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

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 by)

Paperback | 13 August 2026

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A professional guide to understanding and healing the impact of trauma on clients sexual livesA comprehensive guide for psychologists and sexual health professionals to understand how trauma shapes sexuality and intimacy. Drawing on clinical insight and research, it offers strategies to identify underlying causes of sexual difficulties and create pathways towards healing.



What if the challenges your clients face with intimacy are rooted in trauma they cant 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.

Industry Reviews

When Trauma Affects Sex is brilliant - easy to read, relatable, and full of heart. Its one of those rare books that makes your heart thump with excitement because you cant wait to get into the therapy room to put it into practice. With wisdom and generosity, Sarah guides us into the neglected corners of trauma and sexuality work, offering practical strategies and inviting deep self-reflections that inspire both professional and personal growth.
This book will spark a quiet revolution in how we engage with sexuality in the therapy room.



-Dr Carol Sandiford PhD/MPsych (Ed&Dev) Lecturer, Deakin University Sex & Sexuality Unit, Psychologist, Board Approved Supervisor



Dr Ashtons book is an incredibly comprehensive and helpful resource for every clinician who works with sex and trauma. It provides a systematic overview of the landscape of trauma and holds out hope for the many trauma survivors who experience sexual difficulties, and the clinicians who walk with them. Ill be adding this to my bookshelf immediately. -Dr Ahona Guha, Clinical and Forensic Psychologist, Board Approved Supervisor, Author and Speaker



Sexual Symptoms as Trauma Responses radically redefines sexual "problems" as the bodys intelligent attempts to cope with unresolved trauma. Dr. Sarah Ashton bridges neuroscience, attachment theory, and somatic healing to reveal how symptoms like numbness, anxiety, and avoidance are protective adaptations-not personal failures. Grounded in compassion and clinical depth, this book offers a path from sexual disconnection to integration, safety, and aliveness. -Jessica Fern, therapist, author of Polysecure and Polywise



As a clinician with over 30 years of experience, I found this book to be an outstanding and much-needed contribution to our field. In this well-researched, comprehensive, and insightful work, Sarah sheds light on the often-overlooked intersections of sexuality and trauma. With clarity and compassion, she demonstrates the importance of a trauma-informed lens when supporting people with sexual difficulties. Seamlessly interweaving case examples with theory, Sarah brings complex frameworks to life and provides practical tools that clinicians can immediately integrate into their work. This is the book Ive been waiting for. -Dr Anita Elias - Head of the Sexual Medicine and Therapy Clinic, Monash Health; Senior Lecturer, Dept of O&G, Monash University; Malvern Psychotherapy Centre

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