The Ultimate Guide to Sex Therapy & Finding a Sex Therapist
by the Zencare team
Expressions of intimacy; jealousy concerns; self-empowerment; exploring your gender identity: All these are typical topics covered in sex therapy.
Porn usage; erectile dysfunction; masturbation; and the art of the orgasm: All these are, too.
Sex therapy is a type of talk therapy that addresses all things sex. Sex therapy is an option for everyone – regardless of sexual orientation, personal history, and relationship status.
Going to a sex therapy session doesn’t necessitate something is “wrong.” As human beings, we all have complex desires, functions, levels of satisfaction, and intimacy levels – and addressing these is simply part of life.
Curious to learn more about sex therapy? We put together this ultimate guide to bust myths, explain typical sessions, and spread the word. Here’s everything you need to know about 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 sexual contact with or in front of a therapist. Sex therapy is simply a specialized way of treating sexual concerns from a psychological perspective – including addressing any mental health conditions that may relate to, or arise from, these concerns.
Who are sex therapists?
A number of different kinds of mental health practitioners may also be sex therapists, including social workers, psychologists, and psychiatrists.
Sex therapists have additional training beyond their general mental health credentials, and many are certified by the American Association of Sexuality Educators, Counselors, and Therapists (AASECT).
What does a sex therapist do?
A sex therapist’s job is to learn about your sexual history and any other factors that may be contributing to your current concerns, help you work through your thoughts and feelings about those concerns, and experiment with new courses of action in order to resolve them.
Depending on your therapist and the issue you want to work on, sex therapists may help you spot patterns and themes in your thoughts or behaviors or learn techniques for reducing anxiety around sex.
Does sex therapy work?
Yes, several studies have confirmed the efficacy of sex therapy for certain concerns. One study found that sex therapy for female sexual dysfunction reduced symptoms (which ranged from hypoactive sexual desire disorder [74% effective] to vulvodynia [41.7% effective]).
Another study assessed the efficacy of sex therapy on a sample size of men (mean age of 39.9 years) and women (mean age of 36.2 years). The study revealed that, after sex therapy, participants experienced:
Lower levels of sexual dysfunction
More positive attitudes toward sex
Perceptions that sex was more enjoyable
Fewer affected aspects of sexual dysfunction in their relationship
A lower likelihood of perceiving themselves as a “sexual failure”
What can sex therapy help with?
Sex therapy can treat a wide variety of concerns and issues related to sexuality and intimacy. In fact, you don’t even need to have a particular sexual issue in order to seek out and benefit from sex therapy!
That said, there are a some common scenarios that may signal sex therapy could be right for you. A few of these signs include:
Feeling sexually stuck or frustrated, whether individually or in a partnered relationship
Anxiety and/or stress around sex and/or intimacy
Physiological sexual problems that may have a psychological component, including erectile dysfunction, painful intercourse, and premature ejaculation
Difficulty communicating with a partner or partners about sex
Mismatched levels of sexual desire, arousal, or satisfaction within a partnered relationship
Working through healing after experiencing sexual trauma
Desire to explore new areas of your sexuality, such as kinks or non-monogamy
Struggling with sex addiction or pornography addiction
Sexual issues related to gender identity or sexual orientation, such as stress related to coming out or facing discrimination
Sex therapy can be helpful for anyone who is looking to explore their sexuality and/or learn more about subjects like desire, arousal, and satisfaction. Sex therapy is a great way to prioritize your sexual health and well-being.
Can sex therapy help with physical symptoms such as ED and painful intercourse?
Yes! Sex therapists often treat individuals who are looking for support around physical symptoms such as erectile dysfunction and painful intercourse.
While these symptoms may have medical origins and you should always rule out medical problems with the help of a physician, sex therapists can also help you deal with potential psychological underpinnings of these problems. Often, sex therapists will ask for information about your medical history and can in some cases work collaboratively with your doctor.
What does sex therapy for different issues entail?
Sex therapy often includes specific techniques or exercises for treating the following concerns:
Sexual intimacy: Sex therapy for issues related to intimacy may include communication exercises, homework around intimate touch, or ideas for new ways to prioritize foreplay.
Sex addiction or porn addiction: Treatment for sex addiction or porn addiction usually involves treating the underlying psychological factors that may lead to addiction, including depression or anxiety. Cognitive-behavioral therapy is a common treatment for the behavioral compulsions of these conditions. In some cases, in-patient treatment centers are also an option.
