in sexuality, trauma-informed relational work, and somatic approaches to psychotherapy. She also consults with companies and organizations on workplace relational dynamics, communication, and interpersonal complexity. Dr. Renye writes and teaches on topics related to intimacy, desire, attachment, and embodied relational healing.