Sex Therapy 101 with Cami Hurst
Welcome to Sex Therapy 101 with your host Cami Hurst. This is the sexiest podcast in the west for all the right reasons. Cami sits down with amazing experts in the field of sexual health and counseling to learn, converse and add her own expert voice to the conversation. Cuddle up with your partner and get ready to have your love life feel more complete.
Sex Therapy 101 with Cami Hurst
Introducing: Consenting to Unwanted Sex
What happens when women repeatedly say "yes" to sex they don't actually want? The answer might surprise—and disturb—you.
Dr. Cami Hurst pulls back the curtain on her groundbreaking PhD research examining the hidden consequences of "duty sex" in long-term relationships. Drawing from over 1,300 women's experiences, she reveals striking findings that challenge our understanding of consent and sexual health.
Most disturbingly, 53% of women who consented to unwanted sex with their partners developed moderate to high PTSD-like symptoms, despite no history of sexual assault or physical coercion. These women reported significant emotional distress, relationship strain, and sexual aversion that compounded over time. One participant captured this perfectly: "The cycle of duty sex and resentment has killed any kind of emotional intimacy in our relationship."
The research illuminates a troubling reality—that unrecognized verbal and emotional coercion permeates many bedrooms, with 82% of participants experiencing pressure after initially refusing sex. As one woman put it, "He was never coercive, only pouty and mad at me. It was easier to consent than to deal with his emotions."
This episode serves as an introduction to an upcoming series featuring diverse cultural experts exploring how different communities experience this phenomenon. Dr. Hurst aims to expand beyond her homogeneous sample to understand how cultural factors may contribute to or protect against these patterns.
Whether you're struggling with sexual desire discrepancies in your own relationship, working as a therapist with couples facing intimacy issues, or simply interested in relationship dynamics, this research provides crucial insights into why consent alone isn't enough. Share your experiences or thoughts by emailing cami@camhurst.com, and join us as we explore this important conversation over the coming year.
Hi friends, I'm really glad to be back in the podcasting chair and getting to recording and producing, something I really enjoy. But in this break I've taken, I've really been focusing on expanding my PhD research and starting conversations about it and trying to get insights, and begun the process of writing a book for the public about my research and as part of that, I wanted to clear up some of the limitations of my research, which was just this homogeneous sample that we got, you know, 1300 women, but they were pretty simple or similar, not simple, they were pretty similar, which may lead to the simplification of our findings, and really I have a desire to keep it complex so that we can honor each person's experience and needs who may find themselves in this situation. So, you know, several months ago I reached out to other experts in this area who have an cultural angle that can be really instructive in understanding this. So, you know, I reached out to sex therapists, who were an expert with one certain group or community or culture to try to understand how those influences might impact the outcomes some women experience when they consent to unwanted sex as a pattern in their long-term relationships. So what I'm going to show you now is the video I sent out months ago to the people that I really wanted to discuss this with and had a really great response. It's a little overwhelming to step into more of a public facing position and to reach out to like my heroes, like my mentors and the people that I've learned from that I really respect, and it takes some vulnerability and to put your research out there this baby that you created and spent so much time on. But it was so rewarding and I hope that you enjoy it too. So this is our introductory episode to a series that you'll be seeing coming out. The series is this cultural discussion about the outcomes of consenting to unwanted sex, and we're defining culture here as just any group that may have community beliefs or group norms, or may have community beliefs or group norms or rules and ideas based on the group that they belong to Could be racial, religious. You know, anything can start to create a culture within a group, and so here we go. Here's what I sent them. Here was the invitation. Hi there, I really appreciate you taking time to even consider this invitation.
Speaker 1:My name is Cammie Hurst, I have a private practice in Meridian Idaho and I'm working on a personal project which was my, you know, turning the results of my PhD research into something for the public. And the research was around what are the outcomes of women who consent to unwanted sex in the context of their long-term relationships, and we looked at emotionally, psychologically, sexual and relationship distress. And you know. Here's just some information about me. I am ASEC certified. I do have a PhD in clinical sexology. My background is as an LMFT, I do some supervision, I do some free education on a podcast. I don't have any financial disclosures to make at this time but I want to share with you about my PhD research and the outcomes and what I'd really love is your thoughts from your world as a professional in the communities that you come from and the communities that you serve. So this research we got over 1,300 women. It was really fantastic. Right now there's a manuscript in the final stages for peer review, for submission to an academic journal with my colleague, dr Lisa Diamond, who assisted me with this research and was on my dissertation committee, and I'm writing a book for the public about my findings.
