Let’s Talk About Sex
Communication is Key with Dr. Amani Zarroug
Interview by Ayanna Egbarin
Dr. Amani Zarroug is a doctor and clinical psychologist, specialising in psychosexual therapy and relationships. She has worked in diverse settings from forensics through to charities and neurodisabilities but it was her work in paediatrics with children that led her to her current work. Having observed how parents were affected in the paediatrics unit; how they renegotiated their roles as parents and as couples, Dr. Zarroug developed a natural curiosity for how people navigate complex relationships and how we try to express ourselves through it. In this interview, we explore some of the common misconceptions and practices that inhibit many of us from having healthy sexual relationships and the key ingredients for better sex and intimacy.
In your line of work, what are some of the common sex issues that people approach you with?
By far, one of the most common sexual issues that people come with is mismatched desire where one person has much more sexual desire than their partner- that often causes some kind of issue within the relationship so one person might feel more rejected or undesired. It can become quite personal and then a resentment can build because they're then not having sex and they get into these little fights that are that are based more in the frustration of not understanding why the sex isn't happening.
And contrary to common perspective, the mismatched desire isn't always a reflection of how one feels about the other person, it might even be a reflection of how you feel about yourself or your body image. So that person may be struggling with some kind of embarrassment or shame within themselves.
Are you the go-to person in your friend group for sex advice now?
[Dr. Zarroug laughs] I'm definitely one of the go-to people. Because I talk about sex for a living, I’m very comfortable talking about it. At the same time, if someone is struggling to talk about sex, they may be kind of be struggling with an issue they have. I think it takes courage to talk about sex.
Interestingly, during the pandemic people started doing a lot of quizzes and games on zoom so I designed a sex quiz for my friends that was a fun thing to do with a few different groups.
What are the generational differences in how people think about sex and do you see that changing in the future?
When I thought about this question, I thought about the pros and cons of the newer kind of generations views versus the older generations. A big positive is that now, people are more willing to talk about things that were previously seen as taboo or shameful or that just happened in the dark, in your bedroom. Whereas now, I think people are much more willing to share with their friends.
I suppose it was whenever Sex in the City came out that was like some kind of liberation, especially for women to be talking about sex openly, and it's only increased since then.
But a major negative in modern society is how younger people tend to learn about sex through porn. Porn is no reflection of sex because, obviously, these are mostly actors and it's mostly specifically for the male gaze. I heard someone describe porn really well, they said that learning to have sex from watching porn is like learning how to drive from watching The Fast and The Furious.
What I commonly see is people who have learned about sex through porn are trying to emulate something that doesn't feel like what they want, so sex is more performative. That can often cause psychosexual issues, because as soon as you are not present in your body and your desires, you're not really enjoying it in the way that you should be.
The questions I always ask my clients are, ‘when did you learn about sex? How did you learn about it?hat were your thoughts about it? How did you know? And it turns out that if their parent talked about sex with them, they kind of slid the child a book.
What I’ve really discovered is that this can be really culturally specific. For example, in the Netherlands, they tend to talk a lot more about sex in a family environment. To the point where it's almost boring for Dutch teenagers. It's almost like ‘oh God, here we go again, do we really have to talk about when parents discuss sex?’ There are also fewer issues related to unwanted pregnancy and STIs because of this.
Is there a difference between how men and women perceive sex or desire a sexual relationship? What about amongst the spectrum of sexual orientations? Races?
I try not to generalize, but there are definitely generalizations out there.
For example, it won't be the race that affects the way that certain people think about sex but a major influence will be in religion. If you come from a very religious background, regardless of your race, you might have connotations around purity and maturity. You might have thoughts about who you have sex with and when is most appropriate to start having sex. So premarital sex may be something that you think of as not really a good thing. Often girls feel the backlash of that a bit more than boys.
I think when it comes to sexual orientations, there are some statistics around frequency of sex. Men who have sex with men tend to have more sex than men in heterosexual relationships and lesbian women tend to have less sex than women in heterosexual relationships. But, lesbian women have more orgasms than women in heterosexual relationships and men have more orgasms than everyone.
If you're a man or a woman, you know your desire will be different, regardless of if you're a vulva owner or a penis owner. But within that I see couples, where the female has more desire and I see couples where the man has more desire. It's not necessarily what we see often portrayed in the media, where the man is constantly trying to have sex and the woman is constantly like ‘I have a headache’.
Additionally, when I went into practice, people were always saying older men have more desire but, I don't actually think that. Desire fluctuates in your lifetime; it's not a fixed thing.
What does sex mean to you?
To me, sex is about intimacy; it's about comfort; it's self-expression; it's a liberation, it's about communication. It’s closeness; skin to skin contact. For me, it’s about the subtle things like feeling someone's breath on your skin, you know. For me it's very kind of sensual and hopefully juicy.
