Somewhere in southern California, Shandra Barrera and Camille Slusher sit with mirrors between their legs, staring at their yonis.

They are participants on Sex, Love & Goop, the Gwyneth Paltrow-fronted Netflix series, which aims to help couples “experience genuine arousal, desire and pleasure”.

The mirrors are a tool used by Darshana Avila, one of the show’s sex and intimacy coaches who, in this episode, is helping Barrera with the pain she experiences when she receives penetrative touch.

“What does she need to hear?” Avila asks Barrera about her vagina. “Relax!” Barrera responds, shouting at the mirror in between her legs. Avila suggests chiding herself might not be helping. This is all part of the buildup to the main event, when Avila will penetrate Barrera on screen with her hand, hopefully without causing her pain.

That Avila’s job can involve touching clients’ genitals, makes her practice illegal in every US state apart from California. It’s not a service that all of her clients need, but when they do, she works with them to build a healthy relationship based on communication, consent and trust.

“We first are laying down a foundation that helps them learn about tracking themselves, because if you don’t know what’s happening in your body or where your boundaries lie, it’s almost impossible to be in a fully consensual exchange,” Avila explains.

If those conversations go well, they may lead to a session where Avila helps her clients discover pleasure in its many forms. “Sure, it could be ecstatic orgasmic pleasure. But as we saw on the show, it can be the pleasure of Shandra, for instance, receiving penetrative touch without pain.

So why is this service not on offer everywhere?

“If you look at this very simplistically, we have a legal and cultural bias that says, if you are not a medical practitioner, any context in which you were touching somebody’s genitals is wrong, bad and subject to legal action,” she says, pointing out fears of abuse or non-consensual touch. But in the case of sexological bodywork, she explains: “It’s assuming that there is an exchange that isn’t actually happening. [My job] is one directional. I am not receiving touch, I have clothing on. I have gloves on my hands,” she says.

Avila sees a host of clients who come to her for issues ranging from the concise (I can’t orgasm; I have an injury after birth that’s still bothering me) to the ineffable (I don’t feel at home in my body; I love my partner but we don’t bond sexually). “We start creating this journey together, where I get a sense of where the missing puzzle pieces are and we go about filling them in and connecting them up,” Avila explains over the phone.

“I’ve learned that we have a major cultural bias against pleasure,” she says. “We have this really narrow definition, that is: pleasure equals orgasm. But your eroticism isn’t necessarily focused on your genitals,” she says.

For Barrera and Slusher – the ones staring into their vaginas through a mirror – their discomfort with their pleasure is clearly laid out on the show. Barrera’s comes from her strict religious upbringing in a home where sex wasn’t spoken about and lesbianism wasn’t condoned. Now, pleasure makes her feel shame – so much so that her body tenses up when she is about to be touched. For Slusher, her own anxieties about her body prevent her from being able to get out of her head and enjoy sex.

A common misconception that people have about sex, Avila tells me, is that our partners don’t want to hear us say what feels good or bad sexually. We assume it will make them feel inadequate or that it is selfish. In fact, we tend to assume that sex is better when not spoken about very much at all.

“I give people worksheets, that have lists of words about sensations and emotions, and ideas for ways you can touch. People get afraid they’re going to offend somebody. And they haven’t gotten to practice those skills. But they’re very learnable – it’s not rocket science,” she reassures.

The worksheets include knowing exactly what types of touch are available to you – from stillness, compression and squeezing to stroking or tickling. It also includes being able to talk about where you like to experience these sensations and how they make your body feel.

“I’m not saying you’re going to learn everything from a textbook. But there are fundamental things … that will make a difference,” she says.

Avila believes that people talking to one another regularly, concisely and openly deepens intimacy, although she understands why people fear it will destroy it. Telling your partner things aren’t working for you is vulnerable, revealing. We struggle to advocate for ourselves even at the best of times – let alone when we’re naked. So requests need to be made in a way that invites intimacy, instead of taking it off the table.

Much of this is intuitive: don’t start the conversation in the middle of sex, make sure it comes at a time when both partners are ready to receive it (so, not when you’re hungry or in the middle of an argument or tired or drunk); use ample praise– couch requests within the frame of what is going well.

If the sex is really bad – and there are no good things for the requests to be couched in – Avila suggests focusing on the relationship. “Place an emphasis on: ‘I want to be in conversation with you,’” she says, “really emphasize the mutuality of that, even if you’re coming to say something like, ‘You have never touched me in a way that feels good’ or ‘I’ve been faking my orgasms for five years.’”

Being in the presence of a licensed third party, if that’s available to you, can help.

“Often when I’m working with couples, I feel like one of the hats I wear is translator and interpreter. Because I can hear what comes out of one person’s mouth, I can hear how it lands with the other person,” she says.

Are there any questions that come up time and time again?

“‘Am I normal?’” she says. “People want to know, desperately, that they are not the only ones. And the answer is, you are totally normal. You are not the only one and you’re also not broken,” she says.

Avila believes this is the product of the unhealthy culture we live in, one that is dysfunctional, toxic, misogynistic. And that extends to the work that she’s doing not being available everywhere in the US.

In another scene from Sex, Love & Goop, Barrera is laying down, covered by a blanket and her partner, Slusher, is watching. “I’m going to stroke your labia,” says Avila. Then, she places her finger at the entrance of Barrera’s vagina, narrating her movements as she goes. She hears Barrera tense. “I’m starting to feel a little bit of pain,” Barrera says. Avila lightens her touch, and tells Barrera to breathe. “How’s that?” she asks. Soon there is relief, as Barrera realizes she is receiving penetrative touch. “I don’t feel any pain, which is crazy,” she says.

“There is your love,” says Avila. “And here is your body feeling safe enough to receive.”

I ask Avila how it makes her feel, to know that people like Barrera can’t receive this same sort of service openly in so many US states. “Honestly, it breaks my heart,” she says. “It makes me deeply sad on a certain level and angry on another that more people are not being given ready access to the qualities of care and support that really nurture them into their wholeness,” she says.

But she’s also happy that this work has been spotlighted on a show on Netflix.

“Now it is seen in a mainstream context,” she says. “I think all of us need therapy to work through what’s happening in our hearts, in our psyches and our mind. Why would we not want that for our bodies and for our sexuality and intimacy, which are such integral parts of what it is to be alive?”