Explainer Link Copied 07.13.23

We Asked Sex Therapists What They Wish People Knew About Sex Therapy 

Truth is, the TMI limit does not exist. ByAbbey Stone

Shutterstock / Wondermind

Chances are, you know that sex therapists exist. And if you’re dealing with any sort of obstacle between you and a healthy relationship with sex, you might’ve wondered whether booking an appointment could help. “One of the things that people often ask is, ‘How do you know when it's time to see a sex therapist?’” says certified sex therapist Donna Oriowo, PhD, LICSW, MEd. “I would say that the moment that you're asking is probably the moment you should be seeking, because you already have, consciously or not, acknowledged that something is amiss and that you require additional support.”

But let’s back up real quick to discuss what is a sex therapist. These mental health professionals receive specialized training in sex, sexual health, and sexuality, and their expertise is as broad-ranging as the human sexual experience (so basically really, really broad). Mismatched libido with your partner? Experiencing pelvic pain during sex? Looking to explore kink? There’s a sex therapist out there for you—and deciding to find them is the first step to getting some help.

Whatever embarrassing, messy, uncomfortable sexual challenge you’ve bumped up against, sex therapists have likely seen it before—and they’re ready to help, says licensed psychologist and certified sex therapist Kate Balestrieri, PsyD, founder of Modern Intimacy and host of the Get Naked With Dr. Kate podcast. “Even if you think what you are holding onto is something really horrifying and unique to you, that's likely not the case.” 

So, with that in mind, here’s what a sex therapist does, what they don’t, and how to find one that works for you. 

What is a sex therapist?

As you might’ve guessed, a sex therapist is basically a therapist or licensed mental health pro that specializes in sex and relationships, says licensed therapist Rae McDaniel, MEd, LCPC, CST, author of Gender Magic and founder of the Chicago-based gender and sex therapy practice Practical Audacity. 

“They can be a social worker, a professional counselor, a marriage and family therapist, or a psychologist who has already been licensed in the state where they practice,” says Dr. Balestrieri. But the difference between, say, a typical psychiatrist and a psychiatrist who is also a sex therapist is that the latter gets additional training on sexuality and how it impacts mental health.

Though it can totally vary, the sex therapists I spoke to said people often come to them to deal with a difference in sex drive between partners, physiological challenges such as pelvic pain during sex or erectile dysfunction, anxiety around sex, healing from past or present traumas that are impacting their sexual selves, or integrating porn or masturbation into their sex lives in a healthy way. 

And because sex is part of our sense of self and can impact different parts of our lives, unpacking those issues with a mental health expert can be incredibly helpful, says Dr. Balestrieri. 

What does a sex therapist do?

Kinda like seeing a therapist in general, you don’t need to be dealing with a crisis to benefit from the help of a sex therapist, says licensed psychotherapist Shadeen Francis, LMFT, CST. “Any time that you want more support around your sexual self, whether that's your active sexual relationship, your sexual history, or even you thinking about what kind of sexual life you want to live in the future, that would be a great time to reach out to a sex therapist.” 

For example, if you grew up in a sex-negative environment, talking to a sex therapist might help you learn more about your sexuality and work through any shame you’ve been feeling about it, adds Dr. Balestrieri. “If we feel a tremendous amount of shame about something related to sex, I guarantee that shame is limiting somebody at work or in their parenting or in their relationship with a higher power or with their neighbors,” says Dr. Balestrieri. 

Sex therapists also often work with people who want to explore their sexual or gender identity, says Dr. Oriowo. “Sexuality is [often] foisted on us, and a lot of people are still doing a lot of discovery for themselves about who and what they are, how they want to express themselves and show up, and what's actually safe for them to do as well.”

While sex therapy can tackle some pretty significant topics like those, McDaniel points out that seeing a sex therapist can also help boost your relationship with your body, your relationship with sex in general, and your relationship with a partner. So, no, you don't have to be really struggling in order to go see a sex therapist,” McDaniel says. For instance, clients might want to explore new experiences, including kink, ENM (aka ethical non-monogamy), or improving communication about their sexual desires with their partner or partners, says Francis. 

What can’t a sex therapist help with?

Maybe you already assumed this, but if you’re trying to get support for an issue or goal unrelated to sex or sexuality, a sex therapist might not be for you. But that general rule also applies if you’re looking for relationship help. For example, if you want to set boundaries with your partner’s family or talk about money with your S.O. without sweating, a couples therapist might be better equipped to help you, since not every sex therapist has training as a couples therapist (also not every couples counselor has training in sexuality), says Dr. Balestrieri. 

Being clear about your goals from the start can help ensure that whatever professional you’re working with has the skills and training to help you out, adds Dr. Balestrieri

What is a sex therapy session like?

