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.

Sex is often a fun and satisfying part of life, and it’s important to remember that a wide variety of sexual desires, preferences, and behaviors are considered normal and healthy. However, sex can also become stressful, confusing, or worrisome. Many people face challenges around sexual desire, arousal, function, satisfaction, and intimacy with partners. These struggles can come up for individuals of any sexual orientation or gender identity. When difficulties like these become a recurring source of worry or interfere with day-to-day life, sex therapy is one way to work toward resolving them.

You don’t necessarily need to attend sex therapy sessions with your partner, or even have a partner; 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.

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What can a sex therapist help with?

Sex therapists are trained to help with a wide variety of challenges related to sex, including (but not limited to) the following:

  • General stress or anxiety around sex: You may be preoccupied with your worries about sexual concerns, or even find that your anxiety in this area interferes with some aspect of sex.

  • Lack of desire or mismatched desires: You or your partner(s) may not feel as much sexual desire as you want to, or you may not experience the same amount or frequency of desire.

  • 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.

  • 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, issues around sex can challenge an individual’s sense of self-worth.

  • Sexual changes related to life circumstances: You might find that you need to approach sex differently due to having children, aging, a medical condition, or even just major life changes like a new job or a relocation.

  • Exploration of new sexual activities: You and/or your partner might be interested in trying out a new kink or exploring nonmonogomy.

  • Feeling generally stuck or unsatisfied sexually: You might 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, sex therapists can support you around just about any issue related to sex. What’s more, they can also be a valuable resource even if you’re not experiencing a problem, per se; you might just be interested in exploring your sexuality in some way, and a sex therapist can be helpful in that situation too.

Does sex therapy work?

Because so many different 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 more enjoyment of sex and lower levels of sexual dysfunction after completing treatment.

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What are 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.

How is a typical sex therapy session structured?

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. In your first session, your 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 history, both as individuals and (if applicable) as partners

  • Your general mental health history

  • Your sexual orientation

  • Any physical or medical concerns that may be affecting the current issue

  • The course of your relationship and what it’s like outside of sex (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 can expect to talk about the above subjects in more detail and delve into your feelings (and those of your partner[s]) about them. Your therapist’s 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) 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.

Again, 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.

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Who might benefit from seeing a sex therapist?

Just about anyone who has concerns or even curiosities related to sex and intimacy might benefit from seeing a sex therapist. Sex therapy is a great 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.

What therapy approaches do sex therapists use?

Common therapy approaches to sexual health and dysfunction include:

What should I 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 therapist who has training specifically in sex therapy and sexual concerns.

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

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? Men who have challenges with sexual performance? Couples who struggle with sexual intimacy? Do they see clients addressing problems with sexual addiction? While most sex therapists are able to see 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.

Find sex therapists near you

Find vetted sex therapists on Zencare, below. Search by fees and location; watch therapist introductory videos; and book free initial calls to find the right sex therapist for you!

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 common questions about sex therapy for ED.

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