Harmful Sex Words
The words we and our patients use to discuss sex are often part of the problem.
Posted June 2, 2025 | Reviewed by Michelle Quirk
Words are the way we all describe the world to ourselves and others, and they're the central tool of our profession. Let’s look at some words in everyone's sexual vocabulary that we should define, change, or eliminate altogether—because they add up to a narrative of sex as problematic, even dangerous.
1. “E.D.” (erectile dysfunction)
Too many doctors and civilians define this as “if you ever can’t get it up when you want to.” But there are lots of reasons that fully functional penises stay soft when we want them hard: Alcohol . Anxiety . Resentment. Embarrassment . Definitely anxiety.
I would replace E.D. with “I don’t get erect when I want to,” or “I lose my erection when I want to keep it.” That would locate the problem more accurately—not with the penis, but with the guy’s intention or desire. Or his mate’s.
There is such a thing as low desire. But it shouldn’t be measured by simple numbers, and certainly not in comparison to someone with higher “desire.” Because the question is, “desire for what ?” Is it “desire” for sex that’s boring , painful, emotionally vacant, too fast, or with someone who has drunk too much, or can’t remember what you don’t like, or hasn’t bathed in a while—or in a place that looks or smells like it hasn’t bathed in a while?
That’s not “low desire.” That’s reasonable and understandable.
If you want to evaluate your or someone else’s desire, imagine a sexual situation that’s ideal (or ideal for that person). Then ask how much sex you (or that person) would want? If the answer is “very little,” that's low desire. Otherwise, that’s a person who turns down what they don’t want—which all sensible people do.
3. “Too long to orgasm”
Too long for what? People only say this if (1) they’re anxious that they’re not doing something right, (2) they’re bored, or (3) both.
No one complains that it takes “too long” to eat ice cream. There is no right amount of time sex (or orgasm ) “should” take. If someone feels frustrated about what is or isn’t happening during sex, they should discuss it with their partner with curiosity and warmth, not criticism or self-criticism.
4. “Perform” and “performance” (as in genital function)
The sad thing is, “performance” really does describe many people’s subjective experience of sex. They have a set of objective standards they feel obligated to meet (and their partner should meet, too); how well they do so plays an outsize role in their experience of sex.
Instead, I encourage people to discuss criteria like Did I enjoy it? Did I feel close to my partner? Was I relaxed? Would I like the same experience again?
5. “What does my fantasy mean?”
To answer this question, I don’t need to know what the fantasy is. The answer is, it means nothing. More precisely, it means you find it entertaining to think a particular erotic thought. It has no more meaning than a preference for vanilla over chocolate ice cream.
Some people can’t seem to stop having a particular fantasy—and sometimes it’s quite unpleasant, like being cheated on. For them, mindfulness can be quite valuable. Discussing it with a professional is often necessary. And maybe the issue is that someone is obsessive or chronically anxious, and the content of the obsession itself is more or less irrelevant.
This is the ultimate nonscientific, moralistic, unhelpful sexual expression. It’s now applied to people who cheat on their spouses, who want more sex than their partner, who go to sex workers, who prefer masturbation to partner sex that they don’t enjoy, and who desire sexual activities their partner (or therapist, doctor, or clergyperson) thinks are weird.
“ Addiction ” involves physical dependency, a need for increasing dosage, and withdrawal symptoms when the substance is unavailable. Sex fits none of these. Just because some people take risks for sex that others find confusing does not make it an “addiction.” Similarly, repeatedly choosing to do something that isn’t good for you doesn’t make someone an “addict.” Ordinary people make such choices in recreation, health, finances, and relationships all the time. That’s the human condition.
If someone really, really, really can’t help themselves (which is highly unusual), and their choices happen to involve sex, maybe they have an undiagnosed mental health issue: obsessive-compulsive disorder, bipolar disorder , depression , or anxiety.
7. “Intimacy,” “relations,” “it,” “y’know”
People use these and a hundred other euphemisms when they simply mean “sex.” Unfortunately, so do clinicians, such as doctors, pharmacists, physical therapists, surgeons, and, yes, psychologists and marriage counselors.
Possible alternative words? Sex. Being sexual. Having sex. And, if it’s accurate, intercourse. These words are clearer, and they don’t make assumptions. They also don’t pander to the idea that sex is something that polite, clean people should not talk about in a straightforward way.
For decades, many therapists have been trained to not offend clients—including not saying “sex” until patients say it first. I believe the opposite—it’s time we stopped infantilizing and insulting patients by assuming they can’t handle words like sex, penis, uterus, and ejaculation. If such words make them uncomfortable, that isn’t an intrusion on the therapy —let’s use that discomfort as part of the therapy.
As in normal desire, normal penis size, normal fantasies , normal preferences, normal ways to masturbate, normal sounds during orgasm, or normal…anything.
“Normal” is arguably the worst word ever applied to sex. For starters, every idea about what’s sexually “normal” is a cultural artifact. Some cultures think kissing is unhygienic and gross. Some cultures think monogamy is crude, selfish, and completely unworkable. Some cultures are certain that women lose their sex drive after menopause —and consider the women who don’t to be freaks.
Then there’s the question of how much variation in any one dimension is “normal.” For example, it’s common to have sex 100 times a year (twice per week). It’s also common to have sex once per year (yes, really). That’s an enormous variation in what’s normal. Similarly, some women like to masturbate to fantasies of soft breezes and meadows, relaxed days with a gentle gentleman. Other women like to masturbate to images of coercion and violence (these are fantasies, remember). That represents enormous variation, too. The only answer to “which of these is normal?” is “They're both quite common.”
When patients ask me a “what’s normal” question (like, "We’ve been married less than a year. What’s the normal frequency for couples like us?”), I don’t give them a straightforward answer. Because behind most questions about what’s sexually normal, there are unasked questions that are even more important. I’d rather help people by challenging their desire to know what’s normal. When people understand this desire rather than insisting on satisfying it, their sex lives—indeed their lives—are changed forever.
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Marty Klein, Ph.D., is a certified sex therapist and a licensed psychotherapist. He has written five books and 200 articles about sex. His TV appearances include 20/20 and Nightline .
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This article is part of the Bringwise Psychology Journal — daily insights on human behavior, mental health, and personal growth.