Sex is very healthy and I think in a lot of ways, it's health inducing. It's good for your skin, it's good for your heart. It's a practice that should be like our birthright. When I say that, I don't just mean sex with a partner. Sex with a partner is great, but also being able to experience the pleasure that your body has to offer you is also your birthright.
Do you think that that viewpoint or perception has changed throughout the years?
I was brought up in a strict Muslim household and so sex in my home was always seen as a positive thing but only within marriage. You can have as much pleasure as you want, but only after you're married. I never thought that sex was dirty or anything, I just thought it was time specific.
So now, with two consenting adults, regardless of their situation, married, single or whatever, if you both have been honest with each other, you both know what you're doing, and you both intend to have a good time, then that's all you need.
What are signs of a healthy sexual relationship?
Communication is key, like people say, but when you think about sex, communication is lube. There is no other shared activity amongst adults that we don't talk about. For example, if you're going to cook a meal with someone, you plan everything you do. You have a conversation about what kind of food you like, what you are allergic to. You talk about how we are going to do this together, ‘am I going to chop the onions, or do you?’ We have conversations like that and there's no shame around it. It's cooking a meal we're both going to enjoy.
However, when it comes to sex we're very reluctant to talk about it. We imagine that it is going to be spontaneous, that we're both just going to know exactly what to do. But actually that is really a strange concept, if you think about it in terms of everything else we do.
I think that healthy sexual relationships are relationships where you can talk about what the sex is like or will be like. You can talk about your fantasies, you can talk about the things you enjoy and the things that you maybe would like to experiment with. Or the things that maybe you don't like so much or that you've tried in the past, and you think ‘oh that wasn't a great experience’, but it's just about being able to feel the freedom in having the conversation without feeling like it's a taboo subject.
The other ingredient is also being responsible for your own sexual pleasure. We often talk about how ‘he gave me an orgasm’ or ‘I gave her an orgasm’ but actually everyone is responsible for their own orgasm. In reality, she gave herself the orgasm and you gave yourself the orgasm, but you helped each other to achieve it.
However, let's say you're with a partner who has never orgasmed or in the rare case, isn’t physically capable of having one, then you still can engage in a variety of different things whilst having sex. Maybe it's the intimacy, maybe the emotional connection, maybe it's that feeling of closeness that we all kind of crave. It isn't necessarily just about orgasm.
There was a study done by two psychologists and they found that there are 237 reasons why people have sex, and an orgasm is just one of those reasons. People can enjoy sex without orgasming.
How has the portrayal of sex in the media affected our perceptions of sex? Is there any way to combat that if these views are mainly negative or one-sided?
When we see a sex scene on TV, we tend to see that either he's on top or she's on top. There's often one or two thrusts and then it's like, ‘Oh, my God!’ We don't really see the embarrassing things like the queef or the cramp in your foot. We don't see these things because it's not sexy, but actually, every time we have sex, even if it's with the same person, it's a completely different experience. I think we need to embrace the entire experience.
Esther Perel talks about how foreplay starts five minutes after the last orgasm. You asked earlier about what are the good ingredients of a healthy sexual relationship, it's actually the relationship outside of sex. The quality of your relationship will determine what the quality of your sex life is, because all of that still exists in the bedroom. It doesn't go away as soon as you decide to be physical with each other.
Have there been any peculiar scenarios that you've had to deal with in the past, are you able to give us an example?
There is one thing that is quite peculiar. I work with couples who come for a specific problem. Let's say he's got erectile dysfunction and I teach him some exercises. They do some work together and his erectile dysfunction is no longer a problem. Then all of a sudden, she will develop something like a pain during intercourse. For me, it shows that sometimes the psychosexual problem isn't located within one person, although that's what the couple will see, it's actually a shared problem and they can pass it to each other.
How has your work helped people achieve their most optimal sexual relationship or mindset? What do you help people to unlock or realize?
The most optimum mindset around sex and what I like to help people develop is their own sexual relationship with themselves. Having an understanding of where our ideas around sex came from? Are they healthy? Do I want to revise them? Are they helping me to enjoy my body? It’s important that you take responsibility for your own sexual pleasure and not outsource it to someone else.
Alongside that, is reducing shame and deconstructing negative messages from childhood, and realizing that sexual pleasure is people’s birthright and that they can take ownership of that.
The clearest example is that the clitoris is the only organ in the female body that is purely for sexual pleasure, it has absolutely no other function. That means that we should be using it for that. The fact that our body allows us to have the same pleasure as we derive from our taste buds, shows us that it's just a natural thing. You use what you've got because it's given to you.