Lack of arousal or low libido: Sex therapy for lack of arousal can include mindfulness exercises, stress management techniques, and strategies for improving sexual habits, such as scheduling sex and introducing novel sexual activities. Some therapists may also recommend that you see a physician to rule out medical causes.
Female empowerment: This form of therapy often focuses on working through and reversing internalized sexism related to desire and sexual satisfaction. You might focus on unlearning cultural conditioning around sex--such as the idea that women with high sex drives are so-called sluts--and learning techniques for reclaiming your own desires.
Survivors of sexual abuse or trauma: Sex therapy for survivors of abuse or trauma involves aspects of trauma-informed psychotherapy. Sessions might include processing of past trauma and understanding how that trauma informs current concerns.
Erectile dysfunction: In addition to working with a physician to rule out medical causes and prescribe medication when appropriate, sex therapists can help you understand the psychological underpinnings of erectile dysfunction and learn practical techniques such as relaxation exercises and communication strategies.
Painful intercourse in women: Painful intercourse in women is sometimes due to anxiety around sex. A sex therapist will likely recommend that you work with a physician to rule out medical causes, and they can also help you learn relaxation exercises and other practical techniques to make sex more pleasurable.
Mindfulness-based sex therapy: Because issues around sex and intimacy often stem from anxiety, mindfulness-based stress reduction strategies have become a popular component of sex therapy. Mindfulness-based sex therapy often focuses on the physical sensations of sexual activity and can help you gain more sensitivity to how you feel and what you want during sex.
What happens in a sex therapy session?
Approaches vary, but you can expect a typical sex therapy session to look a lot like any other psychotherapy session, with the difference of an added focus on sexuality and whatever specific challenges you’re interested in focusing on.
Your therapist will first conduct a thorough intake, asking about your mental health, family, and medical history, in addition to the concerns around sexuality you are bringing in.
In later sessions, you can expect to talk about these subjects in more detail, and delve into your feelings (and those of your partner[s]) about them. Although sex therapy may involve more intimate information than a general psychotherapy session, you can still expect your therapist to respect your boundaries and give you time to work through issues at your own pace.
You should never feel pressured to reveal more than you’re comfortable with, and a good sex therapist will devote time during early sessions to building rapport and helping you feel safe and comfortable sharing information.
Additionally, most sex therapists assign homework that may be emotional (such as communication or mindfulness exercises) or physical (trying out certain kinds of intimate touch at home, for example) to be completed between sessions. You’ll likely spend some time during each session going over the results of this homework.
Does sex therapy involve physical contact with the sex therapist?
No. Sexual contact with, or in front of, the therapist is not a part of sex therapy sessions.
However, there is a separate experiential treatment known as sexual surrogacy, which usually involves intimate touch and often sexual intercourse with a trained practitioner. It also typically involves breathing exercises, relaxation techniques, and/or anatomical education. Most sex therapists do not work with sexual surrogates, and while you may discuss this option with the therapist, it will never be a required part of sex therapy or something that you’ll be asked to do against your wishes.
Is sex therapy only for couples?
Nope! You don’t need to be in a relationship, or attend with your partner(s) if you are.
Sex therapy can be just as useful for individuals looking for support around their own sexuality, and for people in partnered relationships where the partner does not wish to attend sessions.
What should I do if my partner doesn’t want to attend sex therapy?
You can still work with a sex therapist on issues related to a partnered relationship, even if your partner is not interested in attending therapy.
Some therapists find that working with one partner can be just as effective as working with both, and some may also be open to having your partner join sessions later on if they decide they want to. Check with your therapist about their approach to these issues before scheduling your first session.
How do I prepare for a sex therapy session?
Once you’ve scheduled your first session with a sex therapist, check with your new therapist to see if there’s anything they recommend you do to prepare. Some might ask you to provide some information ahead of time or think through a set of questions to discuss during your first session.
Whatever your therapist’s approach, it’s also helpful to think through the following questions and clarify your answers for yourself and, if applicable, your partner(s):
What are the main concerns or questions that I would like to work on in sex therapy?
What are my goals for working with a sex therapist?
What information am I most comfortable revealing to start with, and what do I expect might be more upsetting or difficult to work through?
