Let’s Talk About Sex...Therapy

As a sex therapist, I have fielded many excellent questions from colleagues, clients, and people in my life regarding the nature of sex therapy. What is sex therapy? Is that even a thing? Why? What can I expect in sex therapy? How do I find a sex therapist? Sex and sexuality, though ubiquitous, are hard topics to discuss, complicated by cultural expectations, partner expectations, myths around sexual feelings and behavior, and a lack of precise definitions and information. By addressing these questions here, I hope to demystify some of the opacity around sex therapy.

What is sex therapy?

Sex therapy is just that - therapy. Though different therapists may work in different ways, sex therapy is a specific form of talk therapy. Much like therapy that targets depression or anxiety, sex therapy involves gathering pertinent information about the issue, understanding how the issue affects your life, and getting to know who you are and how you navigate your life, both currently and in the past.

Sex therapy is not limited to talking only about sexual issues. Sex therapists are simply trained psychotherapists with additional, specialized training in addressing a wide variety of issues related to sexuality. Thus, your sex therapist should also be trained in treating non-sexual issues. This comes in handy, as sexuality can be immensely complicated. It both affects and is affected by challenges in other areas of life (e.g. work, family, school, relationships, etc.), and those challenges may be addressed within the therapy.

Is that even a thing? Why?

Yes. Sex and sexuality are important aspects of well-being, as well as relationship and overall life satisfaction. However, many people, and indeed, psychotherapists, have great difficulty talking about such topics. Sex therapists are specially trained to be attuned to the sensitivity of the subject matter, as well as to have the fund of knowledge required to attend to difficulties regarding sex and sexuality. Furthermore, sex and sexuality are such broad topics! People experience a wide range of sexual difficulties, including issues related to sexual functioning (e.g. desire, arousal, orgasm, etc.), relationships (e.g. desire discrepancies, infidelity, etc.), conflicts around sexual interests, changes related to aging and illness, trauma, and the intersection of gender and sexuality. Sex therapy is a thing because people need a safe, affirming space in which to discuss such important issues with a knowledgeable, empathic professional.

What should I expect in sex therapy?

Short answer - you should expect a personally tailored experience in which you are treated with respect and your concerns are taken seriously. The long answer requires a disclaimer - not all sexual issues are treated the same way; not all sex therapists will treat the same sexual issue the same way. Why? One reason is the nature of the issue. Much like a medical doctor would not treat a broken leg and the flu in the same way, a sex therapist would not treat erectile dysfunction and infidelity in a relationship in the same way. Another reason is the context in which a problem arises. Again, a medical analogy: a medical doctor would not treat the flu in an infant or an elderly person just as they would treat the flu in a healthy person in their 20s. The “context,” in sex therapy is the person and their environment. Even treatment for something as commonplace as erectile dysfunction is likely to vary depending on the client and how their life is affected by it.

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That said, there are some things that you can expect. A sex therapist will help you explore questions about sex and sexuality, as well as other aspects of your life. A sex therapist will talk with you, but under no circumstances should a sex therapist engage in any sexual behavior during a session, nor will you be asked to. Though a therapist may recommend homework that is behavioral in nature, such work is typically done outside of the session, either alone or with a partner, not with the therapist. You and the therapist may explore your experience of assigned homework, but, again, this is done with words, not actions. Lastly, you should expect to be treated with compassion, confidentiality, and respect. Whether engaging in traditional psychotherapy or sex therapy, it is vital that there be trust and safety in your relationship with your therapist. If those elements are not emerging in the first several sessions, you may consider discussing it with your therapist and/or switching to a different therapist.

How do I find a sex therapist?

Finding a therapist is challenging enough, nevermind a sex therapist. You want to make sure that your time in therapy is meaningful to you. The first and most important issue when deciding who to work with is whether or not you are comfortable and can build trust with your therapist. Talking about sex can be intimidating and even scary; if you cannot trust the person with whom you are talking, the treatment will never get off the ground. If and when you realize that a certain therapist may not be a good fit for you, ask for or seek out referrals. Because the fit between therapist and client is SO important, your therapist should be accustomed to navigating situations like this. Second, you will want to look for someone who is qualified. Any sex therapist should be a licensed mental health professional. Though the terminology can vary state by state, in Massachusetts, that means someone who is a licensed mental health counselor (has LMHC after their name), a social worker (LCSW or LICSW), or a psychologist (PhD, PsyD, or EdD). In addition, look for someone who has a certification in sex therapy (often through AASECT) that verifies they have completed specialized training.

Sex and sexuality are extremely difficult topics to bring up; however, they are also extremely important aspects in the pursuit of well-being and satisfaction. Even if you are unsure about whether or not something is an “issue” that might benefit from therapy, consulting with a sex therapist is always an option. Though talking about sex can be hard, it is often harder to suffer in isolation. Reach out for support; we are here to help you navigate your journey toward a more satisfying life!

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