Sex-Positive, Kink Allied Therapists in El Cajon, CA

Photo of Alyse Freitas, Marriage & Family Therapist, MA, LMFT
Alyse Freitas
Marriage & Family Therapist, MA, LMFT
Online Only
In our society of "how do I fix it?", I believe the answer is found in embodied healing. In my practice, I focus on exploring the deeper layers of one’s experiences through more than just talk therapy. Whether you’re struggling with attachment wounds, trauma, disordered eating, marginalized oppression, body image, unhelpful thinking patterns, or the weight of shame and self-abandonment, I lead with a body-oriented approach to support the nervous system in restoring itself to a sense of calm and connectedness with the use of Brainspotting and Somatic Therapy.
In our society of "how do I fix it?", I believe the answer is found in embodied healing. In my practice, I focus on exploring the deeper layers of one’s experiences through more than just talk therapy. Whether you’re struggling with attachment wounds, trauma, disordered eating, marginalized oppression, body image, unhelpful thinking patterns, or the weight of shame and self-abandonment, I lead with a body-oriented approach to support the nervous system in restoring itself to a sense of calm and connectedness with the use of Brainspotting and Somatic Therapy.
(619) 350-2156 View (619) 350-2156
Photo of Cody Gustaveson, Psychologist, PhD, BCB
Cody Gustaveson
Psychologist, PhD, BCB
El Cajon, CA 92020
I'm Dr. Gustaveson, a Navy veteran a clinical psychologist in the San Diego area. I have been helping people manage through chronic pain, chronic illness, chemical dependency, OCD, insomnia, and other psychological challenges since 2017. Some of the people I work with never imagined they would be working with a psychologist. They suffer from conditions like heart disease, cancer, Parkinson's disease, migraines, insomnia, and other chronic health conditions. Some are actively seeking mental health support. I know it's hard to take that next step. Call us today to see if Clinic Ovis is the right fit for you.
I'm Dr. Gustaveson, a Navy veteran a clinical psychologist in the San Diego area. I have been helping people manage through chronic pain, chronic illness, chemical dependency, OCD, insomnia, and other psychological challenges since 2017. Some of the people I work with never imagined they would be working with a psychologist. They suffer from conditions like heart disease, cancer, Parkinson's disease, migraines, insomnia, and other chronic health conditions. Some are actively seeking mental health support. I know it's hard to take that next step. Call us today to see if Clinic Ovis is the right fit for you.
(619) 330-5477 View (619) 330-5477
Photo of Andrew Kocik, Pre-Licensed Professional
Andrew Kocik
Pre-Licensed Professional
Online Only
Feeling stuck in negative patterns or caught up in old stories about the relationship can cause pain and misunderstanding. Communication may feel difficult, trust might be shaken, and truly being heard by each other can seem challenging. The goal is to reconnect and rewrite the shared story in a way that brings hope and understanding. Together, it’s possible to break free from blame and resentment, see each other’s perspectives more clearly, and create a future where both partners feel valued, heard, and empowered.
Feeling stuck in negative patterns or caught up in old stories about the relationship can cause pain and misunderstanding. Communication may feel difficult, trust might be shaken, and truly being heard by each other can seem challenging. The goal is to reconnect and rewrite the shared story in a way that brings hope and understanding. Together, it’s possible to break free from blame and resentment, see each other’s perspectives more clearly, and create a future where both partners feel valued, heard, and empowered.
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Photo of Trinidad Castillo, Clinical Social Work/Therapist, LCSW
Trinidad Castillo
Clinical Social Work/Therapist, LCSW
1 Endorsed
Online Only
Hi, I'm Trini (she/her/ella), a queer and neurodiverse therapist who creates space for healing through authenticity, connection, and care. Our mental health is shaped by more than just personal struggles—identity, trauma, and systems matter, and I honor that in my work. I specialize in supporting adults navigating ADHD, anxiety, depression, life transitions, family conflict, and relationship challenges. I’m especially passionate about supporting first-generation, BIPOC, LGBTQIA+, and neurodivergent individuals who often feel unseen, misunderstood, or marginalized in traditional spaces.
