Psychology Today added new ‘Client Focus Categories’ so potential clients can see if their therapist has experience helping marginalized populations, but they are not currently directly searchable on their website. This post highlights the new categories, provides a description of how to do a Google search to get a list of all the therapists/psychiatrists who specialize in one of the new categories they create, and what the APA Division 44 Consensual Non-monogamy Task Force is doing to advocate that the categories become directly searchable.Read More
One of the first steps to providing culturally competent care is amending client-history and intake forms to assure that they are inclusive toward marginalized populations. An increasing number of mental and medical health centers are taking steps to be inclusive of relationship structure diversity. The following language provided by the APA Division 44 Consensual Non-monogamy Task Force is considered one of many inclusive ways to assessing relationship structure. The language was originally created by Dr. Heath Schechinger with feedback from a diverse group of consensual non-monogamy researchers and community leaders.
For additional background, please consult Harmful and helpful therapy practices with consensually non-monogamous clients: Toward an inclusive framework (Schechinger, Sakaluk, & Moors, 2018).
A pdf version of this resource can be found here.
Two options for assessing relationship structure/style:
When it comes to relationships, I think of myself or identify as:
-Non-monogamous (Polyamorous, Open Relationship, etc.)
-Prefer not to answer
-Other relationship structure/orientation ____________
I describe my relationship structure as:
-Something else: ____________________
-Prefer not to answer
Language for assessing comfort being public (or out) about relationship structure/style:
How comfortable are you being public (or out) about your relationship structure?
-not at all
I created these empirically-informed benchmarks in my role as the co-chair of the APA Division 44 Consensual Non-monogamy Task Force to highlight inclusive clinical practices and procedures for working with people engaged in consensual non-monogamy (CNM), a relationship arrangement in which all partners involved consent to extradyadic sexual and/or romantic relationships. This includes but are not limited to: people who practice polyamory, open relationships, swinging, relationship anarchy and other types of ethical non-monogamous relationships.
Organizations such as the American Psychological Association have approved professional practice guidelines in areas such as multicultural practice and working with lesbian, gay, and bisexual clients. The Human Rights Campaign also has created the Healthcare Equality Index, a tool that evaluates healthcare facilities' policies and practices related to the equity and inclusion of their LGBTQ patients, visitors, and employees. This document is intended to expand this work for individuals engaged in consensual non-monogamy, and is separated into three sections. For additional background, please consult Schechinger, Sakaluk, & Moors, (2018) and Vaughan, Jones, Taylor, & Roush, (2019).
I would like to thank Drs. Amy Moors and Rachel Anne Kieran for their feedback to later versions of this resource. A downloadable pdf version of the latest version of this document can be found here.
Mental Health: Individual
Inclusive language: When discussing past or current relationships, do you clarify that you are supportive of all forms of relationships and use inclusive, CNM-affirming language (e.g., using partner or partners and avoiding husband, wife, couple, spouse, etc. unless the client uses these terms first)? Do you address relationship structure similar to how you would other marginalized identities (e.g., sexual orientation and gender diversity)? Does your website make it clear that you are CNM-affirming?
Inclusive symbols: Are there symbols (e.g., relationship anarchy symbol, polyamory pride flag, infinity heart symbol) in your office to indicate that it is a CNM-affirming space?
Assuming monogamy: When discussing past or current relationships, are you being mindful to avoid assuming clients are monogamous? Do you ask if clients identify as monogamous/CNM and/or if a relationship is open or closed when it is unclear? Do you intentionally normalize the desire for multiple sexual and/or romantic partners when relevant topics are discussed?
Clarifying agreements & terms: When discussing past or current relationships with all clients, are you asking about relationship agreements and preferred relationship terms?
Affairs: Are you mindful to direct the focus away from shaming sexual behavior and/or normalizing the desire for multiple partners when addressing relationship agreement violations? Are you open to seeing clients who are currently engaged in relationship agreement violations?
Blaming non-monogamy: Are you refraining from making suggestions or giving indications that consensual non-monogamy is the cause or symptom of the client’s presenting concern(s)?
Biased or judgmental: Are you being mindful to avoid coming across as having a favorable bias toward traditional/monogamous relationships and/or portraying concern or judgment (verbal or nonverbal) toward consensual forms of non-monogamy? Are you practicing in a way that affirms monogamy and consensual non-monogamy as equally viable options? Are you introducing consensual non-monogamy as a viable option in relevant cases? While being thoughtful of the therapeutic relationship, are you normalizing the desire for multi-partner relationships when a client expresses judgment towards this inclination?
