Sex Therapist

Medically reviewed by Julie Dodson, MA, LCSW and Laura Angers Maddox, NCC, LPC
Updated November 14, 2024by BetterHelp Editorial Team
Content warning: Please be advised, the below article might mention trauma-related topics that could be triggering to the reader. Please see our Get Help Now page for more immediate resources.

Sex, and discussing sex lives, can be a vulnerable topic for many individuals and couples, resulting in stigmas surrounding therapy for sexual topics and sexual issues. However, sex therapy can benefit those experiencing sexual dysfunction, arousal difficulties, intimacy struggles, sexual function issues or past sexual trauma. Understanding the functions of a sex therapist can help clients and prospective therapists learn more about this area of psychology.

Are you looking to resolve something in your sex life?

What does a therapist who specializes in sex do?

Sex therapists are licensed counselors, social workers, therapists, or psychologists with specialized training who can provide specialized services to clients seeking sexual advice and support for sexual difficulties. Most sex therapists have psychotherapy training and are trained in many forms of therapy but may have taken extra courses in topics like, sexuality, sexual trauma, pain during sex, sexual dysfunctions, or intimacy skills. A sex therapist, like all therapists, is not a medical doctor and cannot prescribe medication (though they may have a doctoral degree). Therapy sessions may include different types of therapy including cognitive behavioral therapy or emotion-based therapy. A sex therapist can work with individuals, couples, or groups of clients. 

Sex therapists commonly treat concerns such as the following: 
  • Difficulty achieving arousal 
  • Difficulty achieving orgasm
  • Conflict during intimacy 
  • A lack of emotional intimacy 
  • Mismatched desires or fetishes
  • Physical causes for lack of intimacy
  • Relationship issues related to sex
  • A desire to "spice up" one's sex life
  • Premature ejaculation
  • Erectile dysfunction
  • Confusion about sexual orientation or homosexuality
  • Pain during sex caused by adverse experiences or psychological factors
  • Traumatic experiences
  • Miscarriages and infertility
  • Mismatched libido with a partner 
  • Shame or guilt surrounding sex or physical contact
  • Body image issues
  • Concerns about being asexual or aromantic (and other human sexuality orientations)
  • Difficulty setting boundaries during sex
  • Consent and sexual health education needs 

In some cases, a psychologist may work with a client to find a surrogate partner for surrogate partner therapy. Surrogate partners are separately licensed independent contractors who are not therapists. The surrogate partner will act as a partner for an individual without a sexual partner to practice the exercises learned in sex therapy. These activities are also done outside the session, and the therapist does not participate in or witness it. 

According to the American Psychological Association, sex therapy today is heading in five emerging directions. These include:

  • Mindfulness-based interventions
  • Psychotherapy interventions over medications
  • Expanding inclusivity
  • Considering the couple’s perspective
  • Changing attitudes toward sex

Sex therapist qualifications

A sex therapist can be various types of mental health professionals, including a psychiatrist (a doctor with a medical degree), a marriage and family therapist (LMFT), a clinical psychologist, a clinical social worker (LCSW), or a licensed practicing counselor (LPCs). In addition, sex therapists often attend further educational courses in sex therapy, sexual health, sexual medicine, and couples therapy. 

In many cases, sex therapists obtain a sex therapy certification through a board like the American Association of Sexuality Educators, Counselors, and Therapists (AASECT). In addition, they must have at least a master's degree in a related field, clinical hours under supervision, and an up-to-date state license to practice counseling or therapy. 

Sex therapist techniques

A licensed sex therapist uses various traditional forms of therapy to help clients address concerns, thoughts, and feelings surrounding sexuality, intimacy, relationships, sexual life, sensuality, and sexual function. 

You do not have to have a mental illness, be in a relationship, or struggle to have intimate sex to talk to a sex therapist or social worker. Many of these providers also support those frequently sexually active, those looking to learn more about their bodies, and couples trying to connect in new ways. Sex therapy can be a positive process that aims to reduce shame and open the conversation about sex positivity.