Hi, I'm Trini (she/her/ella), a queer and neurodiverse therapist who creates space for healing through authenticity, connection, and care. Our mental health is shaped by more than just personal struggles—identity, trauma, and systems matter, and I honor that in my work. I specialize in supporting adults navigating ADHD, anxiety, depression, life transitions, family conflict, and relationship challenges. I’m especially passionate about supporting first-generation, BIPOC, LGBTQIA+, and neurodivergent individuals who often feel unseen, misunderstood, or marginalized in traditional spaces.
(626) 263-4171 View (626) 263-4171
Photo of Olga Goodman, Clinical Social Work/Therapist, LCSW, EMDR
Olga Goodman
Clinical Social Work/Therapist, LCSW, EMDR
3 Endorsed
El Cajon, CA 92020
You want to make peace with your past and enjoy the life you’ve built for yourself , but deep down you feel “not enough” and find yourself so overwhelmed that you are just going through the motions. You become irritable “for no reason” and your emotions often get the best of you, making you feel like a horrible person and impacting your relationships. Social interactions leave you exhausted from masking your feelings and overanalyzing everything you said or did. You often think to yourself "Is there something wrong with me?" and you have a sense that painful experiences from your past still affect your life today.
You want to make peace with your past and enjoy the life you’ve built for yourself , but deep down you feel “not enough” and find yourself so overwhelmed that you are just going through the motions. You become irritable “for no reason” and your emotions often get the best of you, making you feel like a horrible person and impacting your relationships. Social interactions leave you exhausted from masking your feelings and overanalyzing everything you said or did. You often think to yourself "Is there something wrong with me?" and you have a sense that painful experiences from your past still affect your life today.
(619) 789-0676 View (619) 789-0676
Photo of Carina Bondoc, Clinical Social Work/Therapist, LCSW
Carina Bondoc
Clinical Social Work/Therapist, LCSW
Online Only
Hello! My name is Carina Leilani Bondoc, and I am a Native Hawaiian and Mexican American Licensed Clinical Social Worker, based out of San Diego, California. My pronouns are she/her/hers. I work with adolescent and adult clients statewide, via telehealth. I am a strong advocate for folks, especially BIPOC and LGTBQIA+ people, to break through cultural stigmas surrounding mental health and use therapy as a tool to be a better version of themselves.
Hello! My name is Carina Leilani Bondoc, and I am a Native Hawaiian and Mexican American Licensed Clinical Social Worker, based out of San Diego, California. My pronouns are she/her/hers. I work with adolescent and adult clients statewide, via telehealth. I am a strong advocate for folks, especially BIPOC and LGTBQIA+ people, to break through cultural stigmas surrounding mental health and use therapy as a tool to be a better version of themselves.
(559) 242-1754 View (559) 242-1754
Photo of Emily Taylor Holcomb, Licensed Professional Clinical Counselor, MS, LPCC
Emily Taylor Holcomb
Licensed Professional Clinical Counselor, MS, LPCC
Serves Area
Hi, I'm Emily. You have the power of choice in choosing how and with who you get the help you want to address life's challenges. With my specialty trainings in Brainspotting and Feedback Informed Treatment (FIT), you have the power of choice to know you have a professional that will receive you and ensure we are on track with your goals. Bringing a down-to-earth approach, a touch of humor, and a genuine passion for helping people I'll use my skills to find solutions and empathy to your journey.
Hi, I'm Emily. You have the power of choice in choosing how and with who you get the help you want to address life's challenges. With my specialty trainings in Brainspotting and Feedback Informed Treatment (FIT), you have the power of choice to know you have a professional that will receive you and ensure we are on track with your goals. Bringing a down-to-earth approach, a touch of humor, and a genuine passion for helping people I'll use my skills to find solutions and empathy to your journey.
(619) 975-3380 View (619) 975-3380