Contextualized case conceptualization: Does your case conceptualization account for how societal stigma toward consensual non-monogamy may be causing and/or amplifying a client’s distress? Does your case conceptualization and/or treatment planning include exploring diverse relationship structures (in relevant cases)?
Proactive education: Are you seeking relevant information about consensual non-monogamy on your own to avoid asking a client to educate you in session?
Pressure: Are you avoiding putting pressure (explicit or implicit) on your clients to come out or end a consensually non-monogamous relationship?
Fixation on sexual activity: Are you making sure your questions about sexual activities are clinically relevant?
Mental Health: Institution
Groups: Do you offer support group(s) that assists individuals in the process of exploring, acknowledging, navigating, and/or coming out about consensual non-monogamy?
Inclusive forms: Do you offer the option to self-identify relationship style on intake/demographic forms? Are your office documents and website explicitly inclusive of consensual non-monogamy (e.g., mentioning CNM in your non-discrimination statement, using “partner(s)” instead of “spouse”)?
Affirming setting & structure: Do you have enough space/chairs to accommodate multiple partners? Are you able to offer longer appointments when working with more than two partners (similar to how you might for families)?
Annual trainings: Do you provide annual trainings for staff to increase their awareness of and sensitivity to the needs of the consensual non-monogamy community?
Recruitment: Do you actively seek to recruit consensually non-monogamous staff, similar to other targeted populations (e.g., staff of color, LGBT staff, international staff)?
CNM-affirming therapy: Do you offer CNM-affirming counseling services, with a staff that is knowledgeable of the needs and experiences of these identities and their related concerns?
Educational programs: Do you offer specific awareness and educational programs for consensual non-monogamy populations directed toward any of the following issues: healthy multi-partner relationships, exploring CNM, coming out as CNM, opening a relationship, coping with CNM stigma, raising children in a CNM household, or safer sex practices?
Sexual health resources: Do you actively distribute condoms, dental dams, and information on HIV/STI services and resources?
STI testing access: Do you offer free, anonymous, easily accessible, and comprehensive HIV/STI testing on a regular basis?
Partner access: Does your system make it easy for patients to share their STI results with their partner(s)?
Inclusive forms Do you ask about relationship structure on your intake and sexual health forms? Do you offer the option to designate more than one emergency contact on intake/demographic forms? Are your sexual health and STI screening/self-testing materials CNM-inclusive (e.g., are sex positive and promote risk-informed sexual practices as opposed to promoting monogamy)?
Inclusive protocols: Have you reviewed your STI testing protocols/recommendations (that may be normed for monogamous populations) for any ways they may put the consensually non-monogamous population at risk (e.g., only offering HPV vaccinations to those under 26, barriers to routine STI testing)? Do you recognize multiple, non-legal “spouses” in health care decisions? Do you permit multiple partners to be present with your patients?
Sex-positive evaluations: Are you/your staff portraying open, affirming attitude towards sex and sexuality when discussing sexual practices with your patients? Are you/your staff being mindful to be avoid judgmental and affirming toward patients with multiple partners when engaging with them about sexual health and wellbeing?
Education: Do you train your staff on how to conduct sex-positive, CNM-affirming, sexual screening risk evaluations?
The Netflix series Wanderlust is but the latest example of how consensual non-monogamy is becoming more mainstream. While it’s wonderful that an increasing number of people are becoming more intentional about the structure of their relationship, what happens when they want to seek support and are instead met with judgment? The very system that is designed to support people who are struggling is grossly unprepared to meet this demand.
Imagine you are in the early stages of exploring your sexual orientation and the very person you trust to guide you through this tender time blames your depression on being queer suggests that you’re not actually queer. Imagine being told that your sexual orientation or gender identity didn’t matter when choosing your mental or medical healthcare provider. This is the current reality for people in the CNM community and we want to see this change.
Healthcare Provider Directory Campaign
Consensual non-monogamy (CNM) is a rising issue in a number of professional circles. This past year, Division 44 of the American Psychological Association established a Consensual Non-monogamy Task Force and I am honored to serve as one of the co-chairs. In light of the difficulty many people in the CNM community have trying to find a CNM-affirming medical or mental health provider, we have established a Healthcare Provider Directory Campaign to raise awareness of this issue and work with healthcare provider directories to make their directories CNM-inclusive.
