How we experience our sexuality has a lot to do with bodies: how we like to touch and be touched, how we respond to different kinds of stimulation or illness or physiological issues that may change our sexual desire and responses. But that’s not the whole picture. A big part of our sex lives is defined by the things we have learned about sex, by what we think and how we think about sex and by what we know and believe about relationships.

Even though there are certain medical issues that can impact our sex lives, many who face sexual health challenges should look to their minds rather than their bodies. Just like we know the placebo effect is real, we understand that sometimes what seems like a physical problem can be all in our heads. I spoke with Dr. Logan Levkoff, AASECT-certified clinical sexologist and sex educator, about how our minds can affect our sexuality.

“There’s a great deal of sexual implications that come from our psychology, our education, our upbringing and the messages we get from culture and the media,” she explains. “These things contribute to how we see ourselves as sexual beings and how we understand sexuality, consent and relationships.”

Where Do We Get Our Beliefs About Sexuality?

Regardless of the culture we grow up in, we hear messages about sexuality from it all the time. What is consent? What are the sexual roles of men and women? When is it appropriate or not to have sex with a partner? What kinds of relationships allow for sex? Are masturbation, pornography and nonheterosexual relationships acceptable?

And as with many cultural messages, sometimes, they don’t match our desires or our experience. Take queer sexuality, for example. Before the gay rights movement, many LGBTQ people felt they had a “disordered” sexuality that required treatment. Homosexuality was considered a mental illness until 1973. The messages around nonheterosexual desire made some people feel distressed about their desires, leading them to believe they were broken or wrong.

“It’s impossible to consider what it means to be sexually healthy without having a really good understanding of the messages that we receive,” says Levkoff. Like it or not, a big part of our sexuality is culturally determined. There are no “inherently natural” acts or roles; as author Yuval Noah Harari notes in Sapiens: A Brief History of Humankind, if it’s physically possible for humans to do, then it’s “natural.” The concept of what’s normal and abnormal is based on cultural beliefs.

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The Role of Shame

According to Levkoff, the way we internalize those cultural messages can lead us to feel shame about our sexuality. “If we feel an ounce of shame about who we are, our identity, consent or speaking up, it can have significant physical and mental sexual health outcomes,” she says. “That’s when we have trouble giving consent or discussing boundaries.”

Everyone, but women especially, is being shamed all the time. Too slutty or too prude; if you’ve been assaulted or raped, it’s your fault; you should be thin but curvy… the list goes on. In our sexual lives, shame stops us from exploring our identity and desires and from expressing our sexuality in the ways that feel authentic to us. “We need to give ourselves the freedom to think about what we want as sexually healthy people,” Levkoff explains. “Acknowledging our wants, desires and needs impacts our self-esteem, our voice and our power.” When shame tells us we’re bad people for wanting what we want, we need to fight it with authenticity and honesty.

MORE: What 7 Women Wish Their Partners Knew About Getting Them Off

Toss the Script

Our thoughts and beliefs about sex can lead us to a wonderful, fulfilling sex life; or it can fill us with shame and guilt. Levkoff insists there is no right or wrong way to experience sexuality and “no one else is allowed to define your sexuality for you.” The power is in your hands to throw away the scripts being hurled at us from every direction and to write our own sexual story.

When it comes to sex, our psychology matters just as much as our physiology—if not more. We may be perfectly physically healthy, but if we believe our sexuality is wrong or disordered in some way, a satisfying sex life will remain out of our reach. So when you face issues in your sexual life, you should certainly consult a doctor to eliminate any physical causes; but more often than not, the root of the problem is psychological.

Originally posted on SheKnows.