A FEW YEARS ago, sex therapy may not have been on most people’s radars. But today, thanks in part to popular TV shows like Couples Therapy and Sex Education, couples might be curious about how therapy could improve their sex lives and relationships.
Sex therapy is essentially talk therapy geared toward helping people have better sex. A sex therapist will speak with you in person or on video about issues you’re facing in your sex life, either individually or as a couple. They might also give you exercises to try at home to connect with your partner or get to know your own body better.
If you’re looking for help with your sex life, you might have a few questions about sex therapy. Here, sex therapists answer common questions to give you a sense of how sex therapy works and whether it might be for you.
What is a sex therapist?
The definition of “sex therapist” is broad, as Florida is the only state requiring someone to be certified before calling themselves a sex therapist, says Rachel Needle, PsyD, a licensed psychologist and co-director of Modern Sex Therapy Institutes. But in general, a sex therapist is a psychotherapist specializing in sexuality.
The most widely respected credential for sex therapists is certification through the American Association of Sexuality Educators, Counselors, and Therapists (AASECT). You can see a directory of AASECT-certified sex therapists here. You can also find directories of mental health professionals with sexuality training via Modern Sex Therapy Institutes and the Society for Sex Therapy and Research.
“Don’t hesitate to meet with a few therapists before making a decision,” says Needle. “Goodness of fit, feeling comfortable, and therapists’ experience and skill are important factors to getting the most out of sex therapy.”
What do people work on in sex therapy?
“Research shows that sex therapy is highly effective in improving sexual functioning, relationship satisfaction, and emotional well-being,” says Melissa Fogel, PsyD, a licensed psychologist and sex therapist. “The benefits include better communication, greater intimacy, enhanced self-esteem, and reduced anxiety surrounding sex.”
One study of sex therapists published in the Journal of Marital and Sex Therapy found that the most common issue people come to sex therapy for is desire discrepancies — that is, when one partner wants sex more than the other. But people also come to treat difficulties with desire, arousal, orgasm, and painful sex, as well as to work through sexual shame and trauma.
What are the other options?
There are other types of professionals who assist people with their sex lives. Sex therapists tend to address “deep-rooted emotional or psychological issues,” while sex coaches “help clients develop skills and strategies to enhance their sexual relationships, overcome barriers to sexual enjoyment, and build confidence,” says Needle. While both can help with sexual issues, sex therapists will spend more time exploring root causes, while coaches will focus on getting results.
Sex educators, on the other hand, “inform and teach individuals or groups,” says Needle — so you might go to one if you want to take a class on a sex-related topic or ask a specific sexual health-related question.
It also may be useful to discuss sexual issues with a medical professional like a gynecologist, urologist, or sexual medicine doctor. “If you have diminished sexual desire, you might prefer a sexuality specialist who is also an MD because your sexual desire might be influenced by biological or pharmaceutical causes,” says sex researcher and Ro advisor Pepper Schwartz, PhD. That said, you’ll likely benefit from sex therapy as well.
A sex therapist may also refer someone to a pelvic floor physical therapist or endocrinologist to treat sexual dysfunctions, says Schwartz. Consulting a doctor is especially important if you’re dealing with painful sex.
What can you expect from sex therapy?
Your first session will include an assessment, where “the therapist gathers information about your sexual history, relationship status, concerns, medical history, and goals for therapy,” says Fogel. “This initial session helps the therapist create a tailored treatment plan to address your specific needs.”
One common technique used by sex therapists is sensate focus, where a couple undergoes different touch exercises at home between sessions. Typically, this will involve touching each other — initially above the belt, and then below as the sessions go on — with no goal other than to be aware of how it feels. Couples then discuss how these exercises went in their therapy sessions, and the therapist gives them new assignments.
In therapy sessions, clients will also discuss the history of their problem, the feelings it brings up, and the couple’s communication and conflict resolution style. “Like all psychotherapists, sex therapists practice a form of talk therapy,” says mental health counselor and sex therapist Ricky Siegel, PhD. “There is no nudity or sexual contact involving the therapist.”
On average, sex therapy sessions are about an hour long and cost $100-$300, according to Fogel. They can sometimes be covered by insurance, though this varies by provider.
How can you increase your chances of success in sex therapy?
You’ll get out of sex therapy what you put in, so make sure you’re ready to put in the work. Success requires “openness, motivation, and a commitment to working on the issues at hand,” says Fogel. “If you’re dealing with underlying mental health issues, substance abuse, coercion, or abuse, those issues may need to be addressed before sex therapy can be beneficial. Setting clear goals, actively participating, and being patient with the process will increase your chances of success.”
What if you feel embarrassed to go to sex therapy?
Talking about your sex life with someone you just met is not exactly normalized in society, so it’s common to feel some embarrassment around going to sex therapy. If you’re experiencing this, it’s helpful to remember that your sex therapist has likely “heard it all,” says Siegel.
“By recognizing that sex therapists are professionals, starting slowly, acknowledging your feelings, and focusing on the benefits, you can gradually reduce your discomfort,” Fogel adds. “Remember, addressing sexual issues is an important part of self-care and relationship well-being, and seeking help is a positive and empowering step.”
Lastly, know that opening up about sex in therapy is a step toward improving communication with your partner. As Siegel puts it: “Increasing peoples’ comfort in discussing sex and sexual topics is a powerful way to increase intimacy, affection, and closeness in peoples’ lives.”
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