In addition, a sex therapist isn't necessarily limited to discussing sexual topics. Often, emotional topics can connect to sex, body image, and sexual activity. A sex therapist may also help individuals and couples address the following: 

  • Family planning
  • Life transitions like moving, having a baby, or getting a new career
  • Emotional challenges
  • Difficulty communicating in relationships
  • Past non-sexual traumas
  • Unhealthy relationship dynamics
  • Finding local resources
  • Mental illness 
  • A lack of romance in a relationship 
  • Dependency on sexual behaviors like watching pornography 

After understanding the client's challenges, a sex therapist recognizes a couples goals and can develop a treatment plan to guide them. A sex therapist can also lead support groups for individuals seeking a community with similar challenges. Often, support groups can be free or low-cost. 

What happens during this therapy?

Sex therapy does not involve sex, intimacy, or physical touching during sessions with the therapist or your partner. Instead, it is often a form of talk therapy about a sexual problem involving a professional conversation about your goals, experiences, feelings, and needs. If you feel uncomfortable meeting with a sex therapist for the first time, you can ask questions and get to know their approach to sessions. 

What is a sex therapy session like?

Sex therapy sessions with a sex therapist may begin with the client describing their intimacy concerns or sexual concerns with their therapist. The therapist can take notes and start to develop a treatment plan while asking questions to get an idea of the client's goals. For example, a personal goal for one client might be feeling more emotionally connected with their partner. One goal for another may be to reduce sexually compulsive behaviors or other sexual problems. While yet another may be to increase sexual desire. The treatment for each goal can differ. 

Sex therapist assessment

Your sex therapist can assess your sexual background, including experiences with past sexual partners, and how it integrates with your current concerns. They may offer a diagnosis or discuss research surrounding the sexual challenges you've come to discuss. For example, suppose you're experiencing pain during sex related to psychological distress. In that case, the sex therapist may offer physical exercises to increase pelvic muscle strength, individual activities to improve psychological comfort, and support your emotional responses to pain so that you can find more comfort during sex.

A sex therapist may give you and your partner exercises to work on in-between sessions. These exercises might include communicating in new ways, reading about sexual health, changing your interactions with your partner, role playing, or trying a new form of touch. These activities might be challenging or awkward initially, but connecting with your partner may improve your sexual connection. 

Discussing sexual intimacy with a sex therapist during therapy

Speaking with a stranger about something as intimate as sex, for many individuals, seems uncomfortable and can be nerve-wracking. However, a sex therapist is a licensed professional trained to support these concerns and may have had clients with similar challenges as you in the past. They are not there to judge you and are ethically required to have an empathetic, open-minded, and supportive practice. 

Does sex therapy last long?

Each client differs, and the amount of time you remain in sex therapy can be your choice. If you're experiencing a short-term challenge, sex therapy may last a few weeks or months. Therapy may take longer if you're experiencing a long-term challenge, mental illness, or memories of a past traumatic experience. Either way, there's no "right" or "wrong" way to do therapy. 

Are you looking to resolve something in your sex life?

Should I go to sex therapy?

When deciding whether to see a sex therapist, ask yourself what benefit you might gain from treatment. If any of the challenges above seem to be present in your life or you feel you need to talk to someone about your body, intimacy, or sexual touch, a sex therapist may suit you. Note that your family therapist or some "regular" therapists may be able to offer sex therapy techniques as well. 

Online therapy for sexuality and mental health

As a client, practice what is most comfortable for you. If you struggle to get yourself to go in person to an office, you can consider online sex therapy to avoid feelings of awkwardness or shame. Through an online platform like BetterHelp for individuals or Regain for couples, you can find a sex therapist and use a nickname during sessions. In addition, you can choose between phone, video, or live chat sessions for flexibility. 

If you're unsure about the effectiveness of online sex therapy, note that internet-based intervention has been found effective in treating symptoms of sexual dysfunction and increasing improved sexual functioning in clients. 

Takeaway

Sex therapists are licensed mental health professionals providing care to a wide range of clients, including individuals, couples, and groups. If you're interested in learning more about sex therapy, consider contacting a therapist for a consultation to see how this specialty might benefit you. You can find a sex therapist in your local area or online.

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