More Therapists Nearby

Photo of Lauren Bountiful - Bountiful Wellness, Marriage & Family Therapist, LMFT
Bountiful Wellness
Marriage & Family Therapist, LMFT
1 Endorsed
Serves Area
We offer telehealth therapy for queer and gender-diverse, kinky, nonmonogamous, and neurodiverse folks across California. While these aren’t the only topics we explore, they are areas where we bring deep, lived-experience expertise. That means you don’t have to explain your identity, define your terms, or worry about judgment. We’re here to see you as you are, support you in reaching your goals, and celebrate every step along the way.
We offer telehealth therapy for queer and gender-diverse, kinky, nonmonogamous, and neurodiverse folks across California. While these aren’t the only topics we explore, they are areas where we bring deep, lived-experience expertise. That means you don’t have to explain your identity, define your terms, or worry about judgment. We’re here to see you as you are, support you in reaching your goals, and celebrate every step along the way.
(805) 926-6950 View (805) 926-6950
Photo of Olivia Duprez, Pre-Licensed Professional
Olivia Duprez
Pre-Licensed Professional
1 Endorsed
Online Only
Waitlist for new clients
I believe that therapy should be an adaptable process tailored to who someone is and what they need. I aim to meet clients with compassion and curiosity, creating an intentional, present, and client-centered space for healing. I am passionate about offering non-judgmental support and helping people live more authentically. I work collaboratively with clients to explore their uniqueness, build insight, and strengthen relationships. My approach empowers clients through open communication and a deep respect for their lived experiences, encouraging growth that extends beyond the individual.
I believe that therapy should be an adaptable process tailored to who someone is and what they need. I aim to meet clients with compassion and curiosity, creating an intentional, present, and client-centered space for healing. I am passionate about offering non-judgmental support and helping people live more authentically. I work collaboratively with clients to explore their uniqueness, build insight, and strengthen relationships. My approach empowers clients through open communication and a deep respect for their lived experiences, encouraging growth that extends beyond the individual.
(858) 365-9733 View (858) 365-9733
Photo of Valeriya Pestrikova - Valeriya Pestrikova - NonMonogamy, Couples, Sex , Marriage & Family Therapist Associate, MA, AMFT
Valeriya Pestrikova - NonMonogamy, Couples, Sex
Marriage & Family Therapist Associate, MA, AMFT
7 Endorsed
Online Only
I offer therapy and coaching for individuals and couples, specializing in alternative lifestyles, including non-monogamy, polyamory, BDSM/ kink, and sex work.
Together we delve into the emotional depths of relationship dynamics, emphasizing open communication and trust. We challenge conventional norms and foster unique paths to intimacy and connection, ensuring a non-conservative, affirming space. My approach is integrative, rooted in Psychodynamic theory, tailored for those exploring alternative lifestyles.
I offer therapy and coaching for individuals and couples, specializing in alternative lifestyles, including non-monogamy, polyamory, BDSM/ kink, and sex work.
Together we delve into the emotional depths of relationship dynamics, emphasizing open communication and trust. We challenge conventional norms and foster unique paths to intimacy and connection, ensuring a non-conservative, affirming space. My approach is integrative, rooted in Psychodynamic theory, tailored for those exploring alternative lifestyles.
(424) 392-6764 View (424) 392-6764
Photo of Rachelle Ann Ramos, Marriage & Family Therapist, MS
Rachelle Ann Ramos
Marriage & Family Therapist, MS
Online Only
I would describe the therapy I offer as client centered, nonjudgmental, collaborative, affirming, multiculturally responsive, and sex positive.
Clients who seek me out for therapy often identify with historically underrepresented groups such as Black, Indigenous, people of transnational-immigrant diaspora, LGBTQIA+ individuals/couples/CNM configurations, sex workers, and more. My therapy services include but are not limited to supporting individuals/couples/CNM configurations navigating life transitions, processing trauma to release the influence of the past on the present, as well as finding/developing their emotional balance. I have experience working with Consensually Nonmonogamous Configurations as well as Kinky populations in regard to my relational work.
I would describe the therapy I offer as client centered, nonjudgmental, collaborative, affirming, multiculturally responsive, and sex positive.
Clients who seek me out for therapy often identify with historically underrepresented groups such as Black, Indigenous, people of transnational-immigrant diaspora, LGBTQIA+ individuals/couples/CNM configurations, sex workers, and more. My therapy services include but are not limited to supporting individuals/couples/CNM configurations navigating life transitions, processing trauma to release the influence of the past on the present, as well as finding/developing their emotional balance. I have experience working with Consensually Nonmonogamous Configurations as well as Kinky populations in regard to my relational work.
(619) 732-3255 View (619) 732-3255
Photo of Stacey Jackson-Roberts, Clinical Social Work/Therapist, MSW, LCSW
Stacey Jackson-Roberts
Clinical Social Work/Therapist, MSW, LCSW
San Diego, CA 92108
This includes queer and trans individuals, parents and partners of LGBTQ+ individuals, practitioners of ethical non-monogamy, and those involved in kink.
I offer therapy to individuals exploring various aspects of gender (transgender, cisgender, and gender diverse) and sexuality (LGBTQ+, ENM/Poly) as well as general mental health. My goal is to create a supportive environment where we can tackle challenges related to sexuality, relationships, personal growth, and overall mental health. Together, we’ll engage in empathetic, nonjudgmental conversations to identify areas for growth and celebrate your achievements. I’ll customize our sessions using diverse therapeutic techniques to meet your unique needs, values, and goals, helping you define your journey in life and relationships.
