Therapy for Black Girls – Session 428: ICYMI: Increasing Sexual Confidence

Host: Dr. Joy Harden Bradford
Guest: Dr. Pia Goff (Sex Therapist)
Release Date: September 10, 2025

Episode Overview

In recognition of "Sex Positive September," this episode revisits a popular conversation between Dr. Joy Harden Bradford and sex therapist Dr. Pia Goff, focusing on how Black women can increase their sexual confidence. The dialogue explores the discomfort surrounding discussions on sexuality, the roots of sexual shame, common sexual concerns such as desire and arousal disorders, the importance of sexual self-reflection, and practical ways to build confidence and pleasure—including a deep dive into sensate-focused therapy. The episode is geared toward destigmatizing sexual health conversations and empowering listeners to reclaim pleasure and intimate confidence.

Key Discussion Points & Insights

1. The Persistent Discomfort Around Sexuality

• Lack of Language & Education: Many, especially Black women, were not taught how to talk about sex at home or in school, leading to embarrassment and fear of judgment.

  "There's a level of embarrassment, there's a level of fear of judgment and shame that I particularly see, especially with black women, that oftentimes they feel that they've been oversexualized... All of these different factors impact a woman's discomfort with, you know, talking about sex with other people."
  —Dr. Pia Goff [05:39]

• Media & Stereotypes: Black women may downplay their sexuality to avoid feeding stereotypes, leading to additional self-consciousness and hesitance towards sexual exploration.

2. Taboo Topics in Sexuality

• Acts Most Stigmatized: Oral sex, anal sex, and masturbation remain highly taboo, even as stigmas shift.

  "I think the new biggest thing now is a taboo around anal sex... and then the next one that I see a lot with women is a taboo around masturbation."
  —Dr. Pia Goff [07:31]

3. Steps Toward Comfort and Confidence

• Self-Reflection is Key: Understanding personal sexual history and identifying sources of internalized shame or stigma can be the first step toward sexual confidence.

  “Doing some more self reflective work... will allow them to have knowledge and tools and skills about how to talk about sex with others.”
  —Dr. Pia Goff [08:26]

• Normalize through Community: Following sex-positive accounts, reading books, and hearing from others can normalize experiences and reduce feelings of isolation or shame.

  "Being able to hear others talk about this, it's like, oh, wow, okay. Like, this is something that a lot of people experience."
  —Dr. Pia Goff [09:33]

4. What Sex Therapy Looks Like (Even When Single)

• Sex Therapy Isn't Just for Couples: Single clients often seek therapy to heal from trauma or address barriers to intimacy.

  "The main reason I tend to see folks who are not in a relationship: they're saying, I don't know how to be in a relationship. I don't know how to be in a sexual relationship."
  —Dr. Pia Goff [10:22]

• Understanding Disorders: Dr. Pia screens for sexual dysfunctions like vaginismus (painful contraction of pelvic muscles) and female sexual arousal disorder (lack of sexual desire/arousal). Many clients don't realize these are issues that can be addressed with a professional.

  “I see a lot of women who come in with vaginismus… I see a lot of women who suffer from female sexual arousal disorder... And funny enough, sometimes when women come into my office and they see the books on my wall, they're like, oh, I was just coming in for anxiety. But... I usually don't have orgasm."
  —Dr. Pia Goff [11:17]

5. Female Sexual Interest/Arousal Disorder

• What It Is: Not wanting or enjoying sex over a period of at least 6 months; often, women internalize the problem.

  "A reduced interest in sexual activity, or a reduced interest in thoughts or fantasies, a lack of excitement or pleasure during sexual activity... over the course of at least six months."
  —Dr. Pia Goff [18:29]

• Self-Defined Normalcy: Normal sexual desire is unique for each person; issues become clinical only if the individual is distressed by the change.

  “We all get to decide what our normal is.”
  —Dr. Pia Goff [19:12]

• Distress vs. Identity: Differentiated from asexuality because asexual people are not distressed by lack of desire, while those with arousal disorder typically are.
  —[20:20]

6. Discussing Desire and Arousal with Partners

• Vulnerability and ‘I Statements’: Self-reflection and using “I statements” can make conversations safer and less accusatory.

