Sex and therapy: on their own, these two words are already intimidating and surrounded by misconceptions. Put the two together and they become twice as intimidating and confounded. With shows like Netflix’s Sex Education popping up on people’s radar the past few months, questions about sex therapy and sex therapists abound. The popular show follows Otis, an awkward British teen who hasn’t ever pleasurably masturbated – let alone had sex – and his mother, Jean, a sex therapist who works from her home office complete with dildos, diagrams of genital anatomy, books on sex, and suggestive artwork. Otis gathers information about counseling clients behind the closed door of Jean’s office and begins acting as a sex therapist for kids at his high school.    

The counseling teenage Otis provides for his classmates reminds us that sex therapy is not just for adults, it’s for people across the lifespan. The show promotes the idea that sex is a topic which should be talked about and explored in many different ways – including talking about it with professionals (although Otis is an unlicensed adolescent with no training). It depicts real conversations about sexuality, the act of sex, and solutions for sex and intimacy challenges.

The show gets a few things right about sex therapy, but it also helps spread some of the most common misunderstandings about sex therapy and sex therapists. Untrained professionals, especially other therapists who are not trained in sex and relationship therapy, should not practice it or see clients. Sex therapists – like all therapists – do not give advice. Instead, they listen and collaboratively help you navigate the concerns that brought you into their office.

Therapists don’t go around psychoanalyzing everyone around them and typically have strict boundaries about when and where they provide services. Although it is extremely rare for therapists to work out of their own home, many sex therapists do have educational sex tools, anatomy diagrams, sexy art, and books on sex and relationships in their office.

Sex therapists also lead sex lives and have relationships as varied as the rest of the world, they aren’t all having sex every day with a different sexy partner, like Jean. Some therapists have their own relationship challenges and may seek therapy from another clinician for help navigating them.

Sexuality is about pleasure, enjoyment, sensuality, and joy – whether it is a part of a sex act or not.

Sex therapists may get mixed up with sexual surrogates, sex workers, and sex educators – which are different professions that work in the field of sexuality. While some sex education may be provided in sex therapy, there is no touching due to ethical concerns. It’s just like other specializations in therapy; the work done in the room may include talking, using therapy tools like worksheets, sandtray miniatures, or other creative measures. The therapist may also send you home with activities to try by yourself or with your partner(s). Sex therapy isn’t just for couples! You can go individually, although bringing your partner(s) into the session can sometimes be the best way to resolve relationship and intimacy challenges.

What is sex therapy?

Our body is a system. Our mental, physical, social, and emotional health is an integrated whole that functions – or dysfunctions – together. Sexual health is included in that mix; it’s an essential part of being human. We are all born sexual beings. Sexuality is about pleasure, enjoyment, sensuality, and joy – whether it is a part of a sex act or not. No matter how we identify our sexuality (or asexuality) and gender (or lack of gender), humans are sexual. So, the notion that sex therapists focus only on concerns surrounding physical sexual problems is a faulty one. Sex therapy is typically a holistic practice which helps you get in tune with your body’s needs. Sex therapists use specialized clinical skills based on evidence- and practice-informed theoretical knowledge to help clients for a multitude of reasons:

Pain or physical difficulty during sexGender identity exploration/affirmation
Physical or emotional infidelityProcessing sexual assault, sex trafficking, and other sexual trauma
Sexual challenges along with physical or mental health challengesDesire discrepancy in relationships
Sexual self-esteem and confidenceNavigating sexual fetishes and kink
Navigating STIs/STDs and/or HIV/AIDsExploring/affirming more than monogamy and/or polyamory
Working on communication about sexual desires with your partner(s)Navigating the consensual sex work profession or being a partner of a sex worker
Erectile challengesOvercoming sexual shame
Unwanted low desire/arousalNavigating cancer and sexuality
Body image challengesNavigating disabilities and sexuality
Sexual orientation exploration/affirmationNavigating ageing and sexuality
Difficulty integrating physical intimacy into life and relationshipsOrgasm challenges
Navigating infertility and related relationship concernsPleasure enrichment
ErotophobiaSexuality and low testosterone

Finding a sex therapist

Like with any good therapist, finding a sex therapist that is the right fit for your concerns can be challenging. The sex therapist is there to help you with some of the most intimate parts of your life. Find someone you trust and be vulnerable with so that you are able to take the positive risks you need to make a change.

Sex therapists are not regulated through licensing in any state but Florida, but they can be certified through various notable organizations that require extensive training and supervision. The American Association of Sex Educators, Counselors and Therapists (AASECT), the American Board of Sexology, and the American College of Sexologists International all train and certify people working in various sex professions. Check out their websites to find certified therapists in your area. Typically, sex therapists do not take insurance, so finding one through your insurance provider may be difficult.

Look at therapists’ websites and ensure the ones you choose to interview for a good fit are specially trained in providing therapy for the challenges you are having. Check their licensing and certification credentials and look at their resume.

It’s important to find a therapist that is not only well-trained and experienced in sex therapy, but one who has a therapy style that will work best for you. Interview therapists either over the phone in a quick consultation or in your first session until you find the right fit.

Illustration by Marta Elena Cortez-Neavel

What to expect in a sex therapy session

Before or right after your first therapy session, the sex therapist may ask that you get bloodwork done by your primary care physician. Many people don’t realize that both mental and physical health challenges – like diabetes, hypertension, anxiety, and depression – can interfere with sexual functioning. Once the bloodwork is done, the therapist will usually ask you and your partner(s) to provide a detailed sexual history, while also exploring your sexual values and knowledge.

Sex therapy is usually short-term unless you are seeing a sex therapist for concerns like navigating mental health challenges and sexuality, processing sexual trauma, or sexual orientation or gender identity exploration. The number of sessions depends on the style of the therapist and the work you put in both in the therapy room and outside of the session.

The sex therapy process includes getting sent home with homework like sensate focus, experimentation, sex education, communication strategies, and other ways to engage yourself or your partner(s).

Most of all, keep an open mind and be curious about engaging in sex therapy. It is common to feel ashamed or embarrassed at the beginning of your foray into sex therapy, but the right therapist will not shame you for your sexual experiences, desires, or hangups and work with you to resolve your concerns. Talking about sexuality and any related challenges often gets easier with practice and as you become more comfortable with your therapist. The more comfortable you are talking about sex, the more comfortable you’ll feel taking healthy risks that may lead to more fulfilling sexual health.

Beth Cortez-Neavel

Beth is a former journalist and current sex-therapist-in-training through Texas State University’s professional Marriage and Family Therapy counseling program. She is a student member of the American Association of Sexuality Educators, Counselors and Therapists. She is not yet a licensed counselor or certified sex therapist but is working toward her licensure and certification.