This includes queer and trans individuals, parents and partners of LGBTQ+ individuals, practitioners of ethical non-monogamy, and those involved in kink.
I offer therapy to individuals exploring various aspects of gender (transgender, cisgender, and gender diverse) and sexuality (LGBTQ+, ENM/Poly) as well as general mental health. My goal is to create a supportive environment where we can tackle challenges related to sexuality, relationships, personal growth, and overall mental health. Together, we’ll engage in empathetic, nonjudgmental conversations to identify areas for growth and celebrate your achievements. I’ll customize our sessions using diverse therapeutic techniques to meet your unique needs, values, and goals, helping you define your journey in life and relationships.
(323) 417-5441 View (323) 417-5441
Photo of Bart Golub, Associate Clinical Social Worker, ASW
Bart Golub
Associate Clinical Social Worker, ASW
1 Endorsed
Serves Area
Do you ever feel trapped by societal expectations about how relationships "should" work, whether that's pressure to find "the one," get married, have kids, or maintain relationships that feel restrictive? Experience anxiety around disclosure—constantly calculating what parts of yourself are safe to reveal in different contexts? Have a pattern of people-pleasing or code-switching that leaves you exhausted and unsure of your own desires? Question your sexuality, relationship orientation, or other aspects of identity but fear the consequences of exploration? Feel isolated, unseen, or misunderstood despite having social connections?
Do you ever feel trapped by societal expectations about how relationships "should" work, whether that's pressure to find "the one," get married, have kids, or maintain relationships that feel restrictive? Experience anxiety around disclosure—constantly calculating what parts of yourself are safe to reveal in different contexts? Have a pattern of people-pleasing or code-switching that leaves you exhausted and unsure of your own desires? Question your sexuality, relationship orientation, or other aspects of identity but fear the consequences of exploration? Feel isolated, unseen, or misunderstood despite having social connections?
(415) 475-3558 View (415) 475-3558
Photo of Danielle Nelson, Clinical Social Work/Therapist, MSW, LCSW
Danielle Nelson
Clinical Social Work/Therapist, MSW, LCSW
1 Endorsed
Online Only
You're not going crazy- you're doing the best you can under crazy circumstances. I offer compassionate, open-minded therapy in Louisiana and California. My focus is to understand things from your perspective and work with you as a team to identify and meet your goals for growth. I know from personal experience that finding a therapist can be overwhelming- especially when you need one. The good news: just being here means you're on the right track. To get you started, I offer a free 15 minute phone consultation, so reach out. Even if we aren't the right fit, I'll try to refer you to someone who might be.
You're not going crazy- you're doing the best you can under crazy circumstances. I offer compassionate, open-minded therapy in Louisiana and California. My focus is to understand things from your perspective and work with you as a team to identify and meet your goals for growth. I know from personal experience that finding a therapist can be overwhelming- especially when you need one. The good news: just being here means you're on the right track. To get you started, I offer a free 15 minute phone consultation, so reach out. Even if we aren't the right fit, I'll try to refer you to someone who might be.
(619) 825-2414 View (619) 825-2414
Photo of Emily Davis, Licensed Professional Clinical Counselor, LPCC
Emily Davis
Licensed Professional Clinical Counselor, LPCC
Online Only
My training specializes in human sexuality, gender exploration, and kink or ethical non-monogamy curiosity.
Sexual liberation and exploration can help uncover psychosomatic healing and self empowerment. My priority is to offer a nurturing, non-judgmental and collaborative space where I support my clients integrate pleasure and autonomy into their lives. My services include, but aren't limited to, navigating desire discrepancies, processing sexual and relational trauma, releasing shame related to sexuality, supporting parents of LGBTQIA+ children and management of anxiety or depression. I work with individuals, couples, ENM configurations, sex workers, queer, trans or neurodivergent individuals.
My training specializes in human sexuality, gender exploration, and kink or ethical non-monogamy curiosity.
Sexual liberation and exploration can help uncover psychosomatic healing and self empowerment. My priority is to offer a nurturing, non-judgmental and collaborative space where I support my clients integrate pleasure and autonomy into their lives. My services include, but aren't limited to, navigating desire discrepancies, processing sexual and relational trauma, releasing shame related to sexuality, supporting parents of LGBTQIA+ children and management of anxiety or depression. I work with individuals, couples, ENM configurations, sex workers, queer, trans or neurodivergent individuals.
(619) 350-0930 View (619) 350-0930
Photo of Dr. Jem Powell, Psychologist, PsyD, MA, HSP-P
Dr. Jem Powell
Psychologist, PsyD, MA, HSP-P
7 Endorsed
Online Only
Updated:10/2/25 I believe that people want a life full of joy, challenge and deep connection with their loved ones and larger community. Unfortunately, many of us desire those qualities of life-but have trouble accessing them in the moment. I am here to encourage you to explore your joy, challenge areas where you struggle to connect and create a path to a life that is full of resonance and enthusiasm. If your goal is to address issues related to society and culture or have someone who deeply understands alternative lifestyles, those are my favorite types of clients. You can rely on my approach to be practical, candid and relatable.