  “If we're able to come to our partner and speak in I statements about what's going on personally for us... it puts us on the seat of being vulnerable, but it allows your partner to be a little bit more receptive.”
  —Dr. Pia Goff [21:00]

• Many Factors Influence Desire: Stress, medication, childbirth, relationship dynamics, and previous trauma can all play a role.

7. Vaginismus Explained

• Pelvic Floor Tension: A psychosexual issue that causes pain and difficulty with penetration; tied to anxiety, trauma, or fear of pain.
  —[23:57]

8. Reimagining Sex Education

• Ideal Sex Ed Components:

  • Accurate anatomy terminology
  • Consent
  • Normalization of masturbation & pleasure
  • Inclusion of birth control and contraception
  • Realities of sexual pleasure for all genders

  "I think first teaching, you know, proper terminology and anatomy. Definitely teaching consent... normalizing self exploration and masturbation and also normalizing pleasure."
  —Dr. Pia Goff [28:44]

• More Information, Not Less: Research shows more information correlates with safer and later initiation of sexual activity among teens.

9. Introduction to Sensate Focused Therapy

• What Is It?: A stepwise, evidence-based therapy for individuals or couples facing desire/arousal challenges, originally developed by Masters and Johnson.

  "Sensate focus does is it teaches clients to focus on the sensations of temperature, texture, and pressure...to explore touch without any sort of motive or any sort of goal or expectation about arousal or pleasure."
  —Dr. Pia Goff [30:48]

• Key Steps (Therapy can last 4–6 weeks):

  • Begin with fully clothed touching, progressing to nude.
  • Focus is on non-genital, non-goal-oriented touch.
  • Communication uses “handwriting” (guiding hands) to express comfort/discomfort, not words.
  • Remove intercourse from the equation for the duration, which often heightens anticipation and rekindles desire.

  "It's like the longest foreplay ever... but that's what's needed to rekindle desire and remove the expectation that we're going to touch and this is going to lead to sex."
  —Dr. Pia Goff [37:47]

• Helps Build Trust & Reframe Expectations:

  “Engaging in a sensate focus exercise removes that pressure... because I also instruct people, look, this should not be an exercise in which you’re talking to one another.”
  —Dr. Pia Goff [34:53]

10. Recommended Resources

• Booklist:
  • Come As You Are by Emily Nagoski
  • Rekindling Desire & Sexual Awareness by Barry & Emily McCarthy
  • The Guide to Getting It On by Paul Joannides: An accessible, comprehensive, and sometimes humorous reference.
• Find Dr. Pia:
  • Instagram: @sexdrpia
  • Practice: resiliencechicago.com

Notable Quotes & Memorable Moments

• "There's a level of embarrassment, there's a level of fear of judgment and shame that I particularly see, especially with Black women..."
  —Dr. Pia Goff [05:39]

• "We all get to decide what our normal is."
  —Dr. Pia Goff [19:12]

• "A lot of times folks who are having issues with desire, they feel this expectation to perform in a certain way... Engaging in a sensate focus exercise removes that pressure."
  —Dr. Pia Goff [34:53]

• "It’s like the longest foreplay ever."
  —Dr. Pia Goff [37:47]

Important Timestamps

• [05:39] – Discomfort around sexuality and its roots in cultural and generational attitudes.
• [07:31] – Taboo acts: oral, anal sex, masturbation.
• [08:26] – Steps for self-reflection and growth.
• [10:22] – Sex therapy for individuals who are single.
• [18:29] – Defining female sexual arousal disorder.
• [21:00] – Tips for communicating about decreased desire with a partner.
• [23:57] – Explanation and causes of vaginismus.
• [28:44] – Blueprint for an ideal, sex-positive high school curriculum.
• [30:48] – Sensate focused therapy explained in depth.
• [37:47] – Unexpected challenges and benefits of taking intercourse “off the table.”
• [39:29] – Recommended reading for further exploration.

Tone & Takeaway

The episode maintains an accessible, affirming, and empathetic tone—gently dismantling shame while celebrating self-discovery. Both Dr. Joy and Dr. Pia emphasize the value of self-knowledge, normalization, and patient, compassionate communication—both internally and with partners. Listeners come away empowered to view sexual confidence as a vital, learnable aspect of well-being.

For more resources or to find a therapist, visit therapyforblackgirls.com. Follow Dr. Joy and Dr. Pia on Instagram for ongoing support and conversation.