Sex Therapy

What is sex therapy?

Sex therapy is a specific branch of psychotherapy devoted to supporting well-being around sex and sexual satisfaction. Contrary to common misunderstanding, sex therapy does not involve contact with or in front of a sex therapist.

Sex therapy is simply a specialized way of treating sexual dysfunction and/or intimacy concerns from a psychological perspective, including addressing any mental health conditions that may relate to or arise from these concerns.

Don't be afraid to seek out a sex therapist if your sex life is causing you stress and affecting your confidence. You deserve to feel fulfilled and happy in your intimate relationships. It's okay to seek help and support towards achieving a satisfying and fulfilling sex life.

What sex therapy can help with

A certified sex therapist is trained to help with a wide variety of challenges related to sex, physical contact, and achieving healthy, satisfying sex lives, including (but not limited to) the following:

• General stress or anxiety around sex: You may feel uncomfortable or be preoccupied with your worries about sexual behavior, performance anxiety, or even find that your anxiety in this area interferes with some aspect of sexual relations.
• Lack of desire or mismatched desires: You or your sexual partner(s) may not feel as much sexual desire as you want to, or you may not experience the same amount or frequency of sexual desires.
• Challenges with sexual arousal: You might have difficulty feeling sexually aroused or achieving orgasm, or you may experience orgasm sooner than you want to. Erectile dysfunction and premature ejaculation fall under this category.
• Sex and/or pornography addiction: Not all sex therapists treat these issues, but some are trained to help you deal with addictive behaviors relating to sex or unwanted sexual fetishes.
• Issues relating to sexual trauma: Individuals who have been victims of sexual trauma often experience ongoing challenges around sex and sexuality. You can find more information about healing from sexual trauma here.
• Challenges relating to sexual orientation or gender identity: If you’re struggling with any aspect of your sexual orientation or gender identity (coming out or facing discrimination, for example), these challenges may affect your sex life as well.
• Painful intercourse: Though it can be caused by underlying medical issues, painful intercourse can sometimes be related to stress or anxiety around sex.
• Body image or self-esteem issues: Especially in a culture that places a high value on sex appeal and physical attractiveness, sexual issues can challenge an individual’s sense of self-worth.
• Sexual difficulties related to life circumstances: You might find that you need to approach sexual encounters differently due to having children, aging, a medical condition, or even just major life changes like a new job or a relocation — this type of stress can be a factor of low libido.
• Exploration of new sexual activities: You and/or your sexual partner(s) might be interested in trying out a new kink, sex toys, or exploring non-monogamy.
• Feeling generally stuck or unsatisfied sexually: You might be stuck in a rut and not quite sure why, or you might be interested in exploring new sides of your sexuality and feel unsure of where to start.

In short, qualified sex therapists can offer a supportive and educational environment for you to discuss any sexual issues. What’s more, they can also be a valuable resource even if you’re not experiencing sexual problems, per se; you might just be interested in exploring your sexuality in some way. You can see a sex therapist for individual therapy, or couples sex therapy, to work on relationship issues related to sexual dysfunction and emotional health — they can be helpful in that situation too.

Effectiveness of sex therapy

Because so many kinds of treatments and issues fall under the umbrella of sex therapy, it’s difficult to assess its overall effectiveness. That said, some studies have found that high percentages of individuals who participate in sex therapy report significant improvement in the enjoyment of sexual encounters and lower levels of sexual dysfunction after completing treatment. Recent sex research has revealed new perspectives on sexuality and groundbreaking methods for managing sexual concerns such as difficulties with arousal, desire, pain, and achieving orgasm.

Different types of sex therapy

For the most part, sex therapy closely resembles traditional talk therapy, though many therapists also assign homework or activities to be completed between sessions. You might attend therapy on your own, or you might attend with one or more partners. Your sex counselor may also recommend that partners have one or more sessions separately from each other.

Sex therapy often includes aspects of other therapeutic modalities including cognitive-behavioral therapy, psychodynamic therapy, and mindfulness practices.

In cases where a medical issue may be related to your sexual issues, your sex therapist (if they are not a medical doctor) will likely recommend that you also work with a physician to have a full check-up and manage any necessary medication for sexual dysfunctions.

Structure of sex therapy sessions

You can expect a typical sex therapy session to look a lot like any other talk therapy or psychotherapy session, with the difference of an added focus on human sexuality and whatever specific challenges you’re interested in focusing on.

Prepare yourself for uncomfortable questions about your sexual history and experiences. Your sex therapist may need to know about your sexual activities, masturbation habits, and how you express sexual desire and affection. You will also be encouraged to discuss your body and your feelings towards it.  

