What is sex therapy?

Sex therapy is any form of psychotherapy (generally talk therapy) performed to treat issues related to sex, one’s thoughts and feelings about sex (including anxiety, shame, body dysmorphia, etc.), maladaptive sexual behaviors (acts that are socially unacceptable or harmful to self or others), as well as sexual orientation, gender identity, and relationships. Sex therapy is supportive, sex positive, and inclusive of all genders, orientations, expressions, and relationship types (including ethical nonmonogamy in its many forms, as well as BDSM/kink).

Interventions may include:

Mindfulness-based techniques

Emotion-based techniques

Attachment-based techniques

Somatic techniques

Trauma intervention (such as EMDR, Brainspotting, Cognitive Processing Therapy)

Couples communication and therapy techniques (such as Gottman Method, Imago, Developmental Model)

A sex therapist is a state-licensed mental health professional (generally a social worker, mental health counselor, marriage and family therapist, or psychologist) who has knowledge and experience performing therapeutic interventions related to sex and relationship topics. If they are not state-licensed, they must be certified, registered, or clinical members of a national psychotherapy organization.

No, they do not go into the bedroom with you! They may work in collaboration with a larger team (medical doctor/psychiatrist/OB-GYN/urologist, nurst practitioner/midwife, sex/relationship coach, etc.) to help as you work on your relationships and continue on your own journey.

Due to the nature of their education in sex issues and the populations they serve, they may also be able to provide some level of sex education and have general knowledge about toys, lubricants, social events, etc., as well as the ability to refer you to other professionals to meet your precise needs.

People seek sex therapists for a number of reasons. They may be experiencing trouble orgasming, sex aversion, changes in sexual attraction or interest, erectile dysfuntion, or vaginismus. They may experience changes in their bodies due to puberty, perinatal/postpartum, menopause, or losses due to cancer. They may be processing shame due to problematic sexual behaviors or trying to leave a past in purity culture. They may be learning who they are in terms of sexual orientation and/or gender expression. They may be thinking about opening their relationship, exploring kink, or simply need help with sex communication. They may want to reduce symptoms of sexual trauma, including incest, assault and rape, gender discrimination, and any other form of traumatic consent violation. The issues discussed in sex therapy are not any different than what can be discussed with any other therapist. The difference is that a sex therapist is specially trained and experienced to approach the conversation in a nonjudgmental and knowledgeable place (that does not mean that other clinicians can’t do the same work, this is a subspecialty).

Yes! Working with the polyamory (and BDSM) community was part of why I decided to become a therapist. There are unique issues (rewarding and challenging!) that come up in these relationship types, and there aren’t many models to learn from. Therapists typically don’t learn much how to handle couples therapy without specific lessons, and very few models of couples therapy are open to issues with polyamory and kink (though many models can be modified). Even when a therapist has this education, there is also the question of comfort with the subject matter and being able to work with difficult questions. I work in and am a part of both communities and want to create a nonjudgmental and knowledgeable space where you feel comfortable and confident to discuss things like jealousy in polyamory or making plans for growing a family with another partner or renegotiating your kink relationship.