The One Big Little Thing Survivors Need to Know About Sex

"Since my first ‘sexual’ experience was sexual abuse, I have never once been able to have an orgasm while having sex.”

We know that the more childhood trauma you were exposed to, the higher your risk for health and wellness challenges later on. But less well known is how past sexual abuse affects intimacy. I've been working with survivors for twenty years and have heard about intimacy issues just as long. Yet, this is an area where there is little hard data. So from 2016-2017 I conducted in-person interviews and did a brief, anonymous survey about the issue. One of the first people to share some of their story with me was “Jane”-

Jane is not alone in what she’s going through but she feels alone and that’s very painful. But here’s the one big little thing Jane needs to know: there’s nothing wrong with her. Her inability to orgasm during sex is common. (Also common are flashbacks, pain, lack of desire and an inability to get aroused.) So what’s going on? There are many possible reasons for a lack of orgasm. Let’s look at four biggies:

1. Vulnerability. Vulnerability is a way that we build and deepen connection with others. It’s a letting down of defenses in large and small ways. To be a survivor, however, means experiencing intentionally harm. It is to understand that you were seen as vulnerable or easy to manipulate. As a result some survivors are less open with people, even those they love and trust. Unfortunately, when they aren’t able to be vulnerable with people they trust, they can feel isolated and misunderstood. Being vulnerable during intimacy can be even harder, resulting in an inability to orgasm as a possible result.

2. Control. An orgasm is the peak of sexual arousal, then a release. Inherent in orgasm is a relinquishing of control*. But control is very important for abuse survivors who were hurt by someone who exerted their power over the survivor. Yielding control to someone else --even if a chosen partner and even with small, non-sexual things--can be very scary. So while it's a good thing to feel like you're in control, it can become a bad thing, especially during intimacy with a chosen partner.

3. Unpredictability of the body. Some survivors experience a betrayal of their body for the first time during their abuse. For example, their body may have responded in a sexual way to their abuse, despite obviously not wanting to be abused. Years later, they may be excited by a chosen partner and in a healthy relationship but their body may respond in a disappointing way, including challenges with orgasm.

4. Triggers. Dr Bruce Perry defines a trigger as any sensory input that reminds an individual of a past traumatic experience. Triggers can be a scent or a certain song. Triggers can happen years after abuse has ended and even if the survivor is in a loving relationship. They can be unpredictable, a trigger is more likely to surface during vulnerable times such as intimacy. Being touched in a specific place or hearing a certain word (“relax”) could be a trigger that inhibits orgasm.

While an understanding of how past abuse can impact the present is vital, so is a sense of personal agency. So what can Jane do?

One thing Jane can do is talk about the abuse. Jane mentioned she told partners that she is a sexual abuse survivor. This is a good first step. But because past abuse can come back to us at any time (triggers, during vulnerable times like intimacy, or even through media or current events) sexual abuse is not a one-and-done conversation. Jane also needs to find trusted people in her life that she can talk to about her abuse, beyond a partner or even a therapist. Having safe, trusted people in our life offers opportunities to practice being vulnerable. Doing so is an important way to build and maintain relationships and helps us feel resilient.

As we've learned, being sexual with someone requires vulnerability and an un-clenching of some of control. Emotionally, it's a very high risk place to be for survivors. But they can practice those skills in a low risk way with their safe, trusted people. Maybe they share a personal story or talk about a time when they felt scared or angry. They then can watch and notice how this information lands with the receiver. The best responses are ones that affirm their worthiness, validate that they're not the only one, remind them that we are loved and important just as they are. If talking about abuse feels scary or inaccessible, Jane could start by looking for an abuse survivor peer support group. Local rape crisis centers often host peer support groups.

Secondly, it’s imperative that Jane’s sexual partner is a chosen, desired partner. This might feel obvious but it's worth saying. A chosen, desired partner is the kind that causes the good kind of butterflies! Anticipation at being with someone and pleasure in their company is essential. These elements might feel different or new and that’s ok. Feeling indifferent or going through the motions work against setting the stage for good sex. And of course, feeling scared or pressured by a partner are red flags. No part of intimacy should ever feel unsafe.

The good news is that orgasms not only feel good but are good for us! They are especially healthy tools for survivors. A few areas of the brain that impact behaviors and thoughts (fear, self-evaluation, fight/flight/freeze) actually shut down during orgasm. These responses can be real challenges for survivors so being able to dim them, even temporarily during intimacy, is a welcome break. This relates back to control. Jane needs to feel as if she has choices and can exert control when she wants to. That is easier with a chosen, desired partner. Relaxing into pleasure can and should be a choice.

It can be embarrassing and lonely to be unable to orgasm with a chosen partner. But for Jane and anyone like her: you're not alone and there’s nothing wrong with you. 

*We can sometimes orgasm against our will, for example when we were abused. But in this case, we’re considering Jane’s story which I’m interrupting as her inability to orgasm during sex with a chosen, desired partner. 

This piece is originally from April 2017 but has been updated September 2025.

Behind The Scenes: "Can My Abusive Partner Change?"

Email from Tara:

"I'm in an eight year relationship and my husband's drinking has become a problem. When he is drunk, he's abusive toward me. I've spoken to him about this (when he's sober) but he either doesn't think there's an issue or can't remember what I'm talking about. I've invested so much time with him so I want it to work. But I'm at a loss about what else to do. Do abusers ever change?"

Tara raises a common question. 

Anyone who has ever been in abusive relationship, including me, can empathize with her. We've invested hard work into a relationship. We're willing to help our partner make changes in his or her own life so we can be in a healthy relationship again. But it takes two people to change what's wrong in a relationship, especially one where there is abuse.