For those of you currently looking, there are a few current directories available for finding a CNM-affirming therapist. It is time, however, for mainstream healthcare provider locator directories to start including consensual non-monogamy (and/or related terms) as a searchable criteria as well. I have included five reasons why I believe this to be true.
1. CNM is Highly Stigmatized
Despite the prevalence and increasing interest of CNM, people who challenge the monogamous status quo are broadly and pervasively stigmatized. Recent surveys point to how CNM is judged negatively in a number of ways, such as being perceived as being more risky, immoral, less trusting, less meaningful, and less satisfying compared to monogamy. Notably, this stigma has been found to be untrue, as research looking into this has found CNM relationships are just as satisfying as monogamous relationships and an equally viable alternative to monogamy.
2. CNM Minority Stress is Associated with Psychological Distress
People who are part of sexual minorities are disproportionately exposed to rejection, discrimination, and victimization compared to heterosexual individuals. As a consequence, these individuals tend to experience more mental health burdens and as a result, utilize mental health services more frequently. The process in which stigma and discrimination create a hostile environment that leads to increased mental health problems is known as minority stress. Forthcoming research indicates that more than half of CNM-identified individuals have experienced discrimination in some form, despite frequently concealing their CNM practices. Recent research has also shown that CNM-related minority stress is positively related to increased psychological distress, such as higher self-reported depression and anxiety symptoms.
3. Most Healthcare Providers Do Not Receive Training on CNM
Mental and medical health providers are uniquely positioned to either help relieve or compound the impact of stigma experienced by their CNM clients. Ideally, healthcare providers would be trained on how to engage in CNM-affirming practices and effectively counteract CNM-stigma. However, it is currently rare for providers to receive explicit training on CNM, and individuals engaged in CNM who seek psychotherapy frequently encounter discriminatory or microaggressive attitudes and practices by medical and mental health care providers.
4. Searching for a CNM-affirming Therapist is Linked to Better Therapy Outcomes
In our study of 249 people engaged in CNM who sought therapy, we found that nearly half of our participants specifically looked for a therapist who was CNM-affirming, highlighting how important finding a CNM-affirming therapist was to them. Notably, those who did search for a CNM-affirming therapist had better treatment outcomes than those who did not search. One-fifth also rated their therapist as lacking the basic knowledge of consensual non-monogamy issues necessary to be effective. These findings highlight the importance of therapist education and creating avenues for CNM clients to find therapists who have been adequately trained about CNM.
5. CNM is a Large and Growing Population
More than one in five people in the United States have engaged in a consensually non-monogamous (CNM) relationship at some point in their life and approximately 4-5% of people in the US are currently in a CNM relationship, which is roughly the size of the LGBTQ community combined. Many healthcare provider locator directories already include search terms related to LGBTQ concerns, but it cannot be assumed that a provider who holds affirming attitudes and/or has received training for working with LGBTQ clients will necessarily hold affirming attitudes or received trained to work with CNM clients.
As interest in CNM has grow and is becoming more mainstream, some are questioning whether CNM is the future of love. In light of this growth, healthcare organizations will face increasing pressure to adopt inclusive practices and systems or risk being labeled oppressive and ostracizing themselves from a large and growing market. We are just starting to include CNM on demographic forms, and I recently received data verifying that 16% of the students accessing mental health services across the 10 University of California Counseling Centers self-identified as something other than monogamous (i.e., CNM 3%, questioning 5%, other 1%, or preferred not to answer 7%). Given the increasing awareness and tolerance of CNM, I anticipate these numbers will continue to rise.
Recent research suggests that the CNM population is large and highly stigmatized, that this stigma is associated with additional mental health burdens, and that when seeking therapists CNM clients frequently experiences discriminatory or microaggressive practices from their healthcare providers. We also know that finding a CNM-affirming therapist is associated with better treatment outcomes (e.g., experiencing fewer discriminatory practices and experiencing their therapist as more helpful), but CNM clients currently do not have widely accessible avenues to access these therapists. While there are a few available resources (that are wonderful), they are not likely to be known to the masses.
