Sexuality and intimacy difficulties are often a part of the aftermath of sexual trauma. We argue that combining techniques from evidence‐based, trauma‐focused treatment with sex‐positive techniques used in sex therapy can best help survivors reduce trauma‐related symptoms and develop or regain comfort with their sexuality. In this article, we illustrate this approach by describing the case of a survivor of sexual assault, who completed 20 sessions of treatment that combined modules of trauma‐focused therapies, Cognitive Processing Therapy (CPT), and Prolonged Exposure (PE) with sensate focus therapy, a technique often used in sex therapy. The outcome of this case suggests that clinicians who work with sexual trauma survivors may want to consider a sex‐positive approach to conceptualizing and planning the course of treatment, to achieve optimal results.

Past research has demonstrated that women initiate sex less frequently than men in mixed-sex relationships, perhaps due to traditional sexual scripts that promote rigid gender roles in sexual interactions. However, there is no existing research on sexual initiation among women in same-sex relationships. This study investigated women's frequency and proportion of sexual initiation behaviors within mixed-sex and same-sex relationships, as well as the strategies women commonly used for initiating sex. Data were collected through retrospective reports (N = 351; 242 women with male partners and 109 with female partners) and two-week daily diaries (N = 60; 29 women with male partners and 31 with female partners). Results indicated that, across relationship type, women reported fairly balanced sexual initiation with their partners, with women in same-sex relationships reporting higher rates of initiation than women in mixed-sex relationships based on retrospective reports but not based on daily diaries. Women in mixed-sex relationships reported using a higher proportion of direct initiation strategies than women in same-sex relationships in the retrospective portion but not the daily diary portion of the project. These results challenge a number of gender and sexuality-related stereotypes about women in general and women in same-sex relationships specifically.