When Trauma Affects Sex: An integrated and inclusive approach to understanding and treating individual and systemic trauma in sexual health therapy

by Sarah Ashton, Kate Balestrieri (Foreword)

What if the challenges your clients face with intimacy are rooted in trauma they can't yet name? Drawing on decades of clinical experience, Dr Sarah Ashton reviews current research and introduces a groundbreaking, easy-to-use systemic model showing how trauma shapes clients' experiences of sexual identity and sexual relationships. Through in-depth fictionalised client narratives, reflective exercises, practical strategies, and the Sexual Health Integrated Formulation and Treatment (SHIFT) model, Ashton demystifies the connections between past experiences and present challenges.

Unpacking the neurological, psychological, relational, and systemic influences on sexual functioning-and using inclusive, neuro-affirming, LGBTIQA+-friendly language-this book provides a practical roadmap for understanding the "roots" of sexual difficulties. It considers attachment history and traumas from family of origin through to minority stress and sexual trauma, guiding therapists to identify underlying patterns, recognise overlooked factors, and apply techniques that foster healing, resilience, and empowerment.

Written for psychologists, sexual-health practitioners, educators, and clinicians, this resource equips professionals to address sexual symptoms with confidence and compassion.

Kindle Edition

Expected publication June 18, 2026