Updated:10/2/25 I believe that people want a life full of joy, challenge and deep connection with their loved ones and larger community. Unfortunately, many of us desire those qualities of life-but have trouble accessing them in the moment. I am here to encourage you to explore your joy, challenge areas where you struggle to connect and create a path to a life that is full of resonance and enthusiasm. If your goal is to address issues related to society and culture or have someone who deeply understands alternative lifestyles, those are my favorite types of clients. You can rely on my approach to be practical, candid and relatable.
(818) 639-8939 View (818) 639-8939
Photo of Stephanie Trecha, Clinical Social Work/Therapist, LCSW
Stephanie Trecha
Clinical Social Work/Therapist, LCSW
1 Endorsed
Serves Area
I'm ENM, Poly, LS/BDSM/ Kink aligned.
Are you longing for a deeper sense of self and struggling to identify or voice your own needs? Falling back into old patterns of thinking and behaving that derail your relationships, your life goals, or trigger diminished feelings of self-worth? Are you struggling to connect intimately with your partner and can't find the words to talk it about it without shame, blame or conflict? Do you struggle to feel connected to people in your life, feel isolated, or overly anxious? Has trauma or past experiences been the building blocks of unhelpful core beliefs you wish to change? You're not alone, let's talk!
I'm ENM, Poly, LS/BDSM/ Kink aligned.
Are you longing for a deeper sense of self and struggling to identify or voice your own needs? Falling back into old patterns of thinking and behaving that derail your relationships, your life goals, or trigger diminished feelings of self-worth? Are you struggling to connect intimately with your partner and can't find the words to talk it about it without shame, blame or conflict? Do you struggle to feel connected to people in your life, feel isolated, or overly anxious? Has trauma or past experiences been the building blocks of unhelpful core beliefs you wish to change? You're not alone, let's talk!
(442) 313-2556 View (442) 313-2556
Photo of Dr. Matthew Seitman, Psychologist, PsyD
Dr. Matthew Seitman
Psychologist, PsyD
San Diego, CA 92108
I currently serve on the APA Kink & BDSM Taskforce.
I believe in the importance of honoring individual experiences, I work collaboratively with clients to provide individualized mental health care to support authentic living and healing. I ensure that my therapy space is a safe, sex-positive, LGBTIA+, ENM/Polyamory, and Kink affirming.
I currently serve on the APA Kink & BDSM Taskforce.
I believe in the importance of honoring individual experiences, I work collaboratively with clients to provide individualized mental health care to support authentic living and healing. I ensure that my therapy space is a safe, sex-positive, LGBTIA+, ENM/Polyamory, and Kink affirming.
(619) 558-1076 View (619) 558-1076
Photo of Elin Kiyoko Campbell, Clinical Social Work/Therapist, MSW, LCSW
Elin Kiyoko Campbell
Clinical Social Work/Therapist, MSW, LCSW
1 Endorsed
Online Only
I'm a sex-positive therapist who is aware and affirming of: LGBTQIA+, ethical nonmonogamy, kink, and am Neurodiversity Affirming.
Imagine being in a space that feels open, accepting, free of judgment—where you can show up as your full self without ever needing to censor or adjust who you are. I understand how challenging it can be to find a therapeutic environment where you feel like you truly belong, and it’s deeply meaningful to witness the relief clients experience when they’re able to engage authentically in the therapeutic journey. My primary focus is supporting individuals navigating complex trauma, sexuality-related concerns, and Neurodiverse clients. I have completed and continue to pursue specialized training and education in Sex Therapy.
I'm a sex-positive therapist who is aware and affirming of: LGBTQIA+, ethical nonmonogamy, kink, and am Neurodiversity Affirming.
Imagine being in a space that feels open, accepting, free of judgment—where you can show up as your full self without ever needing to censor or adjust who you are. I understand how challenging it can be to find a therapeutic environment where you feel like you truly belong, and it’s deeply meaningful to witness the relief clients experience when they’re able to engage authentically in the therapeutic journey. My primary focus is supporting individuals navigating complex trauma, sexuality-related concerns, and Neurodiverse clients. I have completed and continue to pursue specialized training and education in Sex Therapy.
(415) 570-6476 View (415) 570-6476
Photo of Bayley Raiz, Clinical Social Work/Therapist, DBH, LCSW
Bayley Raiz
Clinical Social Work/Therapist, DBH, LCSW
2 Endorsed
Online Only
You’re a gay man in mid-life. You’ve done the work. You’ve built a life with depth, identity, and probably a few scars. You’ve found strength in community—maybe in leather, chosen family, or relationships that don’t fit the mainstream mold. And yet… certain patterns still show up. Emotional walls. Disconnection. That old feeling like something’s missing—or still running the show. Daddy Issues Therapy is built for you. We take your lived experience seriously and use evidence-based tools to help you heal, grow, and lead with emotional clarity—on your own terms.
You’re a gay man in mid-life. You’ve done the work. You’ve built a life with depth, identity, and probably a few scars. You’ve found strength in community—maybe in leather, chosen family, or relationships that don’t fit the mainstream mold. And yet… certain patterns still show up. Emotional walls. Disconnection. That old feeling like something’s missing—or still running the show. Daddy Issues Therapy is built for you. We take your lived experience seriously and use evidence-based tools to help you heal, grow, and lead with emotional clarity—on your own terms.
(213) 787-7499 View (213) 787-7499

