From closing the orgasm gap to consent: what safe & pleasurable sex means today
Rachael Martin
Wellness
Reading time: 6 minutes
“It’s time to reframe what we see as successful sex and instead tailor sex to what feels good to you.” We speak to NHS doctor and sexual wellness influencer, Dr Tihesia Riley on everything from communication to non-penetrative pleasure & more
Sex. Let’s talk about it. There’s no denying it evokes a vast array of views, beliefs, attitudes and opinions. Yet, despite the emotional complexities associated with it, one thing is certain – sex should be safe, consensual and pleasurable. The reality? This isn’t always the case.
With this in mind, we’re having a much-needed conversation with Dr Tihesia Riley, an NHS doctor and founder of the sexual wellness platform She Talks. A force to be reckoned with, Dr Riley uses her Instagram account as a safe space for important discussions around sexual wellness. Her content is unabashed and educational, providing comfort and reason to those of us who have more than just a few questions.
Indeed, it’s platforms like Dr Riley’s that are playing a seismic role in shaping our attitudes and understanding of what sex really means, allowing us to have open and honest conversations about what’s acceptable – and what’s not.
And if you need some extra support or think you may have an STI, help is out there. If you're based in England, you can find a sexual health clinic near you. For Wales, you can find a location near you and for Scotland, you can book an appointment online. Or why not check out the Boots Online Doctor Sexual Health services*? Whether you’re after discreet testing kits or prescription treatments, they can be delivered right to your door – no appointment needed.
Now it’s over to Dr Riley…
Dr Riley on… the importance of communication
We’re all familiar with the phrase ‘communication is key’. And when it comes to sex, it couldn’t be more fitting.
“Communication is the pillar of safe and pleasurable sex,” says Dr Riley. “It’s a great way to tell someone what you clearly like or dislike. Of course, non-verbal cues like body language are helpful, but they can be misinterpreted. There’s only one way to know for sure and that’s to communicate verbally.”
Asking questions isn’t a mood killer
Dr Riley on… consent
“When talking about consent, much of the focus is on the before and not the during,” says Dr Riley. “But consent should be active. It should be both given and received before and during sex in a clear and willing way. It cannot be forced and if you’ve felt pressured into saying yes, that’s not consent. It’s a continuous process – this is why it’s so important to check in and gain consent during sex.”
Worried that checking in might make things feel awkward? Don’t be.
“Asking questions isn’t a mood killer,” reassures Dr Riley. “In fact, it’s sexy and shows that you’re genuinely considerate of your partner’s experience, leading to safer and more pleasurable sex.”
Try asking questions like…
‘Do you like that?’
‘Can I touch you here?’
‘Does that feel good?’
‘Is that OK?’
‘Do you want me to stop/go faster/go slower?’
Dr Riley on… the orgasm gap
There’s no denying that for many people, achieving an orgasm is the ultimate sign of good sex.
“It’s considered the hallmark of pleasurable sex for many people” says Dr Riley. “However, often people who were aiming for an orgasm will have numerous sexual encounters without having one, making for very dissatisfying sex.”
“The orgasm gap is the term used to describe the discrepancy in the number or frequency of orgasms experienced by different genders,” explains Dr Riley. “Statistics from numerous studies show that for cisgender-heterosexual sexual encounters, men orgasm way more than women. Rates as high as 95% have been reported for men, compared to lows of 33% for women.
“When looking at other sexual orientations, one US study found this pattern from the most to the least likely to orgasm on every sexual interaction: gay men (89%), bisexual men (88%), lesbian women (86%), bisexual women (66%).”
But why is this? And what can help close the gap?
Knowing what you like
“Knowing what it is that gets you going and leads to orgasm comes from experience of some shape or form,” says Dr Riley. “For many people, masturbation can be a great way to get to know yourself. Unfortunately, for a lot of vulva owners (I prefer to use this term because not all people with vulvas identify as women), sex education doesn’t focus on the importance of their pleasure. The stigma that surrounds pleasure and masturbation can stop people from exploring what makes them feel good.”
Communicating your needs with a partner
“This comes back to communication being key,” says Dr Riley. “It’s all good and well knowing the directions to the big O, but if you can’t tell someone how to get there, they won’t know. Many factors come into play here, from being comfortable enough with a partner to voice your needs, to previous negative experiences with saying what you want.”