Restricting consensual non-monogamy as a search term on healthcare provider locator directories (whether intentional or not) functionally becomes tangible form of discrimination because it reinforces a harmful erasure of the CNM identity and creates a barrier for this stigmatized population from accessing the mental health care providers that are best equipped to support them. Healthcare provider locator directories play a key role as gatekeepers, and have an opportunity to help alleviate some of the additional burden this community has to go through in order to find the culturally competent healthcare they need and deserve.
Providing education is an important first step to promoting equity and inclusion. My hope is that outlining these arguments will help raise our collective awareness about an important relationship structure diversity issue, and provide ample evidence to bring about tangible change. It is also my hope that there will not be too much resistance from healthcare locator organizations because including consensual non-monogamy is a relatively simple change to make.
How You Can Help
In the 1970s, during the early stages of the LGBTQ movement, individuals were provided opportunities to take a stand for justice and compassion by supporting a community that was misunderstood and unjustly stigmatized. Similar opportunities with regard to consensual non-monogamy are presented today.
This past year, APA’s Society for the Psychology of Sexual Orientation and Gender Diversity (Division 44), which was birthed through the LGBTQ movement, endorsed the legitimacy of CNM through formally sanctioning the Consensual Non-monogamy Task Force. We see this as a historic opportunity for therapist locator organizations to join us in creating avenues for CNM provider/client matching. Our team is formally launching our campaign and we could use your help spreading the word and taking these steps:
Message Healthcare Provider Directories. Send this article to all the the healthcare provider directories you know or use through your preferred social media platform.
Share this article with your network. We appreciate your support in sharing this article on social media or any other relevant networks to help spread the word about our Healthcare Provider Locator Campaign.
Sign our petition. On our petition, you can indicate your support for adding consensual non-monogamy to healthcare provider locator directories. You can also express your support for a number of other CNM-related issues and sign up for our mailing list, which is how we’ll keep you posted on the progress of all our initiatives.
Connect us. Do you know someone who works at an organization with a therapist database (e.g., Psychology Today, an insurance company, etc.)? Even if they don’t work in the department, we would love for you to connect us because they may know who we should speak to. We would love your help connecting with these organizations so we can effectively advocate for inclusion. If you have contacts who may be helpful, please email us at Div44CNM@gmail.com.
It’s hard enough being criticized for being different. We owe it to the CNM community to acknowledge that monogamy is not the only viable option by educating healthcare providers about CNM and creating widely accessible avenues for connecting to culturally competent care. Please join us in taking up this cause.
*I used the term consensual non-monogamy for this article because it is currently the most widely used term that is inclusive of the vast ethical forms of non-monogamy. I acknowledge that this term is problematic by defining itself by what it is not (monogamy), acknowledging (and potentially reinforcing) a less-privileged position.
Heath Schechinger, Ph.D., is a licensed psychologist at the University of California, Berkeley, and Co-chair of the American Psychological Association Division 44 Consensual Non-monogamy Task Force. He has multiple peer-reviewed publications and his work has been featured on popular media outlets such as Goop, Psychology Today, and Vogue Australia. Dr. Schechinger’s private practice specializes in ethical non-monogamy and other queer and non-traditional lifestyles, and he is an advocate for the acceptance and normalization of gender, sexuality, and relational identification variances.
Too many clients who are in consensual non-monogamous (CNM) relationships have to educate their therapists. Too many of them discontinue therapy because their therapist judged them, didn’t know enough about CNM to be helpful, or worse, makes actively stigmatizing comments such as “polyamory isn’t stable,” “women can’t do non-monogamy,” or “we can’t accept you to our therapy group as you’re non-monogamous — you wouldn’t fit in.” These are real quotes from a study about the experiences of CNM clients in therapy a couple of colleagues and I recently had accepted for publication in Journal for Clinical and Consulting Psychology.
We believe our results clearly highlight how we need to start taking the mental health needs of the CNM community seriously. For context, around 4–5% of people in the United States report that they are in CNM relationships, a comparable number to how many people identify as lesbian, gay, bisexual, and transgender. More than one in five adults have also tried CNM at some point, which is not far off from how many people own a cat. We also know that interest and awareness of CNM, especially open relationships and polyamory, is on the rise, despite evidence of blatant stigma directed toward this population.