Remember, the ultimate goal is to understand how sex has looked in the past, how it is currently looking, and how you would like it to look in the future. A positive and supportive relationship with your therapist, known as the therapeutic alliance, is crucial for effective sexual education and care.  

Your sex therapist will work at your pace and level of comfort to ensure progress is made. It's important to note that all conversations and sessions are confidential and judgement-free. Let's work together to improve your sexual wellbeing.

Early sessions are “get to know you” time

In your first session, your sex therapist will likely want to get a sense of the context surrounding your concerns and may ask you questions around the following topics:

• Your sexual background, both as individuals and (if applicable) as partners
• Your general mental health history
• Your sexual orientation
• Any physical or medical concerns that may be causing sexual problems or affecting the current issue
• The course of your relationship and what it’s like outside of sexual activity (if the issue is related to a partnered relationship)
• Your typical sexual habits, including frequency and type of sexual contact and masturbation
• How you show desire and affection beyond sex

If a medical problem might be involved, your therapist may also take a more detailed medical history or refer you to a physician for an examination or medication management.

In later sessions, you’ll dive into more contextual details

As you grow more familiar with your therapist, you can expect to talk about the above subjects in more detail and delve into your feelings (and those of your partner[s]) about them.

Therapy can greatly improve your sexual experiences. You'll learn to build skills for pleasure and arousal as an individual and/or couple. Manage anxiety that's affecting your sex life and improve communication with your partner. You'll receive sex education around anatomy, men and women’s sexual health, and sexual function and pleasure.

Additionally, you'll examine any dependencies on erotica for arousal, and find masturbation habits that aren't conducive to functioning with a partner. Discover your body-mind connection and what stimuli work for you. Transform the focus of sex from a performance and orgasm-focused one to a fulfilling and embodied experience. Address any underlying mental health concerns, sexual trauma, or other issues that may prevent you from truly feeling desirable. Remember, therapy is customized to each client, and can involve both insight-oriented work and hands-on exercises to develop skills.

Homework is often involved

Sex therapists recognize their job is to help you spot patterns around these issues, gain a sense of security in working on them, and experiment with new courses of action. To that end, most therapists assign homework that may be emotional (such as communication or mindfulness exercises for relationship therapy) or physical (trying out certain kinds of intimate touch at home, for example) to be completed between sessions, and you’ll likely spend some time during each session going over the results of this homework.

Who could benefit from seeing a sex therapist

Just about anyone who has concerns or even curiosities related to their sex life or issues surrounding sex and intimacy might receive help from seeing a sex therapist.

Sex therapy is a fantastic way to prioritize your sexual health and well-being, and it can give you a compassionate, non-judgmental environment in which to explore your sexuality, address sexual dysfunction, and get help to achieve a fulfilling sex life.

Therapy approaches that sex therapists use

Common therapy approaches to sexual health and dysfunction include:

• Cognitive behavioral therapy (CBT)
• Couples therapy
• Mindfulness practices
• Interpersonal psychotherapy
• Psychodynamic therapy
• Psychoeducation around sexual health

The purpose of therapy is to understand the root causes of your struggles, while approaching your desires with compassion and acceptance. It’s about giving you the tools to face your challenges with resilience and gain insight. Remember, with strength and determination, you can overcome anything life throws your way.

What to look for in a sex therapist

Therapists differ in their approaches to treating sexual challenges, but it can be a good idea to find a licensed sex therapist who has training specifically in sex therapy and sexual concerns.

Look for a therapist with specialized training

When looking for a sex therapist, learn about the provider’s education and training and see if they have any specialized training in this area.

For example, you may want to look for a practitioner who has been certified by the American Association of Sexuality Educators, Counselors, and Therapists (AASECT), someone who focuses on female sexual dysfunction, or sexual medicine.

AASECT-certified sex therapists have had specialized training and fulfilled academic and licensure requirements, and they must also complete ongoing continuing education credits to ensure that their clinical practice is informed by the latest developments in the field.

If you’re seeking help with a particular issue, see if the therapist references it in their profile

You can also read their online profiles or websites for information they share on their specialties — within sex therapy, do they mostly see women who have a history of sexual trauma or sexual abuse? Men who have challenges with performance or sexual dysfunction? Couples who struggle with intimacy and sexual satisfaction? Do they see clients addressing problems with sexual addiction?

While most sex therapists can address a range of concerns that fall into this category, finding a specialist in the particular challenge you are facing may help you address your concerns more effectively.

Learn more about what to look for in a sex therapist here, or to continue your sex therapy education, read our ultimate guide to sex therapy, explanation of sexual health and dysfunction, what to expect in sex therapy, how to choose between ED pills and sex therapy, and/or common questions about sex therapy for ED.

New to therapy? Learn about how to find a therapist here.