For the Kinksters

Something OT practitioners need to keep in mind as we (humbly) approach the topic of sex with clients is how people can have sex in countlessly different ways –many that may be unfamiliar to us, and some of ways that may even be considered…

Kinky.

Kink is a broad term that describes aspects of sexuality that fall outside of the mainstream ideas of sexuality. In more detail, The Kink Clinical Practice Guidelines Project defines kink as “…sexual identities, erotic behaviors, sexual interests and fantasies, relationship identities, relationship orientations, and relationship structures between consenting adults not accepted by the dominant culture. We specifically include BDSM (Bondage/Discipline,  Dominance/Submission, Sadism/Masochism), Leather, and Fetish as important parts of the umbrella term of kink” (p. 4). 

 The Kink Clinical Practice Guidelines Project is composed of a multidisciplinary team of healthcare providers, therapists, educators, and advocates working in the area of sexual health. The organization spent years pulling from research, experts, and best-practice guidelines to create The Kink Clinical Practice Guidelines, a series of 23 recommendations designed to assist providers in delivering competent care to patients.

 A few of these guidelines stand out to me as parallels to our own Code of Ethics and Standards of Conduct:

•  Guideline 2: Clinicians will be aware of their professional competence and scope of practice when working with clients who are exploring kink or who are kink-identified, and will consult, obtain supervision, and/or refer as appropriate to best serve their clients.
•  Guideline 17: Clinicians should evaluate their own biases, values, attitudes, and feelings about kink and address how those can affect their interactions with clients on an ongoing basis.

As OT/OTAs it's on us to work through the discomfort and biases we have about the occupations people engage in - otherwise we are likely negatively impacting therapeutic relationship or causing harm. Remember, it's not about knowing or understanding everything. Lacking competency is expected - how could we possibly know about every occupation as engaged in by people with diverse client factors?? We can't! Cultural humility is about knowing yourself and your biases and then taking responsibility to work through those biases.

And remember, these are occupations that bring people joy and pleasure. While there's guidelines to help us as clinicians and social messaging that is exclusionary, these folks are having a grand time getting their kink on & as clinicians we can be joy/pleasure centered when we're working with them!

Have questions about kink and OT? Reply back and let us know!

 Talk soon and keep up the trailblazing!

American Occupational Therapy Association. (2020). AOTA 2020 occupational therapy code of ethics. American Journal of Occupational Therapy, 74(Suppl. 3), 7413410005. https://doi.org/10.5014/ajot.2020.74S3006

Kink Clinical Practice Guidelines Project. (2019, December). Clinical Practice Guidelines for Working with People with Kink Interests. https://www.kinkguidelines.com/