PEER COMMENTARY Sex Therapy in a Cultural Context Aleksandar S ˇ tulhofer Æ Goran Arbanas Published online: 10 July 2009 Ó Springer Science+Business Media, LLC 2009 Binik and Meana (2009) should be thanked for their contro- versial (provocative?) essay that prompted a number of col- leagues (the authors of this comment included) to rethink some of the assumptions about sex therapy that are usually left unquestioned. In their essay, Binik and Meana eloquently argue that sex therapy never possessed a differentia specifica that would legitimate its claim to uniqueness and its dis- tinctiveness from general psychotherapy. From there, Binik and Meana proceeded to advocate a quiet (and, presumably, self-inflicted) death of sex therapy, regarding it as a necessary sacrifice for a greater good—a unified, biopsychosocial ap- proach to treating sexual health problems. Simply put, Binik and Meana assert that the existing sex (psycho)therapy blocks a more integrated and, therefore, a more efficient interdisciplinary enterprise. We agree with Binik and Meana that there is very little that makes sex therapy a unique enterprise, particularly if this issue is approached from a taxonomic and systematizing standpoint. The lack of clear demarcation lines becomes obvious when inspecting sex therapy training programs. Aside from a few specific behavioral or cognitive and behav- ioral tools (such as the famous sensate focus exercises)— which were at least inspired by some more general thera- peutic principles and approaches—and the emphasis on de- veloping sensitivity to a variety of sexual choices and expres- sions, there is precious little that would be excluded from professional training in, for example, gestalt, integrative, or cognitive behavioral psychotherapy. An interesting parallel, though, could be drawn with the medical profession. Although, for example, nephrologists or ophthalmologists do not use treatment techniques that are unique to their respective fields, they are nevertheless considered specialists based primarily on the particular organ they treat. As much as we agree with Binik and Meana that sex ther- apy’s identity is a vague one, we disagree with the conclusions they arrive at. Firstly, we are not convinced that sex therapy in its mainstream form does not deserve a specialty status. Sec- ondly, we find their plan of action dangerous. If it were to be put into action, the outcome could well be the opposite to the one the authors are hoping for. Our disagreement stems primarily from the cultural context within which we work. It may be that Binik and Meana’s proposal has merits in the North American context, but it would have disastrous consequences in the Southeast European context. Sex research, medical sexology, and sex therapy are either non-existent or marginalized pro- fessional fields in this region. The absence of tradition and lack of professional training programs, as well as financial and status-related disincentives for young aspirants, makes sexual problems and dysfunctions nobody’s business. Together with the recent increase in the influence of religion, particularly in the post-communist, post-transitional societies, the situation is hardly one in which a handful of sex therapists are denying well-established medical professionals an opportunity to try their hand (no pun intended) at treating sexual difficulties. On the contrary, the emerging field of sexual psychotherapy in Croatia, which has been received quite positively by the media, provided a platform for sensitizing and educating the public about sexual health issues. In addition, it was the inspiration behind the recent introduction of the first elective course on human sexuality at the University of Zagreb Medical School. Recently, the Croatian Psychological Association recognized the importance of sexual health by supporting the creation of a A. S ˇ tulhofer Sexology Unit, Department of Sociology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia G. Arbanas (&) Day Care Center, Department of Psychiatry, General Hospital Karlovac, A. Stampara 3, 47000 Karlovac, Croatia e-mail: goran.arbanas@ka.t-com.hr 123 Arch Sex Behav (2009) 38:1044–1045 DOI 10.1007/s10508-009-9490-x