Speaker 1:The purpose was to look at middle-aged women who are having an experience of sexual avoidance, low desire, sexual shutdown in their relationships. Some people might call this, you know, a long-term pattern of duty sex or sexual acquiescence or sexual compliance. But O'Sullivan, muehlenhard and Peterson are calling this consenting to unwanted sex and they left a lot of implications for further research in their findings. And that's what I picked up, all the things that they said. We want to know what this does in future research and those are the things that I chose as my hypotheses. The requirements for this group was that they needed to be over 30, because most of this research was done with college cohort women. We were asking for women who didn't have a history of sexual abuse, assault or violence, because we didn't want to mix those results in with the findings we were specifically looking for. They had, you know, to say yes, I've consented to unwanted sex in my long-term relationships and we were looking for people who'd been in a relationship longer than three years, so we weren't seeing a bunch of results from the limerence phase. So the first understand coercion. We ask that they not have a history of assault. But we really realized through this that recognizing emotional and verbal coercion on that other end of the spectrum that's not physical force, that it was really unrecognized, that here are the percentages of women who after they said no to an invitation to sex, what their partner attempted to do to try to get them to change their answer and realized that there's quite a bit of unrecognized coercions in long-term relationship. That's emotional or verbal coercion, and so we controlled for that in all of our outcomes. When we looked at what are the emotional, psychological, sexual and relational outcomes of this pattern, let's make sure we see what's from coercion and what's not. Unfortunately, there were only 18% of our sample that said that they had never experienced any of those post-refusal strategies. And so here is basically the end from the beginning. This is where we're headed, this is what we found and the difference between those who had some verbal and emotional coercion and those who had no verbal and emotional coercion. And here's just some examples. The participant quotes are the gold in this research study Over 700 submissions in their own words, and here's one you know, just kind of showcasing this confusion about coercion.
Speaker 1:It said he was never coercive, only pouty and mad at me. It was easier to consent than to deal with his emotions. His need for sex outweighed my disinterest in it. And this last one, one time I had a UTI. I tried to say no multiple times, but we were on vacation and he wanted to more. Since we were on vacation, even though it hurt and I cried, I let him. I should have said no more, but I figured if he didn't listen the first two times and he can see my physical responses of crying and being tense and he still kept going his need must be greater than mine. Again, these are people who checked that box of. I have no history of sexual assault, trauma or abuse, just completely unrecognizing what is coercion and what is not.
Speaker 1:Now for our emotional outcomes. We used the PANIS 20 to ask during the most distressing events of consenting to unwanted sex, what are the feelings that you had? We believe that there would be a significant minority of women who were experiencing high levels of distress, but in fact we found that the majority of women were experiencing high levels of stress during the most distressing times. They're feeling upset, irritable, distressed, guilty, ashamed, nervous, some even hostile. Here's some quotes about you know how it felt. And while resentment was not on the pannus, it was mentioned 157 times by the research participants when asked in their own words what the negative outcome was Guilt, shame, spiraling. I feel like I can be in my bedroom without feeling nervous and dreading that he will start touching me in my expectation of sex or I feel like I can't be. I should say the blame and the guilt makes me feel angry. I feel disrespected because he puts his needs first.
Speaker 1:Now we study the psychological outcomes of we use the PCLS to measure on your PTSD symptoms. We fully recognize that there wasn't a physical threat here and these percentages are women in the survey who reported experiencing this from a moderate to extreme levels. Here we can see the avoidance is super high, feeling upset is high, angry outbursts, irritability high and really, when we scored the PANAS with our sample, 39% had no severity. So that is great. There's 39% of women who consult or consent to unwanted sex in their relationships and we're not having psychological symptoms of PTSD with any severity. However, when you look at those who had a moderate to high severity, we're now at 53% of our survey population who were experiencing moderate to high PTSD symptoms from this specific situation.
Speaker 1:Here are some quotes that talk about you know, feeling some trauma-like symptoms. They're saying I feel like I have trauma now because of this. I find myself avoiding him when he's home. I avoid having sex with him. I avoid vacations because I sense they're another tactic to get sex. I feel an aversion now to sexual activity. I am uninterested now in sex most of the time.
Speaker 1:Another measure we use to look at what is the sexual and relational outcome of this long-term pattern and used this measure here from Frost and Donovan. You know there's a lack of physical affection, a sense of sexual predictability, a lack of initiation, a sense of hopelessness, a lack of normalness, anxiety, guilt, all coming up within the relationship because of this pattern. Oh man, these women just say such touching things, such profound things I have no desire for sex anymore, I have no desire for my partner. The cycle of duty, sex and resentment has killed any kind of emotional intimacy in the relationship, you know. And when we then coded the qualitative responses, we found that 31 times by survey participants they said they had a lack of sexual desire on sexual shutdown. So we looked at what about the frequency and ratio? Some of my critique was in the past. When this has been studied it's been how many times last two weeks. But what we're learning is a major symptom of sexual avoidance. And so we really can't exclude those low sex and no sex relationships from our findings and have them be very valuable. And so here we're looking at, you know, for this population, often, and very often we're up to 35% of people who consult, consent to unwanted sex in that relationship. You know they said everything just got worse as it continued. This patterns led to less intimacy. There's resentment, frustration and distance between us. There's a lack of desire to engage, resentment, frustration and distance between us. There's a lack of desire to engage.