It is still rare, however, for mental and medical health professionals to receive training on how to effectively support people who are engaging in or exploring consensual non-monogamy. Given what we know about minority stress causing additional mental health burdens, I am concerned about the lack of support this community is receiving.
As co-chair of the American Psychological Association’s Division 44 Consensual Non-monogamy Task Force, I’m calling for my colleagues to thoughtfully examine our assumptions around monogamy, pursue and promote education about relationship diversity, and approach this issue with the same level of respect and care that we do with other marginalized communities.
Results, Implications, and Calls to Action
In our study, Drs. John Sakaluk, Amy Moors, and I asked 249 people engaged in CNM about their experiences in therapy, making it the largest study to date on this topic. Significantly, the study was accepted at a top-tier, mainstream clinical journal, signaling that the field of psychology is starting to recognize the importance of addressing relationship diversity.
Monogamy is privileged. It is the unquestioned status quo, prompting many therapists to assume by default that their clients are monogamous, or even, for some, that their clients should be. The publication of this paper means that mainstream psychologists may read about and subsequently treat the needs of the consensual non-monogamy community with an elevated level of respect. The article also calls on mental health researchers and providers to examine our biases and take a nonjudgemental posture toward clients engaged in consensual non-monogamy — just as we would with LGBTQ clients.
We asked participants in structured and open formats what their therapist did (or did not do) that they found to be helpful and unhelpful, allowing us to generate broad and specific practice recommendations and calls to action.
One of the most prominent themes in our data was the importance of educating therapists about CNM. For example, our participants rated therapists as being more helpful when their therapists: (1) educated themselves about CNM issues; (2) held affirming, nonjudgmental attitudes toward CNM; (3) helped them feel good about being CNM; and (4) were open to discussing issues related to a client’s relationship structure. By contrast, CNM clients rated therapists as less helpful and were more likely to prematurely discontinue therapy when their therapist: (1) lacked or refused to gather information about CNM, (2) held judgmental, (3) pathologizing, and/or (4) dismissive attitudes toward CNM.
One-fifth of our participants also reported that their therapist lacked the basic knowledge of consensual non-monogamy issues necessary to be an effective therapist, and/or had to be constantly educated about CNM issues.
That is not to say all therapists were unaware of CNM. One-third of therapists in our study were described by CNM clients as quite knowledgeable of CNM communities and resources. We also asked in an open format what our participants’ therapists did that they found particularly unhelpful. One in five of those responding mentioned their therapist lacking or refusing to gather info about CNM.
It is important to note that our results may be inflated positively as nearly half of our participants reported intentionally seeking a therapist who was affirming toward CNM. Results were generally worse among those who did not search for a CNM-affirming therapist.
These results in conjunction with the size and stigma directed toward the CNM population has led me to conclude that educating therapists needs to be addressed at the highest levels of the mental health profession. It is time to include CNM in therapist training and continuing education programs, and I am calling on my colleagues to join me in advocating for this change.
Removing Barriers to Treatment
Being able to find a therapist who is educated and affirming of CNM is also a critical issue. CNM therapy clients who screened for a CNM-affirming therapist reported better treatment outcomes. They experienced more “exemplary” and fewer “inappropriate” therapy practices by their therapists, and they rated their therapists as being more helpful than those who did not search for a CNM-affirming therapist.
I am also requesting my colleagues advocate for CNM to be included as a search term on therapist locator websites (such as Psychology Today and APA Psychologist Locator) to help remove barriers to the CNM community accessing culturally competent care.
This is a step that I am pleased to announce that APA Psychologist Locator has agreed to take. We are currently in dialog with them about adding ‘Consensual Non-monogamy’ and ‘Kink/Diverse Sexualities’ as searchable categories, with the changes (hopefully) set to go live in November/December 2018. We hope Psychology Today and other therapist locators will follow suit.
Blaming Problems on Relationship Style
Over half of participants indicated their therapists held judgmental or pathologizing beliefs towards consensual non-monogamy. The most common way this judgement appeared to manifest was in attributing clients’ problems to CNM.
For example, when a monogamous couple is having problems we typically don’t assume it’s because they’re monogamous. We also don’t assume a monogamous client is depressed or anxious because they are “attempting monogamy.” Without adequate education and exposure, even well-meaning therapists may engage in these and other types of biased, unhelpful practices.