Additionally, you’ll want to make sure you’ve worked out the following logistics, as you would in preparation for working with any new therapist:
How long the session will last (most are around 50 minutes, but initial sessions can be longer so you’ll want to check with your therapist)
How to find your therapist’s office (public transit directions, parking info, etc.) and what you should do when you get there (Do you need a code for the door? Should you knock when you arrive, or wait to be called in from a waiting area?)
How much the first session will cost and how you plan to pay for it
Sorting out these questions ahead of time will help make your first session less stressful and let you focus on the therapeutic work at hand.
What is typically discussed in sex therapy?
The types of discussions that occur during sex therapy vary widely. Remember, your comfort level and interests should guide the sessions as much as possible; a sex therapist should never ask you to reveal more than you feel safe disclosing, and sessions should always be tailored to your unique situation and concerns.
That said, part of your sex therapist’s job will sometimes be to gently guide you toward discussing topics that may feel uncomfortable at first. It can be helpful to read through the above list of potential topics that your therapist may ask you to discuss, and get a sense of which areas you expect to be more or less comfortable with.
Feel free to bring up this information with your therapist early on, so that you can work together to make a plan for discussion that feels safe and supportive to you.
What are the 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 sex therapy on your own, or you might attend with one or more partners. Some therapists 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 concerns, your sex therapist (if they are not a medical professional) will likely recommend that you also work with a physician to have have a full check-up and manage any necessary medication.
Is there homework for sex therapy?
Yes, there is often homework for sex therapy, which you (and your partner(s), if applicable) will use to try out the techniques discussed during therapy sessions. These techniques may be emotional (such as setting aside time to work through a communication exercise), sensory (such as kissing for five minutes or giving each other massages), or sexual (such as trying out new sex positions or sex toys). In many cases, you can expect to spend part of most sessions discussing homework and how it might inform your treatment.
Sex coaching vs sex therapy: What’s the difference?
Much as life coaches offer an alternative to traditional therapists, sex coaches differ somewhat from sex therapists. While sex therapists generally focus more on causes of current issues and resolving their psychological underpinnings, sex coaches may focus more on action plans and strategies for immediate improvement. You might choose to work with a sex coach if you aren’t experiencing a particular problem but are simply interested in learning more about how to experience more sexual pleasure and fulfillment.
While sex therapists have mental health certification and advanced training, sex coaches may not, so be sure to inquire about your coach’s training, experience, and credentials before setting up your first session.
How much does sex therapy cost?
The cost of sex therapy sessions varies depending on your location, frequency of sessions, and provider type – however, most sex therapy sessions cost about the same as a general psychotherapist session in your area.
Seeing a sex therapist in New York City, for example, may cost between $125 to $250 per session if you are paying out-of-pocket. A sex therapist in Boston on average costs between $80 and $150 per session, if you are paying out-of-pocket, and similarly, you can expect to pay about $80 to $150 per session when seeing a sex therapist in Providence.
How can I find the right sex therapist for me?
The most important factor is finding someone that you (and your partner(s), if applicable) feel comfortable with. While it may be difficult to gauge chemistry and personality fit prior to your first session, simply knowing that you might not mesh with every single therapist can be empowering – it may inspire you to keep searching until you find the right therapist for your needs.
Additionally, you’ll want to be sure that your therapist has professional training, ethical standing, and sufficient experience working with people facing the issues that you want to work on.
Some questions you might as on your initial calls with sex therapists include:
Do you have experience working with people who are dealing with [your main concern, e.g., intimacy issues, porn addiction, health concerns, or healing from sexual trauma]?
How long have you been working with people dealing with this issue?
What training and/or certification in sex therapy do you have?
How do you stay up-to-date with new research and best practices in this field?
If your cultural or racial identity, gender identity, or sexual orientation and/or expression may be a factor in your treatment, you may also want to ask potential therapists about their experience working with people who share your identity (i.e. queer women of color, trans-men, etc.).
Finally, you can also review our full guide to knowing whether you’ve found the right therapist; much of the information there applies to sex therapists as well.
Where can I find a qualified sex therapist?
Find a vetted sex therapist on Zencare below!
Search by your neighborhood, check fees, watch the therapist’s video introduction, and book a 100% free initial call directly via their profiles. If you can’t find a sex therapist near you, you can try expanding your search to include online remote therapists, too.
And if you want to continue your sex therapy education, read on for explanations of sex therapy and sexual health and dysfunction, what to expect in sex therapy, how to choose between ED pills and sex therapy, and common questions about sex therapy for ED.