Your understanding & aims of sex
“The mainstream media and pornography can warp our perception of what sex looks like and what sex should be,” Dr Riley warns. “More often than not, it portrays an unrealistic view of sex from a stereotypical male gaze. It rarely includes consent, communication, STI prevention or a realistic variation of bodies. And it certainly doesn’t show us a realistic depiction of female pleasure.”
While there are pockets of the industry that are trying to instigate change here, it’s important to remember that, for the most part, it doesn't provide an accurate depiction of real life.
“While pornography frequently shows female orgasm through penetration, one study found that only 18% of vulva owners can orgasm from penetration alone. For many others, clitoral stimulation is essential. And of course, no two people are the same, with different speeds, pressures and patterns of feeling best for different people. This is not reflected in the images of sex that we see, leading to potentially dissatisfying encounters.”
Penetration doesn’t have to be the main event of every sexual interaction
Dr Riley on… non-penetration focused sex
It’s a big misconception that for sex to be pleasurable it must involve penetration.
“Penetration doesn’t have to be the main event of every sexual interaction,” explains Dr Riley. “As we’ve learned, many people with vulvas do not orgasm without clitoral stimulation, so penetration may not be what they want to focus on.
“As well as this, some people may find giving or receiving penetrative sex dysphoric for their gender identity. There are also many people with conditions like vaginismus, endometriosis and other conditions that cause chronic pain, meaning penetrative sex can be painful or very uncomfortable.”
So, if the focus is to rush through foreplay and get to penetrative sex, it could be helpful to reconsider and look at other options.
“It’s time to reframe what we see as successful sex and instead tailor sex to what feels good to you,” says Dr Riley. “Instead of just penetration, you could try mutual masturbation or solo masturbation but with a partner present, massages, touching, kissing... the possibilities are endless.”
Dr Riley on… contraceptives and STI prevention
There are numerous methods out there for protecting yourself against sexually transmitted infections (STIs) and unwanted pregnancies.
When it comes to avoiding unwanted pregnancies, “contraceptive options range from pills and patches to injections and implants”, explains Dr Riley. “Some people also opt for non-hormonal methods like condoms, cycle monitoring or the intrauterine device (IUD – better known as the copper coil).
“One of the oldest, but least reliable methods in the book is the pull-out or withdrawal method. With a staggering failure rate of 27% with typical use, it runs a higher risk of pregnancy than other methods. Each has its pros and cons and what works for someone else might not work for you, and vice versa,” says Dr Riley.
When it comes to protecting yourself against STIs, condoms are the most widely used method but by no means the only one. Dr Riley sheds some light on other options.
“Dental dams can be used for oral sex performed on someone who has a vulva, and they can be made from condoms,” she says. “Vaccines are available to help reduce the risk of getting the hepatitis B virus. Also, pre-exposure prophylaxis (PrEP) can be taken to reduce your risk of getting HIV. Don’t forget, some infections can be passed on through skin-to-skin contact, such as herpes and the human papillomavirus (HPV).”
It’s also still advisable to use condoms to protect yourself, in addition to these other methods.
“As no method is 100% effective, it’s crucial to ask someone about their STI status and to disclose your own before sex to keep everyone safe and informed,” adds Dr Riley.
It’s time to reframe what we see as successful sex and instead tailor sex to what feels good to you
Dr Riley recommends...
Looking for further useful sources to continue exploring the world of sexual wellbeing? Here are Dr Riley’s Instagram account recommendations for open and honest conversations around sex. Click that follow button now.
Queer Sex Therapy @queersextherapy
An account run by Casey Tanner, a qualified sex therapist. Each post aims to enlighten and inform about sex and relationships. There’s also a focus on the LBGTQIA+ community.
https://www.instagram.com/queersextherapy/?hl=en
Disabled Eliza @disabled_eliza
A ray of sunshine, Eliza creates disability-focused content on a range of topics including sex, relationships, travel and body image.
https://www.instagram.com/disabled_eliza/?hl=en
UNGIRL @weareungirls
If you’re after honest and unfiltered content about sex, self-love, relationships and intimacy, then look no further than UNGIRL.
https://www.instagram.com/weareungirls/?hl=en
Cliterally The Best @cliterallythebest
What a handle – think myth-busting and debunking of unhealthy sex views.
https://www.instagram.com/cliterallythebest/?hl=en
*Access to prescription-only medicine is subject to an online consultation with a clinician to assess suitability. Subject to availability. Eligibility criteria and charges apply.
