"When women start talking about sexuality and refuse to sit down and shut up about it, that benefits everyone," says certified sex therapist Dr. Kate Balestrieri. If you disagree with that statement, this article probably isn't for you.
Dr. Balestrieri talks about sex (and listens to people talk about sex) for a living. She is a licensed psychologist, certified sex therapist, and the founder of Modern Intimacy, a therapy practice that offers services for couples and individuals of all genders in Los Angeles, Denver, Chicago, New York, and Miami.
She is also House of Wise's resident sex expert, and we're honored to have access to her wisdom, whether she's espousing the benefits of vibrators, offering advice on how to increase your libido in a relationship, or helping our audience embrace sex positivity.

"I think a lot of people think 'sex positive' means being open to any sexual experience in the world, and I just don't agree with that," says Dr. Balestrieri. "I think sex positive means you can decide what feels right for you, but what you are also deciding is that every single person gets to decide what's right for them, as long as consent is a given."
"That, to me, is what sex positivity is about: not shaming yourself, not shaming other people, and understanding that what you've been taught may not be the absolute truth for you or for other people."
When you remove the morality issues, Dr. Balestrieri points out, sex is simply a series of activities and behaviors. "It's a playground for connection and expression and pleasure; it's stress relief; it's attunement," she says. "It's really no different than a lot of the other physical practices that we might do — for example, yoga — that help us better understand our bodies. When we take away the blanket of meaning that's been put on it by sex-negative ideologies and contexts, sex is just pretty fucking awesome."
Her Journey to Sex Positivity
Dr. Balestrieri grew up in an Italian Catholic family in a small Midwestern town. Not only was she the first woman in her family to go to college, but she was also the first person in the family to earn a doctorate, making her something of a rebel.
"[My family] wanted what they believed was best for me," she says. "What that meant for them was to be a very good girl who is Catholic and marries a good Italian boy, and we live next door and make Italian babies. That life is beautiful for a lot of people. I'm not saying there is anything wrong with any of that, but it wasn't for me."
When it came to funding her higher education, Dr. Balestrieri did it all on her own, first earning an associate's degree in marketing, then an undergraduate degree in psychology. She worked for a while as an employee benefits salesperson, which she enjoyed and which was lucrative, but it wasn't what she was passionate about.
She went back to graduate school and earned her master's degree and her doctorate in psychology, with a concentration in forensic psychology. Her early professional work involved treating convicted sex offenders. In 2016, she co-founded Triune Therapy Group, an intensitve outpatient practice, and in 2019, she completed her training as a certified sex therapist.
"Growing up there was a lot of sex shaming, slut shaming, sex negativity. All the things that you might expect from a very conservative Catholic upbringing," Dr. Balestrieri says. "As I've gotten into the field of sex therapy and started to become more vocal about gender equality and being sex positive, it's created tension in my family. They don't understand why it's important for a woman to talk about vibrators."
The Vision For Modern Intimacy
Dr. Balestrieri's personal journey makes her better equipped to help her clients unpack their own sexual shame or sex negativity. As she puts it: "I understand how scary it is to start unpacking that, but I'm walking proof that doing it is healthy and positive and helpful."
Over her years of personal growth and professional practice, Dr. Balestrieri has not only become more sexually aware, but she has also gained a strong awareness of "the interconnected systems in our world that sexuality plays a part in: religion, money, socioeconomic status, culture, politics, power, gender, and all of these intersecting conversations."
In 2020, Dr. Balestrieri opened the Modern Intimacy practice, which currently has two additional clinicians, though she hopes to have at least 10 by year's end. The vision of Modern Intimacy is to give people multiple entry points to learn about sex and intimacy, even if they don't have access to therapists in their area who specialize in those topics. The company offers a lot of free content, as well as courses, ebooks, individual therapy, couples therapy, group therapy, and workshops.
Uniting all of Dr. Balestrieri's work is the belief that "healthy love and healthy sex will never require you to shut a part of yourself down. Healthy love and healthy sex always make room for you to love yourself and for your needs to be respected."
Dr. Balestrieri maintains that no one else gets to dictate what makes you happy — in life, in love, or in the bedroom. "We are incredibly diverse beings," she says. "There's no right or wrong way to construct a relationship, as long as everyone involved in the relationship feels respected, is consenting to the dynamic involved, and has a voice."
What to Expect From Sex Therapy
If you have ever been to therapy before, seeing a certified sex therapist will feel familiar in many ways. (In case you're wondering: yes, certified sex therapist is a professional designation, so be sure to seek out practitioners with that certification.) The first few sessions will be primarily focused on gathering information and collaboratively developing goals to work toward.
What might feel different from other therapy, says Dr. Balestrieri, is that when you are working with a certified sex therapist, "you are working with someone who has learned to recognize and challenge all of their own biases and who has learned to hold their own relationship to sex at bay to make room for yours and yours alone in the therapeutic context."
Sex therapy, she says, provides "a safe place where you talk about a topic that probably hasn't felt very safe for you in other areas of your life or even with other therapists. Not because other therapists are bad, but because this is a very specialized niche, and there is a lot more to learn than what we are taught in our basic graduate programs."
Two of the topics that couples are often most terrified to talk about are sex and money. Not coincidentally, says Dr. Balestrieri, sex and money are also two of the topics people are most terrified to talk about with a therapist.
"Working with somebody who specializies in sex can give people permission to talk about a topic that has felt taboo to even think about," she says.
Shifting Sexual Norms
Perusing the content on Modern Intimacy's blog, Instagram, and other social channels, you'll notice that Dr. Balestrieri embraces a very liberal, open-minded, and inclusive approach to sexuality and relationships. While many topics, like kink or polyamory, may not be considered "mainstream" just yet, Dr. Balestrieri sees the Millennial and Gen Z generations gradually evolving the conversations around sex, gender, and — crucially — power.
"There will always be a faction of people who are sex negative, who are organized around shame and fear around sex, and it will serve them in the way it needs to serve them psychologically," she says. "But right now, I'm seeing a lot of conversations about sex and who has the rights to it. We are seeing a lot of jockeying for power across lots of different intersecting conversations: race, gender, sexuality, sexual orientation, money."
"It's like this quiet but rising cauldron of boiling water, and pretty soon it will open up to something really beautiful in terms of real sustained, sociological change."
Sexuality, and women's sexuality in particular, has long been used as a marketing tool. But, Dr. Balestrieri says, it's time for women to reclaim their own sexuality. Because we cannot move forward, she says, if we continue to perpetuate the limits that society puts on us to be quiet about our sexual health, our sexual pleasure, and our sexual power.
"Women have to have a seat at the lead table when we are talking about sexuality in this country," she says. "If they aren't going to be given a seat at the table, they need to create their own table."
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