As open as we are about sex in American culture, the more personal it becomes, the less likely we are to discuss it. And even less inclined to talk about improving it.

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Given that sex is everywhere in our culture — there are even sexual innuendos in G-rated Disney movies — you wouldn’t think we’d have a problem discussing it with our sexual partners. But we do.

I recently had the opportunity to discuss sex and candor on the Inside Mental Health podcast with Dr. Bat Sheva Marcus, a licensed clinical social worker with a PhD in human sexuality.

She explained that sex in our culture is so overly romanticized that we can’t talk about it in any meaningful way outside of humor, prowess, or bravado. This leads to myths that great sex “just happens” persisting and, when it doesn’t, people believe there’s something wrong with them — or their partners.

“Nobody actually has real conversations,” Marcus begins. “When was the last time you sat with friends or family and had real conversations about real issues that come up with sex?”

You can bookmark this article on how to get comfy talking about sex.

I brought up pop culture portrayals of sex. In the movies and on television, sex is perfect. No stuck buttons or zippers, and even makeup stays on without so much as a smudge. Marcus points out that it’s more than just how sex looks in the movies. “They always have intercourse,” she says, while further expounding that “the woman has an orgasm from intercourse, which is so unusual.”

When you consider that we aren’t having candid conversations surrounding sex and that we’re comparing our real-world sex lives to what we see in pop culture, it’s not surprising that we’re left uncertain about our own sexual skillset.

It’s no wonder that many people — and relationships — are suffering due to some cognitive dissonance and a lack of basic information.

“In the movies and on television, sex is perfect. No stuck buttons or zippers, and even makeup stays on without so much as a smudge.”

– Gabe Howard

If we’re reluctant to speak to our partners about sex-related issues, I was curious if people are seeking — or should opt to seek — counsel from a clinical professional.

“Yes,” Marcus began to answer, but then she pivoted in a way I didn’t expect, which she’s wont to do. To be fair, Marcus is a front-runner in her industry with cutting-edge opinions and research on sex ideals and issues.

“Often, therapists themselves are so uncomfortable with sex. They have some of the same preconceived notions. They don’t know how to address these issues.”

I asked her point-blank if she believed that people were getting incorrect information from the average therapist, and Marcus replied, “I’m going to say something even more direct here, which is that therapists often become unwitting accomplices in this narrative of ‘if you can fix the relationship, the sex will follow.’“

While a bad relationship could lead to bad sex, it’s also possible for bad sex to lead to issues in the relationship, she says. The general advice that all sexual issues can be resolved by working on the relationship is equally wrong, Marcus asserts.

Marcus points out that some sexual issues are biologically based. “Because you get older,” she explains, “your hormones are lower, your blood flows less good, all fixable, all addressable.” She notes that if you tried to fix any of the aforementioned issues by working on the relationship, you would fail and likely blame yourself, your partner, or your relationship.

While a bad relationship could lead to bad sex, it’s also possible for bad sex to lead to issues in the relationship. The general advice that all sexual issues can be resolved by working on the relationship is equally wrong.

–Dr. Bat Sheva Marcus

I asked how a person determines if sex is good, great, or bad, considering that this is largely a matter of opinion, and if we aren’t discussing it with our partners, it becomes a matter of a single person’s opinion.

“What I think is an incredibly helpful notion to people is that your sex life is going to constantly change,” says Marcus. She explains that great sex at 20 may be bad sex at 40. The aging process alone can impact how we feel about sex.

“But if you consider other factors like switching partners, lifestyle changes, and even repetition, what was once great sex can easily become boring or bad sex,” Marcus elaborates.

To assume great sex is this static Hollywood snapshot would be akin to this analogy:

“[It’d be like] If I handed you a suit when you were like 18 years old,” Marcus begins with a slight chuckle, “and said, ‘This is a suit you’re going to wear for your whole life, and it doesn’t matter if you grow 3 more inches or gain weight or lose weight or the styles change or the elbows fray, you’re just going to wear this suit your whole life.'”

Her analogy made me think about other activities I enjoyed doing at 18, 25, or even 30 that I no longer enjoy in my mid-40s. On an intellectual level, she made sense, but on an emotional level, I can see where something as personal as our sex lives isn’t as easy to swap out as something like musical preferences or hobbies.

Great sex at 20 may be bad sex at 40.

– Dr. Bat Sheva Marcus

Marcus explains that consistently great sex is negotiated between couples on an ongoing basis.

“There will always be changes in your sex life, and you will always hit road bumps,” she says, noting the importance of communication again. “Realistically, it makes more sense that sex isn’t some magical ability we are born with, but rather a skill set we can learn and improve upon.”

Researchers in 2020 curated a compilation of interviews and studies to find commonalities of magnificent sex that’s timeless and universal. Components included:

  • present moment awareness
  • partner synchro and connection
  • erotic intimacy
  • profound empathy and (nonverbal and verbal) communication during sex
  • authenticity
  • vulnerability
  • exploration
  • An “undoing,” or transcendence beyond the physical

“You don’t give up on sex the first time you hit a roadblock,” Marcus states matter-of-factly. “Almost everything is solvable. If there’s a problem, you can make it better. When people realize that, it’s an aha moment.”

I asked Marcus to address some of the stereotypical things that get in the way of having good sex. “The big overriding one is that they don’t address the problems,” she says, “because, on some fundamental level, they don’t think they’re fixable.”

Marcus stresses that when people are having bad sex, they think “it’s because something fundamental and deep is wrong, as opposed to let’s make some tweaks, let’s see if we can make it better, because I promise you, in most [instances] that is the case.”

Marcus adds, that, in fact, she has seen the reverse be true of relationship issues:

“And I’ll even go one step further, Gabe, which is that sometimes if you fix the sex, the relationship will follow. That’s the irony that we just don’t even acknowledge culturally. We just don’t acknowledge that.”

Want to learn more from Dr. Bat Sheva Marcus? Click the player below or visit the official episode page for “Is Sex a Skill We Are Born With?” Inside Mental Health Podcast episode.

Gabe Howard

Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book “Mental Illness Is an Asshole and Other Observations,” available from Amazon; signed copies are also available directly from the author.Gabe is the host of Healthline Media’s weekly podcast, “Inside Mental Health.” You can listen and learn more here. Gabe can be found online at