Speaker 1:Here we were looking at the motivations, because that's kind of been the model by O'Sullivan is. Well, are your motivations to consent to unwanted sex an approach motivation toward the relationship? Are they an avoidance motivation, to avoid something negative? And we did find that the avoidance motivations were higher, more highly correlated with negative emotional and psychological outcomes. But for those who were even using approach motivations, they also had negative consequences, just not as high, like that the most. You know. Here's the reasons.
Speaker 1:I felt it was necessary to satisfy my partner's needs. I wanted to avoid tension in the relationship. I felt guilty, I was worried I would jeopardize our relationship. You know, here are all the motivations, with the percentages of our population and how they identify to this scale. This scale, okay, you know, and these women are saying I allowed myself to believe that if I didn't give it to him he'd find it elsewhere. I did give it to him and he still found more elsewhere. It was a false sense of security. So this is starting to feel like a coping mechanism, right Consenting to unwanted sex as a coping mechanism for some relational insecurity. I don't feel like I can make it on my own financially, so I stay in the relationship to have sex with him and Lisa Diamond and I you know we're like is this?
Speaker 1:We had a little discussion with the language. Is this really an avoidance or should we be looking at this as a coping strategy? Really, that sex is how women are keeping their safety in this relationship and that's why it's showing up as trauma. Even when there's not coercion. It's still showing those high distress emotional outcomes, those high PTSD-like symptoms, even when there's not coercion. It's high stakes for many of these women. Here's some of the quotes that lead to this idea of this is how we're keeping some social safety and that's why it's traumatic and why it's a big deal.
Speaker 1:I think the feeling that I shouldn't say no made consenting to unwanted sex traumatic. I worry that if I say no too often, he won't feel satisfied in our relationship. I get anxious about sex. I'm constantly worried about pleasing my partner and sometimes I have panic attacks before, during or after sex. For years I thought, and was told by my therapist, that there might be something wrong with me and that he would leave me if I didn't help meet his needs. It was my job to please him and not pleasing him would put me in a dangerous position. So this is where the trauma I think is coming from the social safety aspect.
Speaker 1:And so throughout this research, with our hypotheses most of them were confirmed that consenting to unwanted sex in long-term relationships did in fact for some women, in many cases, the majority of women create long-term negative emotional, psychological, relational and sexual symptoms for these women. Now this is a really quick recap of the research study, but we're playing around with this idea of proposing a possible syndrome of consenting to unwanted sex syndrome where there's emotional distress before, during or after a sexual encounter. It's highlighted by sexual resentment, sexual guilt, sexual inadequacy. These women are scoring moderate to high for situationally based post traumatic symptoms, and those symptoms at the height are avoidance, some developed aversion and anxiety, and the sexual relationship outcomes are these are low sexual frequency, relationships with sexual arguments with a decrease in sexual desire for the female and low sexual satisfaction for both. And here's how you can see how consent is just not enough to judge if the sex in a long term relationship has positive outcomes or negative outcomes. We need to be looking at more than just consent. We need to be looking for unrecognized coercion and we really need to be looking at the outcomes of the sex, not just if sex is happening, but what is the emotional, psychological, sexual and relational outcomes of the sex that is being had?
Speaker 1:Here's where I'd love your help. This study was very homogeneous in the cultural background and, as I'm writing this book, I'm not comfortable with that and I would love to have an interview with you. I'd love to pay you for your time and I want to really tap into your expertise. I'd love to know what your thoughts are about the community you come from and the community you work with, as far as what are the historical aspects of that culture that might contribute to this pattern of women consenting to unwanted sex? I'd also love to hear the aspects of the current community culture that's reinforcing this pattern, and I'd love to hear all the exceptions, about the cultural ideas that can be interpreted as preventative of this pattern and I'd love to hear all the exceptions, about the cultural ideas that can be interpreted as preventative of this pattern. Here are just the seven structured interview questions I'd love to ask you I want to set up a time. I'd love to pay you for your time. We'd spend about one hour really focused on these seven questions with you teaching me about how you would interpret my findings with your cultural expertise.
Speaker 1:Thanks so much for watching this. It was a huge ask. I really appreciate your energy and attention and time already and I hope to hear back from you to see if we can set up an interview to help flush this out for this project I'm working on. Thanks so much. So there you go. That is the conversation that began this series that we're about to begin releasing to you every couple of weeks, a new discussion with a new expert about a new group and how the idea of consenting to unwanted sex within that group might be practiced or experienced. I'm really looking forward to going on this journey with you guys over this upcoming year. I would love to hear your conversations and your thoughts and your insights. Feel free to email me at cami at camhurstcom If you'd like to share your experience with consenting to unwanted sex and its outcomes, or if you're a partner or a therapist of people who've worked through this dynamic as well. I would love to hear from you.