The good news is that abusers can change. 
The bad news is that they don't usually want to.

Abusers know what works for them and they continue to do it because it does work. It works when there are no repercussions from their actions. The partner stays. The job keeps them on. Their siblings still speak to them as always.  Without any kind of accountability, there is no reason on his end to make a change.

Except love.

In a healthy relationship, if we bring a challenge to our partner, they will work with us on it because they love us. We are one of the most important people in their life. They want us to be happy.

In an abusive relationship, problems aren't problems unless they are the abuser's. Tara's husband is unwilling to admit that his actions cause her harm. My guess is that he may go a step further and blame her for what he does.  Abusers usually find a way to offload responsibility for their actions. Abusers are not skilled at owning their own shit. 

Abusers will sometimes stop their behavior when they are caught. When they get a DWI or get fired from their job for example. But stopping abusive behavior in those situations is circumstantial and often temporary. 

Everyone of us only changes when we want to change. 

I have lived the story of wanting someone to change too, Tara. And I've been teaching people about abuse forever. If he is not listening to you -the person he loves most in the world- he's not going to change.

So it's on you, dear one. You make the choice to save yourself or try to continue to save him, sacrificing yourself. It's never easy but it is that simple: there are only those two choices.  

Just remember, you're worth it. Now, today and tomorrow. Always.

11 Reasons Why "Breast Is Best" Makes You Wrong

A recent piece on Romper got me incensed. The author, Fiona Tapp, had given some thought to the "breast is best" mantra. Given the backlash she'd experienced, Tapp considered the facts behind "breast is best". In the end, she decided that saying "breast is best" is "perfectly OK". Tapp proceeded to offer 9 reasons to support her conclusion.

It's been a while since I have tackled this topic on the blog. But I talk about it often so it feels like a good time to revisit why I hate, yes hate, this term. Here are 11 reasons why "breast is best" makes you wrong.

1) Baby cared for and protected is more important than what baby is fed. Need science on that? Look at the ACE Study (here or here) or any other research on the affects of early childhood trauma and neglect. An especially good resource is Dr Nadine Burke Harris' TED talk. That's here.

2) Let's get this out of the way. Yes, formula is manufactured. And it's also medically necessary for many babies. Formula may be* the only option for babies who have a congenital deformation, some forms of hypoglycemia or babies who have lost too much weight. It's not common but some babies are actually lactose intolerant so they must formula. Medically necessary or not, babies need to be fed. If that's confusing, see #1 above.

3) 1 in 3-4 women will be survivors of sexual abuse in their lifetime. Some sexual abuse survivors are not willing or able to breastfeed. Feeding on demand, even in the middle of the night, and often in bed can be triggering for a survivor of abuse whose body has been controlled by someone other than herself. 

4) Low income moms are at a double disadvantage with breastfeeding. A) They are more likely to work low wage jobs which don't leave money for breastfeeding supplies. Supplies (from nipple shields to single use bags to a dependable pump) can be expensive! B) Poor moms are also more limited in childcare options. They may need to rely on an unethusiastic caregiver who isn't knowledgable about breastfeeding because of affordability or access issues. 

5) Not all parents have breasts! The breast cancer survivor, two dads, foster parents or adoptive parents may not have breasts or be able to lactate.

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6) Some moms cannot breastfeed, no matter desire, it's just not happening. This is something that I have heard for years. But last week I reached out to a Facebook group and asked about it. One woman, “Laura”, shared this ---------->

7) Breastfeeding isn't "natural" or "intuitive; it is learned. For topics that aren't covered in school (breastfeeding, healthy relationships), we rely others' experiences. Breastfeeding may remain a mystery if mom, sister or friend didn't do it. Support from an breastfeeding professional can be expensive and time-consuming.

8) Speaking of which...breastfeeding can save money but it can cost money. Time away from your work, even to breastfeed, generally means time you are not paid for. The United States is the only industrialized country without paid family leave. I asked a group of women how long they took off from work after their first baby. 90% of women said that they went back before they wanted to.

9) BF can also be scary for women who have struggled with body image issues. Here's how Fearless Formula Feeder Suzanne Barston describes it in her book, Bottled Up., having swollen, enormous leaking breasts was not only physically uncomfortable; it brought back every dark thought, every weird insecurity from a ten-year struggle with anorexia." (92)

10) Every day 3 women are murdered by their boyfriend or partner. These women usually aren't safe in their own homes. An unsupportive / abusive partner can see time with baby as time away from them. Formula feeding can stave off abuse, distract and/or get help around baby.

11) Some moms don't want to breastfeed. It doesn't matter why. Leave them alone already. Unless their baby is in imminent danger, just walk away from your judgment of their life.

Bottom line: Breastfeeding is a privilege. Some of us are more privileged than others. Until we right the wrongs mentioned above and add:

milk sharing programs;

donor milk programs that are actually free; 

access and education for all families who want to breastfeed;

paid leave;

 and so much more, breastfeeding will remain a privilege.

Slogans like "Breast Is Best" make us wrong but maybe that doesn't bother us. But what should bother us is the marginalization and isolation of new parents. BIB comes out after the presents are open and the freezer full of food is empty. It's bandied around at a time when some some moms don't have a moment to themselves to shower. When the partner has gone back to work and mom is alone for at home with a crying baby. When new parent policy is more endangered than ever, we need to strengthen the ties that bind us, not encourage further divisiveness.

We’re better than this.

*I say "may be" here because expressed milk can be an option. Milk banks are banks, however, and are usually too expensive to be sustainable long-term for even the most resourced families.