Whether you’re going by yourself or with your sexual partner or partners, during your first session, you can expect your therapist to ask a lot of questions—there’s no such thing as TMI.

McDaniel describes that first visit as an “information gathering” exercise. You can expect a lot of really personal questions about your body, your sex life, your past experiences, your current relationships, and probably even details about the sex you’re currently having.

They might also want to know about the times when you feel connected to your body and have great sex, as well as the times you don’t. They’ll also likely ask about your goals, like what kind of sex or relationship you want and the kinds of fantasies you have. Your relationship with porn and masturbation are also on the table.

But even if they’re all up in your business, it’s important to remember that sex therapists do not engage in sexual activity with their clients. “A sex therapist never touches clients and does not participate in the witnessing of sexual behavior of their clients,” says Dr. Balestrieri.

After learning more about your unique circumstances and concerns, your sex therapist will let you know if a different type of professional might be better suited for helping you achieve your goal, Dr. Oriowo points out. For instance, if they suspect a medical issue is behind something you’re experiencing, like pelvic pain or erectile dysfunction, they may refer you to a medical specialist or pelvic floor therapist first, she adds.

How to find the right sex therapist for *you*.

While the benefits of working with a sex therapist are pretty clear, finding one can be a little confusing. That’s partially because the term “sex therapist” isn’t regulated, says Francis. That means there’s no national or international group that regulates who can call themselves a sex therapist and what credentials they need to do that, she explains. 

So, how do you make sure you’re seeing someone with the legit training to help you? For starters, you can look to see if someone is a certified sex therapist (CST), which is a credential facilitated by the American Association of Sexuality Educators, Counselors, and Therapists (AASECT). In order to be eligible for certification as a sex therapist through AASECT, candidates have to have a doctorate or master’s degree (and have one or two years of clinical experience, respectively) before taking sexuality education courses from an accredited university or college. Then they receive sex therapy training and work with patients under the supervision of certified sex therapists, according to AASECT. Plus, they also need to take training that addresses their own values and beliefs around sexuality, stick to a code of ethics, and keep up with continuing education every three years. TL;DR, this credential is kinda the gold standard for sex therapists.

When you’re scrolling through the socials you might also come across sex educators, sex counselors, sexologists, and sex coaches who want to help you improve your sex life. While these people might have some level of education and expertise, they’re not licensed mental health professionals or AASECT-certified sex therapists (unless specified). 

Of course, that doesn’t mean they’re necessarily less helpful than a certified sex therapist. “There are so many incredibly talented educators out there who have not had formal training in the sense that a university certified them,” McDaniel says. So depending on your circumstances and concerns, they could still be the right fit for you as long as they’re providing a safe and responsible environment. Just keep in mind that they don’t have to meet the same requirements that AASECT-certified therapists do. 

Aside from vetting a potential sex therapist’s training, finding one who can create a safe space for your individual circumstances requires a little legwork too. To start your search, you can check out databases from organizations like AASECT or Psychology Today, or, if you’re already seeing a mental health professional, you could also ask them for a recommendation. 

Once you’ve identified some folks who seem to have experience in the areas you’re looking for, give ‘em a call to find out more about their values, the kinds of clients they work with, and whether they’re aligned with your goals, says Francis.

That could sound something like, “Hey, I want to work on opening up my marriage. Is that something that you have expertise in? Is that something that you work with a lot of clients around and have you worked with them successfully to do that? And if not, is there someone in your professional network that you might refer me to?” explains Francis.

Dr. Oriowo says it can also help to ask a potential sex therapist directly about their experience working with people who identify the way you do. You could say, “I’m a Black, queer, kinky, dominant. Is that a population that you work with?” You don’t have to give them all of your details, but sharing the bigger picture can help you learn more about their background.

You can also ask questions about what kinds of modalities they practice (like CBT) and the limits of confidentiality, to  help you get a sense of whether this person feels safe to work with, says Dr. Balestrieri 

If you’re looking for a queer-affirming therapist, McDaniel advises making sure the person’s profile or professional website speaks explicitly to working with LGBTQ individuals. If you’re getting green flags and great vibes, congrats, you’re ready to schedule an appointment.

It’s true that answering the types of questions that sex therapists ask might feel uncomfortable. Sex is a deeply personal, private, and vulnerable topic for a lot of people. It’s not exactly every day we’re telling strangers about our orgasms or sexual partners. “The idea of sex therapy can feel really intimidating,” McDaniel explains.“But [sex therapists] have had a lot of practice and a lot of education in talking about sex, and they're going to do everything in their power to make you feel comfortable, to not push you, to go at a pace that you are comfortable with.”

And, in the end, you might feel better after booking your first session, says Dr. Balestrieri. “When people start to explore sex and sexuality a little bit more intentionally, they usually feel a lot more liberated to be fully who they are, and it's so powerful and so beautiful.”