See more therapy options for El Cajon

Sex-Positive, Kink Allied Therapists

Why might an individual want to see a sex-positive, kink-allied therapist?

A sex-positive or kinky individual may want to see a sex-positive, kink-allied therapist because the client may feel safer and more supported discussing their experiences and challenges. A therapist who identifies as kink-friendly will have experience with clients having diverse sexual preferences and will likely be nonjudgmental and supportive about issues brought to the table. It is important to note that sex-positive, kink-allied individuals may find equal success with therapists who do not have such specialized knowledge and background. The most important factor in the success of therapy is for the client and practitioner to form a strong, trusting bond.

Do therapists have special training to gain expertise in sex-positive, kink-allied treatment?

Generally, no. There are limited training programs and unofficial accreditations that therapists can pursue, but a therapist’s expertise will ultimately come from their previous experience with similar clients, their engagement with organizations that promote sex positivity or kink-allied lifestyles, and the importance they place on safety and cultural sensitivity.

How can individuals recognize a good sex-positive, kink-allied therapist?

An experienced therapist is able to help clients explore their sexual identity and expression and relieve any discomfort or stigma attached to discussing such matters and the client’s overall challenges. A therapist who is sex-positive and kink-allied is able to create an environment that honors a client’s experience and sexual preferences. To recognize a good therapist, clients can simply ask directly about topics and issues important to them and gauge their comfort level and connection with a clinician based on the responses.

Can clients benefit from having a therapist with a focus on sex positivity and alternative sexual lifestyles?

Some individuals may feel most comfortable knowing that the clinician they’re working with has a commitment to creating an atmosphere of sex positivity and has experience with relationship diversity and alternative relationship structures. Working with a sex-positive, kink-allied therapist may help clients respect their own challenges and improve identity-affirming treatment.