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Sexual Wellness

What Does a Sex Therapist Actually Do?

| 03/10/2022

ultimatums Illustration by Sophi Gullbrants

When it comes to taking care of ourselves, we have traditionally turned to diet, exercise, taking a day off from work, or perhaps working even harder to meet our goals. Seeing a therapist was thought to be reserved for people in crisis, severe trauma, or suicidality. As the topic of self-care became more integrated into our vocabulary, therapy inevitably became part of the conversation. Now, there are apps, influencers, and ads dedicated to therapy and mental health. Mental health care is becoming more accessible, and with that accessibility, the nuances and niches of therapy are getting more attention. So, what about sex therapy? How is it similar and different from traditional therapy? What might lead you to look for a sex therapist, and what can you hope to get from the work?

What does a sex therapist do?

A common impression about sex therapists is that we focus on sex addiction, porn addiction, and erectile dysfunction. While some sex therapists may work with those issues, sex therapy covers a vast amount of treatment areas. Because sex and erotic desire are so problematized in our society, one of the biggest reasons someone might seek out a sex therapist is to work through shame they might be feeling about sexual orientation, sexual desire, fantasies, kinks and fetishes, sexual assault, relationship challenges, non-monogamy, navigating orgasms, anatomical questions, and more. Essentially, if you find yourself wondering, “is the fact that I _____ normal?” you might benefit from connecting with a sex therapist. (Hint: the answer to that question is probably yes).

The best part about sex therapy is that it is expansive. It considers a wide variety of what might be affecting your wellbeing. 

What drew me to sex therapy, (other than the fact that I love to talk about sex) was the opportunity to destigmatize and de-shame sex. Like many people, I grew up lacking a comprehensive sex education. From a cultural, formalized education, and social perspective, I navigated the world with significantly more questions than answers about sex and sexuality. As a sex therapist, I operate from a place of curiosity, sex and pleasure positivity, and intersectionality. 

Sex therapy is also trauma-informed. Meaning that it considers the impacts of varying levels of trauma and how to work intentionally with clients as a result. So, less about sex addiction, a term which very rarely if ever applies, and more from a perspective of figuring out what you like, how to find community in it, and navigate your desires. 

How Could a Sex Therapist Help?

Sex therapists work with individuals, relationships, and groups, depending on their specialty. Because so many of the issues affecting us come from shame and stigma, that might be where your work with a sex therapist begins. Figuring out what, if any, sex education you received, and how it has affected your relationship with yourself and others throughout your life and presently. 

A sex therapist can help you work through a recent break-up by supporting you in acknowledging what was and wasn’t working in the past relationship. A sex therapist might help you discover gender euphoria as you navigate gender identity or support you in coming out to family or friends. They might give tips or suggestions regarding sexual curiosity, masturbation, or fantasy you never shared with anyone else. The goals of your work with a sex therapist are decided primarily by you. What do you hope to gain from the experience, and how can a therapist help you get there?

When working with relationships, a sex therapist might help you navigate desire discrepancies. For example, if one partner finds themselves wanting more or different sex than their partner, sex therapy can help come to a place of understanding and compassion to lead to less conflict and more empathy. You might be working through recently opening your relationship or considering non-monogamy. A sex therapist can help you in establishing boundaries, figuring out how to deal with jealousy, and making space for the voices of all partners to be heard and validated. Sex therapists also support clients in exploring the role sex and intimacy play in their relationships with other people and themselves.

How is sex therapy different than “traditional” therapy?

Typically, sex therapists are trained similarly to all therapists. When any therapist decides on their niche, they will spend more specialized time working with a particular population and receiving training about their niche. Unfortunately, the lack of comprehensive sex education extends beyond our earlier experiences, and into the graduate school level. It’s not as common for all therapists to be thoroughly educated on human sexuality in school, and as a result, not all therapists feel comfortable discussing sex in their clinical work. 

Discomfort itself isn’t necessarily a bad thing, it can be where some of the work happens.

Sex therapists feel more comfortable talking about and prioritizing sex as part of the treatment. Fortunately, a lot of mental health professionals develop a robust referral network, so if they feel something is outside of what they typically work with, they can suggest you see a therapist who specializes in what might be most beneficial to you.

Sex therapy inevitably will talk about issues beyond sex and sexuality. Anxiety, trauma, depression, career struggles, friendships, and more all come up in my sessions. The best part about sex therapy is that it is expansive. It considers a wide variety of what might be affecting your wellbeing. 

What to expect 

When getting ready for the first session with a sex therapist, or any therapist, you might feel excited, nervous, confused, or prepared. This is normal. If the therapist you are interested in seeing offers consultations, I recommend setting up an initial consult to see if you feel like you’d be a good fit. This can also be done in the first session. Something important I like to share is that if you don’t feel like your therapist is a good fit, or you’d like to work on something different or expect something different from the work, or if they say something that doesn’t resonate with you, tell them. This can feel uncomfortable, but ultimately, this practice will help you in your life outside of therapy, and therapists want you to get the best treatment for you even if it means you work with someone else. Developing agency is also one of the benefits of working with a sex therapist!

Remember, any therapeutic experience should feel safe although sometimes, therapy feels uncomfortable. If you’re sharing something you’d never shared before, or the most tender parts of yourself, or you’re looking for growth or change, there might be some discomfort. Discomfort itself isn’t necessarily a bad thing, it can be where some of the work happens. Your therapist has likely worked with a wide variety of clients, so the hope is that whatever is on your mind, you feel safe disclosing it to your therapist. 

If you’ve ever thought a sex therapist might be good support for you as you navigate the world and your relationships, understand that seeking this support is a completely reasonable and brave decision. I hope that you find someone who helps you feel seen, validated, and safe!

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