“Do you see other men who do this?” Reflections upon working with men who visit commercial sex workers in a National Health Service sexual health clinic

摘要

There is often an assumption that buying sex signals inadequacy and in the literature there is considerable diversity in the reasons given by men who paid for sex. Men who buy sex and present to services are a fraction of the broader population of men who buy sex and are unrepresentative in that they, at some level, perceive it as problematic. They have few obvious places to bring their concerns. We report on the work we have done with heterosexual men who bought sex and accessed psychology services at a central London Sexual Health Clinic. We outline common factors that led men to seek advice at our clinic and argue that buying sex needs to be understood in the context of relationships with others and the self. Moreover, this is important when it comes to understanding cases where buying sex has been termed a “sex addiction”, a concept that we argue is unhelpful. We apply a Cognitive Analytic Therapy framework to illustrate how relational understandings offer alternative insights to sex addiction.