It is important to note that there are multiple peer-reviewed studies that have compared data on monogamous and CNM relationships with regard to participants’ relationship quality and personal well-being. Their results consistently suggest CNM is a viable alternative to monogamy, at least among those who self-select into CNM.
Compared to monogamous relationships, CNM relationships appear to exhibit approximately equal levels of commitment, longevity, satisfaction, passion, and love. The research also indicates that CNM relationships enjoy advantages of greater levels of trust and lower jealousy.
The collective scholarship demonstrates that relationship structure (e.g., monogamy or CNM) is not an effective predictor of psychological well-being (e.g., depression, happiness) or relationship well-being (e.g., satisfaction, commitment, longevity). There is also substantial overlap in the perceived benefits of monogamy and consensual non-monogamy.
In other words, therapists’ comments about CNM relationships not lasting or causing problems for clients have more to do with therapists’ pre-existing biases than they do with CNM. These biased attitudes are informed by our mononormative culture, not empirical data.
Assessing Relationship Style on Demographic Forms & Benchmarking CNM-inclusive Practices
Another way stigma shows up in therapy is assuming clients are monogamous. This was one of the most common mistakes made by therapists with over one-third of our sample indicating that this happened to them. The hopeful news is that this practice is easily preventable — we just have to ask. I wrote a post for the APA Division 44 newsletter highlighting reasons therapists should ask about relationship style on intake demographic forms.
This step has been embraced by an increasing number of mental and medical health centers, including all ten University of California counseling centers.
Where do we go from here?
Given the size of the CNM population, the pervasive stigma they experience, and the lack of therapist training, I believe the mental health field has an ethical imperative to improve how we address the needs of the CNM population. Some professional organizations are beginning to respond to the growing awareness of relationship diversity. In January 2018, the Executive Committee of APA Division 44 unanimously approved a proposal for the first task force within the APA dedicated to promoting awareness and inclusivity about consensual non-monogamy and diverse expressions of intimate relationships.
Dr. Amy Moors and I are serving as co-chairs of the APA Division 44 Consensual Non-monogamy Task Force and are currently recruiting volunteers to lead or contribute to projects addressing a range of issues such as including CNM as a protected legal status, educating therapists, making it easier to find CNM-affirming therapists, and creating a fact sheet about CNM.
We believe this task force is a significant sign of how far the non-monogamy movement has come and suggests there is hope that the world will become safer for people in CNM relationships.
While I strongly advocate for the changes to our field I’ve suggested in this post, I also believe we need additional studies regarding their efficacy. It is important to be sure that these measures actually foster the inclusivity for CNM clients that is intend.
Resources & Getting Involved
One of our initiatives is to advocate for the eventual creation of practice guidelines, similar to those that were created by the American Psychological Association for working with lesbian, gay, and bisexual therapy clients as well as transgender and gender nonconforming therapy clients.
In an effort to progress toward practice guidelines, I developed empirically-informed benchmarks that can be used to assess practices at the institutional and individual levels as well as sample language for assessing relationship style on demographic forms. Dr. Michelle Vaughan also led the charge in creating informational brochures that people engaged in CNM can provide to their medical and mental health provider(s).
You can access these resources when you join the APA Division 44 Consensual Non-monogamy mailing list or sign our petition to support relationship diversity in mental health, medical health, and the legal profession.
These resources and this post can be shared freely with your network as well as your current medical and mental health providers.
In addition to signing our petition and/or joining our mailing list, we would like to invite you to follow us on Facebook and Twitter, where we will be posting updates. I will also be making updates on my Twitter, Facebook, and Linkedin accounts.
Educating therapists, removing barriers to accessing treatment, asking about relationship status on demographic forms, setting benchmarks, and signing petitions will not eliminate the judgment and discrimination experienced by the CNM community — but we believe these are all important steps forward. With education and exposure we can challenge the mononormative assumptions promoting a one-size-fits all model of relating — in the same way we challenge assumptions about sexual orientation and gender diversity.
Just as monogamy is not right for everyone, neither is consensual non-monogamy. It’s not about what’s right for all, but what’s right sized for the individual.
Heath Schechinger, Ph.D., is a licensed counseling psychologist at the University of California, Berkeley, and Co-chair of the American Psychological Association Division 44 Consensual Non-monogamy Task Force. His private practice specializes in providing support to the CNM, kink, queer, and gender non-conforming communities.