The Fundamentals of Sex

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Positive body image strengthens sexual assertiveness and relationship satisfaction.

Body image impacts sexual functioning more than BMI or body size.

Assertive expression of desire predicts greater relational and sexual fulfillment.

New research provides key insights into what partners need when it comes to more pleasurable sex.

General couples/relationship therapists observe common relational and systemic dynamics that affect most romantic relationships, such as:

Communication patterns

Attachment styles of each partner

Past traumas (including sexual trauma, childhood trauma, and domestic violence)

However, another critical factor shows up frequently in individual and partner therapy with certified sex therapists, which can be frequently overlooked by general couples therapists and/or a romantic partner: negative body image.

Many people who struggle with sexual connection, low desire, or relationship satisfaction may not be struggling with the love they feel for a partner or the level of commitment they have to their romantic relationship(s). What they may secretly be challenged by is the lack of comfort and safety they have in their own skin.

A negative body image can come with a host of symptoms, including avoidance of:

Expressing desire to a partner, and/or

Communicating boundaries

In a recent 2025 study in Behavioral Sciences, Rizzo et al. examined how body appreciation, sexual esteem, and sexual assertiveness influence relationship satisfaction. They found that the way people feel about their bodies and whether this impacts their communication contributes to how they show up in their sex lives, which in turn can affect their romantic relationship(s) as a whole. These findings align with what the Sex Esteem® framework aims to improve in somatic sex therapy........

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